Introduction and Welcome from the Program Director, Leena Mathew, MD
Thank you for your interest in the Pain Medicine Fellowship Program at Columbia University Medical Center/New York Presbyterian Hospital. Our one year long Fellowship Program is fully accredited by the ACGME and is an integral part of the Department of Anesthesiology. Graduates of our program are eligible to continue their examination progress towards subspecialty certification in Pain Medicine. The fundamental goal of the Pain Medicine Fellowship program is to train excellent pain clinicians and future educators and investigators in the field. This is done through a carefully structured mentored experience, providing comprehensive, team-based interdisciplinary patient-centered care. Over the course of this year, we provide opportunity to develop increasing autonomy towards the achievement of demonstrated competence in the treatment of acute, chronic and cancer pain in adult and pediatric patients. The program is complemented by a comprehensive multidisciplinary didactic curriculum, with opportunities for basic and clinical research.
The Fellowship experience at Columbia University Medical Center
Experiential learning is attained through meaningful and responsible patient care under faculty supervision. Informal daily interactions with rotating residents, medical students, faculty and inter-professional team members occur in an academic environment that uniquely blends community and hospital-based medicine. These experiences prepare the pain medicine fellow for future practice in any setting. Patients are seen in the inpatient setting at the New York Presbyterian Hospital, Columbia University medical center. Additionally patients are seen for consultation and interventional therapy at the Columbia Doctors offices at 5 Columbus Circle. This state of the art ambulatory practice is three subway stops away from the main hospital. At both clinical sites the pain fellows obtain critical skills needed to provide patient care using an individualized, multidisciplinary approach with interventions focused on functional restoration and analgesia. The vast patient diversity affords exposure to a wide variety of pain problems that allow the fellow to develop competencies and skills needed to respond to the dynamic health care needs of patients across cultural and socioeconomic boundaries. They become facile at the art and science of integrating pain treatment with primary disease management.
Every core faculty member in the Pain Division is dedicated to providing compassionate, respectful, patient-centered care, while using stylistically distinct approaches to therapeutics and staying bound by ethical, evidence and value-based guidelines. This comprehensive training allows Pain Medicine fellows to broaden their perspectives and to develop the awareness needed to adopt practice styles consistent with their future career plans
Pain Medicine Fellowship Educational Activities
A comprehensive lecture series is in place to provide the didactic foundation for the fellowship. This complements their extensive clinical experience. Fellows who graduate from the Columbia Pain Medicine Fellowship program are able to document a procedural and clinical experience that far exceeds ACGME requirements and seamlessly prepares them for independent practice. Through direct observation and feedback from faculty and inter-professional team members, the fellows are able to self-reflect and evaluate their personal clinical effectiveness to constantly improve their own skills. This experience, in association with research/scholarly activities, helps to develop all aspects of the expert consultant. Formal feedback on their competency development, aided by a self-reflective learning portfolio process, helps the fellow in establishing and monitoring individualized learning plans. The fellows are expected to take the Pain Medicine In-Training Exam in the latter half of the fellowship year, as a measure of their acquisition of medical knowledge regarding Pain Medicine in anticipation of the actual subspecialty certification examination.
I. Rotations and Clinical Experience
The fellowship clinical experience comes through rotations divided into repeating cycles for a longitudinal experience, consisting of two weeks in an outpatient office-based practice, four weeks in the Interventional Suite and two weeks of chronic inpatient care interspersed with one-two week multidisciplinary experiences throughout the year. The multidisciplinary experiences include Psychiatry, Electrophysiology, Palliative Care, Physical medicine and rehabilitation, Physical therapy, Pediatric Pain, Neuro-radiology and Neurosurgery. Fellows who come from backgrounds other than Anesthesiology are additionally trained in the core concepts of Anesthesiology through a structured four week rotation to develop basic competency and understanding of emergency airway management, neuraxial techniques and to develop basic familiarity with use of local anesthetics, intravenous analgesics and sedation techniques. All fellows participate in national cadaveric courses to enhance their understanding of advanced implantation techniques. Additional elective time may be arranged as well depending on the background and interests of the fellow.
In addition to clinical rotations, fellows are required to engage in an academic project in clinical or basic science for the year with faculty mentorship culminating in a presentation at the Academic Evening held each year by the Department of Anesthesiology, and/or other professional meetings. Participation in state and national meetings is highly encouraged and meeting time and financial support is provided. Additionally, all fellows present a grand rounds lecture for the Department of Anesthesiology. We train our fellows to be educators by ensuring their participation in the clinical education of our residents as well as medical students.
The Center for Pain Medicine
Fellows obtain their clinical experience in interventional procedures and treatment modalities as detailed below at the Columbia Doctors Pain Practice at 5 Columbus Circle on 1790 Broadway. The cutting edge facilities at this location include well appointed consult and exam rooms, a recovery room and an interventional suite. The Interventional suite is equipped with a state of the art fluoroscopy unit, GE ultrasound unit for image guided interventions and a Neurotherm radiofrequency ablation unit for radiofrequency procedures. Advanced invasive interventional procedures including implantable techniques are performed in the Operating Rooms in New York Presbyterian Hospital-Columbia Medical Center.
- Cervical Epidural Steroid Injections
- Cervical medial branch nerve blockade
- Radiofrequency ablation of the medial branch nerve
- Cervical selective nerve root blocks
- Stellate ganglion blockade
- Ultrasound guided brachial plexus blockade for acute, chronic and cancer pain management
- Epidural steroid injection
- Intercostal nerve blockade and radiofrequency
- Ultrasound guided paravertebral blockade and catheter placement
- Epidural steroid injections
- Selective nerve root blockade
- Medial branch blockade and Intraarticular facet injections
- Radiofrequency ablation of medial branches
- Sacroiliac joint blocks
- Piroformis injection
- Vertebral augmentation procedures
- Lumbar sympathetic nerve blocks
Abdominal and Pelvic Procedures
- TAP blocks for acute, chronic and cancer pain with ultrasound guidance
- Celiac plexus and splanchnic nerve blockade
- Hypogastric plexus block
- Pudendal nerve block
- Ganglion Impar block
- Neurolysis procedures
- Peripheral nerve blockade and radiofrequency ablation
- Intrathecal and epidural trials
- Intrathecal pump placement for cancer pain management
- Spinal cord stimulator trial and implantation
- Occipital nerve stimulators
In addition to diagnostic peripheral nerve blocks and perineural catheter placement for infusion therapy for pain management, radiofrequency and cryoablation techniques are also employed in the following areas:
- Supraorbital, infraorbital and supratrochlear
- Brachial and lumbar plexus
- Ultrasound and fluoroscopy guided joint injections
- Bursa injections with ultrasound and fluoroscopy guidance
- Trigger point injections
- Epidural blood patch
- Botox for migraines and musculoskeletal pain syndromes
In addition to interventional techniques, the following treatment modalities are also offered at The Center for Pain Medicine:
- Cognitive behavioral therapy
- Non steroidal anti-inflammatory agents
- NMDA antagonists
- Calcium channel blockers
- Topical agents
- Muscle relaxants
II. Didactic Curriculum
The didactic curriculum is comprehensive and is based on the ACGME requirements for training in Pain Medicine, as well as the Content outline for the Pain Medicine subspecialty Certification exam, the International Society for the Study of Pain, and evolving trends in Pain Medicine
Behavioral Psychology Seminar: 2nd Tuesday 8:00AM- 9:00 AM
This informal session allows the fellows and residents to discuss pain medicine cases with complex psychopathology and offers a problem based learning scenarios. It also provides an opportunity for self-reflection and improvement.
Pain Psychology Lecture: 4th Tuesday 8AM-9AM
This lecture series provides a structured curriculum to enable fellows to concentrate on psychopathology as well as behavioral interventions targeting patients with acute, chronic and cancer pain.
Department of Anesthesiology Grand Rounds: Thursdays, 7:00 - 8:00 a.m.
Pain Fellows are expected to attend and participate in Grand Rounds offered by the Department of Anesthesiology. Grand Rounds covers topic areas pertinent to evolving areas of Anesthesiology, Critical Care and Pain Medicine. During the course of the year, in collaboration with Pain Medicine Faculty, the Pain Medicine fellows provide at least one presentation pertaining to Pain Medicine.
Core Fellowship Didactic Lecture Series: 1st and 3rd Fridays 8: 00 9:00 AM
Provided by Pain Medicine Core faculty as well as Multidisciplinary Faculty and guest speakers from Addiction Medicine, Neurology, Physical Medicine and Rehabilitation, Critical Care Medicine and Neurosurgery. Additional topics in Patient Safety/Quality Improvement methodologies, Epidemiology, basic science research and statistics are included in the core lecture series, as well as areas of Faculty clinical and academic interest.
Journal Club: 2nd Friday 8:00 - 9:00 a.m.
Critical evaluation of the medical literature, understanding evidence based approach and current advances in the field of basic and clinical pain research is a key component of the fellowship. Fellows are encouraged to choose meaningful articles with faculty for discussion at journal club and spearhead discussions. Additionally residents rotating in Pain Medicine also participate and engage fully in journal club presentations.
Case Conference: 4th Friday 8:00- 9:00 AM
This multidisciplinary conference includes all Pain Medicine faculty/staff, trainees and invited faculty/staff from other departments. Selected cases are presented and discussed. In addition to being an educational forum, this conference serves to improve patient care through the open discussion of treatment successes and failures. As such, this conference is an integral part of the Quality Improvement/Patient Safety process.
Pain Medicine Board Review:
This specialized format held during the last month of fellowship, reviews all topics and questions relevant to the examination for subspecialty certification in Pain Medicine.
Department of Anesthesiology Research Seminars
Pain Medicine fellows have the opportunity and are encouraged to attend Department of Anesthesiology Research Seminars that are held on a monthly basis.
Fellow Participation in the Education of other Learners
Our fellows are afforded the opportunity to further their own skills to prepare them to be future consultants and role models as proficient teachers who demonstrate quality improvement and patient safety in the context of their everyday practice.
The Pain Faculty and Fellows play an active role in medical student education. The fellows prepare and present an introduction to pain management lecture to the Columbia University medical students as part of their Anesthesia experience in their Major Clinical Year (MCY). In addition, the Department sponsors a four week Multidisciplinary Pain Medicine elective for senior medical students. During the rotation the medical student is encouraged to be an integral part of the team with the Pain Fellows and rotating residents. The fellows have the opportunity to work with the Faculty in providing exposure to all aspects of clinical pain medicine.
The fellows also have the opportunity to collaborate with the Pain Faculty in the education of Anesthesia residents. Fellows participate as a team member as the residents are exposed to the entire spectrum of pain syndromes. While residents gain clinical experience in a graduated fashion through rotations in acute pain, office based outpatient pain management, inpatient pain and the interventional suite, fellows enhance their own teaching, mentoring and feedback skills.
Core Pain Faculty
Anthony (Robin) Brown, M.B.Ch.B., F.F.A. (S.A.)
Professor of Anesthesiology at CUMC and Vice Chair
Chief, Division of Orthopedic and Regional Anesthesia
Board Certified in Anesthesiology
Anis Dizdarevic, MD
Assistant Professor of Anesthesiology at CUMC
Fellowship: Pain Management, Brigham & Women's Hospital, Harvard Medical School
Board Certified in Anesthesiology and Pain Medicine
Robert Maniker, MD
Assistant Professor of Anesthesiology at CUMC
Director, Acute Perioperative Interventional Pain Program
Fellowship: Pain Management, Brigham & Women's Hospital, Harvard University
Board Certified in Anesthesiology and Pain Medicine
Leena Mathew, MD
Associate Professor of Anesthesiology at CUMC
Director, Pain Medicine Fellowship Program
Fellowship: Columbia University
Board Certified in Anesthesiology and Pain Medicine
William S. Schechter, MD, MS, FAAP
Professor of Anesthesiology & Pediatrics at CUMC
Chief, Division of Pediatric Pain Medicine, Symptom Management and Palliative Care Director, the Pediatric Pain Medicine Program and Advanced Care Team
Board Certified in Pain Medicine, Critical Care Medicine, Pediatrics and Anesthesiology
Nomita Sonty, PhD
Associate Professor in Medical Psychology (in Anesthesiology & Psychiatry) at CUMC
Fellowship: Pain Management & Behavioral Medicine, St. Louis University Health Sciences Center
Michael L. Weinberger, MD
Professor of Anesthesiology at CUMC
Chief, Division of Pain Medicine
Fellowship: Pain Management, Memorial Sloan-Kettering Cancer Center
Board Certified in Internal Medicine, Anesthesiology, Pain Medicine, and Palliative Care
Who can apply?
Residents who are completing an-ACGME accredited residency in any of the following fields are eligible to apply for a fellowship in Pain Medicine.
- Rehabilitation Medicine
What are the salary and benefits for the Pain Medicine Fellows?
All fellows receive a competitive salary and benefits from New York Presbyterian Hospital (NYPH), our ACGME Institutional Sponsor. Please refer to the NYPH Graduate Medical Education Website for more specific information.
What additional support is provided by the Department of Anesthesiology?
The Department provides an educational allowance for all fellows of $1600, which can be used to attend a pre-approved professional meeting, or to purchase additional books or an iPad. All pain fellows are given the following Pain Medicine texts at the outset of their fellowship:
- Interventional Radiology of the Spine, McGraw
- Image-Guided Spine Intervention, Fenton and Czervionke
- Essentials of Pain Medicine, Benzon, et. Al
- Basic Surgical Techniques, Kirk
- Atlas of Implantable Therapies for Pain Management
- iPad Mini
How do I apply?
The Pain Medicine Fellowship participates in the National Resident Matching Process. Applications are accepted through ERAS starting December 1- June 30, in anticipation of the NRMP Match opening in June. Additional information on the application process and NRMP Match can be found below
Electronic Residency Application System (ERAS)
National Resident Matching Program (NRMP)
For further information, regarding applying to the Pain Medicine Fellowship please email or contact:
Coordinator, Pain Medicine Fellowship Program
622 West 168th Street (PH 5-Stem)
New York, NY 10032
Or the PD, Dr. Leena Mathew - firstname.lastname@example.org