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Education

Pain Management Fellowship

The University of Chicago offers four, one-year Accreditation Council for Graduate Medical Education accredited Pain Fellowship positions. Each fellowship comprises a 12-month program at The University of Chicago Medical Center, with intensive training in evaluating and treating patients with chronic non-cancer and cancer pain. The emphasis is on multidisciplinary approaches to pain management with a focus on outpatients, in-patients, and patients in intensive care settings. The environment of care includes consultations and collaboration with several specialties to meet the needs of our pain patients. The specialties include General Surgery, Pediatrics, Pediatric Surgery, General Medicine, Hematology/Oncology, OB/GYN, Neurosurgery, Orthopedics, Neurology, Radiology, Physical and Occupational Therapy, Rehabilitation Medicine, Psychology, and Psychiatry. In 2020, our program received the “Fellowship Excellence Award” from the American Academy of Pain Medicine (AAPM). The award is presented to one fellowship per year, selected from more than 100 programs nationwide and based on an evaluation of multidisciplinary approaches as well as the procedural and surgical acumen of pain fellows. Our pain fellowship is at the forefront of pain management, recognized for continually introducing innovative interventional and surgical procedures.

Clinical Rotations:

Each fellow spends nine months in the Pain Clinic and three months in offsite rotations as part of a multidisciplinary teaching concept and per ACGME educational requirements. Three months of offsite rotations include the following:

  • Anesthesiology: 2 weeks, for fellows whose primary specialty is not anesthesia
  • Physical Medicine and Rehabilitation: 2 weeks, for fellows whose primary specialty is not PMR
  • Inpatient Pain Service: 1 week (fellows take calls one weekend per month)
  • Pain Psychology Outpatient Service: 2 weeks
  • Palliative Care: 2 weeks
  • Neurology: 2 weeks
  • Radiology: 1 week
  • Elective Rotation: 2 weeks, e.g., regional anesthesia, acupuncture

The fellowship program provides multidisciplinary training in managing pain patients, including both pharmacological and non-pharmacological training. The program comprises a variety of interventional pain procedures, including advanced surgical interventions (e.g., spinal cord stimulation, peripheral nerve stimulators, intrathecal drug delivery systems, interspinous spacers, basivertebral nerve ablation, and kyphoplasty). The pain division optimizes operating room block time for performing surgical procedures, which accounts for two days (15-20 hours operating room time) per week every week of the year. Fellows are exposed to theories, indications, and practical applications of various procedures for diagnostic and therapeutic purposes in a variety of acute and chronic pain states.

The following is a brief list of procedures fellows perform during their one-year rotations: 

Trigger point injections with/without ultrasound (US)

Various joint and bursa injections under US or fluoroscopic guidance 

Radiofrequency ablation of peripheral nerves (e.g., genicular nerve ablation)

Paravertebral nerve blocks Fascial plane blocks (FPBs)

Caudal, lumbar, thoracic, and cervical epidural steroid injections 

Transforaminal epidural steroid injections

Lumbar facet and median branch blocks

Caudal lysis of epidural adhesions 

Peripheral and central somatic nerve and plexus blocks under ultrasound guidance 

Diagnostic and neurolytic sympathetic ganglia and plexus blocks 

Tunneled peripheral nerve catheter

Radiofrequency ablative procedures 

Spinal cord stimulator trials and implants 

Dorsal root ganglion stimulator trials and implants

Peripheral nerve stimulation //changed to stimulation based on Internet search//

Intrathecal trials and intrathecal drug delivery system implants

Discography Vertebral augmentation (kyphoplasty) Interspinous spacers

Basivertebral nerve ablation

Variety of ultrasound-guided interventional pain procedures

Didactics

We offer strong didactic curricula that covers the ABA Pain Medicine content outline. One-hour didactic sessions occur daily at noon in the pain clinic with the exception of Wednesdays and Thursdays, which are surgical procedure days for pain fellows in the operating room. Fellows participate in surgical skills workshops during the first quarter. Monthly morbidity and mortality conferences take place in the Department of Anesthesia and Critical Care Core Program, as well as those specific to the Pain Clinic. Journal clubs are held quarterly with multi-institutional participation of pain fellows and physicians throughout the Chicago metropolitan area.  

Scholarly Activity

Pain fellows participate in several scholarly activities, including publishing book chapters, case reports, and review articles. They present abstracts and medically challenging cases at local, regional, and national conferences. Pain fellows are required to present scientific papers to at least one national pain conference (e.g., ASRA Pain, NANS, ASA). The scholarly requirements include completing a quality improvement project. Fellows also participate in the annual Chicago Pain Summit,  a multi-institutional seminar that reunites all programs in the Chicagoland area. Ample opportunities exist for research within the section. Indeed, fellows are encouraged to actively participate in ongoing research or to pursue topics of interest with their pain faculty mentors. Among the research conducted by pain fellows, some received high marks at national meetings, for example, American Society of Regional Anesthesia and Pain Medicine received the presidential award. Past fellows’ topics of interest include real-life evaluation of the Vertiflex™ procedure efficacy and use of neuromonitoring for spinal cord stimulation mapping. The pain clinic has a robust research section that includes industry-funded and investigator-initiated research opportunities.

Administrative

All four trainees share the position of Chief Pain Fellow, rotating in this position every three months. This not only enhances the educational curriculum but also helps trainees develop their leadership and administrative skills. Chief Pain Fellows meet often (e.g., monthly) with the Fellowship Program Director. Each Fellow functions as deputy director of operations, overseeing clinic activities and coordinating schedules of colleagues and other trainees.

Facility

The Pain Medicine Center is located at the Duchossois Center for Advanced Medicine (DCAM). It resides in the Outpatient Center of The University of Chicago Medical Center, third floor, clinic 3E.

The clinic consists of six exam rooms, two recovery bays, and two fluoroscopic procedure suites. Surgical procedures are performed at the DCAM Surgery Center and the Center for Care and Delivery (CCD) operating rooms. The Pain Medicine Center also operates two off-site facilities, one in Orland Park and one in Downtown Chicago.

Call Responsibilities

Fellows share call-coverage responsibilities at the inpatient Pain Consult service with CA-I, CA-II, and CA-III residents at night, on weekends, and holidays. Calls are taken in-house during the day, so pain fellows have no overnight responsibilities. All fellows assume responsibility for calls on two weekend days per month. Pain fellows do not have mandatory in-house calls.

Application process ----

Pain Management Fellowship positions are filled through the National Resident Matching Program (NRMP) utilizing the Electronic Residency Application Service (ERAS). For information, please visit their websites at www.nrmp.org and aamc.org/eras. In addition to the ERAS application, please e-mail Tiffany Schmidt at tschmidt@bsd.uchicago.edu regarding your basic exam scores.

Interview days for the 2024 Match will be posted soon. Proposed dates are as follows:

May 9, Thursday

May 29, Wednesday

June 6, Thursday

 

Faculty