The focus of the fellowship is the training for interventional pain management of the adult patient. Being multidisciplinary, fellows rotate through other departments to round out their knowledge of chronic pain rehabilitation, palliative care for terminal illness, neurology, neuroradiology, and psychiatry and addiction.
Focused Training
Elemental to interventional training is our focus on performing fluoroscopically directed interventional blocks in our campus same day surgery center and the VA pain suite. Here we do many interventions such as epidural steroid injections, facet joint injections, medial branch blocks, radiofrequency nerve ablations, SI joint injections, Kyphoplasty, MILD, muscle and joint injection ( often under ultrasound), vertebral augmentation, intradiscal techniques, spinal cord stimulators, and neuroaxial opioid trials and long-term spinal pump management.
Clinic exposure will focus on understanding the pathology, clinical presentation, and management of a vast array of painful conditions, as well as essential follow-up management, suture and wound checks, pump refills, and stimulator programing.
As pain is often initially separated into spinal vs non-spinal pain, and entire month of neuroradiology will provide the fellow with excellent analytical skills in assessing spinal film, CT scans, and MRIs - all key to successfully interacting with neurosurgeons and performing advanced interventions.
Work Schedule
In addition to the eight full months devoted to interventional pain in the clinics and procedural suites, rotations though PM&R, Psychiatry and Addiction, Neurology, and Radiation Oncology/Palliative Care will broaden the fellow’s understanding of functional restoration, psychiatric and substance abuse intervention, EMG analysis, headache management, and care of the terminally ill patient.
Though not required, it is hoped that each fellow will pair up with a faculty mentor to engage in clinical research. Opportunities for basic science research also exist.
Fellows will have clinical responsibilities on weekdays, and be available for some phone consultation after hours.
Didactic Schedule
Our weekly didactic schedule will focus on interventional procedures, the neurophysiology of pain, appropriate opioid management, and specific pain syndromes such as myofascial pain, facial pain, neuropathic pain, headache, and cancer pain. All discussions will be focused on clinical assessment and diagnosis, performing interventional procedures, and passing the pain boards.
The main textbooks used are Essentials of Pain Medicine (4th edition) by Benzon, Raja, Liu, Fishman, Cohen and Atlas of Image Guided Intervention in Regional Anesthesia and Pain Medicine (2nd edition) by Rathmell.
Additionally, the Pain Pass Machine (The Pain Board Review) will be purchased for each fellow as specifically passing one’s boards is an essential goal of our program.
Salary and Benefits
Salary and benefits, including health insurance, vacation and meeting days, are commensurate with the PGY-5 resident level at IU School of Medicine with an additional stipend for the mandatory research component. Find details about employment terms and benefits through the Office of Graduate Medical Education.
Application Information
Currently we are accepting those who successfully completed an anesthesia or PMR residency program. All interested individuals are encouraged to submit a completed fellowship application, completion certificate of residency, USMLE scores, three letters of recommendation to our Fellowship Program Coordinator, Serena Mahoney, at 317-274-4343 or semmitch@iu.edu.
