psych pediatric pain

[Crystal8]

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Sorry if this has been posted elsewhere, but I've searched best I can and couldn't find any info on the forums so thought I'd just ask: I think I'm interested in child/adol and interventional pain fellowship. I have research in pediatric pain management from a multidisciplinary setting (ages/rheum/psych) from a few years back and would love to pursue that path by way of my psych residency. I love the idea of having the skills to treat pain through the use of my psych and potential interventional skills.

Just had a few questions, I'd really appreciate any input to:

1. Anyone out there who has done both CAP and pain fellowships? If so, is it a poor idea in that it's "too" specialized?

2. And, any advice regarding how to go about getting that interventional pain fellowship from a psych residency especially in light of the fact that compared to those we're competing against (anes/neuro/pmr), we have just about no formal training in physical anatomy?

Thanks so much for any input!

 

[BobA]

Sorry if this has been posted elsewhere, but I've searched best I can and couldn't find any info on the forums so thought I'd just ask: I think I'm interested in child/adol and interventional pain fellowship. I have research in pediatric pain management from a multidisciplinary setting (ages/rheum/psych) from a few years back and would love to pursue that path by way of my psych residency. I love the idea of having the skills to treat pain through the use of my psych and potential interventional skills.

Just had a few questions, I'd really appreciate any input to:

1. Anyone out there who has done both CAP and pain fellowships? If so, is it a poor idea in that it's "too" specialized?

2. And, any advice regarding how to go about getting that interventional pain fellowship from a psych residency especially in light of the fact that compared to those we're competing against (anes/neuro/pmr), we have just about no formal training in physical anatomy?

Thanks so much for any input!

It can be done, but it is unusual to go into interventional pain from psych. If you really want to do interventional pain, you're best off doing Anesthesia.

Another track might be FM/Psych combined program --> pain. Pitt might be a good place to do this, but that's a complete conjecture.

 

[splik]

i am sure some people will argue with me but much of interventional pain medicine is about helping the physician to line his pockets by performing harmful procedures which tend to make patients worse, not better, and in any case have a terrible evidence base. those places that emphasize multidisciplinary management of pain, tend to de-emphasize the procedural element and use less invasive ways of managing pain and improving quality of life and functioning. These are the places that have fellowships that tend to have psychiatrists compared to anesthesiologists etc.

 

[whopper]

I've encountered so many pain patients through Suboxone practice that I sometimes wonder if I know treating pain better than PCPs by now because all of them seem to be throwing opioids at the problem, getting the patients addicted to them, and then they seek Suboxone treatment.

But getting to answering your question, you can try that route, but I'd recommend perhaps partnering with a very good pain doctor with a sincere mutual interest treating pain and mental health. Such a doctor may be hard to find, and if done, building the bridge where both of you are consulting each other regularly can also be tough.

In a university setting, meeting other doctors is easier. In private practice, after several months, I started noticing which pain doctor were the better ones. I've tried to make a good working relationship, but the reality was I was too busy to go to their practice or have them go to me, but we did call each other quite a few times and talk in-depth about a few patients.

 

[vistaril]

It can be done, but it is unusual to go into interventional pain from psych. If you really want to do interventional pain, you're best off doing Anesthesia.
.

or pm&r.....

anesthesia > pm&R >> neuro >>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>> psych

 

[vistaril]

Sorry if this has been posted elsewhere, but I've searched best I can and couldn't find any info on the forums so thought I'd just ask: I think I'm interested in child/adol and interventional pain fellowship. I have research in pediatric pain management from a multidisciplinary setting (ages/rheum/psych) from a few years back and would love to pursue that path by way of my psych residency. I love the idea of having the skills to treat pain through the use of my psych and potential interventional skills.

Just had a few questions, I'd really appreciate any input to:

1. Anyone out there who has done both CAP and pain fellowships? If so, is it a poor idea in that it's "too" specialized?

2. And, any advice regarding how to go about getting that interventional pain fellowship from a psych residency especially in light of the fact that compared to those we're competing against (anes/neuro/pmr), we have just about no formal training in physical anatomy?

Thanks so much for any input!

if you want to do pain medicine(peds or adult), you need to do something other than psychiatry

 

[nitemagi]

Pain fellowships were actually originated in psychiatry, but we've largely given it away. On the other hand there's a bit more of a movement to bring psychiatry back into pain (I heard secondhand that this was talked about at a keynote at one of the major pain conferences in the last 2 yrs).

Availability for fellowships will be limited -- some don't allow psych at all, those that do tack on a few months to catch up on procedures in general (which Anesthesiology have well practiced).

And think about what type of pain medicine you want to do (a "block shop" as a colleague and prior pain spec switching into psych called them...or more of a comprehensive approach).

So in short, it is A path. Not a common path. It is a doable path. And it might give you a niche practice that few others anywhere offer, which could be quite cool.

To do research, contact the individual fellowships while in residency, let them know your interest and your background, and put together a list of those accepting psychiatrists. Then go from there. You might even be able to do a pain rotation during residency if you plan things out right...

 

[BobA]

If you do plan on doing psych --> pain, you should ask current pain docs about how likely they would be to higher a psych trained pain doc. I have completely no facts to back this up, but it would seem as though there could be some stigma when it comes to ability to perform procedures. This isn't to say there isn't a lot of overlap between pain and psych (pain is a subjective experience in the brain, after all), but just a caution to ask those practicing in the field if they'd hire a psych trained interventionist, especially in the case of kids.