Pain Medicine Fellowship

 
 
Clinical Experience
 

A fellow’s clinical experience is divided among clinics, procedure rooms, and specialty clinics. Fellows spend two-and-a-half days per week evaluating patients in clinic and two days per week in the procedure room at the Madison Surgery Center, where thousands of spinal interventional pain procedures are performed each year.

Procedures

Pain fellows gain experience in various spinal and peripheral nerve block techniques employed in workup and management of acute, chronic, benign, and cancer pain.

Under the direct supervision of an attending faculty member, fellows learn to perform all types of lumbar injection procedures in the first six months and cervical injection procedures in the second six months. Fellows become proficient in image guided (fluoroscopy and ultrasound) common interventional pain management procedures in cervical and lumbar spine, joints/ soft tissues/peripheral nerves, radiofrequency ablations, sympathetic blocks, visceral plexus blocks. They develop clinical, procedural and surgical skills for advanced procedures such as spinal cord stimulation, peripheral nerve stimulation and pump implants.

Specialty Clinics

Fellows spend up to one full day per week in the Spine Clinic, Pain Management Clinic, Headache Clinic, and/or Cancer Pain Clinic to gain competence in assessment, workup, and management of patients with various types of pain states. They become familiar with basic neuroimaging studies including CT and MRI of the spine and brain, psychological testing, and electrophysiologic tests including quantitative sensory tests.

More than 10,000 patients visit the Spine Clinic each year. The Spine Clinic rotation helps fellows gain competence in musculoskeletal system examination techniques, diagnosis and management of musculoskeletal injuries and pain states, evaluation and treatment of injured workers and athletes, and impairment rating.

The Chronic Pain and Headache Clinic serves approximately 10,000 patients per year. Fellows are trained in neurological assessment techniques, diagnosis and treatment of neuropathic pain, visceral and pelvic pain, use of opioid and non-opioid analgesics, multimodal therapy, managing and troubleshooting patients with implantable drug delivery systems, and adjusting intrathecal analgesics. Fellows gain experience in evaluation and treatment of primary and secondary headache disorders. Fellows also spend one week with psychology faculty to:

  • Understand the principles of psychological testing and treatments
  • Develop effective interview and communication techniques
  • Learn team training and conflict resolution skills
  • Identify and manage pain patients with psychological co-morbidities

Inpatient Rotations

Each fellow completes five weeks of inpatient rotations in two-week blocks on:

  • Acute pain service
  • Inpatient pain consult service
  • Palliative care service
  • Addiction Medicine
  • Psychology
  • Radiology

Inpatient rotations are at American Family Children’s Hospital, University Hospital, and UW Health at The American Center. On inpatient services, fellows gain experience treating both pediatric and adult patients. Acute pain service rotation provides experience in acute postoperative pain, epidural and regional analgesia, and anesthesiology techniques.

Fellow’s schedules rotate on a two-week basis. See sample schedule below.

Week One

MondayTuesdayWednesdayThursdayFriday
AMHeadache ClinicProceduresProceduresPain ClinicProcedures
PMPain ClinicProceduresResearch TimePain ClinicProcedures

Week Two

MondayTuesdayWednesdayThursdayFriday
AMProceduresProceduresSpine ClinicProceduresPain Clinic
PMProceduresPain ClinicSpine ClinicProceduresPain Clinic