Core Clinical Experience

Mayo Clinic Pain Clinic (7-8 months)
Pain medicine fellows train under the supervision of the pain clinic faculty. Trainees participate in the evaluation and treatment of patients with a wide variety of pain problems including cancer pain, spine pain, sympathetically mediated pain, neuropathic pain, visceral pain, and myofascial pain. Trainees are expected to completely evaluate their patients and present their findings and treatment plans to pain medicine faculty. Typical treatment plans may include, interventional pain procedures, medications, physical therapy, or behavioral modification approach to treatment. Fluoroscopically-guided interventional pain procedures are performed in the on site procedural facility located within the Mayo Clinic Hospital

Hospital-Based Pain Consultation Services at Mayo Clinic Hospital
The pain medicine fellow will learn how to evaluate postoperative pain patients, manage complications, and, most importantly, how to organize and safely manage a hospital-based pain consultative service. All hospital-based pain service activities are directly supervised by pain medicine faculty. The hospital training experiences is incorporated throughout out the 7-8 month rotation in the pain clinic.

Additional rotations available
Neurology Rotation (2 weeks)
The pain medicine fellow will develop the necessary knowledge, attitudes, and skills required to manage patients with neuropathic pain and headaches.

Physical Medicine & Rehabilitation Rotation (2 weeks)

The pain medicine fellow will gain experience in assessing chronic pain patients using a rehabilitation model. Each fellow will develop the necessary knowledge, attitudes, and skills to initially evaluate and appropriately refer patients for therapy, including development of a rehabilitation plan of care. In addition, the fellow will also be exposed to physical and occupational therapy treatment sessions for the patients they evaluate and refer for therapy

Neurosurgery Rotation (2 weeks)

The pain medicine fellow will gain experience in assessing patients for neurosurgical intervention for spine and limb pain. They will be involved in pre-operative and post-operative assessment. They will also receive education regarding basic surgical skills such as surgical preparation, sterile technique, skin suturing technique, and post-op wound assessment / management.

Neuroradiology Rotation (2-4 weeks)

The pain medicine fellow will develop the knowledge and skills necessary to make appropriate decisions regarding the utilization of available imaging techniques including x-ray, CT, and MRI. Interested trainees can learn the indications and techniques for intradiscal procedures and vertebral augmentation.

Psychology / Behavioral Medicine (2-4 weeks)
The pain medicine fellows will learn to recognize psychologic symptoms and syndromes and to initiate appropriate treatment and consultation. This knowledge base will enable the fellow to differentiate between symptoms that are suggestive of a primary psychologic disorder from those suggestive of a primary neurologic disorder.

Anesthesia Skills Training (2weeks)
The pain medicine fellow will be able to prevent, recognize, and treat immediate and potentially life-threatening complications that can occur following interventional pain management techniques. Trainees will complete the ACGME required training regarding airway management, intubation, sedation, and IV access among other skills.

Electromyography (EMG) (2 weeks)
This elective is specifically tailored to those trainees who have attained prior competence in EMG and wish to hone their skills prior to departing the fellowship. Fellows will perform routine and complex nerve conduction studies (NCS), and needle EMG independently in a supervised setting.

Hospice/Palliative Care (2 weeks)
The pain medicine fellow will learn basic concepts of hospice care including eligibility and certification; cancer pain and symptom management in terminal patients; and ethical issues related to death and dying. Information about palliative sedation, depression and anxiety management are taught during this rotation. Trainees are supervised by faculty specialists in palliative care during this training.

Anatomy Dissection Laboratory (1 week)
An anatomy course is offered through Mayo Clinic in Rochester, MN and is organized specifically for pain medicine trainees and conducted on an annual basis. Fellows are asked to dissect anatomical areas of interest that are relevant to pain medicine training and practice. Pain medicine trainees and faculty subsequently meet in the Anatomy Laboratory to review the dissection with the assistance of an anatomy faculty. Anatomy dissection conferences are conducted during the spring quarter each year.