Fellowships: Pain Management

Pain Medicine Fellowship Program

INTRODUCTION

The University of Maryland Pain Management Center (PMC) was founded in 1992 as a division of the Department of Anesthesiology.  The practice was located at the downtown Baltimore campus until 2003 when it was relocated to Kernan Orthopaedics and Rehabilitation Hospital, seven miles from the downtown campus.  The practice is a hospital based out patient clinic that utilizes a multidisciplinary team approach treating a variety of chronic pain syndromes. Our team includes physicians who are board certified in Anesthesiology and Pain Medicine, a licensed clinical psychologist, fellows, nurses, physical therapists and a radiographer.  All participate in weekly meetings to discuss appropriate treatment options for patients. These may include a multi-modal regimen consisting of medication management, interventional therapy, behavioral and physical therapy.

OVERVIEW OF PROGRAM 

We currently train three fellows per year in our ACGME accredited pain medicine fellowship. Fellows easily meet and exceed ACGME training requirements including those for interventional procedures.  Fellows train at various locations including Kernan Hospital, the University of Maryland Medical Center (UMMC) and the Veterans Affairs Medical Center (VA).  All are located in close geographical proximity.

ROTATIONS 

Chronic Pain

Fellows will spend a majority of their time in the Pain Management Center at Kernan Hospital. This exposes the fellow to a wide variety of chronic pain conditions.  Fellows are scheduled in the PMC at least three weeks out of every month unless they are assigned to other rotations. Fellows divide their time between seeing patients in the clinic setting or performing interventional pain procedures. Fellows work under the guidance of a pain medicine faculty member.

Our chronic pain patients are referred by physicians from Maryland and the surrounding states. Approximately 4,000 clinic visits occur annually.  Fellows are involved in the patient evaluation and treatment planning process.  These treatments may include medication management including opioid therapy, referrals to our pain management psychologist for behavioral services, and referrals to physical therapy.  Fellows also identify appropriate patients as candidates for interventional therapies. 

The various interventional treatments offered by our Center include nerve blocks, radiofrequency lesioning, discography, ultrasound guided procedures, and implantable therapies. Our Center is equipped with a fluoroscopy suite, a radiographer and a dedicated nursing staff.  Approximately 1,400 fluoroscopically guided procedures are performed annually. In addition, our Center also offers advanced implantable therapies such as spinal cord stimulation and intrathecal pumps. Under the direction of the pain medicine attending, fellows are trained in surgical implants. 

Adult and Pediatric Acute Pain

Fellows gain experience in acute pain medicine at UMMC and are assigned to this rotation for one week every six weeks. The Acute Pain Management Service (APMS) provides postoperative pain management for both adult and pediatric patients utilizing neuraxial and systemic Patient Controlled Analgesia (PCA) techniques.   The acute pain service responds to inpatient consultations for the management of postoperative pain, malignant pain and other chronic and acute pain syndromes. 

We have a dedicated staff of Pediatric Anesthesiologists who provide specific training to our fellows.  Over 500 pediatric patients per year are seen with a variety of diagnoses requiring pain management. Diagnoses include oncologic related pain, sickle cell disease and other pain conditions. 

Overnight call is taken from home during this rotation. APMS nurses usually cover the pager at night and fellows serve as back up. A supervising pain medicine attending is always assigned to the service and fellows are encouraged to contact them when necessary.  It is a very rare occurrence that the fellow needs to return to the hospital at night, although it may occur in an emergent situation.

Additional Rotations

DIDACTICS

The Pain Medicine Fellowship Program offers a well-established educational program that fulfills the requirements of the ACGME.  These include:

• Daily teaching rounds on the acute pain service
• Weekly multidisciplinary case discussions
• Weekly pain medicine lectures
• Visiting lecturers in pain medicine
• Journal club
• Interdisciplinary meetings
• Quality Assessment/Improvement and M&M Conferences
• Practice management and compliance meetings

Fellows are expected to take an active role in teaching their colleagues and residents. Each fellow presents a Grand Rounds lecture as well as additional lectures including presentation of journal articles and continuing quality improvement processes

RESEARCH OPPORTUNITIES 

Each fellow is expected to complete a research project related to either acute or chronic pain management.  This includes preliminary literature review, writing of the research protocol, and submission of the protocol to the IRB by the end of the fellowship year.  Each fellow is assigned dedicated research hours to devote to this activity. Fellows also meet regularly as a group with the PMC Research Coordinator who assists and guides the fellows through this process.  In addition, each fellow is mentored by one of the Pain Medicine attendings who may assist with the selection of a research topic.   

ADDITIONAL EDUCATIONAL OPPORTUNITIES 

• Cadaver labs
• Neurostimulation seminars
• Fluoroscopic guided procedures using anatomic model

HIGHLIGHTS OF BALTIMORE 

Baltimore’s Neighborhoods

Baltimore is a city alive with adventures and excitement around every corner.  Renowned for our vibrant waterfront and laid-back attitude, Baltimore beckons you to explore all that the city offers from our world-class attractions to our dynamic neighborhoods.  These include the Inner Harbor, Mount Vernon, Little Italy, Fell’s Point, Federal Hill, Canton, Harbor East, the Westside and Hampden.   The Inner Harbor, in particular, is home to many tasty restaurants, unique shopping, famous museums, live entertainment, local pubs and taverns.  Other attractions at the Inner Harbor include the Baltimore Aquarium and the Maryland Science Center.  There are also many family oriented neighborhoods located in surrounding suburbs with excellent school districts.

Sports

Baltimore is passionate about sports and our fans support a world-class variety of professional, college and amateur sports teams. Our professional sports teams include Baltimore Ravens football, Baltimore Orioles baseball and Baltimore Blast soccer. The Ravens Stadium and the Oriole Park at Camden Yards are located within walking distance of UMMC.

Culture

We have many historical and cultural attractions such as Fort McHenry, the home of the National Anthem, and museums such as the American Visionary Art Museum, the Baltimore Museum of Art and The Reginald F. Lewis Museum of Maryland African History.  Theatres include Centerstage, the Lyric Opera House and the Hippodrome.  The Baltimore Symphony Orchestra performs classical, pops, family, summer and holiday concerts showcasing world-renowned artists. 

How to Apply

Department of Anesthesiology Fellowship Application Form 

FELLOWSHIP APPLICATION REQUIREMENTS 

Your application is complete when we have received:

• Three letters of reference, one of which should be from the chairman or program director of your training program
• The completed University of Maryland Application for Fellowship in Anesthesiology, including your personal statement
• Your specialty specific in-service board scores and/or any national standard scores
• Your USMLE I, II & III /COMLEX scores; NBOME scores, if applicable
• A copy of your medical school transcript
• Current curriculum vitae

APPLICATIONS SHOULD BE MAILED TO: 

Dr. Thelma Wright
University of Maryland Pain Medicine Fellowship Program
Department of Anesthesiology
22 South Greene Street – Room S8B12
Baltimore, MD  21201
410 328-1239

Division of Pain Management Information