Pain Medicine Fellowship

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The Department of Anesthesiology and Washington University School of Medicine, together with Barnes-Jewish Hospital, sponsor an ACGME-accredited fellowship in Anesthesiology Pain Management. Through this fellowship training program, we are committed to providing top-quality experience to pain management fellowship trainees, with a balanced exposure to acute, chronic and cancer pain. Our multi-faceted, one-year program is designed to prepare a consultant for a rewarding career in pain management.  Washington University Medical Center is a tertiary referral center and Level-1 trauma center. This broad clinical base gives pain management fellowship trainees an excellent opportunity to participate in managing a wide spectrum of pain problems.

Participation of pain management fellowship trainees in research is included. In addition, the Pain Medicine Fellowship Program is excited to expand our fellowship training program to include a 24-month combined research and clinical fellowship track. The goal of this distinctive track is to help develop and explain the field of academic pain management by focusing on training clinician scientists.

Our pain management clinical practice is largely divided into two arenas: acute and chronic pain management. The acute Pain Management Service facilitates the exposure and training of fellows in managing postoperative and post trauma pain, using various nerve blocks, and complex pharmacological management. This experience also assists fellows in development of relationships with patients and colleagues, skills which are vital to becoming leaders in Pain Medicine in the community.

The chronic Pain Management practice is primarily based at the Pain Management Center, Barnes-Jewish Hospital, with additional rotations at Missouri Baptist Hospital. Anesthetic, medical, and interventional techniques are used within the context of multidisciplinary pain management. In addition to the evaluation of patients, fellows gain expertise in fluoroscopic and ultrasound guided interventional pain techniques, such as various nerve blocks, neuraxial blocks, joint injections, neurolytic procedures, and radiofrequency lesioning.

A multidisciplinary approach is widely used and encouraged, through the regular and active participation of a pain psychologist, physical therapists, and neurologists. Various treatment modalities include acupuncture, biofeedback, physical therapy, psychotherapy, and interventional techniques such as local anesthetic and neurolytic nerve blocks, implantable pumps and spinal cord stimulators.

The importance of didactics is emphasized through weekly multidisciplinary pain conferences, didactic lectures, problem based learning cases, and journal clubs. Weekly anesthesiology grand rounds and clinical conferences help fellows to remain updated with anesthesiology. Fellows are regular presenters at weekly didactic lectures. Monthly “hands-on” cadaver lab sessions provide excellent opportunities for practicing techniques of interventional pain management.

Fellowship training may include rotations in psychology, neurology, physical therapy and/or other rotations. We currently have 12 faculty members with proficiency in a wide variety of skills. This high faculty to trainee ratio allows us to provide intensive, individualized training to maximize each fellow’s experience.

Lesley Rao, MD Director, Pain Fellowship Program Washington University School of Medicine