Our multi-faceted, one-year program is designed to prepare a consultant for a rewarding career in pain management. Washington University Medical Center is a tertiary referral center and Level-1 trauma center. This broad clinical base gives pain management fellowship trainees an excellent opportunity to participate in managing a wide spectrum of pain problems. The trainees will have opportunities to care for patients from diverse backgrounds, different social economic statuses, and wide range of pain complexities.  

Participation of pain management fellowship trainees in research is included. In addition, the pain medicine fellowship program is excited to expand our fellowship training program to include a 24-month, combined research, and clinical fellowship track. The goal of this distinctive track is to help develop and explant the field of academic pain management by focusing on training clinician-scientists. 

Our pain management clinical practice is largely divided into two areas: acute and chronic pain management. The acute pain management service facilitates the exposure and training of fellows in managing postoperative and post-trauma pain, using various nerve blocks, and complex pharmacological management. This experience also assists fellows in the development of relationships with patients and colleagues, skills that are vital to becoming leaders in Pain Medicine in the community. 

Our fellowship is a rounded training program—the trainees will have ample interventional experiences and great exposure to multidisciplinary pain training, while at the same time enjoying a balanced work-life. There are built-in none clinical days for the fellows to participate in scholarly activities and wellness.  

The chronic pain management practice is primarily based at the Pain Management Center, Barnes-Jewish Hospital, with additional rotations at Missouri Baptist Hospital and Barnes-Jewish Hospital West County. Anesthetic, medical, and interventional techniques are used within the context of multidisciplinary pain management. In addition to the evaluation of patients, fellows gain expertise in fluoroscopic and ultrasound-guided interventional pain techniques, such as various nerve blocks, neuraxial blocks, joint injections, neurolytic procedures, and radiofrequency lesioning. The fellows will have opportunities to develop surgical skills including, trial and permanent placement of dorsal column SCS, DRG and peripheral stimulator, MILD, VTP, Vertiflex, and intrathecal pump  

A multidisciplinary approach is widely used and encouraged, through the regular and active participation of a pain psychologist, physical therapists, palliative care medicine, and neurologists. Various treatment modalities include acupuncture, biofeedback, physical therapy, psychotherapy, and interventional techniques such as local anesthetic and neurolytic nerve blocks, implantable pumps, and spinal cord stimulators. 

The importance of didactics is emphasized through weekly multidisciplinary pain conferences, didactic lectures, problem-based learning cases, and journal clubs. Weekly anesthesiology grand rounds and clinical conferences help fellows to remain updated with anesthesiology. Fellows are regular presenters at weekly didactic lectures. There will be one month of didactic that is devoted to practice building, contract negotiation, and billing. Monthly “hands-on” cadaver lab sessions provide excellent opportunities for practicing techniques of interventional pain management. Fellows will participate in patient safety training through Department Case Review Committee and Division M&M.  

Fellowship training may include rotations in psychology, toxicology, neurology, physical therapy, physiatry, palliative care, and/or other rotations. We currently have 17 faculty members with proficiency in a wide variety of skills. This high faculty-to-trainee ratio allows us to provide intensive, individualized training to maximize each fellow’s experience.