Pain Fellowship Program

Friedl Pantle-Fisher, MD
Director and Associate Professor

The Pain Medicine Center at the University of Chicago Medical Center (UCMC) is a pain program accredited by the Accreditation Council for Graduate Medical Education (ACGME) since 1996. Each accreditation cycle was for 5 years unconditionally. It provides two (2) fellowship positions per year.

The fellowship program consists of a twelve (12) month program at the Pain Medicine Center of the University of Chicago Medical Center. The fellowship program is designed to provide intensive training in the evaluation and treatment of patients with chronic pain of benign and malignant etiology, and in the differential diagnosis of chronic pain states. Emphasis is placed on multidisciplinary approaches to pain management in outpatient, in-patient, as well as intensive care settings. Our environment of care includes consultation with other specialties ( e.g. General Surgery, Pediatrics and Pediatric Surgery, General Medicine, Hematology/ Oncology, OB/GYN, Neurosurgery, Orthopedics, Neurology, Radiology, Physical Therapy, Occupational and Rehabilitation Medicine, Psychology and Behavioral Medicine) as needed to best meet the needs of pain patients.

The program provides rotation through specialties, such as Neurology, Radiology, Physiatry and Rehabilitation Medicine, Psychiatry, Oncology and Palliative Care, as required by the new ACGME requirements for fellowship education starting in July, 2007.

Each fellow has special responsibilities in the In-House Pain Management Consult Service at the University of Chicago Medical Center. Fellows provide care to postoperative surgical patients and chronic pain patients (weekends and overnight coverage, calls are taken from home during the night), as well as teach and guide the CA-1, CA-2 and CA-3 residents and students rotating through the Pain Medicine Center.

Intensive Care Medicine is an important part of the curriculum in regard to the postoperative management of surgical patients (no PCA coverage for routine post-surgical patients), as well as the management of chronic cancer patients. Principles and techniques of acute postoperative pain management, especially of patients requiring an intensive care environment, are components of the clinical training experience.

Additionally, our curriculum offers fellows familiarity with theory, indication, and practical application of multiple non-invasive and invasive procedures, mostly performed under fluoroscopy guidance for diagnostic and therapeutic purposes in many chronic and acute pain states.

Procedures are performed five days per week under fluoroscopy guidance.

The following procedures are most frequently performed by the fellows during their one-year rotation:

Regional and Central Analgesic Techniques

1. Trigger point injections
2. Various joint and bursa injections
3. Minor and major joint injections
4. Caudal, lumbar, thoracic and cervical epidural steroid injections
5. Caudal lysis of epidural adhesions
6. Peripheral and central somatic nerve and plexus blocks
7. Diagnostic and neurolytic sympathetic ganglion and plexus blocks
8. Neurolytic nerve blocks
9. Tunneled catheter placements into various nerve sheaths
10. Radiofrequency ablative procedures
11. Dorsal column stimulator trials
12. Intra-spinal catheter placements for intrathecal opioid trials
13. Dorsal column stimulator trial and permanent placement (in conjunction with Neurosurgery)
14. Intra-spinal catheter placements with implanted infusion systems (in conjunction with Neurosurgery)
15. Discography
16. Intradiscal Electro Thermocoagulation (IDET)
17. Ultrasound-guided procedures are performed as indicated.

Didactics

The fellows have ample time allotted for didactic sessions. Pain Medicine conferences include daily one-hour morning teaching sessions with active trainee participation in the presentation of various pain topics, particularly the management of the chronic pain patient; there are presentations and discussions of newly published articles and journal reviews, as well as monthly morbidity and mortality conferences.
     
An In-House Consult Service for treatment of in-patients with acute and chronic pain states provides trainees with ample opportunities and significant experience in preparation for the role of a consultant in Pain Medicine and Intensive Care Medicine. Trainees are supervised by faculty members on a daily basis in the Outpatient Pain Medicine Center, as well as during their In-House Acute/Chronic Pain Consultation rotation.

Role of the Pain Management trainee as a consultant to other specialties

The pain medicine trainees will, in preparation for their role as a consultant in pain medicine, gain significant experience in providing consultation under the direction of the pain faculty. The trainee is responsible for evaluation of the patient, communication of their clinical findings, and development of a detailed treatment plan. Additionally, the trainee will perform any necessary diagnostic and therapeutic pain management procedures to complete the patient’s treatment plan. 

Role of the Pain Medicine trainee in teaching other residents

The Pain Medicine program provides the trainee with the opportunity to develop skills in clinical care and judgment, as well as to gain broad knowledge and technical skills. This enables the trainee to act as instructor to anesthesia residents rotating through the Pain Medicine Program, teaching patient management and the performance of procedures.  The trainee also helps to structure the teaching schedule for the daily one (1) hour teaching sessions, and prepares case presentations of interesting patients that will provide additional outcome learning experiences.

Research Experience

Research is facilitated by an existing, active research program of the UCMC, Department of Anesthesia and Critical Care. While one year of fellowship is often too short to begin an independent research project, there is research space and more than ample equipment available for joining a research project for the devoted trainee.

We expect that fellows during their one year fellowship be involved in active scholarly activities, which will be established and maintained by the faculty, and which includes peer-reviewed publications of original research in a peer-reviewed journal, review articles or chapters in textbooks, as well as publications or presentations of, for example, case reports or clinical series at local, regional, or national professional and scientific society meetings.

Complementary to the above scholarship is the regular participation of the teaching staff in clinical discussions, rounds, journal clubs, and research conferences in a manner that promotes a sprit of inquiry and  scholarship.

Call Policies

Fellows will share the coverage for the APS/In-House Consult Service with the CA-I, CA-II and CA-III residents during the night and on weekends and holidays, but in general take four to six (4-6) calls per month.
Calls are taken during the day in-house, and during the night from home.

Fellows trained since the accreditation of the Fellowship Program in 1996:

33 fellows were trained since the accreditation of our Pain Medicine Program in 1996. Most of them continued in academic positions but also in private practices.

FACULTY

A total of five (5) faculty members of the Department of Anesthesia and Critical Care, all board certified in Anesthesiology with a Certificate of Added Qualification in Pain Management by the American Board of Anesthesiology are primarily assigned to the Pain Medicine Center at the University of Chicago Medical Center (UCMC)

The faculty teach, supervise and train fellows on a daily basis, five (5) days per week, in all aspects of acute and chronic pain management, including the intensive care environment

Friedl Pantle-Fisher, M.D.
Director
Pain Medicine Center
Associate Professor
Department of Anesthesia and Critical Care
University of Chicago Medical Center

Gita Rupani, M.D.
Faculty
Pain Medicine Center
Assistant Professor
Department of Anesthesia and Critical Care
University of Chicago Medical Center

Tariq Muslim Malik, M.D.
Faculty
Pain Medicine Center
Assistant Professor
Department of Anesthesia and Critical Care
University of Chicago Medical Center

Magdalena Anitescu, M.D.
Faculty
Pain Medicine Center
Assistant Professor
Department of Anesthesia and Critical Care
University of Chicago Medical Center

Andrea Shashoua, M.D.
Faculty
Pain Medicine Center
Assistant Professor
Department of Anesthesia and Critical Care
University of Chicago Medical Center

Atul Gupta, M.D.
Faculty
Pain Medicine Center
Clinical Associate
Department of Anesthesia and Critical Care
University of Chicago Medical Center

STAFF:

Clinical Operations Supervisor:
Natasa Vujic

Outpatient Pain Clinic Nurses:
Janet Rook, RN, BSN
Joanne Morsovillo, RN
Yvette Thomas, RN
Mae Watkins, RN, BSN

Medical Assistants:
Shconia Johnson
Khanedgia Harris

Pain Clinic Secretaries:
Elizabeth Kadisak
Sue Mullen

Radiology Technicians:
Rotating, Department of Radiology Staff

Fellowship Application

The University of Chicago is an Equal Opportunity Employer.