Department of Anesthesiology
Pain Management Fellowship Program Overview
Entry into the Program
Summary of Benefits
The Department of Anesthesiology of the Texas Tech University Health Sciences Center
(TTUHSC) is located in Lubbock, Texas. In the heart of West Texas; rich agricultural
region, Lubbock is a growing educational, commercial, medical, and cultural center.
The metropolitan population, in excess of 200,000 residents, lives in mild seasonal
conditions with an average of 267 days of sunshine per year. With eight hospitals
and no less than 85 health care clinics, Lubbock is known as the medical center for
West Texas and Eastern New Mexico.
Lubbock's entertainment possibilities range from major theatrical touring companies,
to weekend rodeos, to exhibits at the museum of Texas Tech University. The city maintains
a symphony orchestra, ballet company, civic chorale and numerous community theatres.
Regional outdoor activities are limitless with only short drives from the city. Depending
on the direction of the excursion, residents can enjoy desert terrain sports, inland
lake activity, or seasonal mountain adventures. New Mexico ski resorts can be reached
in less than a five hour drive. For more information about the City of Lubbock, click
Under the guidance of Director Miles Day, MD, the Department of Anesthesiology and
International Pain Center offers three 12-month positions each year.
The fellowship program is, to a large extent, evaluation and management of complex
pain problems by a multi-disciplinary team. The fellowship program trains candidates
to be qualified in pain management by the American Board of Anesthesiology and the
American Board of Pain Medicine. Fellows must have completed an anesthesiology residency
at an accredited residency training program. Fellows completing a residency in a specialty
other than anesthesiology will be considered on an individual basis. Fellowship training
is available in common and advanced interventional techniques such as radiofrequency,
cryoneurolysis, neuroaugmentation in the form of spinal analgesics, peripheral nerve
stimulation and the use of spinal narcotics, continuous epidural infusion, and peripheral
nerve infusions. Behavioral management, pharmacological management, rehabilitative
management, and cancer pain management are also encompassed in the program. Fellows
are also required to participate in teaching and research activities.
The Pain Center at Grace Clinic sees approximately 1,000 patients per month and performs
300-500 in-patient and out-patient procedures. Of these, approximately ninety percent
are chronic pain patients, forty percent are in-patients, six percent are acute pain
patients, and four percent are cancer pain patients. Services directly available in
the program include: physician evaluation, multi-specialty evaluation, and multi-disciplinary
management (Anesthesia, Psychology, Neurology, Physical Medicine and Rehabilitation).
The Pain Management Fellowship Program at Texas Tech University Health Sciences Center
Department of Anesthesiology is fully accredited by the ACGME.
Please visit the American Board of Anesthesiology website in order to review the ABA Booklet of Information. The Booklet of Information
provides information on the policies, procedures, regulations, and requirements regarding
the certification and eligibility process to take the board examination.
The purpose of the training program is to provide in-depth pain medicine training
to fellows enrolled at TTUHSC. The learning objectives encompass the six Core Competencies
and include in-depth graduate medical training in key areas of modern pain medicine:
Acute Pain, Chronic Pain, Cancer Pain, and Hospice and Palliative Care. The core
curriculum content reflects the current subspecialty pain management program published
by the American Board of Anesthesiology.
Goal: The fellow will provide care that is compassionate, appropriate, and effective for
the treatment of the patient with acute and chronic pain. The fellow will develop
manual dexterity and be able to develop and execute patient care plans appropriate
for their level of training.
- Learn and perform thorough assessments of patients in acute and chronic nonmalignant
and malignant pain
- Develop and implement treatment plans using clinical and scientific data and patient
Competently perform all medical and invasive procedures considered essential for managing
pain which include, but not limited to:
- Image-guided cervical, thoracic and lumbar spinal injections
- Minor and major joint or bursa injections
- Trigger point injections
- Sympathetic blocks
- Neurolytic techniques including chemical and radiofrequency treatment for pain
- Intradiscal procedures including discography
- Spinal cord stimulators
- Placement of permanent spinal drug delivery systems
- Vertebral body stabilization techniques
- Collaborate and communicate effectively with patients and their families
- Achieve and document the required number of patient interactions required in each
of the disciplines described in the ACGME Pain Medicine Fellowship Program Requirements
Goal: The fellow will achieve detailed knowledge of the evaluation and management of pain
patients. The fellow will learn to critically evaluate and demonstrate knowledge of
how to access today’s scientific information.
- Develop an investigatory and analytical thinking approach to clinical situations
Recognize and apply knowledge of clinical sciences that is appropriate to pain management
- This includes, but no limited to, the topics stated in the ACGME Pain Medicine Fellowship
- Incorporate their didactic teaching in the field of pain management into the management
of their patients pain
- Stay current with up-to-date medical knowledge
- Develop and apply an algorithmic approach to the treatment of pain
- Develop the ability to critically appraise evidence about treatment effectiveness
as it relates to pain management
- Identify an area of pain management from which to create a Grand Rounds presentation
- Encouraged to establish new or participate in ongoing departmental pain research studies
Practice-based Learning and Improvement
Goal: The fellow will investigate and evaluate his or her own patient care practices,
appraise and assimilate scientific evidence, and initiate improvement in patient care.
- Utilize their personal faculty, ancillary staff and patient evaluations to assess
the effectiveness of their patient care activities
- Incorporate evidence from scientific studies relating to the treatment of pain into
the patient’s treatment plan
- Use information technology to support medical decision-making processes
- Interact with the professional, technical, and clerical personnel as it relates to
- Participate in quality assurance/improvement conferences
Interpersonal and Communication Skills
Goal: The fellow will learn to demonstrate interpersonal and communication skills that
result in effective information exchange with patients, their families, and professional
- Work with faculty, colleagues, and support staff in an efficient, courteous manner
that facilitates patient care
- Communicate and sustain a therapeutic and ethically sound relationship with patients
and their families
Goal: The fellow will learn to demonstrate a commitment to carrying out professional responsibilities,
adherence to organizational and ethical principles, and demonstrate sensitivity to
diverse patient population.
- Maintain a professional appearance
- Observe HIPAA regulations at all times
- Apply professional and ethical principles to the practice of medicine
- Demonstrate sensitivity and responsiveness to patient’s culture, age, gender, religion,
sexual preference, socioeconomic status, beliefs, behaviors and disabilities
- Practice medicine that ensures patient safety
- Treat the anxious or distressed patient and/or family member with respect, compassion,
integrity and kindness
Goal: The fellow will demonstrate an awareness of, and responsiveness to, the larger context
and system of healthcare and be able to call on system resources to provide care that
is of optimal value to their patients.
- Provide clear and thorough documentation of the patient evaluation, including information
from previous medical records
- Obtain appropriate medical records from other facilities
- Practice cost-effective healthcare that does not compromise quality of care
- Learn business skills necessary for effective practice management
Rotations have been established with Neurology, Psychiatry, Physical Medicine and
Rehabilitation, and Palliative Care. Below is a brief description of each of the rotations
each Fellow will experience in Pain Management Program at Texas Tech University Health
4 week inpatient neuropsychiatry rotation at University Medical Center
Essentials of neurologic and psychologic examinations
Instruction in evaluation of neuroimaging studies
Fellow spends four weeks on block rotation
Physical Medicine and Rehabilitation
2 week inpatient (University Medical Center) and outpatient rotation (clinic)
Essentials of PM&R physical examination
Dystonia and spinal cord injury clinic
Fellow spends 2 weeks on block rotation
Inpatient hospice and home visits with faculty and staff
1 week Hospice rotation (5 consecutive Fridays)
Cancer Pain Clinic; UMC TTUHSC Cancer Center
Friday morning Tumor Board Conference
Every Friday morning
Acute and chronic cancer pain clinic
Inpatient consult service
Fellow attends at least 8 clinics
Pain fellows are required to either be involved in ongoing clinical, translational,
or basic research, or initiate research. Prior to completion of the fellowship, fellows
will participate in the presentation of research in the quarterly Pain Grand Rounds
and write a manuscript suitable for publication.The Anesthesia Research Laboratories
have analytical chemistry and related equipment (HPLC, IR, and UV Spectrophotometers)
that are used to measure concentration of drugs in biological samples (e.g. plasma).
The facility also contains equipment for doing invitro studies on isolated tissue
and organs, and biochemistry studies. Equipment for doing complex studies of single
or multiple organ systems (e.g. nervous system, cardiovascular system, respiratory
system) on intact animals and human volunteers is also available. Research resources
of other clinical departments and basic science departments in TTUHSC are available,
along with access to the high quality animal resource facility that is available to
all departments at the TTUHSC School of Medicine. The Department of Anesthesiology
research facility is directed by senior scientist, James E. Heavner, DVM, PhD, a world
leader in pain research.
Individuals who are interested in the Pain Management Fellowship Program should begin
their application two years before their hopeful start date. Applications are to
be made by the candidates and will be screened by our Directors. There is an interview
required. If there is formal acceptance by the candidate after an offer, an institutional
license is available in lieu of a Texas license. For more information about our application
process, click here.
The salary for the 2012-2013 school year is $50,436.00.
- 15 days vacation leave each year
- 5 days sick leave each year
- 5 days professional (meeting) leave (academic good standing)
Medical and Dental Insurance
Medical Insurance is provided for graduate trainees and their dependents. Insurance
is provided through the University and includes major medical and special hospital
allowances, which provide additional coverage for maternity and out-patient care.
Dental insurance is also available for graduate trainees and their eligible dependents.
For more information about salary and other benefits click here.
Lab coats, laundry service, malpractice insurance, disability insurance, and life
insurance are provided for graduate trainees.
The stipends for fellows at the Texas Tech University Health Sciences Center are consistent
with other medical centers in the Southwest area and may undergo adjustments each
year. Stipends are currently $500 per year and may be used for books or meeting travel.
Miles Day, MD, DABA, FIPP, DABIPP, DABPM, Associate Professor, Pain Management Fellowship
Director, Department of Anesthesiology, Texas Tech University Health Sciences Center.