Multidisciplinary Pain Medicine

Sites: MGH
Director(s): Alberto Puig, Shiqian Shen
Prerequisites: HMS Principal Clinical Experience (Core Clinical Clerkships) or equivalent
Offered: Full time every month.
Location: MGH - Mass. General Hospital (3)
Open to Exclerks: Yes (may be restricted for international students)
Description: Since pain is a prevalent feature in treating all patients, this rotation is intended to offer training for students interested in any clinical specialty. Students will be directly involved with the practice of contemporary multidisciplinary Pain Medicine including acute, chronic and cancer pain. Students will work with attending staff from disciplines of anesthesiology, palliative care, psychiatry, neurology, and physical medicine and rehabilitation. They will follow staff, fellows and residents on daily rounds on the inpatient and service as well as in the outpatient clinic. Students will be part of the team that provides medical management of chronic and cancer pain in both the outpatient continuity care setting and the inpatient consultation setting. Students will also be exposed to interventional procedures, such as nerve block techniques like epidural steroid injections, sympathetic nervous system blocks (stellate ganglion blockade, lumbar sympathetic blockade, intravenous phentolamine), facet joint blockade, as well as bier blocks and intravenous lidocaine infusions. The program offers a daily mix of formal and informal educational experiences. Students are exposed to contemporary thinking in pain treatment from multiple disciplines. Our core faculty collectively has formal training in Pain Medicine as well as Anesthesiology, Neurology, Internal Medicine, Pediatrics,Psychiatry, basic science research and clinical trials. Collaborations with almost every other service at MGH offer our students an extremely diverse experience. From the experience on this rotation, students will be expected to have gained the following skills: 1) understand basic concepts of the physiology of pain; 2) understand and be able to perform a pain oriented evaluation and physical examination; 3) understand the known diagnostic classifications of pain and their treatments; 4) understand the complex interplay of medical, psychological and social issues with pain; and 5) understand the basic indications for and practice of analgesic therapy.
Incorporation of Basic Science Content and Evidence-Based Medicine:
Clinical practice in inpatient and outpatient services emphasize evidence based medicine and principles are applied daily. There is also opportunity to learn from pain researchers. There is a breadth of experience among our staff who spend condiderable time in basic and clinical research studies. We offer didactic sessions throughout the month, including journal club, two weekly conferences (one broad topic chronic pain, and one interventional pain), as well as fellow presentations to residents and weekly anesthesia grand rounds.
Grade Criteria:
Honors with Distinction: Well exceeds expectations and demonstrates the highest level of knowledge base, diligence, high complementary evaluations from pain center faculty, displays compassionate care and high degree of professionalism. Honors: Exceeds expectations and demonstrates a high level of competency, as evidenced in evaluations from pain center faculty. Satisfactory: Satisfies the requirements of the course. Unsatisfactory: Fails to attend and participate, does not apply principles to practice