Goals and Objectives

The goals and objectives are designed to provide advanced training in the assessment and management of pain. The training is based on direct involvement in patient care under the direct supervision and instruction of full time faculty of our section. All fellows benefit from active interaction with all medical disciplines involved in the care and treatment of pain patients.

The primary objective or outcome of the fellowship program is that the fellow should be competent to serve as a consultant for problems related to pain management. This includes the management of straightforward and complex pain syndromes in ambulatory and hospitalized patients. Fellows should be able to manage such problems, even when complicated by the presence of other symptoms, complex medical illness and psychological distress. The following goals and objectives address Accreditation Council of Graduate Medical Education (ACGME) general competencies and those of the fellowship program itself.

Patient Care and Interpersonal Communication

  • To provide patient care that is honest, compassionate, appropriate and effective to assess and treat pain
  • To actively participate in an information exchange about pain management in patient care with patients, their families and other health professionals
  • To provide patient-focused care while gathering essential and accurate information
  • To make informed decisions about diagnostic and therapeutic interventions based on patient information and preference, documented scientific evidence and clinical judgment
  • To demonstrate ethical decision-making skills in communicating with or counseling patients and their families
  • To establish and carry out follow-up plans for patients
  • To develop a proactive approach to managing patient and family expectations and needs
  • To perform competently all procedures considered essential for the area of practice
  • To create and sustain therapeutic and ethically sound relationships with patients
  • To use effective listening skills and provide information using effective nonverbal, explanatory, questioning and writing skills

Medical Knowledge

  • To understand about established and evolving biomedical, clinical and cognate (e.g., epidemiological and social-behavioral) sciences and the application of this knowledge to patient care
  • To know and apply the basic and clinically supportive sciences applicable to pain management patient care
  • To understand and gain expertise in the pathophysiology, assessment and management of acute, chronic and cancer pain and the related component symptoms (e.g., depression, anxiety, delirium, cachexia and dyspnea)
  • To become familiar with the pharmaco-kinetics and pharmaco-dynamics of all major drug groups, as well as other medicine (opioids, antidepressants, anti-epileptics, anti-emetics and psychotropics) where appropriate
  • To understand the implications, benefits and risks of anesthetic and neurosurgical procedures to control pain, including local anesthetic and neurolytic blocks and implantation and maintenance of spinal drug delivery systems
  • To comprehend the principles of long-term rehabilitation as applied to malignant and nonmalignant pain
  • To understand the principles of acute pain management, epidural management and intravenous patient-controlled analgesia use
  • To become familiar with psychological assessment and treatment techniques including behavioral therapy, hypnosis, acupuncture and the methodological and content aspects of pain management research
  • To reach a consultant level in the expert prescription of a complex pharmacopoeia

Practice-Based Learning and Improvement

  • To gain hands-on experience in anesthetic procedures used to treat malignant and nonmalignant pain
  • To acquire a diverse understanding of the principles, philosophy and knowledge/ skills of pain management and how a pain management clinic operates
  • To analyze practice experience and improve practice-based activities using a systematic methodology
  • To critically appraise pain management literature and research methodologies
  • To apply knowledge of study designs and statistical methods to the appraisal of clinical studies
  • To utilize information technology to support patient care decisions and education, to access online medical information and to support their own education
  • To participate and assist in presentations, lectures and facilitating the learning of all other health professionals
  • To act as an effective advocate for the rights of the patient and family in clinical situations involving serious ethical conditions


  • To pursue a commitment to excellence and ongoing professional development
  • To demonstrate respect, integrity and accountability while maintaining responsiveness to the needs of patients and society that supercedes self-interest
  • To adhere to an agreement to carry out professional responsibilities
  • To apply sensitivity to the culture, age, gender and disabilities of patients

Systems-Based Practice

  • To understand the health care organizational structure of other health care professionals and society in general and how these elements affect their practice
  • To assist institutional and community pain management programs in developing standards of care
  • To become familiar with the process of developing curriculum for pain management
  • To understand the organization and reimbursement for pain management services
  • To understand how types of medical practice and delivery systems differ from one another, including methods of controlling health care costs and allocating resources
  • To practice cost-effective health care that does not compromise the quality of patient care
  • To network with other health care managers and health care providers to assess, coordinate and improve health care and know how these activities can affect system performance