Pain Fellowship Reviews

[nvrsumr]

BWH is the most interventional because of the surgical training-pumps, stims, portacaths etc...

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[hrmm]

Can anyone discuss their personal experience in landing a job post-fellowship based upon location and quality of fellowship training?

Eg. If I wanted to eventually land a job in Chicago, should I:

1) Go to a decent program (eg. NW, Rush, UChicago; albeit not a "national top-notch" program) IN THE AREA of where I want to work..
vs.
2) Go to a "national top-notch" program (eg. BWH, Hopkins, UCLA, BIDMC/MGH, MD Anderson)?



Personal experience, difficulties encountered, pros/cons, etc. would be helpful.

 

[Ducttape]

i hate to say this, but being in the area, you get to know the players, and it is a heck of a lot easier to set up an interview.

if you want to go into academia, then you should go to a top notch program. if you want to be a clinician first and foremost, then getting a job in the area that you want to live the rest of your life makes your spouse happy and gives you better contact/opportunity...

 

[Nonphysiologic]

Hey guys...any opinions or reviews on the program at USF University of South Florida program? It's the only neuro based pain program

 

[unchockey21]

University of Arizona
Details
1 fellow
Interview about 15
New program- 2 years old, Very laid back attitude, extremely flexible program that you can tailor to your interests
2 pain attendings (both new this year), both with PhDs in pain pharmacology before doing anesthesiology (1 trained at MGH for fellowship and the other at UCSD)
Banner Healthcare recently bought UA, plans to build new pain clinic with integrated PT, psych, etc in same building, likely a few years away from completion
Current hiring freeze b/c of merger but plans to hire 1-2 new pain attendings b/c clinic is booked 3 months out
1 fluoro room in an endoscopy suite, but room is only used for pain procedures
Each attending has 2 days of clinic, 1 day of procedures, and 2 days of research- days are staggered so a fellow would get 2 days of clinic and 2 days of procedures, each Friday is used for off service rotations, research, or electives
Procedure days average about 16-18
They do NOT Rx opioids, only recommendations.
EPIC EMR/dragon dictation software, good templates, home access
There is acute pain exposure but there is no call (no call on any rotation for entire fellowship), anesthesia residents cover night call
Don't do pumps currently but could change with new hires
Do SCS trials but no implants, can rotate with NSGY to get implant experience
Good number of bread and butter procedures
Weekly lectures
Typical day: 8am – 4:30pm
Extremely outgoing and nice attendings and staff, went out of their way to be accomodating and make you feel comfortable

Interview Day/Questions
Interview with ~5 other applicants
Morning starts off with PD doing overview of program and continental breakfast
Tour of main campus hospital with fellow, then tour of labs in building connected to main hospital
Fellow drives you to south campus where pain clinic and procedure room are located for tour
2 1-on-1 interviews x 15-20 min each – very laid back questions, mostly just wanting to get to know you as a person
Lunch with fellow
Free time with PD for any other questions

 

[freddydpt]

The best way to learn about programs is to talk to current fellows in each program. Find their emails and ask to talk to them over the phone. Every program has strengths and weaknesses. I wouldn't go exclusively by reputation on SDN. I promise that will lead you down the wrong path.

 

[No Pain All gain]

Can anyone discuss their personal experience in landing a job post-fellowship based upon location and quality of fellowship training?

Eg. If I wanted to eventually land a job in Chicago, should I:

1) Go to a decent program (eg. NW, Rush, UChicago; albeit not a "national top-notch" program) IN THE AREA of where I want to work..
vs.
2) Go to a "national top-notch" program (eg. Hopkins, UCLA, BIDMC/MGH, MD Anderson)?



Personal experience, difficulties encountered, pros/cons, etc. would be helpful.

I am a current fellow on the West Coast and planned to go back to the East Coast to a specific area before starting fellowship. I started calling practices back in May 2014 and put my name and CV out there. By September I had interviewed for 3 jobs and by November I was entertaining three great offers. I am joining a great practice in the exact area I want to live.

Anything can happen as long as you put your name out there and make connections. Be bold. Going to a national, top-notch program is always going to help you. That was my thought process doing what I did. My future practice is marketing me heavily based on my training, and I have to think that it got me in the door and ahead of other applicants. Of course, they have to like you too!

PM with specific questions.

 

[brainmedicine]

Anybody who is a current fellow has a Psychiatrist in the pain fellowship? I am interested in doing pain, and I was wondering how common it is?

 

[geauxg8rs]

Anybody who is a current fellow has a Psychiatrist in the pain fellowship? I am interested in doing pain, and I was wondering how common it is?

You should be asking "how does it make you feel to have a psychiatrist in the fellowship? Do you have feelings of hurting yourself or others?"

Jk

 

[BIGphysician]

Anybody who is a current fellow has a Psychiatrist in the pain fellowship? I am interested in doing pain, and I was wondering how common it is?

I'm not sure that's even possible. I guess technically anything is possible, but pain is pretty competitive and I can't imagine someone coming from a field with zero procedural background just stepping in and being up to speed with former anesthesiology residents etc. you'd have to settle for some program out in the boon docks I'd imagine if at all. PMR residents have a hard enough time matching into pain and they actually do some procedures.

 

[Flake0006]

There were two Psychiatrists in the UCSD program this year

 

[BIGphysician]

There were two Psychiatrists in the UCSD program this year

That sounds crazy to me, no experience with any Neuraxial procedures, blocks, anything, no background in anesthetic agents? 3 years of just talking to patients. Wow, maybe I went the wrong route. 3 years of basically no call and no setting rooms up would have been nice to arrive at the same spot in the end.

 

[cbest]

The chairman of UPMC has a psychiatry background

Are you sure UCSD matched two psychiatrists? I know they matched to physiatrists

 

[soccerpunk600]

That sounds crazy to me, no experience with any Neuraxial procedures, blocks, anything, no background in anesthetic agents? 3 years of just talking to patients. Wow, maybe I went the wrong route. 3 years of basically no call and no setting rooms up would have been nice to arrive at the same spot in the end.

Wow you're spiteful. Sticking needles in people is just one part of taking care of pain patients, would you not agree?

 

[Quito]

Having spent some time with anesthesia, physiatry, and psychiatry I would say the more challenging part of pain medicine is identifying the pain generator(s) and then deciding whether an injection is warranted based on the etiology and risk/benefit analysis. Not everyone does the latter analysis and then we end up with others having to come in police the subspecialty by cutting reimbursements, etc. I can tell you that psychiatry is in a unique position to address the sleep disturbances and mood disturbances with pain, and physiatry is very good at identifying the pain generators. Anesthesia has a strength in it's procedural ability no doubt. So give credit where credit is due because none of us are omnipotent or all-knowing. None of us are God.

 

[Flake0006]

The chairman of UPMC has a psychiatry background

Are you sure UCSD matched two psychiatrists? I know they matched to physiatrists

Positive. Met one during the interview. Not sure what the issue with background is. The docs with Anesthesia, IM, Physiatry and Psychiatry backgrounds I worked with all seemed equally skilled in their practices.

 

[BIGphysician]

Wow you're spiteful. Sticking needles in people is just one part of taking care of pain patients, would you not agree?

Just an easier path is all I'm saying.

 

[lord_jeebus]

When I was at UCSD, the pain chairman had a strong interest in recruiting a pain-boarded psychiatrist to round out the department, which is mostly anesthesiologists. One of my co-fellows was a psychiatrist and was offered a faculty position but declined. Given their rarity, I'm not surprised that more psychiatrists were taken on as fellows, in the hope of keeping one.

 

[unchockey21]

When I was at UCSD, the pain chairman had a strong interest in recruiting a pain-boarded psychiatrist to round out the department, which is mostly anesthesiologists. One of my co-fellows was a psychiatrist and was offered a faculty position but declined. Given their rarity, I'm not surprised that more psychiatrists were taken on as fellows, in the hope of keeping one.

At my interview, several people mentioned hiring a pain trained psychiatrist as a continuing goal. They're expanding the faculty by 2 but both positions are for anesthesia because they involve some OR time. A "multidisciplinary approach" to pain is somewhat of a buzzword with programs these days but they were the one program I've been to that actually seems to do it. I can also confirm that this graduating class had 2 Psych and 1 neuro. The incoming class is anesthesia and PMR. With the Match, it's hard to know who you're going to get and because of that they said they just rank good candidates without regard to specialty (ie they don't rank a bunch of psychiatrists just in the hopes of getting one).

 

[Got Em]

Can someone please comment on Texas Tech's pain fellowship?

I read some posts back in 2004 that it was the top national program (Dr. Raj and Racz are nationally known), but haven't seen in discussed since. Thanks!

 

[Paindoc9]

Yes, UCSD had two psychiatry trained fellows that just finished. One was good, the other was not very good. Word is they are trying to stick to more traditional (anesthesia and pm&r) trained fellows now. That's why now they only have anesthesia and pm&r fellows this year.

 

[RehabDr]

Can anyone talk about U. Southern California program. I checked all old posts but nobody talk about this program. Thanks.

 

[Nonphysiologic]

Yeah and how about UC IRVINE, UC DAVIS

 

[dangerfield]

Does anyone know about the St. Lukes Roosevelt program? The previous threads talked about how awesome this fellowship program was. I know the hospital system was bought out by Mount Sinai and heard that they lost a couple Pain attendings. Please PM me. Thanks!

 

[Bruinsfootball]

Anyone care to share info on any of the following programs please, having a tough time ranking them.
1) Cedars
2) Rush
3) UVA
4) NYU
5) Mount Sinai
6) UC-Davis
7) Case Western
8) UIC

 

[Paindoc9]

Anyone know about Thomas Jefferson? How's their program?

 

[dangerfield]

Anyone care to share info on any of the following programs please, having a tough time ranking them.
1) Cedars
2) Rush
3) UVA
4) NYU
5) Mount Sinai
6) UC-Davis
7) Case Western
8) UIC

I interviewed at cedars and thought it was a strong program. Would rank them in top 2 or 3 were it not for geographic limitations. UC Davis i hear from a friend who graduated from the fellowship, loved it. I did not interview there but my friend could have had his pick of most pain programs and chose Davis. I think Davis is in your list of top 2.

 

[cbest]

The Rush pain fellows rotated on the PM&R service with me every so often when I was a resident... those guys got rocked! I remember one telling me he'd work upwards of 100 hours per week on call weeks.

Was very impressed with UC Davis when I interviewed there last year and heard good things about UVa from a friend of mine who is currently a fellow there.

 

[Bruinsfootball]

I interviewed at cedars and thought it was a strong program. Would rank them in top 2 or 3 were it not for geographic limitations. UC Davis i hear from a friend who graduated from the fellowship, loved it. I did not interview there but my friend could have had his pick of most pain programs and chose Davis. I think Davis is in your list of top 2.

Why did you like Cedars? I heard they require 3 months of inpatient ie epidural management and also mandate overnight anesthesia coverage. They did not seem to have great numbers for SCS, etc?

Also, UC Davis seemed to be minimally interventional beyond bread and butter. I don't understand the hype with this program?
Keeping in mind they are all likely solid training programs.

 

[Bruinsfootball]

The Rush pain fellows rotated on the PM&R service with me every so often when I was a resident... those guys got rocked! I remember one telling me he'd work upwards of 100 hours per week on call weeks.

Was very impressed with UC Davis when I interviewed there last year and heard good things about UVa from a friend of mine who is currently a fellow there.

What did you like about UC-Davis?
I've heard the same about the work hours at Rush. Any specifics on the UVA program.
Thanks all for the comments.

 

[Nonphysiologic]

You know I kind of agree about UC DAVIS. I think there is hype because of big names but I was definitely surprised they mainly do bread and butter I was expecting them to be much more procedure based from the hype

 

[cbest]

I got the impression that it was going to be a really well rounded fellowship from both a clinical/skills and didactic standpoint. I personally wasn't looking for a place that does a bunch of pumps 'cause those patients aren't exactly what I'm looking for in my future practice. Plus, there was very little inpatient which I also dug!

 

[dangerfield]

Coming from an anesthesia background I actually want a place that helps me preserve my anesthesia skills, I worked too hard and I want to be able to do both, especially with the current changes in healthcare. I would like to do some pumps enough to know and troubleshoot but I don't judge a program by how many stims they do. I agree with cbest, also not something I'm looking to eagerly do in the future.

 

[Bruinsfootball]

Does anyone know about the St. Lukes Roosevelt program? The previous threads talked about how awesome this fellowship program was. I know the hospital system was bought out by Mount Sinai and heard that they lost a couple Pain attendings. Please PM me. Thanks!

Heard that SLR has historically been a good program. Not sure how these Mount Sinai buyouts are going to effect the fellowship programs?

 

[ampaphb]

http://slranesthesiology.org/about_us/faculty_fellows.php

 

[Bruinsfootball]

Any recent thoughts on the nyc programs? NYU? Columbia? Sinai?

 

[gaspain]

Long-time lurker, first time poster. Followed this thread for awhile so thought I'd contribute.

Cornell/MSK/HSS - 5/10
So many great names in this tri-institute program but the training just wasn't what I had hoped. I felt like the fellows had to compete with each other and with HSS fellows for good procedures and volume. Everyone was very nice and the area was nice for NYC. 8 spots. I interviewed at the other NY programs and weren't impressed either so I won't list them. I'd say if I had to be in NYC, Cornell would still be the place to go. I didn't interview at St. Lukes but I hear that is a good program in the city.

UCSF - 6/10
For such a prominent anesthesia department, their pain program was very lackluster. The interview day was kind of disorganized. They are pretty academic and they really stressed my research experience and if I had any further research desires. Didn't seem as interventional as the other Cali programs.

UCDavis - 6/10
Mostly bread and butter. Solid training but nothing above and beyond that really impressed me. 5 spots.

UCI - 6/10
Same as UCDavis. Nothing all that impressive but the fellows seemed happy and were finding decent jobs right out of fellowship. I thought the PD was very supportive, which is always a plus. Overall good not great. Nice and clean city, fairly new hospital.

MD Anderson - 7/10
Good for cancer pain. They do a month or 2 at a private practice bread and butter shop. The fellows say this is where they get their best training, however it's only 1-2 months out of the entire fellowship year. Also a PM&R guy who does a good number of procedures. They work hard here. Long days, long nights. Like I said, good for cancer pain. 6 spots.

UCSD - 7/10
I believe they had 2 neuro fellows this year. Everyone was super nice and it's probably because everyone is happy living in La Jolla. My only issue with them is that they covered several hospitals and had to see consults at all of them when you're on call, sometimes after a full day of being in clinic. Sounded painful. Nice facilities. More (maybe even most) interventional vs. other Cali programs. If I had to rank all the Cali programs, I think I would place UCSD near the top. 4 spots.

MGH - 8/10
Probably the most prominent name on my list of interviews. Mostly bread and butter stuff, few advanced procedures but they seemed to have just enough to be relatively comfortable. A great alumni network, especially for an academic career.

Brigham & Women's Hospital (BWH) - 10/10
No doubt in my mind that BWH is the TOP program in the country. This forum has always stated Brigham as the best and after my interviews and speaking to many other people, I think I agree. The most interventional of the programs, good cancer experience at Dana Farber Cancer Institute. Alumni network is big just like MGH and the Harvard name doesn't hurt either. Speaking with all the fellows, the Brigham Pain name travels far when looking for a job as practices and recruiters nationwide would love a Harvard-trained physician on their staff. They work hard but decent hours. Nice people. Their interview day seemed kind of rushed though. This program wins a ton of awards. Overall outstanding training. I've heard that if you receive an interview here, you can consider yourself top of the recruiting class for that year. 8 spots.

Best of luck.

 

[A Witty Fool]

My top programs in California would be (based on my interviews and those of my pals and speaking to a SCS device rep who sees which fellows get quality training):

#1. UCSD

#2. Cedars

#3. tie UC Davis & UCLA

#4. Stanford

 

[cbest]

Admittedly I didn't interview at Stanford when I was gonna through the process but word on the street was that their procedural experience was very low

 

[swamprat]

Any1 have any info on when to apply for the next year? Seems like the universal pain app ceased to exist and there isn't any other info I'm able to find on the web about it.

 

[paintrain]

Any1 have any info on when to apply for the next year? Seems like the universal pain app ceased to exist and there isn't any other info I'm able to find on the web about it.

I'm not sure when ERAS opens up but I'd start asking for letters of recommendation within the next few months. I didn't have my application completely submitted until April/May of the Match year (which was fine because most of the programs I applied to had traditionally sent out applications in the Summer). However I know some programs start sending out interview invites as early as February.

 

[madcye]

I think start was Dec-Jan.

 

[Green Grass]

Any word on how competitive it was last year? How much are in training exams factored in vs LOR and overall residency performance?

 

[A Witty Fool]

Pain Medicine stats for 2015 cycle:

416 Applicants
112 Failed to match
2 positions went unfilled in the initial round

Few fellowships are more competitive that this. Your top tier programs like B&W, BIDMC, Mayo, Cedars, UCSD receive upwards of 300+ applications for a few spots, some of which go to internal applicants.

Any word on how competitive it was last year? How much are in training exams factored in vs LOR and overall residency performance?

Only PDs would know these answers.

 

[Green Grass]

See below.

 

[Green Grass]

Pain Medicine stats for 2015 cycle:

416 Applicants
112 Failed to match
2 positions went unfilled in the initial round

Few fellowships are more competitive that this. Your top tier programs like B&W, BIDMC, Mayo, Cedars, UCSD receive upwards of 300+ applications for a few spots, some of which go to internal applicants.



Only PDs would know these answers.

Does this include all applicants (all specialties, FMGs, etc...)? Skews the numbers in my opinion.

 

[A Witty Fool]

Does this include all applicants (all specialties, FMGs, etc...)? Skews the numbers in my opinion.

416 TOTAL applicants

Of the 303 who matched, 214 were US Grads (70%). What we don't know is how many US Grads applied vs US Foreign vs DO vs Foreign vs Canadian (this is how NMRP breaks it down). Nevertheless, a 27% failure rate is high for a fellowship.

 

[madcye]

Any word on how competitive it was last year? How much are in training exams factored in vs LOR and overall residency performance?

If you want top tier i think with ERAS they cut off by the step scores. My coresident went to 20+ interviews at big name programs with 240-250 step scores and 98-99% ITEs. Mine were average scores for both and i got 7 interviews at good programs but not BWH/BID etc. I think the places I went to went to liked my personal statement and research because they said so during the interview.

 

[Green Grass]

If you want top tier i think with ERAS they cut off by the step scores. My coresident went to 20+ interviews at big name programs with 240-250 step scores and 98-99% ITEs. Mine were average scores for both and i got 7 interviews at good programs but not BWH/BID etc. I think the places I went to went to liked my personal statement and research because they said so during the interview.

How important is research in the application?

 

[madcye]

Depends on the program. It gives you something to talk about but most programs understand a research project is hard to finish in one year. UPMC actually has a research track associated with the pain program if thats what you are interested in.