Clinical Pain Medicine Fellowship Experience & Curriculum

Interventional Experience

Our division is proud to offer our patients and trainees a diverse range of interventional pain techniques, including fluoroscopic and ultrasound based procedures. As a tertiary and quaternary center, we routinely perform challenging and higher risk procedures on complex patients. Please click the button below to download the Interventional Medicine Slideshow and see some examples of these procedures.

As listed below, our fellows gain experience by treating a complex and diverse patient population in various clinical settings. Fellows divide their time at four training sites throughout the year. Two months of academic time are specifically allocated for independent research and development.

In addition to clinical responsibilities, fellows are expected to attend weekly didactic lectures, teaching rounds, monthly journal club meetings, grand rounds, and mortality and morbidity conferences. We also encourage our fellows to register and attend relevant national pain conferences and workshops.

Stanford Medicine Outpatient Center

5 Months

  • Pain Clinic
  • Office, U/S Procedures

2 Months

  • O.R. Procedures

Stanford Hospital

2 Months

  • SCIPP
  • Acute Pain Service
  • O.R. Procedures

VA Palo Alto

2 Months

  • Pain Clinic
  • O.R. Procedures

Other

7 Weeks

  •  Academic 

1 Week Each

  • Neuro-radiology
  • Neuro-spine Clinic at Neurosurgery 
  • Pediatric Pain

Procedural Experience

Our fellows receive experience in performing a wide variety of interventional procedures (listed below). If they wish to gain experience in other procedures, we will arrange for them to train with our colleagues at in other specialties, such as neurosurgery and orthopaedics, or with an affiliated community pain practice.

Advanced Procedures

  • Minimally Invasive Lumbar Decompression (MILD)
  • Intrathecal Pump Implantation
  • Spinal Cord Stimulator Implantation
  • Spinal Catheter Placement and Infusion Trial
  • Spinal Cord Stimulator Lead Trial
  • Neuromodulation revision
  • Peripheral Nerve Stimulation
  • Sacroiliac Denervation (via SImplicity III)
  • Indwelling Catheters for Infusion Therapy (eg- epidural, intraspinal, lumbar plexus, peripheral nerve)

Sympathetic Blocks

  • Stellate Ganglion
  • Celiac Plexus
  • Lumbar Sympathetic
  • Superior Hypogastric Plexus
  • Ganglion Impar

Head and Neck Blocks

  • Trigeminal (Gasserian and Trigeminal Divisions)
  • Sphenopalantine Ganglion
  • Peripheral Nerve Blocks

Neurolytic Techniques

  • Continuous and pulsed radiofrequency treatments to medial branch nerves, peripheral nerves, scar neuromas
  • Absolute EtOH injections

Ultrasound Guided Pain Techniques

  • Major bursa and joint injections
  • Stellate ganglion blocks
  • Peripheral nerve blocks
  • Trigger point injections

Infusion and Other Medication Therapies

  • Interthecal Ziconotide (Prialt)
  • Intravenous Ketamine
  • Intravenous Lidocaine
  • Topical 8% Capsaicin (Qutenza)

Neuraxial Procedures

  • Epidural steroid injections
  • Epidural blood patches
  • Medial branch nerve blocks
  • Facet joint injections
  • Selective nerve root blocks
  • Sacroiliac joint injections
  • Caudal injections

Other Pain Management Procedures

  • Scar injections
  • Trigger point injections
  • Botox injections via the PREEMPT protocol for Migraine Headaches
  • Bier blocks

Second Fellowship Year in Pain Research

A second fellowship in pain research is available following completion of the first clinical year. Research fellows are given 4 days per week (80% time) to conduct research and 1 day per week (20% time) as a clinical instructor in the pain clinic.

Applicants are also encouraged to apply for the T32 Anesthesia Training Program in Biomedical Research, or for Dr. Mackey's recently awarded T32 Interdisciplinary Research Training in Pain and Substance Use Disorders. Fellows will have a year of research targeted toward their individual needs and goals. We have had significant success in mentoring and developing fellows to obtain fellowship and NIH K award training. More information on the research being conducted in the Division of Pain Medicine can be found at the Stanford Systems Neuroscience and Pain Lab (SNAPL) website.

Life After Fellowship

Our program focuses on training future leaders in the field of pain medicine, whether they pursue academic or community practices. The table below indicates the number and percentage of fellows between 2006 and 2012 who have pursued academic practice, community practice, or an additional fellowship, immediately following the conclusion of their fellowship.

Since our program’s inception in 1989, our graduates have established pain clinics throughout the country, developed institutional pain programs, and conducted groundbreaking pain research. We maintain close, collaborative relationships with our graduates throughout their careers.