Psychiatry to pain

[reca]

Hey, I'm a PGY-3 psychiatry resident who very recently discovered that it's even possible to go into pain from psychiatry. I was strongly considering anesthesiology and then pain in med school but switched into psychiatry at the last minute (literally, August of M4 year). From what I understand, pain is an uphill fellowship to match into for a psychiatry resident but I still have an interest in it so was wondering what I would need to do to maximize my shot at a fellowship? I understand there's a significant chance I won't match into a pain fellowship but I'd rather take the chance and fail rather than not apply at all.

Do I start out by reaching out to my own program director with my interests? The pain fellowship director at my institution? I have no idea where to begin. I have no research or background in pain whatsoever so I know I have a lot to catch up on if I want to even have a chance.

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[blockstar]

yes need to show interest, get letters from pain docs and do something pain related.

join asra if youre allowed and go to a meeting and present a case report to introduce yourself.

decent percentage of pain patients have a dual diagnosis and need assistance with mental health issues in addition to their pain but you need to put your hands on some patients and get more comfortable with procedures so a program director doesnt think hes getting an intern skills wise. just my two cents.

 

[RaceCanyon]

Hey, I'm a PGY-3 psychiatry resident who very recently discovered that it's even possible to go into pain from psychiatry. I was strongly considering anesthesiology and then pain in med school but switched into psychiatry at the last minute (literally, August of M4 year). From what I understand, pain is an uphill fellowship to match into for a psychiatry resident but I still have an interest in it so was wondering what I would need to do to maximize my shot at a fellowship? I understand there's a significant chance I won't match into a pain fellowship but I'd rather take the chance and fail rather than not apply at all.

Do I start out by reaching out to my own program director with my interests? The pain fellowship director at my institution? I have no idea where to begin. I have no research or background in pain whatsoever so I know I have a lot to catch up on if I want to even have a chance.

I know you know this already, but it's going to be a massive undertaking. Are you going to be able to do a few pain rotations this year? you would need to get some letters from Pain physicians, so you would need to have a rotation early enough to get letters written for the winter months to submit your application as early as possible. Another option, would be to take any free moments to do some informal shadowing and then parlaye that experience into a letter of recommendation. If I were you I would try to maximize my elective potential in the next few months and fill them all with pain rotations. The problem you will have is that if anyone else is interested in pain at your institution they have likely already snatched up all the rotations, but it's worth a shot. Also, case reports! you need to find a way to get your name on as many case reports as possible in the next few months. This is going to be tough as at this point most people have had a few case reports or publications under their belt. Again, you're going to have to reach out to people from the pain department and let them know that you are interested in helping out with a case. if you are lucky and there are multiple options, you need to submit multiple cases to any conferences coming up soon. There are a number of local and regional conferences depending on your area so you're going to need to look them up. That's all I can think of right now, good luck.

 

[clubdeac]

apply to UVA. They have a psychiatrist become pain doc on staff, or at least they did when I rotated through 10 years ago. They may be more sympathetic

 

[joshmir]

Would you be interested in non-ACGME accredited Interventional fellowships? I know a couple that routinely accept neurologists. I think Brigham also has a psychiatrist who does procedures on their staff. PM me if interested, I have 2 psychiatrists in my immediate family

 

[Birdstrike]

Hey, I'm a PGY-3 psychiatry resident who very recently discovered that it's even possible to go into pain from psychiatry. I was strongly considering anesthesiology and then pain in med school but switched into psychiatry at the last minute (literally, August of M4 year). From what I understand, pain is an uphill fellowship to match into for a psychiatry resident but I still have an interest in it so was wondering what I would need to do to maximize my shot at a fellowship? I understand there's a significant chance I won't match into a pain fellowship but I'd rather take the chance and fail rather than not apply at all.

Do I start out by reaching out to my own program director with my interests? The pain fellowship director at my institution? I have no idea where to begin. I have no research or background in pain whatsoever so I know I have a lot to catch up on if I want to even have a chance.

Your perceived weakness as a psych applicant will be your procedural skills. Do an interventional pain elective rotation and get exposed to as much hands on procedures as possible, and meet as many pain people as possible. Then just apply.
Yes, it's an uphill battle. But so are most things in life worth anything. I was an ER attending when I applied and I got a solid accredited fellowship spot. Give it a shot. What do you have to lose?

 

[Orin]

Reach out to some of the folks at large fellowship programs that are psychiatry boarded and did a fellowship to start

One person that comes to mind is always:

Ajay D. Wasan, MD, MSc | Department of Anesthesiology & Perioperative Medicine

www.anesthesiology.pitt.edu

This is a great time to be doing that as the requirements for non-anesthesia trained fellows have gotten a lot lower/simpler, and there will likely be a lot more non-anesthesia based fellowships for people in the next few years.

Consider a "gap fellowship" if you can afford the opportunity cost with something complementary maybe in addiction or palliative care, where you can get more exposure/contacts with pain medicine people.

And yes, always talk to your program director and your local pain fellowships director or affable faculty. Communication is important. It's rare people want to screw you because you show interest in their field.

 

[reca]

Thanks for all the advice, I appreciate it! I'll start out by talking with both my PD and the pain fellowship director. We don't have any electives during our PGY-3 year but I'll try to get an interventional pain rotation in beginning of PGY-4. Will definitely consider a gap fellowship as well.

 

[geesinger]

I felt as though I was reading my own post. I considered surgery or anesthesia, then changed to psych last minute as well. I have been seeking to fill the void since. I thought addiction medicine for sure, but then decided on child fellowship, hoping this feeling of longing for procedural work would pass and I may be able to do child/adolescent addiction, finally finding fulfillment. Almost 4 months into fellowship, I’m considering repeating residency in neurology and I bumble into discussions online about pain fellowship via psychiatry. Well hot damn; this could truly marry the specialties I’ve been interested in...though it seems like a long shot. (Me convincing my PD to assist me after potentially leaving fellowship vs finishing when I’m really not happy) Interested in talking to you more about this if you want to PM me!

 

[chudat]

Where did the OP end up???

 

[silentscope]

I have the similar situation as well. Our Psy Program is supportive, and arranged me 1 month international pain rotation during my PGY-2, but we dont have Pain fellowship around . Hopefully I could end up somewhere. Pray to GOD, for both of us!

 

[chudat]

Did anybody from psych or family med match into pain this yr?

 

[reca]

Where did the OP end up???

Ended up deciding against it. Covid was an eye-opener and I realized that lifestyle is more important to me than doing procedures. I'm doing private practice cash telepsychiatry and working about 30 clinical hours a week.

 

[NJPAIN]

Now I want to know if I’m too old for the transition of pain management to psych.