Rotations

Chronic Pain

Fellows will spend a majority of their time in the Pain Management Center at University of Maryland Rehabilitation & Orthopaedic Institute. 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 comprehensive experience in acute pain medicine during a dedicated four-week rotation at the University of Maryland Medical Center (UMMC). The Acute Pain Management Service (APMS) provides postoperative pain management for both adult and pediatric patients, utilizing neuraxial techniques as well as systemic Patient Controlled Analgesia (PCA). The service also responds to inpatient consultations for postoperative pain, malignant pain, and other complex acute and chronic pain syndromes. During this rotation, fellows also gain exposure to a variety of regional anesthesia procedures under the guidance of faculty trained in regional anesthesia.

The fellowship benefits from a dedicated team of Pediatric Anesthesiologists who provide specialized training. Each year, the service manages over 500 pediatric patients with a wide range of diagnoses, including oncologic pain, sickle cell disease, and other acute and chronic pain conditions.

Fellows may occasionally take a pager call from home while on this rotation; however, call responsibilities are limited, and APMS nurses typically provide primary after-hours coverage. A supervising pain medicine attending is always available for support, and fellows are encouraged to contact them when needed. While it is rare for a fellow to return to the hospital overnight, emergent circumstances may occasionally require it.

Additional Rotations

(Fellows entering the program from PM&R, Psychiatry, Neurology, or Anesthesiology backgrounds will have the required elective rotation waived, as their core residency training already fulfills this requirement.)

Specialties	Locations	Durations
Palliative Care	UMMC	2 weeks
Physical Medicine & Rehabilitation	VA & UMMC	2 weeks
Physical Medicine & Rehabilitation	UM Rehabilitation & Orthopaedic Institute	2 weeks
Neurology	UM Rehabilitation & Orthopaedic Institute	2 weeks
Neurology	UMMC	2 weeks
Radiology	UMMC	2 weeks
Pain Psychology	UM Rehabilitation & Orthopaedic Institute	2 weeks
Psychiatry	UMMC	1-2 weeks
Acupuncture	UM Rehabilitation & Orthopaedic Institute & UMMC	2 days
Physical Therapy	UM Rehabilitation & Orthopaedic Institute	3 days
Anesthesiology (if not anesth trained)	UMMC	4 weeks
Private Practice Observership	Private Practice	1 week