The pain rotation provides residents a broad exposure to common issues in both in-patient and out-patient pain management.
Junior residents in their CA-1 and CA-2 years will generally spend two rotations of four weeks each in pain management. The two weeks of the in-patient consult service at Barnes-Jewish Hospital are divided between the Acute Pain Service (APS) and Chronic and Cancer Pain Service (CCPS). APS emphasizes the evaluation and management of complex acute pain patients, including post-surgical patients, acute cancer pain patients, and trauma patients, while CCPS focuses on chronic pain from all latitudes of medical conditions including cancer.
Working in a team with other residents, fellows, nurse practitioners, and attendings, residents will have the opportunity to evaluate and formulate management plans, place and manage neuraxial infusion catheters, and actively participate in the decision-making process of their patients. The other two weeks are spent in the outpatient clinic located in the Center for Advanced Medicine. A multidisciplinary approach to managing chronic pain is emphasized as residents evaluate new patients and manage existing patients under the supervision of an attending. In this clinic setting, residents also gain technical skills for various interventional treatment modalities.
For senior residents in their CA-3 year, elective rotations are offered to further supplement their pain management experience. Residents can pursue additional four-week rotations on either APS or CCPS, where they will act as the junior fellow on the team.
Formal didactics during the pain rotation include weekly problem-based learning sessions, journal club meetings, multidisciplinary pain conference, as well as monthly joint conferences with the pain research division.