Pain/MSK/Spine/Sports fellowship list

[lobelsteve]

I don't think programs were "left off" or purposely removed. I remember getting an e-mail from the academy a couple of months ago with an attachment to fill out the yearly program form to have an entry in the guide this year. So, if a program director didn't bother to fill out the form and send it in, then the program's not going to be listed.

Regarding the "pain" fellowships, you have to remember, this is an AAPMR sponsored fellowship guide. I don't think any anesthesia program directors have any desire to request a listing. If you look at the entry for Emory, one of the listed instructors is the program director for their PM&R residency program, so I'm sure he throught it would be a good idea that the fellowship be listed.

The UC-Davis anesthesia pain is well know to train Physiatrists, but the one listed in the guide is their PM&R sports fellowship.

There's uncertainty as to whether the AAPMR is going to continue sponsoring PM&R fellowships. Go the Pain and MSK council meetings at the annual assembly this year where I'm sure these things are going to be discussed. Should be quite interesting/entertaining after ampa's e-mail blast.

I think the AAPMR and ABPMR have already given us true Pain guys the heave ho by creating a member council that breaks up pain. Whether it is jealousy or short sighted vision, most of us serious folks have moved on. My money is best spent where I feel it would do good. And this is not in the support of the Academy. In reviewing the responses to AMPA's letter, I have no desire to give my money to folk's who clearly do not want to advocate on my behalf.

Further underscoring the need to make Pain its own residency is the folks who claim to be pain practitioners, the ferral injections, and the myofascists (the purported "pain" folks with the AAPMR).

---

Members don't see this ad.

 

[Finally M3]

I know of two non-accredited spine spots

UMichigan
Stanford

The Michigan one is a moderately high-volume fellowship, every procedure except kypho/vertebroplasty, multiple settings (office, ASC, academic v. community).

Stanford, I can't speak to the volume, but the PD is very reputable and is great to work with. You'll learn tons from him.

 

[olafa]

AAPMR has just revised its "fellowship list" now that PASSOR has been dis-assembled - the 3 groups are divided into "AAPMR recognized" and the "other" fellowships and electives.
Below is copied from the introduction....

Fellowships that were previously recognized by PASSOR are now listed in the section
entitled “Academy Recognized Fellowships”. All other fellowship entries are listed in the section entitled “Additional Fellowships”. Fellowships not listed in the “Academy
Recognized” section may be quality fellowships from a learning and exposure
standpoint, however they did not previously meet the PASSOR guidelines or were new​

entries submitted this year.

 

[Llenroc]

Couple of questions:

1) Do all interventional pain fellowships fill, the same way all residency slots fill? Or do the number of spots exceed the number of people applying?

2) Are there many attendings (who graduated residency 2-3 years prior) who apply for these fellowships, or is that uncommon/looked down upon?

 

[Godzilla777]

Has anyone heard of this interventional pain fellowship? There's a brochure that is advertising this. It's based in St. Louis and can be either a 1 or 2 year program.

 

[spinemd]

I am currently a fellow at Dr. Fortin's Interventional Spine Program and think that it deserves designation as one of the best fellowships in the country. Labeled as an Interventional/musculoskeletal fellowship the training offered here is more appropriately distinguished as Interventional Pain, as there is a multidisciplinary theme in the program's mission. Though needle dynamics and manual dexterity are key elements in the fellow's training, there is also a strong emphasis in CT, MRI, and radiographic interpretation, musculoskeletal examination, EMG, and Psychological and Medicinal Pain management. These skills are impressed to insure that the fellows have a well-rounded approach to diagnose and treat a myriad of painful conditions.
I have listed some positive attributes below:
-1:1 training with Dr. Fortin, one of the most highly regarded Pain Physicians in the country.
-Variety of Interventional procedures including, but not limited to:
about 40% thoracic and cervical procedures (many including headache management), vertebroplasty, vertebral bone biopsies, SCS trials and operative implantation, peripheral nerve stimulation, IDET, US guided MS injections, US guided peripheral nerve blocks, and US guided radiofrequency ablation.
-Academic schedule which includes weekly exams and publishing requirements
-Many graduated fellows have become very successful in academia, or have started their own private practice. This serves as a testament to the well-roundedness of education provided
-Wonderful office staff!!!
-No General Rehab consults. All Pain Management. No scut.
-Office serves as a model for anyone seeking to venture into private practice, as productivity and efficiency are remarkable.

 

[SSdoc33]

I am currently a fellow at Dr. Fortin's Interventional Spine Program and think that it deserves designation as one of the best fellowships in the country. Labeled as an Interventional/musculoskeletal fellowship the training offered here is more appropriately distinguished as Interventional Pain, as there is a multidisciplinary theme in the program's mission. Though needle dynamics and manual dexterity are key elements in the fellow's training, there is also a strong emphasis in CT, MRI, and radiographic interpretation, musculoskeletal examination, EMG, and Psychological and Medicinal Pain management. These skills are impressed to insure that the fellows have a well-rounded approach to diagnose and treat a myriad of painful conditions.
I have listed some positive attributes below:
-1:1 training with Dr. Fortin, one of the most highly regarded Pain Physicians in the country.
-Variety of Interventional procedures including, but not limited to:
about 40% thoracic and cervical procedures (many including headache management), vertebroplasty, vertebral bone biopsies, SCS trials and operative implantation, peripheral nerve stimulation, IDET, US guided MS injections, US guided peripheral nerve blocks, and US guided radiofrequency ablation.
-Academic schedule which includes weekly exams and publishing requirements
-Many graduated fellows have become very successful in academia, or have started their own private practice. This serves as a testament to the well-roundedness of education provided
-Wonderful office staff!!!
-No General Rehab consults. All Pain Management. No scut.
-Office serves as a model for anyone seeking to venture into private practice, as productivity and efficiency are remarkable.

US guided RF? still doing IDET?

 

[spinemd]

We have performed US guided peripheral nerve ablations (using pulse dosing) on patient's with refractory stump pain, ankle, knee, and shoulder pain with very good long term results (6 months).
IDET is uncommon, but still performed at our office. The payers for IDET have been either OOP (out of pocket) private pay or workman's compensation.

 

[ampaphb]

We have performed US guided peripheral nerve ablations (using pulse dosing) on patient's with refractory stump pain, ankle, knee, and shoulder pain with very good long term results (6 months).
IDET is uncommon, but still performed at our office. The payers for IDET have been either OOP (out of pocket) private pay or workman's compensation.

When you do prf of a peripheral nerve, what do you bill it as?

 

[SSdoc33]

tread cautiously, spinemd.......

 

[ampaphb]

tread cautiously, spinemd.......

Awww ... it's no fun when you warn that a trap is being set ...

Afterall, these are Dr. Fortin's billing practices we are discussing, not spinemd's

 

[RUOkie]

IDET is uncommon, but still performed at our office. The payers for IDET have been either OOP (out of pocket) private pay or workman's compensation.

How do you justify this?

 

[ampaphb]

How do you justify this?

Pain Pract. 2004 Jun;4(2):84-90.
Intradiscal thermal annuloplasty for discogenic pain: an outcome study.
Mekhail N, Kapural L.

Department of Pain Management, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. [email protected]
Abstract
OBJECTIVES: Published studies of intradiscal thermal annuloplasty (IDTA) have shown at most 50% pain relief as an improved outcome with little focus on functional improvement in the treatment of discogenic pain. Previous studies have used a number of criteria for patient selection including low back pain unresponsive to conservative care, no compressive radiculopathy, positive provocative discography and absence of previous surgery at the same symptomatic level. The purpose of present study is to examine the hypothesis that additional inclusion criteria for patient selection such as disc height, absence of degenerative disc disease (DDD) in untreated discs, absence of herniated nucleus pulposus or lumbar canal stenosis may improve the outcome of treatment. METHODS: In this prospective case-series study additional criteria of patient selection were introduced, namely disc height of at least 50%, no lumbar canal stenosis, one or two levels of DDD, no evidence of nucleus pulposus herniation on magnetic resonance image. Thirty-four patients were enrolled in the study and 32 of them were followed over a period of 12 months. The visual analog scale (VAS) pain score and seven activities of daily living (ADLs) were followed and reported on a scale from 0 to 10. RESULTS: Sustained decrease of the VAS pain scores was observed from 3 to 12 months following IDTA. ADLs improved in all patients between 3 and 12 months post-treatment. Patients in the Bureau of Workers Compensation (BWC) group had a higher VAS score but showed the same level of improvement in ADLs as compared to commercial insurance or self-pay patients. In the non-BWC patient group an average VAS pain score decrease of more than 6 points on a 10-point scale was reported at 6 to 12 months following IDTA. CONCLUSIONS: We found dramatic improvement of pain scores and ADLs following IDTA when strict patient selection was applied. We believe that IDTA is an effective, minimally invasive treatment for discogenic pain in properly selected patients.


Pain Physician. 2006 Jul;9(3):237-48.
Treatment of intractable discogenic low back pain. A systematic review of spinal fusion and intradiscal electrothermal therapy (IDET).
Andersson GB, Mekhail NA, Block JE.

Department of Orthopedic Surgery, Rush University Medical Center, 1653 West Congress Parkway, Chicago, IL 60612, USA. [email protected]
Abstract
BACKGROUND: A growing number of patients suffer from severe low back pain of discogenic origin that is not responsive to conservative medical management. These patients must consider the option of surgical spinal fusion or minimally-invasive intradiscal electrothermal therapy (IDET). OBJECTIVE: To conduct a systematic review of clinical outcomes in patients undergoing spinal fusion or the intradiscal electrothermal therapy (IDET) procedure for intractable discogenic low back pain. DESIGN: Systematic literature review. METHODS: English-language journal articles published from January 1995 to December 2005 were identified through computerized searches of the PubMed database and bibliographies of identified articles and review papers. Articles were selected if disc degeneration or disruption was the primary indication for spinal fusion or the IDET procedure and if follow-up outcome data included evaluations of back pain severity, condition-specific functional impairment and/or health-related quality of life. The literature reviewed encompassed 33 spinal fusion articles: 10 randomized controlled trials, 1 nonrandomized controlled trial, 9 before-after trials, and 13 case series. There were 18 IDET articles: 2 randomized controlled trial, 2 nonrandomized controlled trials, 11 before- after trials, and 3 case series. Data were extracted and summarized on patient characteristics, surgical methods, and clinical outcomes. RESULTS: Overall, there were similar median percentage improvements realized after spinal fusion and the IDET procedure, respectively, for 2 of the 3 outcomes evaluated: pain severity (50%, 51%), back function (42%, 14%) and quality of life (46%, 43%). There was an identifiable randomized controlled trials trend of both treatments reporting a smaller magnitude of improvement in all 3 primary outcomes (pain severity, back function, quality of life) compared to other types of trials. Perioperative complications were commonly associated with spinal fusion (median: 14%, range: 2% to 54%, n = 31 study groups) whereas adverse events were rarely experienced with the IDET procedure (median: 0%, range: 0% to 16%, n = 14 studies). Randomized controlled trials of spinal fusion, in particular, had important methodological limitations. CONCLUSION: The majority of patients reported improvement in symptoms following both spinal fusion and the IDET procedure. The IDET procedure appears to offer sufficiently similar symptom amelioration to spinal fusion without the attendant complications.


Pain Physician. 2009 Jan-Feb;12(1):207-32.
Systematic review of the effectiveness of thermal annular procedures in treating discogenic low back pain.
Helm S, Hayek SM, Benyamin RM, Manchikanti L.

Pacific Coast Pain Management Center, Laguna Hills, CA, USA. [email protected]
Abstract
BACKGROUND: Chronic discogenic low back pain is a common problem with significant personal and societal costs. Thermal annular procedures (TAPs) have been developed in an effort to provide a minimally invasive treatment for this disorder. Multiple techniques utilized are intradiscal electrothermal therapy (IDET), radiofrequency annuloplasty, and intradiscal biacuplasty (IDB). However, these treatments continue to be controversial, coupled with a paucity of evidence. STUDY DESIGN: A systematic review of the literature evaluating the efficacy or effectiveness of TAPs. OBJECTIVE: To determine the effectiveness of TAPs in reducing low back pain in patients with intradiscal disorders. METHODS: A comprehensive evaluation of the literature relating to TAPs was performed. The literature was evaluated according to Cochrane Review criteria for randomized controlled trials (RCTs) and according to the Agency for Healthcare Research and Quality (AHRQ) criteria for observational studies. The level of evidence was classified as Level I, II, or III based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Pain relief was the primary outcome measure. Other outcome measures were functional improvement, improvement of psychological status, and return to work. Data sources included relevant literature of the English language identified through searches of PubMed, EMBASE, the Cochrane Library, and the Database of Reviews of Effectiveness (DARE). OUTCOME MEASURES: Short-term effectiveness was defined as one-year or less and long-term effectiveness was defined as greater than one-year. RESULTS: Systematic review of IDET identified 2 RCTs and 16 observational studies with an indicated evidence of Level II-2. Systematic review of radiofrequency annuloplasty identified no RCTs but 2 observational studies with an uncertain evidence of Level II-3. Systematic review of IDB identified one pilot study. The level of evidence is lacking with Level III. LIMITATIONS: The limitations of this review include paucity of the literature and lack of evidence with internal validity and generalizability. CONCLUSION: IDET offers functionally significant relief in approximately one-half of appropriately chosen chronic discogenic low back pain patients. There is minimal evidence supporting the use of radiofrequency annuloplasty and IDB.

 

[dc2md]

Ampaphb,
Do you have a database of research for all the procedures you do, or do you perform a pubmed search each time. I'm impressed.

 

[DOctorJay]

Ampaphb,
Do you have a database of research for all the procedures you do, or do you perform a pubmed search each time. I'm impressed.

he has a database but he should be using evernote...
www.evernote.com

 

[PMR 4 MSK]

he has a database but he should be using evernote...
www.evernote.com

He only uses pubmed to give you the exact pages of the articles within the journals. Otherwise, he knows most of the journal and article titles and has argued with most of the authors.

 

[ampaphb]

He only uses pubmed to give you the exact pages of the articles within the journals. Otherwise, he knows most of the journal and article titles and has argued with most of the authors.

Now hold on! I have never picked a fight with Drs. Dreyfuss or Derby (wait, I guess that does mean I have held spirited discussions with a number of the others)

 

[RUOkie]

In lieu of requoting ampabhb's post with those articles, I post here.

Those articles when read critically, would not prompt me to send a patient for IDET. There are other articles which do not support it's use. Here are 3.

Spine (Phila Pa 1976). 2007 May 1;32(10):1146-54.

Percutaneous thermocoagulation intradiscal techniques for discogenic low back
pain.

Urrútia G, Kovacs F, Nishishinya MB, Olabe J.

Centro Cochrane Iberoamericano, Servei d'Epidemiologia i Salut Pública, Hospital
de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain.
[email protected]

Comment in:
Spine (Phila Pa 1976). 2007 Dec 1;32(25):2927-8; author reply 2928-9.

STUDY DESIGN: Systematic review. OBJECTIVE: To systematically review the evidence
on the efficacy, effectiveness, and safety of percutaneous thermocoagulation
intradiscal techniques for discogenic low back pain. SUMMARY OF BACKGROUND DATA:
The intervertebral disc is thought to be the source of pain in a relevant
proportion of cases of low back pain (LBP). Two percutaneous thermocoagulation
intradiscal techniques have been described to treat discogenic LBP: percutaneous
intradiscal radiofrequency thermocoagulation (PIRFT) and intradiscal
electrothermal therapy (IDET). METHODS: An electronic search was performed in
MEDLINE, EMBASE, and the Cochrane Library databases up to 2005, to identify
nonrandomized controlled trials and randomized controlled trials (RCTs) on those
techniques. All relevant studies were methodologically assessed independently by
3 reviewers. RCTs were assessed following the criteria recommended by the
Cochrane Back Review Group. A qualitative synthesis of results was performed.
RESULTS: Six studies were included with a total of 283 patients. Two open,
nonrandomized trials (95 patients) showed positive results for IDET compared with
rehabilitation and PIRFT. Results from 2 RCTs showed no differences between PIRFT
and placebo, and between different PIRFT techniques. Two RCTs compared IDET with
placebo. One suggested differences only in pain and in disability, while the best
quality RCT showed no differences. CONCLUSIONS: The available evidence does not
support the efficacy or effectiveness of percutaneous thermocoagulation
intradiscal techniques for the treatment of discogenic low back pain.
PMID: 17471101 [PubMed - indexed for MEDLINE]

2. Eur Spine J. 2006 Aug;15 Suppl 3:S448-57. Epub 2006 Jul 26.
IDET: a critical appraisal of the evidence.
Freeman BJ.Centre for Spinal Studies and Surgery, Queen's Medical Centre, UniversityHospital, Nottingham, UK. [email protected]

Smith and Nephew (Endoscopy division, Andover, MA, USA) have estimated that60,000 Intra-Discal Electrothermal Therapy (IDET) procedures have been performed world wide up to June 2005. Despite the large number of procedures performed, acritical appraisal of the evidence of efficacy of IDET has not appeared in theliterature. This paper reviews the current evidence of clinical efficacy for IDETobtained via a systematic review of the literature. Studies were included if theyused at least one of four specified primary outcome measures; pain intensity asassessed by a visual analogue score (VAS), global measurement of overallimprovement, back specific functional status such as Oswestry disability Index(ODI) and return to work. Levels of evidence were assigned according to thehierarchy described by the Oxford Centre for Evidence-Based Medicine(www.cebm.net). Papers addressing possible mechanisms of action of IDET were not considered as the focus of the literature review was clinical effectiveness.Eleven prospective cohort studies (level II evidence) were reported on a total of256 patients with a mean follow-up of 17.1 months (range 12-28 months). The mean improvement in the VAS for back pain was 3.4 points (range 1.4-6.5) and the mean improvement in ODI was 5.2 points (range 4.0-6.4). A total of 379 patients werereported in five retrospective studies (level III evidence). Between 13 and 23%of patients subsequently underwent surgery for low back pain within the studyperiod. Two randomised controlled trials of IDET have been reported in theliterature. The first randomised 64 patients (37 to IDET, 27 to Sham). Theadvantage for IDET patients amounted to 1.3 points on the VAS and seven points onthe ODI. The second study randomised 57 subjects (38 to IDET, 19 to Sham) andshowed no benefit from IDET over placebo. The evidence for efficacy of IDETremains weak and has not passed the standard of scientific proof.PMCID: PMC2335390PMID: 16868786 [PubMed - indexed for MEDLINE]

3. Spine (Phila Pa 1976). 2005 Nov 1;30(21):2369-77; discussion 2378.A randomized, double-blind, controlled trial: intradiscal electrothermal therapy versus placebo for the treatment of chronic discogenic low back pain.
Freeman BJ, Fraser RD, Cain CM, Hall DJ, Chapple DC.Department of Orthopaedics and Trauma, Royal Adelaide Hospital, Adelaide, SouthAustralia. [email protected]ent in: Spine (Phila Pa 1976). 2006 May 20;31(12):1402; author reply 1402-3. Spine (Phila Pa 1976). 2006 Jun 15;31(14):1636; author reply 1636-7. Spine (Phila Pa 1976). 2006 Jun 15;31(14):1637-8; author reply 1638.

STUDY DESIGN: A prospective, randomized, double-blind, placebo-controlled trialof intradiscal electrothermal therapy (IDET) for the treatment of chronicdiscogenic low back pain (CDLBP). OBJECTIVES: To test the safety and efficacy of IDET compared with a sham treatment (placebo). SUMMARY OF BACKGROUND DATA: InNorth America alone, more than 40,000 intradiscal catheters have been used totreat CDLBP. The evidence for efficacy of IDET is weak coming from retrospective and prospective cohort studies providing only Class II and Class III evidence.There is one study published with Class I evidence. This demonstratesstatistically significant improvements following IDET; however, the clinicalsignificance of these improvements is questionable. METHODS: Patients with CDLBP who failed to improve following conservative therapy were considered for thisstudy. Inclusion criteria included the presence of one- or two-level symptomatic disc degeneration with posterior or posterolateral anular tears as determined by provocative computed tomography (CT) discography. Patients were excluded if therewas greater than 50% loss of disc height or previous spinal surgery. Fifty-seven patients were randomized with a 2:1 ratio: 38 to IDET and 19 to sham procedure(placebo). In all cases, the IDET catheter was positioned to cover at least 75%of the annular tear as defined by the CT discography. An independent technicianconnected the catheter to the generator and then either delivered electrothermal energy (active group) or did not (sham group). Surgeon, patient, and independent outcome assessor were all blinded to the treatment. All patients followed astandard postprocedural rehabilitation program. Independent statistical analysis was performed. OUTCOME MEASURES: Low Back Outcome Score (LBOS), OswestryDisability Index (ODI), Short Form 36 questionnaire (SF-36), Zung DepressionIndex (ZDI), and Modified Somatic Perceptions Questionnaire (MSPQ) were measured at baseline and 6 months. Successful outcome was defined as: no neurologicdeficit, improvement in LBOS of greater then 7 points, and improvement in SF-36subsets (physical function and bodily pain) of greater than 1 standard deviation.RESULTS: Baseline demographic data, initial LBOS, ODI, SF-36, ZDI, and MSPQ were similar for both groups. No neurologic deficits occurred. No subject in eitherarm showed improvement of greater than 7 points in LBOS or greater than 1standard deviation in the specified domains of the SF-36. Mean ODI was 41.42 atbaseline and 39.77 at 6 months for the IDET group, compared with 40.74 atbaseline and 41.58 at 6 months for the placebo group. There was no significantchange in ZDI or MSPQ scores for either group. CONCLUSIONS: The IDET procedureappeared safe with no permanent complications. No subject in either arm metcriteria for successful outcome. Further detailed analyses showed no significant change in outcome measures in either group at 6 months. This study demonstratesno significant benefit from IDET over placebo.PMID: 16261111 [PubMed - indexed for MEDLINE]

 

[ampaphb]

The first article you cited (Urrútia) reviews Pauza and Freemen.

The second study you cited again reviews Pauza and Freeman, and is authored by Freeman.

The third study you cited is the Freeman study.

The Freeman study is notorious for reporting no placebo effect, and no effect in the treatment group. Dr. Bogduk refers to this phenomenon as the "nocebo" effect.

Typically, using invasive procedures, 35% of the sham or placebo arm participants respond favorably. Dr. Bogduk infers that Dr. Freeman and his colleagues biased his subjects to believe the treatment was unlikely to be effective. As a result, no one got any relief.


The three studies you cite are based on one largely discredited study.

 

[spinemd]

I do not know much about the billing practices.
In response to IDET: The few cases of IDET that we have performed have been granted by workman's compensation after all the outcome studies have been reviewed. Our most recent case was granted when a judge favored IDET because "MMI was not reached with (our) patient" and he believed that something more could be done. I mentioned IDET on my previous emails not as reason to perform them or because we heavily support it, but moreso to display the variety of procedures done here. From a fellow's standpoint it is one thing to read about IDET, yet quite different to do one.

When you do prf of a peripheral nerve, what do you bill it as?

 

[SportsMed09]

Sorry to disrupt the flow of this recent discussion, but just wondering, are there any new accredited fellowships coming around the bend in the next few months?

 

[mad city]

I was asked to sticky this list

Some traditionally anesthesia run pain fellowships that have taken PM&R in the past:
Oregon
UPenn
Jefferson
Penn State
Beth Israel in NYC
Harvard - both Mass General and Brigham
MD Anderson
UTSW
UC Irvine
Loma Linda
Stanford
Michigan State
Loyola
Univ. of Chicago
I think UCSD??
Cook County
Robert Wood Johnson
Hopkins
Cleveland Clinic
Univ of Pittsburgh
UVA
Univ of Washington
St. Vincents in NYC
Univ of Iowa


Anti PM&R pain fellowships:
Rush


PM&R based or strong PM&R presence ACGME accredited pain fellowships:
UCLA
U Colorado
Spaulding
U Mich
Northwestern
MCV
NRH/Georgetown (accredited??) - (a couple years ago got bad reputation for knowing they were going to take an internal candidate but interviewing external candidates anyway)
LSU
Temple (??) - Falco
Furman - possible new affiliation with a NY program
UCDavis

not accredited but popular(both spine and pain) - pretty much most of the PASSOR board members have good fellowships
Slipman (high volume, high workload, kind of scutty from what I could see - lots of internal politics - would definitely NOT apply to both this and the UPenn anesthesia fellowship)
RIC - has sports and spine fellowship (up to 2 spots) and ACGME accredited pain fellowship
Heidi Prather at St Louis
University of Wisconsin musculoskeletal, spine and pain fellowship: excellent broad based clinical and interventional experience
Sports/spine at UWash (??interventional opportunities)
Geraci in Buffalo
sports/spine fellowship at U Colorado
First PM&R based ACGME accredited sports medicine fellowship - UC Davis
good sports fellowship - Stanford
Kessler has a good sports fellowship
Jay Smith at Mayo
Bagnall also in Buffalo
Windsor in Atlanta (pm ampaphb or steve lobel for more info)
I think Goodman in Alabama lost his accreditation??(anyone care to confirm?)
Utah - good sports program
MCW - sports/spine fellowship with Hoch(sp)
Cleveland Clinic Spine fellowship
Florida Spine - Clearwater
Fort Wayne Indiana (Dr Fortin), not accredited, but top notch with excellent training in lumbar, thoracic and cervical spine injections and peripheral joint/ nerve ultrasound guided injections , interpreting imaging (fluoroscopic, CT, MRI) with solid understanding of anatomy and pathology, EMG.

**many of the more sports oriented fellowships will probably get ACGME accreditation in Sports Medicine





Feel free to keep adding.

In addition, there is a sticky for pain fellowship reviews that dates back several years - it covers both PM&R based and anesthesia based fellowships. http://forums.studentdoctor.net/showthread.php?t=144647

I recommend Dr Fortin's fellowship in Fort Wayne, Indiana. Excellent mentor, great experience, well balanced. Fellows gain good understanding of anatomy and pathology on imaging studies ( Fluoro, CT, MRI), one of the few PMR fellowships training in cervical and thoracic procedures, and ultrasound guided injections.

 

[dingrid]

I am a current fellow in York with Dr Furman-if oyu want any imformation let me know

Hi db36jp78,

just wondering if you could provide any current information on the status of the Furman (York, Pa) fellowship?
1. approx. % spine to % sports
2. EMG's? daily??, weekly, monthly??
3. Interventional spine? types and how often??
4. How many fellows do they take per year?

I appreciate your time and help in advance.

 

[vikingsfan]

Anyone have any recent (past 2 years) first hand experience with the following sports and spine fellowship programs?

HSS
University of Washington
UC Davis (I believe it's just sports)

Specifically
1) How is fellowship split up into rotations?
2) Quality of teaching/mentorship from staff?
3) What type of jobs are graduates getting?

Understand if you want to keep responses private by IM.

Thanks

 

[PMR2008]

I am applying to Sports and Spine fellowships this year. I am certain that I want to do a comprehensive fellowship that trains me to perform all kinds of advanced procedures, exposes me to ultrasound, PRP, prolo and I get to do EMGs. I see myself working with a Physiatry group or starting my own practice so learning the business aspect of outpatient PM&R is imperative. I have just started researching and some of the places that would fulfill my requirement are
Fortin in Ft. Wayne, Larry Frank in Chicago, Chou in Phily and Wolff in Phoenix.

Does anyone know of any other places that would be a good match based on my criteria?

 

[clarence]

PM&R based or strong PM&R presence ACGME accredited pain fellowships:
UCLA
U Colorado
Spaulding
U Mich
Northwestern
MCV
NRH/Georgetown (accredited??) - (a couple years ago got bad reputation for knowing they were going to take an internal candidate but interviewing external candidates anyway)
LSU
Temple (??) - Falco
Furman - possible new affiliation with a NY program
UCDavis

[/url]

I'm a pgyIII and am going to be applying to PM&R based Spine/pain fellowships this year. I was wondering how up-to-date this list is (initially posted in '08).
I looked at the ACGME site and pain is not listed as a subspecialty for PM&R only anesthesia. http://www.acgme.org/adspublic/default.asp
How do I find out which PM&R based fellowships are ACGME accredited for pain?

Thanks!

 

[lossnwilderness]

They are listed under anesthesia regardless if they are PM&R or anesthesia. You have to click on view details and it will tell you who is the sponsoring department. So, I am not certain if the list above for accredited fellowships is correct based on what the ACGME currently lists as accredited programs. Also, two programs are newly accredited for 7/2011 (Einstein and EVMS). You can find this on the ACGME website as well.

 

[DOctorJay]

Any word on the Mayo (Rochester and Phoenix) pain programs?

Mayo
Rochester typically takes 1 PM&R for the fellowship each year, took 2 for 2012-2013

Jacksonville takes 1 fellow each year (*may expand to 2), last 2 fellows have been PM&R, next one is Anes

Scottsdale takes 1 fellow each year, current fellow is PM&R, haven't heard who they took for next year

 

[cbest]

Hoping to get any updates on any pain/MSK/sports fellowships previously discussed, especially the ACGME accredited programs.

Has anyone heard anything about Dr Bodor's fellowship on Napa?

Any fellowships gaining ACGME accreditation in the near future?

Thanks!

 

[DrMattOglesby]

While I think you are looking more for ACGME accreditation status/timelines, I felt obliged to comment anyway as I am from Napa and a former gym member of the facility in which Dr. Bodor serves as the medical director. Some of the features I noticed during my time at Synergy were a large room staffed by PTs around the clock, a warm water pool for aquatherapy sessions (w/ Lifeguard), and a separate cardio rehab unit supervised by PTs. It was really inspiring for me to workout there as a premed as I kept thinking how great it would be to work as a physician in a place like that.

 

[cbest]

Bump

 

[kstarm]

a

 

[Prof Moriarty]

Southwest Spine & Sports (Wolf): Busy spine/MSK/interventional pain type private practice with several clinic sites around the Phoenix metro area, home base in Scottsdale. There are a few attendings (former fellows) but main guy/PD is Michael Wolf. He’s doing some regenerative med stuff as well, including PRP and stem cells, though fellows don’t seem to participate in that as much. Otherwise high volume of fluoro procedures in their own ASC/procedure suites. Also exposure to MSK US. 2 fellows per year. PD seems to genuinely enjoy teaching. Local med students rotate through. I think it is one of the better S&S progs and training is probably good. My interview seemed a bit disjointed and didn’t leave me with a great feeling about the fit for me personally. Also it was 108 degrees. Great Mexican food though. I don’t know much about the other fellowships in the area (there seem to be a bunch) but I think this is the premier one if you want to be in Phoenix.

 

[Prof Moriarty]

OSS [Orthopaedic & Spine Specialists, York, PA (Furman)]: First place I interviewed and it set kind of a high bar. 2-day interview. Interview really consists of spending time in clinic/procedure suite with 2-3 of the attendings and the fellows and seeing a couple of “days in the life.” You have to give a short presentation one of the days. 5 fellows currently, switching to 6 next year. Three start in July and three start in January, so there’s always a senior group of fellows to help guide the next group. PD is Mike Furman, lead author of Atlas of Image Guided Spinal Procedures (great book, highly recommended for anyone doing interventional spine/pain).

Outpatient-based, interventional spine and sports, private practice, multidisciplinary group type set up in stand-alone ortho hospital/clinic w/ most subspecialties represented. Really smoothly run place. Excellent procedure exposure, incuding fluoro and recently more MSK US as well. Used to be pain accredited, but lost that when acgme started requiring inpatient pain service/palliative care/etc. Then was sports accredited but losing that supposedly because they are not affiliated strongly enough with Sinai Baltimore PM&R prog (hour away ~Baltimore). Nevertheless strong program with happy fellows who appear to do very well professionally. Seems to be a tight-knit group who stays in touch long after they move on to their post-fellowship careers.

In addition to interventional spine clinic/procedures, there is gen MSK/sports, concussion clinic, EMG’s, MSK US, time with ortho surg (various subspecialists), radiology, ortho urgent care, and local HS and college sideline sports med coverage as well as some other event coverage, plus new away rotation to place that does more MSK US and regenerative med.

This was my first interview and remained one of my top places throughout the interview season, matched for me only by the UCLA/VA pain program. Admittedly this review may be slightly biased by the fact that I got an offer here mid-Sept and accepted (pulling out of the pain match before the ROL was due). At the end of the day, my decision was based on personal fit in terms of the content, learning environment, collegiality, happiness of the fellows, mentorship from nationally known leader in the field, and professional development/opportunity. YMMV.

 

[axm397]

2015-16 Fellowship Opportunity @ Wake Forest Baptist Health, Winston-Salem, NC

We offer a one year fellowship in neurorehabilitation, the clinical science of guiding and sustaining the rehabilitation of patients with neurological and musculoskeletal injuries or diseases. Fellows participate in the care of inpatients and outpatients with stroke, traumatic brain injury, spinal cord injury, and neuromuscular disorders. Our training program includes regularly scheduled didactic conferences and monthly journal club provided by our PM&R attending physicians and outside speakers from other specialties and disciplines. The fellows will have opportunities to spend elective time in either interventional pain management, pediatric neurorehabilitation or musculoskeletal medicine. Inpatients are treated in a state-of-the-art rehabilitation hospital and consults in the Wake Forest Baptist Medical Center. Outpatient opportunities include spasticity management with botulinum toxin injection or intrathecal baclofen pumps, an interventional pain management clinic, cancer rehabilitation, musculoskeletal medicine, MS and other neurological conditions, a brain injury clinic, and a fellows follow up clinic of patients treated on the inpatient rehabilitation unit.

Prerequisite:
Each applicant is required to have completed a neurology or physical medicine and rehabilitation residency program accredited in the United States or Canada. Applicants must qualify for licensure by the North Carolina Board of Medical Examiners and must be Board Eligible in their relative specialty.

Foreign medical graduates are considered and must have passed the E.C.F.M.G. and U.S.M.L.E. exams.

How to Apply:
Please submit the Neurorehabilitation Fellowship application, your letter of interest, curriculum vitae, and three letters of recommendation (one letter must be from the director of your core residency program) to Dr. H. Michael Guo, Assistant Professor, Director, Neurorehabilitation Fellowship, Wake Forest Baptist Medical Center, Department of Physical Medicine & Rehabilitation, Medical Center Blvd., Winston-Salem, NC 27157-1078; Tel. (336) 716-1442; Fax (336) 716-1595.

 

[axm397]

The New England Baptist Hospital Spine Physiatry Fellowship

Contact: John C. Keel, M.D. at [email protected]

The NEBH Spine Center in Boston, MA, offers a one-year fellowship training program geared towards the development of outstanding clinical skills in evaluation, treatment and management of a broad variety of spinal disorders as well as other general musculoskeletal conditions. Clinical skills in the outpatient evaluation and examination of spinal pain through sound physical examination techniques and radiographic assessment are emphasized. The fellow will become proficient in reading his/her own imaging. The fellow will have solely performed about 1,000 interventional procedures by the end of the fellowship year. Exposure to interventional spine procedures is thorough, and includes all spine levels. Fellows attain proficiency in cervical, thoracic and lumbar procedures, including interlaminar epidurals, transforaminals, medial branch blocks, rhizotomies, discograms, kyphoplasties, facet and sacroiliac joint injections, and peripheral joint/MSK injections.

Fellows are expected to be actively involved in a research and education project(s) and publication for successful completion. Approximately 50% of the fellow's time is spent in the outpatient clinic, 40% procedures/spinal injections and 10% EMG clinic and research.

Fellowship year is from Aug 1, 2014 - July 31, 2015.

If you are interested contact John C. Keel, M.D. at [email protected] or visit www.nebh.org for more information.

 

[goosequacks]

I'm no expert in Sports but I think applications are due soon and I wanted to give anyone who's interested in MSK/Sports about a new journal just launched by a bunch of bigwigs in PM&R... It's a review journal so submissions are relatively simple to do. Worth a shot I think. Here's the link for any of you who might be interested: http://www.sportsreviewjournal.com

 

[drconsul]

The New England Baptist Hospital Spine Physiatry Fellowship


Contact: John C. Keel, M.D. at [email protected]


The NEBH Spine Center in Boston, MA, offers a one-year fellowship training program geared towards the development of outstanding clinical skills in evaluation and management of a broad variety of spinal disorders as well as other general musculoskeletal conditions. Clinical skills in the outpatient evaluation and examination of spinal pain through sound physical examination techniques and radiographic assessment are emphasized. The fellow will become proficient in reading his/her own imaging. The fellow will have solely performed about 1,000 interventional procedures by the end of the fellowship year. Exposure to interventional spine procedures is thorough, and includes all spine levels. Fellows attain proficiency in cervical, thoracic and lumbar procedures, including interlaminar epidural, transforaminal injection, medial branch block, rhizotomy, cryoablation, kyphoplasty, facet and sacroiliac joint injection, and peripheral joint/MSK injection. Fellows will understand the natural history of painful spine disorders.


Fellows are expected to be actively involved in a research and education project(s) and publication for successful completion. Approximately 50% of the fellow's time is spent in the outpatient clinic, 40% procedures/spinal injections and 10% EMG clinic and research.

Fellowship year is from Aug 1, 2016 - July 31, 2017.


If you are interested contact John C. Keel, M.D. at [email protected] or visit www.nebh.org for more information.

 

[Spartyon]

Bumped the list to see if there are any fellowships that are inactive or if anybody knows of new fellowships to add

Some traditionally anesthesia run pain fellowships that have taken PM&R in the past:
Oregon
UPenn
Jefferson
Penn State
Beth Israel in NYC
Harvard - both Mass General and Brigham
MD Anderson
UTSW
UC Irvine
Loma Linda
Stanford (swallowed up the former PM&R fellowship)
Michigan State
Loyola
Univ. of Chicago
I think UCSD??
Cook County
Robert Wood Johnson
Hopkins
Cleveland Clinic
Univ of Pittsburgh
UVA (took 2 PM&R this year, both internal candidates, but in the recent past there have been bad feelings between the two departments)
Univ of Washington
St. Vincents in NYC
Univ of Iowa
UCDavis (not a PM&R based program)

Anti PM&R pain fellowships:
Rush


PM&R based or strong PM&R presence ACGME accredited pain fellowships:
UCLA
U Colorado
Spaulding
U Mich (PM&R and Anesthesia do NOT get along, from what I have been told)
Northwestern
MCV
NRH/Georgetown (accredited??) - (a couple years ago got bad reputation for knowing they were going to take an internal candidate but interviewing external candidates anyway)
LSU (headed by a neurologist, taught by anesthesia, only PM&R presence is administrative)
Temple (??) - Falco
Furman - possible new affiliation with a NY program


not accredited but popular(both spine and pain) - pretty much most of the PASSOR board members have good fellowships
Slipman (high volume, high workload, kind of scutty from what I could see - lots of internal politics - would definitely NOT apply to both this and the UPenn anesthesia fellowship - trained head of fellowships at MCV (DePalma), RIC (Plastaras), U of Rochester (Patel) and recent residency PD @ LIJ (Lipetz)
RIC - has sports and spine fellowship (up to 2 spots, highly regarded but NOT accredited) and ACGME accredited pain fellowship
Heidi Prather at St Louis
Sports/spine at UWash (??interventional opportunities)
Geraci in Buffalo
sports/spine fellowship at U Colorado
First PM&R based ACGME accredited sports medicine fellowship - UC Davis
good sports fellowship - Stanford
Kessler has a good sports fellowship (is it still good even after Dr. Malanga left?)
Jay Smith at Mayo
Bagnall also in Buffalo
Windsor in Atlanta (pm ampaphb or steve lobel for more info)
I think Goodman in Alabama lost his accreditation??(anyone care to confirm?) (Confirmed)
Utah - good sports program
MCW - sports/spine fellowship with Hoch(sp)
Cleveland Clinic Spine fellowship (Multi-diciplinary - pm M3)
Florida Spine Institute - Clearwater (senior injectionist Robert Gruber left about a year ago, as did senior spine surgeon)
Hospital for Special Surgery (Greg Lutz)
BI New York (6 mo spine c Stuart Kahn, 6 mo sports c Robert Gotlin)

 

[sdvb469]

Bumped the list to see if there are any fellowships that are inactive or if anybody knows of new fellowships to add

Anyone know of any sports and spine fellowships which provide a good mixture of sports exposure as well as interventional?? Most sports and spine programs that are non ACGME are heavy spine and minimal to no sports exposure such as concussion management. Any guidance would be greatly appreciated.

 

[RM38]

OSS/Furman would probably be your best choice. They used to be sports accredited and have a lot of opportunities for game and ortho urgent care coverage. Still has a heavy spine component, but more actual sports compared to most other places.

 

[RooAgg10]

This year some of the non-ACGME sports & spine fellowships are forming a NASS Interventional Spine Fellowship Consortium. From what I've been told on my fellowship trail, the eventual goal is to have a shared curriculum that sets a minimal standard for the fellows. One aspect of the consortium is to collaborate among the programs with some sort of online lecture series. I think these are some exciting plans for the future! As an upcoming fellow, I'm looking forward to see what happens!

The programs will also be participating in their own match-like process called the "common offer date". I've copied and pasted the details from OSS's website.

------------------------------------------------------------------------------------------

You are receiving this letter because you have applied to one or more of the Interventional Spine and Musculoskeletal Medicine fellowship programs listed on the accompanying page.

These programs have agreed to a Common Offer Date for the 2016 interview cycle of Saturday September 17, 2016. This letter is intended to provide you with information on the Common Offer Date (COD). You will receive this letter from each program you have applied to and this serves as confirmation of the program’s participation in the process. Note that this is not an automated match; however, the goal is to improve the offer process for the applicant and the programs to ensure the best possible fit for both.

The Common Offer Date process is as follows:
1. The programs have agreed that no formal offers will be given prior to the COD.
2. The applicant may inquire about their status with the programs prior to the COD only. The individual programs may decide the degree to which they will offer feedback to an applicant.
3. On the COD, applicants should refrain from making status inquiries to keep phone lines open during the offer process.
4. The applicant should have a “rank list” of these programs ready prior to the COD. Carefully consider each program with friends and family prior to the COD. There will be a very limited window for this on the COD.
5. The applicant should confirm accurate personal email address(es) and phone number(s) with each program prior to the COD to ensure prompt communication.
6. At 10AM Eastern (7AM Pacific) each program will make their first round of offers to applicants via telephone and/or email. The number of offer calls will be equal to the number of available positions. An applicant that receives an offer will have up to 1 hour to respond either accepting or declining the offer.
7. If an applicant declines an offer, or fails to respond in a timely manner, the program will extend an offer to the next applicant on their list.
8. After accepting an offer verbally, the program will notify the applicant in writing
9. Acceptance of an offer from a program implies that the applicant will withdrawal applications from other programs or any future matches including the Pain and Sports Medicine matches.

Participating programs for 2016:
Alabama Orthopedic, Spine, & Sports Medicine Associates Interventional Fellowship (4-5 positions) Birmingham, AL
Program Director: Brad Goodman, M.D.; Program Director and Coordinator: Sri Mallempati, M.D. Assistant Director: Charles Totoro Carnel, M.D.

Cleveland Clinic Spine Medicine Fellowship (4 Positions) Cleveland, Ohio
Program Director: Russell DeMicco, DO; Asst. Directors: Adrian Zachary, DO, MPH and Santhosh Thomas, DO, MBA

Desert Spine & Sports Physicians (1-2 positions) Phoenix, Arizona
Program Director: Susan Sorosky, M.D. Assistant Director: Brad Sorosky, M.D.

Hospital for Special Surgery (3 Positions) New York, NY
Program Director: Peter J. Moley, MD Asst. Director: James Wyss, MD

NERA Spine, Sports & Pain Medicine (1 position) Bethlehem, PA
Program Director: Scott Naftulin, DO

OSS Health Interventional Spine & Sports Medicine Fellowship (6 positions; 3 July, 3 January) York, PA
Program Director: Michael Furman, M.D.

University of Pennsylvania Spine, Sports, & Musculoskeletal Medicine Fellowship (3 positions) Philadelphia, PA
Program Director: Christopher T. Plastaras, MD

Rothman Institute (1 position) Philadelphia, PA
Program Director/Coordinator: Jeffrey Gehret, DO

The Spine and Sports Center (1 position) Interventional Spine and Sports Fellowship Houston, TX
Program Director: Benoy Benny, M.D.

EvergreenHealth Sport & Spine Care (1 position) Kirkland, WA
Fellowship Director: Alison Stout D.O.

 

[hoddemic]

Hey guys,

Looking for any advice. I'm looking into non-accredited MSK/Sports/Spine programs, but for family reasons I am significantly geographically limited and only looking at UPenn, Rothman, and University of Michigan. Does anyone have any particular input on any of these programs to help compare / contrast? Thanks!

 

[oreosandsake]

Utah Center for Pain Management & Research – Nexus Pain Specialists

Fellowship Program type: Pain, Spine, Musculoskeletal, One Year.



IMMEDIATE OPENING AVAILABLE FOR POSITION STARTING JULY 1

Dr. Rosenthal and the Nexus Pain Specialists have a track record of training over 20 fellows



Nexus Pain Specialists is a comprehensive multidisciplinary musculoskeletal practice with an emphasis on minimally invasive spinal procedures and regenerative medicine for the treatment of chronic pain. Our team is made up of Physical Medicine and Rehab physicians, as well as a pain Anesthesiologist. Research and education are integral to our treatment approach. In our busy practice setting you will experience all major spinal injections using both fluoroscopy and ultrasound guidance during your two procedure days (one day of training and one day of independent procedures); on average you will perform 700-1,000 procedures during your 12-month training. Our curriculum includes: correct diagnosis, fluoroscopic guided injections (including radiofrequency lesioning of both medial branches and the DRG, SCS, IT opiates, and RF procedures, Spinal Cord Stimulator trials, participation in regular multidisciplinary rounds, journal clubs, research publications are required, and skills needed to run a successful private practice. The clinic medical director, Dr. Richard Rosenthal, is a master instructor for the Spinal Injection Society (SIS) and teaches several in interventional pain management each year. In addition, Dr Rosenthal teaches physicians techniques in regenerative medicine.

Dr. Rosenthal has published multiple prominent book chapters including the widely read chapter on RF lesioning in Waldman’s Pain Management. He is also the editor of the interventional pain section of the journal Practical Pain Management


For more information about the Fellowship, Dr. Richard Rosenthal, or the Fellowship Curriculum feel free to visit our website, www.nexuspainspecialists.com or contact us at 801-356-6100.


For more information about Utah visit www.utah.travel

 

[bear2020]

Any updates of good spine and sports programs this year? Would be good to hear some persepctive.

 

[bear2020]

For anyone interested there is a list of NASS recognized spine and musculoskeletal fellowships (ISMM) now up in the fellowship directory of the NASS website. Looks like they might use the San Francisco match for future applicants. This would be a good place to look for any residents who are looking to go the spine route but don't know where to start or what programs are legitimate.

 

[blastoff]

Also wanted to know about tnt top interventional spine programs. Are nass programs the top?