Pain Fellowship Program The Pain Medicine Center at the University of Chicago Medical Center (UCMC) is a pain program accredited by the Accreditation Council for Graduate Medical Education (ACGME) since 1996. Each accreditation cycle was for 5 years unconditionally. It provides two (2) fellowship positions per year. The fellowship program consists of a twelve (12) month program at the Pain Medicine Center of the University of Chicago Medical Center. The fellowship program is designed to provide intensive training in the evaluation and treatment of patients with chronic pain of benign and malignant etiology, and in the differential diagnosis of chronic pain states. Emphasis is placed on multidisciplinary approaches to pain management in outpatient, in-patient, as well as intensive care settings. Our environment of care includes consultation with other specialties (e.g. General Surgery, Pediatrics and Pediatric Surgery, General Medicine, Hematology/ Oncology, OB/GYN, Neurosurgery, Orthopedics, Neurology, Radiology, Physical Therapy, Occupational and Rehabilitation Medicine, Psychology and Behavioral Medicine) as needed to best meet the needs of pain patients. The fellows are assured 9 months of continuous education in the Pain Center with the remaining 3 months in outside rotations in different outpatient teaching clinics or inpatient services in the University of Chicago Medical Center as part of a multidisciplinary teaching agreement with the parties involved and as per ACGME pain management fellowship educational requirements established in 2007. The rotations are undertaken based on the availability of teaching physicians of the participating clinics, as well as the availability of faculty and fellows in the pain clinic.
The 12 weeks duration of the outside rotations are:
- Outpatient Pain Clinic – 36 weeks
- Anesthesiology (for Fellows whose primary specialty is not Anesthesia) – 2 weeks
- Physical Medicine and Rehabilitation (for fellows whose primary specialty is not PMR) – 2 weeks
- Acute Pain Service/Inpatient Consultation Service – 2 weeks (fellows will be taking call 1 weekend per month)
- Psychiatry Inpatient Consult Service – 2 weeks
- Palliative care, Inpatient Consult Service and Home Visits – 2 weeks
- Neurology, Outpatient clinic and Electromyography clinic – 1 week
- Radiology – 1 week
- Elective rotations – 2 weeks
This program provides fellows with interventional pain experience; during their training, the fellows perform an important number of surgical procedures (Kyphoplasties, Dorsal Columns stimulators leads and generator implants, Intrathecal Drug delivery systems, etc.,) under attending supervision in the ambulatory operating rooms. Trainees become familiar with theory, indication and practical application of various procedures for diagnostic and therapeutic purposes in many chronic and acute pain states (see below). The fellows have ample time allotted to didactic sessions Pain Medicine conferences include daily one (1)-hour teaching sessions from 7:00 to 8:00 AM in the Pain Clinic Conference room, which has audio- and video equipment. Active trainee participation is expected in the presentation of various pain topics, particularly the management of the chronic pain from all etiologies, and the presentation and discussion of newly published articles and journal reviews. There are monthly morbidity and mortality conference presented in the Department of Anesthesia and Critical Care, Core Program, as well as presented in the Pain Clinic. The journal club is held monthly as a multi-institutional meeting with participation of pain fellows and physician from the pain clinics within the Chicago metropolitan area. Each fellow has special responsibilities for the Acute Pain Consult Service and Acute Postoperative Pain Service at the University of Chicago Pain Medicine Center, to provide care to postoperative surgical patients and chronic pain patients from the In-House Consult Service, weekend coverage, as well as provide teaching and guidance to CA-1, CA-2 and CA-3 residents rotating through this service. In addition of the one – two weeks rotating through the In-House Consult service/Acute pain service, each fellow is required to have two weekend days call per month. The pain fellows do not have mandatory in-house call. Procedures are performed five days per week under fluoroscopy and/or ultrasound guidance.
The following procedures represent an abbreviated list of procedures commonly performed by the fellows during their one-year rotation:
- Trigger point injections with/without ultrasound (US)
- Various joint and bursa injections under US or fluoroscopic guidance
- Minor and major joint injections under US or fluoroscopic guidance
- Caudal, lumbar, thoracic and cervical epidural steroid injections
- Caudal lysis of epidural adhesions
- Peripheral and central somatic nerve and plexus blocks under ultrasound guidance
- Diagnostic and neurolytic sympathetic ganglia and plexus blocks
- Neurolytic nerve blocks
- Tunneled catheter placements into various nerve sheaths
- Radiofrequency ablative procedures
- Dorsal column stimulator trials and surgical implants
- Intra-spinal catheter placements for intrathecal opioid trials
- Intra-spinal catheter placements with implanted infusion systems
- Ultrasound-guided procedures are performed as indicated.
Didactics Didactics occur every day in the pain clinic from 7 to 8 am with the exception of Wednesday when the lecture is held from 8-9 due to Department of Anesthesia and Critical care Grand Rounds that occurs from 7-8 am. The lectures involve active trainee participation whether through presenting the material or conducting discussions on various up to date published scientific evidence. The topics discussed follow the Pain Medicine Fellowship Curriculum and includes topics of newly published articles and recent journal reviews as well as monthly morbidity and mortality conferences. An In-House Consult Service for treatment of in-patients with acute and chronic pain states provides trainees with ample opportunities and significant experience in preparation for the role of a consultant in Pain Medicine. Trainees are supervised by faculty members on a daily basis in the Outpatient Pain Medicine Center, as well as during their In-House Acute/Chronic Pain Consultation rotation. Role of the Pain Management trainee as a consultant to other specialties The pain medicine trainees will, in preparation for their role as a consultant in pain medicine, gain significant experience in providing consultation under the direction of the pain faculty. The trainee is responsible for evaluation of the patient, communication of their clinical findings, and development of a detailed treatment plan. Additionally, the trainee will perform any necessary diagnostic and therapeutic pain management procedures to complete the patient’s treatment plan. Additionally, the fellows play an important role when rotating through the other specialties. Their knowledge is enhanced with new techniques regarding care for the complex pain patient using multidisciplinary and multimodal diagnostic and therapeutic approach. Research Experience Research is facilitated by an existing, active research program of the Department of Anesthesia and Critical Care and the Pain Clinic. While one year of fellowship is often too short to begin an independent research project, there is research space and more than ample equipment available for joining a research project for the devoted trainee. Funding can be sought and mentors are available for an additional fellowship year to initiate and develop research skills, approaches, and projects. In addition to the department resources, the pain medicine center is an active clinical research center. Pain fellows are required to present a scientific paper to at least one of the national anesthesia and/or pain annual meetings such as ASRA or ASA; there are ample opportunities for research within the section and pain fellows are encouraged to actively participate in on-going research or finding their own topic under attending supervision.
Magdalena Anitescu, M.D., Ph.D.
Associate Professor of Anesthesia & Critical Care Interim Section Chief, Pain Medicine Program Director, Pain Medicine Fellowship
Dalia Elmofty, M.D.
Assistant Professor of Anesthesia & Critical Care
Tariq Malik, M.D.
Assistant Professor of Anesthesia & Critical Care
Maunak Rana, M.D.
Associate Professor, Anesthesia & Critical Care
Helene Rubeiz, M.D. – Neurology
Marie Tobin, M.D. – Psychiatry
Michelle Gittler, M.D. – Orthopaedic Surgery & Rehabilitation Medicine
Clinical Associate Professor
Carina Yang, M.D. – Radiology
Stacie Levine, M.D. – Palliative Medicine
Palliative Medicine Fellowship Director, Palliative Care Program Co-Director
The Pain Medicine Center is located in the Duchossois Center of Advanced Medicine, the Outpatient Center of the University of Chicago Medical Center, on the third floor, clinic 3E.
Clinic consists of 4 exam rooms equipped with basic monitors and oxygen outlets as well as suction, 2 infusion rooms, 2 recovery beds (equipped with ASA monitoring and resuscitation capabilities), and 2 fluoroscopic suites with 2 recovery bays.
In the large fluoroscopy suites, all invasive procedures are performed with the option to provide conscious sedation. A radiology technician is available from 8:00 AM to 4:00 PM on a daily basis and serve both suites.
Fellows will share the coverage for the APS/Inpatient Pain Consult Service with the CA-I, CA-II and CA-III residents during the night and on weekends and holidays. Calls are taken during the day in-house, with no overnight responsibilities for the pain fellows.
Fellows trained since the accreditation of the Fellowship Program in 1996:
40 fellows were trained since the accreditation of our Pain Medicine Program in 1996. Most of them continued in academic positions but also in private practices.
Our Pain Management Fellowship positions are filled through the National Residency Matching Program (NRMP) utilizing the Electronic Residency Application System (ERAS). For information, please visit their websites at aamc.org/eras and www.nrmp.org. In addition to your ERAS application, please e-mail Theresa Cumming, Director of Operations at firstname.lastname@example.org with all In-Training exam and Basic Exam scores.
Our interview days for the 2020 Match are not yet available.