Pain Medicine Fellowship
The Division of Pain Medicine, a part of NYU Langone’s Department of Anesthesiology, Perioperative Care, and Pain Medicine, offers a comprehensive one-year multidisciplinary training program. The Pain Medicine Fellowship, accredited by the Accreditation Council for Graduate Medical Education, is the recipient of the 2018 Pain Medicine Fellowship Excellence Award by the American Academy of Pain Medicine.
The fellowship’s mission is to help trainees acquire the knowledge and skills needed to practice compassionate independent pain medicine in an academic or private practice. Training occurs through the Center for the Study and Treatment of Pain, offering fellows opportunities to develop skills in medical diagnosis, therapeutic judgment, clinical care, teaching, administration, and research in pain medicine.
Pain medicine fellows become competent in the following areas:
- pain assessment and diagnosis
- formulation and coordination of multidisciplinary and multimodal treatment plans
- integration of pain treatment with primary disease management and palliative care
- interaction with other team members, regardless of their primary specialty
After completion of training, fellows are eligible to take the American Board of Anesthesiology Special Qualifications Certifications in Pain Medicine, provided they are board-certified in their primary specialty.
Fellowship Clinical Rotations
Clinical training occurs at NYU Langone’s Tisch Hospital and Kimmel Pavilion, NYU Langone Ambulatory Care Center East 38th Street, NYU Langone Orthopedic Center, NYC Health + Hospitals/Bellevue, and the VA NY Harbor Healthcare System. These locations offer exposure to a diverse patient population and clinical experience in multidisciplinary, inpatient, and outpatient pain care across a variety of clinical conditions.
Core multidisciplinary clinical activities involve anesthesiology, rehabilitation medicine, neurology, psychiatry, neurosurgery, and other disciplines. Fellows also rotate through three disciplines outside of their primary specialty. We provide the time and date for such experiences at the beginning of training.
Tisch Hospital and Kimmel Pavilion Rotation
During a two-month rotation with the in-house pain consult service at Tisch Hospital and Kimmel Pavilion, fellows provide care to postoperative surgical patients and patients with chronic pain. They are responsible for teaching and guiding anesthesiology first-, second-, and third-year residents, also known as CA-1, CA-2, and CA-3 residents, on this service and participate in one weekend day call.
During training, fellows acquire the knowledge and skills necessary to provide care for adult and pediatric inpatients with chronic pain, including cancer pain. In addition to specialists from the Department of Anesthesiology, Perioperative Care, and Pain Medicine, collaboration occurs with physicians from other services. These include the Departments of Neurology, Neurosurgery, Orthopedic Surgery, Pediatrics, and Psychiatry, as well as the Ronald O. Perelman Department of Emergency Medicine, Division of General Surgery, Division of General Internal Medicine and Clinical Innovation, Rusk Rehabilitation, and Perlmutter Cancer Center.
Center for the Study and Treatment of Pain Rotation
Throughout the four-month outpatient rotation at the Center for the Study and Treatment of Pain, located within NYU Langone Ambulatory Care Center East 38th Street, fellows work with chronic pain medicine faculty mentors to provide care. They gain knowledge of the anatomy, physiology, and pharmacology of pain transmission and modulation; the natural history of various musculoskeletal pain disorders; and general principles of pain evaluation and management, including neurological exam, musculoskeletal exam, and psychological assessment. Fellows also learn about indicators and interpretation of electrodiagnostic studies, including X-rays, MRI, CT scan, and clinical nerve function studies.
Trainees acquire experience in clinical and experimental pain measurement; psychosocial aspects of pain, including cultural and cross-cultural considerations; and proper management of opioid use, including an understanding of opioid agreements, risk mitigation tools, and appropriate use of drug screening. During this rotation, instruction is provided via wide range of pain medicine procedures as outlined in Interventional Pain Management Procedures.
NYU Langone Orthopedic Center Rotation
The two-month rotation at NYU Langone Orthopedic Center offers training in the knowledge, skills, and abilities necessary to assess, diagnose, and treat patients with chronic pain in an outpatient setting. This clinic is fast-paced with high turnover, replicating a private practice model.
All fellows rotate at Bellevue for two months as part of the core curriculum. They develop procedural and clinical skills in the management of acute and chronic pain in outpatients. Rotations with palliative care providers are part of the interdisciplinary team approach to improving quality of life and mitigating suffering among patients with severe, complex illnesses.
VA NY Harbor Healthcare System Rotation
Fellows spend one half to one full day per week working closely with faculty at the VA NY Harbor Healthcare System’s Manhattan campus on the following services: consultation–liaison psychiatry, addiction psychiatry, neuroradiology reading room, neurology, pain clinic, pain operating room, neurology pain clinic, physical medicine and rehabilitation clinic, electromyography procedures clinic, and anesthesiology (for non-anesthesiology specialty fellows). When on pain services, fellows teach NYU Langone residents in anesthesiology, neurology, and psychiatry, and geriatric medicine and palliative care fellows.
Interventional Pain Management Procedures
Fellows learn a wide range of pain medicine procedures, including trigger point injections, epidural blood patch in all regions of the spinal cord, and abdominal interventions such as splanchnic nerve, celiac plexus, and ilioinguinal nerve blocks. Other interventions include peripheral nerve blocks and cryoanalgesia blocks.
Sacral and Coccygeal Procedures
As a fellow, you also learn sacral and coccygeal procedures, including caudal epidural steroid injections (ESI) with and without catheter, ganglion impar and sacroiliac joint injections, S1 transforaminal ESI, pudendal nerve block and nerve ablation, and piriformis block.
Lumbar, Thoracolumbar, and Thoracic Procedures
Lumbar interventions include interlaminar and transforaminal ESI, facet joint injection, medial branch blocks and radiofrequency ablation, and sympathetic blocks. You also learn thoracolumbar intrathecal pump placement and refill, thoracolumbar spinal cord stimulator trials and placement, thoracic ESI, intercostal nerve block and radiofrequency ablation, and serratus plane block.
Cervical, Craniofacial, and Neck Procedures
Training features cervical spine procedures including interlaminar ESI, medial branch blocks and radiofrequency ablation, and stellate ganglion block.
Craniofacial and neck procedures include sphenopalatine ganglion block; greater and lesser occipital nerve block and radiofrequency ablation; auriculotemporal and greater auricular nerve block and radiofrequency ablation; trigeminal nerve block and radiofrequency ablation, including supraorbital, infraorbital, and mental; inferior alveolar nerve block; temporomandibular joint injection; and Botox® injection.
Shoulder, Knee, and Hip Procedures
We train you to administer shoulder bursa and greater trochanter bursa injections; acromioclavicular injections; suprapatellar injections; genicular and lateral femoral cutaneous nerve blocks and radiofrequency ablation; and intra-articular injections.
Neuromodulation and Intrathecal Pump Implantation Procedures
You also have the opportunity to learn from pain medicine faculty about neuromodulation and intrathecal pump implantation techniques for pain management. Twice a week, one fellow is assigned to report to the operating room for a neuromodulation case scheduled with Alon Mogilner, MD, PhD. These cases include spinal cord stimulator trials and implants, dorsal root ganglion stimulator implants, intrathecal pump implants, and generator exchanges. During this time, you have the opportunity to learn about different devices, lead placement, procedural planning, and more.
Fellowship Didactic Program
Our comprehensive didactic training includes a daily curriculum, case conferences and quality improvement meetings, journal club, a neuromodulation case with neurosurgery, pain medicine simulation modules, and teaching and research opportunities.
We provide a didactic curriculum, Monday through Friday, with sessions that fellows can attend from 7:30AM to 8:30PM. These didactics include Anesthesiology, Perioperative Care, and Pain Medicine Grand Rounds, Pain Medicine Board Review, and lectures based on the American Board of Anesthesiology Pain Medicine Examination content outline.
Didactics cover recent updates on various guidelines, pharmacological safety, procedural interventions, and comprehensive interdisciplinary patient care. Our fellowship program strives for the promotion of evidence-based practice. We require attendance at 70 percent of lectures for graduation.
Case Conferences and Quality Improvement Meetings
Every afternoon from 1:00 to 2:00PM, fellows, nurse practitioners, residents, and medical students co-present complex inpatient cases for discussion. These case conferences focus on an interdisciplinary approach to chronic pain care. Participants work as a team to analyze difficult pain cases for educational purposes and to challenge critical thinking skills.
Throughout the year, fellows also attend outpatient case conferences, during which complex clinical cases are presented for group discussion with pain faculty members, other fellows, guest surgeons, and subspecialists. This allows for education of interdisciplinary care and approaches to chronic pain patients across the healthcare system.
Fellows also present at our monthly pain medicine quality improvement meetings, where root cause analysis is performed on each case. During these meetings, feedback from faculty and other fellows is received in a collegial environment.
A monthly journal club helps to interpret medical literature. A review of a mix of influential papers and newer literature offers a comprehensive background of evidence-based clinical practice and knowledge of pain mechanisms.
Pain Medicine Simulation Modules
Fellows also participate in simulation modules covering emergencies that may occur during procedures. They gain exposure to the diagnosis and management of procedural complications and medical emergencies that may not otherwise be seen during the fellowship.
Teaching and Research Opportunities for Fellows
A primary goal of our fellowship is to develop effective teaching skills. Partnering with a faculty member, all fellows teach one to two sessions of a monthly pain medicine lecture series. Attending partners give feedback on presentation and teaching skills. Additionally, a one-hour presentation at grand rounds on a pain topic of the fellow’s choice occurs toward the last quarter of the fellowship. Teaching of residents and medical students is rendered at all clinical sites.
Fellowship Timeline and Application Process
Our program accepts six fellows each year. The Pain Medicine Fellowship participates in the National Resident Matching Program® (NRMP®), or The Match®, and the Electronic Residency Application Service® (ERAS®). To apply, register with ERAS® and complete the online application.
The fellowship runs from July 1 through June 30. Applications are accepted through May 31 of each year. We accept applications from candidates who have successfully completed a core anesthesiology, physical medicine and rehabilitation, neurology, or psychiatry residency by the start of the fellowship.
Candidates are evaluated on the strength of their preparedness, aptitude, academic credentials, ability to perform in a team-oriented multidisciplinary setting, ability to pass the pain medicine subspecialty board exam, communication skills, and personal qualities such as motivation and integrity.
Special emphasis is given to candidates with the desire to learn integrated and multimodal pain medicine in a multidisciplinary setting. We select motivated candidates who are planning to achieve board certification in their primary specialty as well as in pain medicine in addition to those who wish to practice predominantly pain medicine.
All applicants selected for an interview receive information on salary, leave, and the terms and conditions of employment on interview day. Applicants are interviewed by the Division of Pain Medicine faculty.
Following the NRMP® match date, all matched applicants receive an NYU Grossman School of Medicine offer letter from the program director.
For more information about the Pain Medicine Fellowship, please contact Shengping Zou, MD, program director, at firstname.lastname@example.org or 212-201-1004; or Pamela Shaw, program coordinator, at email@example.com or 212-598-6074.