Pain Management
Fellowship
The goal
of the Pain Management Fellowship at the University of Cincinnati
, Department of Anesthesiology is to provide a one year
advanced training in the medical discipline concerned with
multidisciplinary management of acute, chronic and cancer
pain. The educational program will consist of both didactic
and clinical components as outlined in the Residency Review
Committee for Anesthesiology Program Requirements for Residency
Education in Anesthesiology Pain Management. This will be
done with the goal of ensuring that trainees upon completion
of the program have acquired sufficient knowledge, clinical/technical
skills and judgment to competently practice pain management
and become board certified. The
Department of Anesthesia has a long tradition of innovation
and excellence in regional anesthesia. The Division of Pain
Management is based on the same foundation.
Clinical
fellows will spend their time on the Inpatient services
(cancer pain management, palliative care and acute pain)
and on the Outpatient service (chronic and cancer pain clinic).
Fellows shall also spend period equivalent to 2-4 weeks
per year on psychiatry, neurology and physical medicine
and rehabilitation services to provide them with a comprehensive
multidisciplinary experience.
Fellows
can expect to become proficient in comprehensive management
of a chronic pain patient. Fellows will be trained in evaluation,
diagnosis and treatment of complex pain problems including
low back pain, neck pain, failed back surgery syndrome,
neuropathic pain, as well as cancer pain. A strong interventional
approach integrated with multidisciplinary management of
pain patient differentiates this fellowship from other programs.
Fellows will be proficient in performing interventional
procedures ranging from transforaminal selective nerve root
blocks to most advanced spinal cord stimulators, radiofrequency
ablative procedures, advanced disc procedures and vertebroplasty.
Other disciplines available for patient care include physical
medicine and rehabilitation services, neurological and psychological
evaluation and management.
The
Inpatient Pain Service experience involves advanced regional
techniques forperioperative patient comfort. To name a few
it includes continuous thoracic epidurals, single and continuous
peripheral nerve blocks as well out-patient continuous peripheral
nerve catheters experience.
There
is also an integrated cancer pain experience, which involves
taking care of cancer pain by advanced interventional approaches,
such as intrathecal pumps and neurolytic blocks.
There
is a strong basic and translational pain research group
under direction of Dr. Jun-Ming Zhang with NIH funding and
there are opportunities available for interested fellows
to involve in current projects and start new research protocols.
Fellows
interested in pediatric pain management may take a one month
elective at the Children's Hospital Medical Center.
The
service provided by the Pain management center is of large
volume. Approximately 2000 neural blockage procedures are
performed annually. New referrals for acute and chronic
pain each are in the range of 150 to 200 patients per month.
The
pain fellowship is busy and rigorous considering the clinical
work done, however is one of the best opportunities for
training for pain management as both academic or private
practice.
Facilities
Inpatient pain management services are available
at the University Hospital. Chronic pain management services
are available at the UC Physicians Pain Center located at
the University Hospital
and at University Pointe.
Pain Fellows rotate
to both locations during their one-year fellowship.
Services for children
are available at Children's Hospital Medical Center. AcutePain
Service, Cincinnati Children's Hospital Medical Center.
Faculty
The attending faculty of the Pain Fellowship Program
consists of anesthesiologists, dentists and clinical psychologists.
Fellowship Director
Muhammad Munir, M.D
Pain Service, University
Hospital, Inc.
Hammam Akbik, MD, Director
Michael Blust, M.D.
Phillip
Bridenbaugh, M.D.
Richard
Caudell, M.D.
Nasr Enany,
M.D.
Karen Krone,
M.D.
Umeshraya
Pai, M.D.
Faculty
provide 24-hour faculty coverage for the Pain Service.
UC
Physicians Pain Centers
Hammam Akbik, MD
Richard Caudell, MD, Faculty
Nasr Enany, MD, Faculty
Karen
Krone, MD, DABA
Muhammad Munir, M.D.
Children's
Hospital Medical Center
Kenneth Goldschneider, MD, Director, Pediatric Pain Service
Mark
Meyer, M.D., Faculty
Thomas
Taghon, D.O., Faculty
Norbert Weidner, MD, DABA, DABP, Faculty
Pain Service
The Inpatient Pain Service
provides experience in the management of acute and postoperative
pain. Onthis service the fellow and anesthesia residents
are responsible for all postoperative pain patients, in-house
consultations and inpatient admissions. The fellow will
learn the principles and practical management of continuous
epidural analgesia, patient controlled analgesia, continuous
intravenous analgesia, and regional anesthetic procedures
for postoperative pain management. The fellow will also
gain some experience in chronic cancer pain management during
this time through the management of in-house consultations.
Fellows will take at-home pager call every other week during
this rotation.
Chronic
Pain Management
Rotations at the Pain Control
Center at the U.C. Physicians Pain Center and the University
Hospital Pain Clinic provide experience in the multidisciplinary
management of chronic pain syndromes. A variety of chronic
pain syndromes are treated through an outpatient multidisciplinary
approach. Low back, headache, sympathetic and non-sympathetic
neurogenic, post herpetic and cancer pain syndromes are
all represented.
Pediatric
Pain Management
Fellows may request a one
month elective on the Pediatric Pain Service. Active involvement
on the service includes use of regional anesthesia for acute
and chronic pain management in children at the Children’s
Hospital Medical Center, the busiest pediatric surgery center
in the United States.
Didactic
Instruction Program
The
Pain Fellowship Program provides a comprehensive didactic
program, which adheres to the ACGME and IASP core curriculum
education in pain medicine. Didactic program include fellow
initiated reading club weekly, in addition to the fellow
curriculum lectures that are delivered every Wednesday morning
by pain faculty. In addition to these weekly lectures, once
a month a Journal Club is conducted to review the latest
advances in pain medicine. Invited lecturers from other
specialties are invited for dinner presentations once every
month. Departmental Morbidity and Mortality conferences
are regularly held for quality assurance and improvement
in patient care. Research seminars are presented by the
Department of Anesthesiology research faculty periodically.
Fellows
will also be expected to actively involve in resident and
medical student teaching. Fellows are required to take a
lecture for rotating pain residents every Friday afternoon.
In addition, fellows will present one Grand Round presentation
for the department during their fellowship year.
Interventional
Experience and Cadaver Sessions
Fellows
will have advanced training in interventional pain medicine
during their fellowship year. In addition to supervised
training and education in the procedure rooms and operating
room, fellows will have once every two month, a Cadaver
session for learning principles and perfecting advanced
techniques of interventional pain management.
Research
Experience
Research is encouraged but is
not a mandatory requirement for this fellowship. Each fellow
may select an area of interest and design and develop a
basic science or clinical study project in the area of pain
management. The project should be discussed with a pain
faculty member and submitted to the Research Committee,
at least three months prior to the proposed start date of
the study. Each project should have a staff advisor and
co-investigator to provide guidance in design and development
of the project. Fellows may also participate in Department’s
ongoing clinical and basic science research.
On-Call
Responsibilities
During
the Inpatient Pain Service rotation, pain fellow will take
one week at home back up beeper call. On weekdays, fellow
will be required to provide back up for the in-house anesthesiology
resident for acute pain problems and for the after hour
calls from patients seen at the TUH clinic. On weekend,
fellow will conduct patient rounds with the faculty on call
and provide back up for the in-house anesthesiology resident
after direct patient care rounds. The pain faculty on call
will be responsible for providing supervision for the on-call
fellow.
Supervision
All cases requiring pain management
must be discussed with the attending faculty prior to proceeding
with the treatment plan. Performance of procedures by the
Pain Fellows will be supervised at all times by the attending
faculty.
Application
Application
for Pain Fellowship
or
Email veselscv@ucmail.uc.edu for an application.
To apply send
the with 3 letters of recommendation and your USMLE scores
to:
Christine
Veselsky
Department of
Anesthesia
University of
Cincinnati
234 Goodman Street
P.O. Box 670764
Cincinnati, Ohio
45267-0764
513 584-0909 Phone
513 584-4003 FAX
Cardiothoracic Anesthesia Fellowship
Our
subspecialty program in cardiothoracic anesthesiology
is structured to ensure optimal patient care while providing
fellows the opportunity to develop skills in clinical
care and judgment, teaching, and research. The fellow
will become proficient in providing anesthesia care for
patients undergoing cardiac surgery with and without extracorporeal
circulation and thoracic surgery including operations
on the lung, esophagus and thoracic aorta. Training
will also include patients undergoing nonoperative diagnostic
and interventional cardiac, thoracic and electrophysiological
procedures. In addition, the fellow will develop
skills in the conduct of preoperative patient evaluation
and interpretation of cardiovascular and pulmonary diagnostic
test data, hemodynamic and respiratory monitoring, advanced
level perioperative transesophageal echocardiography (TEE),
management of cardiopulmonary bypass (CPB), pharmacological
and mechanical hemodynamic support, perioperative critical
care including ventilatory support and perioperative pain
management. Our program provides exposure to the
wide variety of clinical problems in cardiothoracic patients
that is necessary for the development of these skills.
Facilities
Fellow will practice at the University Hospital
which is affiliated with the University of Cincinnati.
http://www.ucphysicians.com/universitypointe.html.
Facilities
are readily available at all times to provide prompt noninvasive
diagnostic and therapeutic cardiothoracic procedures.
These include echocardiography, cardiac stress testing,
cardiac catheterization, electrophysiological testing
and therapeutic intervention, cardiopulmonary scanning
procedures and pulmonary function testing.
Faculty
Fellowship
Director
J. P. Lawrence, M.D.
Cardiac
Faculty
Andrew Friedrich, M.D.
Ahmed
Khalil, M.D.
Benu
Makkad, MD
Rajreshri
Nayak , MD
Samata Paidy,
M.D.
David Porembka,
D.O.
Ping Wang,
M.D.
Clinical
Experience
Six months operating
room clinical activity providing surgical procedures involving
adult patients requiring CPB to include anesthetics involving
valve repair or replacement and myocardial revascularization
procedures with or without CPB. The fellow will
provide anesthetic management for patients undergoing
minimally invasive cardiac surgery. the fellow will
provide anesthetic management for congenital cardiac procedures
performed on adult patients. the fellow will gain
sufficient experience to independently manage intra-aortic
\balloon counter pulsation. tHe fellow will be actively
involved in the management of patients with left ventricular
assist devices.
Additional experience
will include anesthetic management of patients undergoing
noncardiac thoracic surgery and the anesthetic management
of adult patient undergoing surgery on the ascending or
descending thoracic aorta requiring full CPB, left heart
bypass and/or deep hypothemic circulatory arrest.
the fellow will have experience in the anesthetic management
of adult patients for cardiac pacemaker and automatic
implantable cardiac defibrillator placement, surgical
treatment of cardiac arrhythmias, cardiac catheterization
and cardiac electrophysiologic diagnostic/therapeutic
procedures.
Advanced perioperative
echocardiography education will be provided according
to the training objectives from the American Society of
Echocardiography and the Society of Cardiovascular Anesthesiologists"Guidelines
for Training in Perioperative Echocardiography".
This will include the study of perioperative echocardiographic
examinations, at least some of which are comprehensive
intraoperative TEE examinations personally performed,
interpreted and reported by the fellow.
The fellow will
have a one-month experience managing adult cardiothoracic
surgical patients in a critical care (ICU) setting which
will include management of nonsurgical cardiothoracic
patients.
Research
Experience
Research is encouraged but is
not a mandatory requirement for this fellowship. Each
fellow may select an area of interest and design and develop
a basic science or clinical study project in the area
of cardiothoracic management. The project should be discussed
with a cardiothoracic faculty member and submitted to
the Research Committee, at least three months prior to
the proposed start date of the study. Each project should
have a staff advisor and co-investigator to provide guidance
in design and development of the project. Fellows may
also participate in Department’s ongoing clinical
and basic science research.
Supervision
The fellow will perform under
the direct supervision of the staff anesthesiologists
assigned to the cardiothoracic anesthesia service.
The fellow will assist in the teaching and supervision
of anesthesia residents who are assigned to the service.
Application
Application
for cardiothoracic fellowship
To apply, you
may download the application above and send it with 3
letters of recommendation and your USMLE scores to:
Donna
Benesch
Department of
Anesthesia
University of
Cincinnati
P.O. Box 670531
Cincinnati,
Ohio 45267-0531
513 558-6356
- Phone
513 558-0995
- FAX
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