Pain Medicine Fellowship

• Curriculum vitae
• Personal statement

Other items that may be required for application:  

• Three letters of recommendation: If currently in a residency program, one additional letter of good standing from the program director indicating trainee standing and expected completion with the program is required.
  
• USMLE, COMLEX, FLEX scores report
• Medical transcripts
• Medical diploma: copy
• Certificate of training completion – copy for each certification

Interested in applying? Let us know why you want to join our program.

Rotations
Fellows rotate through different experiences one week at a time (excluding external or special electives which may be two to four weeks).
These rotations include:

• Outpatient Clinic 
• Inpatient Consultant Service
• In-office Procedures
• Operating Room Procedures
• Neurology
• Anesthesiology/Acute Pain (for non-anesthesia fellows)
• PMR (for non-PMR fellows)
• Two-week “Fellow’s Choice” elective
• Four-week interventional private practice experience
  
  

Didactics
Didactic sessions are scheduled throughout the week and include regular lectures, Chair’s roundtables, multi-institutional teleconferences, evidence-based medicine review, GME Core Curriculum lectures, M&M conferences, and Journal Club. Fellows are relieved from clinical duties to attend all sessions. In addition, fellows are enrolled in Canvas, an online learning management system, wherein they are assigned weekly readings, quizzes and videos to study at their own pace.

Sample Week at a Glance

Simulation Lab
Fellows will have the unique opportunity to participate in pain medicine simulation training in which they will learn practical tools to manage procedure-related crisis scenarios in a safe environment.

Two-Year Research Fellowship
A two-year research track is available for those applicants interested in developing their career in academic medicine. Fellows spend one year conducting research targeted toward their individual needs and goals under the mentorship of department chair Salahaddin Abdi, M.D., Ph.D. The second year is spent as a clinical fellow.

Please see the MD Anderson Graduate Medical Education (GME) page for details of benefits.

December 1: Applications open on ERAS

December 1 - May 15: Applications reviewed by selection committee

May: Interview letters are sent to chosen applicants

Mid-June to Early August: Interviews are held on 2-3 dates TBA

September: All candidates are ranked in NRMP

Early October: Match Day through NRMP

Early October: Matched fellows for next academic year work with Program Coordinator to upload all necessary documents

December: Future fellows are submitted to the Academic & Visa Administration-Trainee (AVA-Trainee) department at MD Anderson

January-June: Future fellows work with Research Trainee Programs to upload all required documents (ACLS, PIT, DEA, etc.)

When does the application process start? 
Applications open December 1 and end May 15.

Do you use ERAS for the application process? 
Yes.

Do all listed documents have to be uploaded in order for the application to be reviewed by faculty? 

No, only the completed Application, CV, Letter of Good Standing (for current residents) and three letters of recommendation are required in order for your application to be reviewed.

How many positions are there in the MD Anderson Pain Medicine Fellowship? 
There are six fellows per class.

When are interviews held? 
Interviews will start in June and end in August. If you are offered an interview, there will be 2-3 dates to choose from. Virtual interviews are held on Saturdays.

Our program focuses on training future leaders in the field of pain medicine, whether they pursue academic or community practice. Since our program’s inception in 1989, our graduates have established pain clinics throughout the country, developed institutional pain programs and conducted groundbreaking pain research. We maintain close, collaborative relationships with our graduates throughout their careers.

MD Anderson Cancer Center is located in Houston, in the Texas Medical Center, which boasts:

• The finest in medical education and treatment
• Numerous parks, including Hermann Park which has an outdoor theater and large zoo
• An academic and cultural arena that includes Baylor College of Medicine, Rice and St. Thomas Universities, the Museum of Fine Arts and the Museum of Contemporary Arts
• Close proximity to Houston's noted symphony orchestra, opera, theater and ballet.

Other sites of various activities available within a few minutes' drive include Moody Gardens, Sam Houston Race Park, Cynthia Woods Mitchell Pavilion, SplashTown Waterpark, Downtown Aquarium, Space Center Houston, Lone Star Flight Museum, San Jacinto Battlefield, NRG Stadium, Minute Maid Park, Toyota Center and the George R. Brown Convention Center. The cost of living is moderate and housing is very reasonable. For more information, visit our About Houston page. 

7/2014-6/2015

• Adam Dailey, M.D.
• Anish Doshi, M.D.
• Carrie Johnson, M.D., Ph.D.
• Joyce Kim, M.D.
• Monika Patel, M.D.
  
  

7/2015-6/2016

• Carlos Roldan, M.D.
• Christina Le, M.D.
• Daniel Rothstein, M.D.
• Peggy Kim, M.D.
• Ratan Banik, M.D.
• Rohan Jain, M.D.

7/2016-6/2017

• Adam Antflick, D.O.
• John Welker, M.D.
• Maxime Debrosse, M.D.
• Hiral Patel, M.D.
• Puneet Sayal, M.D.
• Rakhi Singh, M.D.

7/2017-6/2018

• George Rakkar, M.D.
• Haijun Zhang, M.D.
• Siddarth Thakur, M.D.
• Emily Petersen, M.D.
• Tony Lo, D.O.
• Uzondu Osuagwu, M.D.

7/2018-6/2019

• Jennifer Erian, M.D.
• Saiyun Hou, M.D.
• Saba Javed, M.D.
• Ian Lipski, M.D.
• Jaideep Mehta, M.D.
• Harold Ray, M.D.

7/2009- 6/2010

• Danesh Mazaloomdoost, M.D.
  
• Eldor Brish, M.D.
• Steven Pulley, M.D.
• Tristan Pico, M.D.
   

7/2010-6/2011

• Mariam M. EI-Baghdadi, M.D.
• Ronald N. Parris, M.D.
• Thomas Chai, M.D.
• Lance Smith, M.D.

7/2011-6/2012

• Baominh Vinh, M.D.
• David Cooper, M.D.
• George Atallah, D.O.
• Michael Sprintz, D.O.
• Mitchell Engle, M.D., Ph.D.
  

7/2004-6/2005

• Paul Chiu, M.D.
• Phillip Phan, M.D.
• Thomas Spain, M.D.
• Joseph C. Ting, M.D.

7/2005-6/2006

• Anisa Gopalani, M.D.
• Deborah Nilson, M.D.
• Ryan Ness, M.D.
• Tarun Jolly, M.D.
• Ramoun Jones, M.D.

7/2006-6/2007

• Brian M. Bruel, M.D.
• lrfan Lalani, M.D.
• M. Todd Warrick, M.D.
• Matthew S. Mosura, M.D.
  

7/1999-1/2000

• Hazem Zekry, M.D.
• Bilal F. Shanti, M.D.

7/2000-6/2001

• Jay Bender, M.D.
• Young Kim, M.D.

7/2001-6/2002

• Ghyasuddin Syed, M.D.
• Jing Chen, M.D.
• Madhuri Motaparthi, M.D.
• Thu Le, M.D.
  

Welcome to your orientation rotation at Chronic Pain Clinic, The University of Texas M.D. Anderson Cancer Center. Your experience during this rotation will be directed toward achieving certain goals and objectives. The objectives that follow are concrete landmarks that you must reach at your level of training in order for you to become proficient and competent in the practice of chronic pain management, both clinical and didactic.

These goals and objectives are also intended to assist you in achieving competencies appropriate for all physicians and can be met through customary methods including fulfillment of supervised clinical assignments, attendance and participation in didactic activities, and personal study.
These are intended to assist you in gaining an understanding of this subspecialty, achieving general competencies appropriate for all physicians, and building upon those attributes necessary to become diplomats of the American Board of Anesthesiology.

Formal evaluation at the completion of the rotation will be based on your ability to meet these goals and objectives; therefore, if at any time you think you may be having difficulty, please contact the rotation director or the fellowship program director to discuss possible options for additional assistance.

I. PATIENT CARE
a. Preprocedure Evaluation
A comprehensive and concise evaluation provides the critical information necessary to develop an appropriate plan of management as well as to anticipate potential problems and prepare contingency plans. It also provides the opportunity to discuss options and plans with the patient and patient’s family, and answer any questions.
i. Completes a thorough and concise evaluation in a timely manner
ii. Uses available information technology, such as computerized laboratory reporting, computerized radiology studies, computerized charts to obtain pertinent information
iii. Identifies and prioritizes medical and anesthetic concerns
iv. Identifies need for further medical work up or medical optimization prior to procedure.
v. Explains options and plan to patient and family members and answers questions in a clear and respectful manner
vi. Verbally presents a clear and concise evaluation to supervising faculty
vii. Identifies need for and orders appropriate preprocedure medication
viii. Discusses the risk and benefits of anesthesia and procedure with team and family.
b. Development of Treatment Plan
i. Develops and is able to justify an treatment plan based on history and physical evaluation, accurate and current scientific information, standards of care, clinical judgment, and patient preference if applicable
ii. Anticipates potential problems and develops contingency plans
iii. Verbally presents a clear and concise management plan to supervising faculty
c. Intraprocedure Management
i. Adequately prepares the procedure table, including meds and equipment checks and availability of emergency/resuscitative drugs.
ii. Performs procedures on awake patients in a manner that addresses patient comfort without compromising patient safety.
iii. Effectively implements the plan, while demonstrating the ability to adapt to changing clinical conditions
iv. Demonstrates technical skills in pain management procedures.
v. Demonstrates proficiency in clinical/technical skills, including spinal injections and fluoroscopy techniques including stimulating techniques under fluoroscopy.
vi. Demonstrates an understanding of the risks, benefits, and indications for invasive procedures and intrathecal pump
vii. Develops the knowledge and skills necessary to interpret data from invasive monitors, along with how to use this data in clinical decision-making.
viii. Interacts with members of other medical specialties or other health care teams effectively as a pain consultant for the purpose of providing patient-focused care.
d. Postprocedure Care
i. Demonstrates an understanding of common problems occurring in the Post-Procedure Care, including pain, hemodynamic and respiratory derangements, and nausea and vomiting, and demonstrates knowledge of appropriate treatment options
ii. Demonstrates proficiency in providing cardiopulmonary resuscitation
iii. Demonstrates an understanding of clinical criteria for discharge from Pain Clinic Recovery Area.

II. MEDICAL KNOWLEDGE
• Demonstrate comprehensive knowledge of chronic pain management
• Demonstrate an investigatory approach to and analysis of clinical situations
• Apply basic and clinically supportive sciences to chronic pain management
• Understand and be able to discuss the following:
a) Anatomy and physiology of the pain projection system:
i. Physiology of nociception – transduction, transmission, modulation, and perception
ii. Pathophysiology of neuropathic pain
iii. Pathophysiology of sympathetically maintained pain syndromes
b) Pharmacology of opioid and non-narcotic analgesics:
i. Pharmacokinetics of commonly used opioids and NSAIDS
ii. Side effects, tolerance, dependence, addiction
iii. Spinal versus systemic effects
c) Pharmacology of centrally acting drugs used in pain management:
i. Anticonvulsants
ii. Antidepressants
iii. Major tranquilizers
d) Principles of neural stimulation:
i. Transcutaneous electrical nerve stimulation (TENS)
ii. Peripheral nerve and central nervous system stimulation
e) The role of nerve blocks in chronic pain management to include continuous catheter techniques
f) Neuroablative procedures:
i. Neurolytic blocks
ii. Ablative neurosurgery
g) Behavioral, cognitive, and supportive psychotherapy treatment principles
h) The advantages of a multi-disciplinary approach to chronic pain management
i) The management of implantable intrathecal drug delivery systems and spinal cord stimulators
j) Principles of physical therapy and rehabilitation of the chronic pain patient
k) Principles and practice of cancer pain management utilizing guidelines set forth by the Agency for Health Care Policy and Research and the World Health Organization
l). Principles and practice of the management of chronic non-malignant pain
13. Principles and ethics of pain research in patients and experimental animals:
i. Design and evaluation of clinical trials
ii. Interpretation of placebo response
iii. Pain measurement techniques

III. PRACTICE-BASED LEARNING AND IMPROVEMENT
a. Critically reviews and discusses current publications on topics pertaining to the practice of pain medicine in general
b. Assimilates into clinical practice new advances upheld by current peer-reviewed literature
c. Demonstrates an understanding of how to use various technological resources, such as computerized medical databases, to obtain current information

IV. INTERPERSONAL AND COMMUNICATION SKILLS
a. Speaks in a clear and concise manner
b. Maintains appropriate eye contact
c. Conveys respect for others and displays an appropriate degree of confidence
d. Engages in therapeutic and ethically sound relationships with patients and their family
e. Uses effective listening skills
f. Interacts effectively with members of other medical specialties or health care teams
V. PROFESSIONALISM
a. Demonstrates integrity, compassion and respect for others
b. Demonstrates responsiveness and accountability to patients, patients family, society and the medical profession
c. Demonstrates a commitment to ethical principles pertaining to patient care as well as business practices
d. Demonstrates sensitivity and responsiveness to patients’ culture, age, gender, and disabilities
e. Demonstrates a commitment to excellence and continuing professional development
VI. SYSTEMS-BASED PRACTICE
a. Demonstrates an understanding of the different types of medical practice and health care delivery systems
b. Practices cost-effective health care and resource allocation that does not compromise quality of care
c. Advocates quality health care and assists patients in dealing with complex health care delivery systems
d. Works with other members of the health care delivery team to improve health care and health care system performance

OBJECTIVES
I. Cognitive skills
a) Uniformly evaluate routine patients
b) Establish a complete plan for routine patients
c) Completely evaluate and identify pertinent issues in complex patients
d) Outline a complete plan for complex patients which is routinely accepted by faculty with minimal modifications
e) Manage routine patients without assistance
f) Anticipate possible adverse events in complex patients
g) Identify adverse trends in complex patients and intervene appropriately
h) Rapidly recognize complications of invasive treatments and initiate correct intervention
i) Establish a reasonable post treatment plan
II. Technical skills
a) Regularly prepare treatment setting for routine patients
b) Identify needs for complex patients in advance
c) Prepare treatment setting for complex patients without assistance from faculty
d) Routinely achieve diagnostic techniques
e) Routinely achieve invasive treatment techniques
f) Maintain accurate records
III. Communication skills
a) Establish patient rapport
b) Communicate effectively in outpatient pain clinic setting
c) Effectively communicate treatment plan to patient and obtain informed consent
d) Communicate effectively with patient during procedures
e) Effectively communicate with anesthesiology faculty and all members of multi-disciplinary team
IV. Professional skills
a) Always maintain availability
b) Anticipate problems
c) Seek advice when necessary
d) Provide routine follow up
e) Interface well with all members of multi-disciplinary team
f) Demonstrate interest in learning
g) Willingly receive constructive criticism
V. Knowledge
a) Demonstrate excellent command of basic knowledge
b) Demonstrate comprehensive subspecialty knowledge
c) Seek information to bridge gaps in knowledge
d) Actively participate in didactic activities
e) Demonstrate evidence of outside study
f) Demonstrate sound data acquisition skills

Please Note
• The patients have complex pain and psychiatric issues. Your kindness and consideration play a big role with treatment. Rotating through the Chronic Pain Clinic will enable you to learn the skills needed for future practice of anesthesia and Chronic Pain Clinic.
• It is required for you to contact and be supervised by attending physician for all critical points of your rotation in Chronic Pain Clinic.
• It is necessary for you to inform and consult attending physician for any concerns and questions about care of patient.
• Intervention procedures in Chronic Pain Clinic are done under fluoroscopy. Please inform the attending physician if you have any concerns about radiation exposure before procedure commences.