DURATION:Ìý1-²â±ð²¹°ùÌý
NUMBER OF POSITIONS:Ìý1
BACKGROUND OF THE CANDIDATE: The candidate should be a fully licensed anesthesiologist with at least one year experience in pediatric anesthesia or pediatric chronic pain and/or one year experience in adult chronic pain. The candidate should have been trained in ultrasound guided regional anesthesia in adults or in children.Ìý The trainee should be able to work independently and as a member of a chronic pain multidisciplinary team.
FELLOWSHIP SUPERVISOR:ÌýDr. Indrani Lakheeram (Anesthesia Fellow Coordinator) andÌýDr. Pablo Ingelmo (Director, Chronic Pain Service)
HOSPITAL:ÌýThe Montreal Children’s Hospital
FUNDING:ÌýThis is a funded fellowship
MISSION STATEMENT:
To provide the trainee with consultant expertise in the principles and treatments of chronic pain in the pediatric population, both on an inpatient and outpatient basis.Ìý
BACKGROUND:Ìý Ìý Ìý Ìý Ìý ÌýÌý
This pain fellowship was created in honor of Dr. Joëlle Desparmet.Ìý The Chronic Pain Service of the Montreal Children Hospital (CPS-MCH) was created 20 years ago by Dr. Joëlle Desparmet, pioneer in pediatric chronic pain management in Canada. The CPS-MCH is a specialized service for the assessment and treatment of children and adolescents with chronic pain. The multidisciplinary team includes an advanced practice nurse, a psychologist, a physiotherapist, a social worker and an anesthesiologist. Medical and surgical specialists are consulted when needed.Ìý
The CPS-MCH receives referrals from various subspecialties including rheumatology, surgery, neurology, emergency, orthopedics, pediatrics, and psychiatry. Approximately 80 new patients are seen per year with approximately 70 patients being followed continuously. The members of the CPSMCH team simultaneously evaluate children and families two days per week.ÌýÌýAfter a comprehensive interdisciplinary evaluation, individualized treatments are prescribed.ÌýTreatments within the CPS-MCH include pharmacological, physical, and psychological therapies. The CPS-MCH also provides interventional therapies (central and peripheral nerve blocks, radiofrequency ablation, cryotherapy, and neurolytic blocks) occasionally with the collaboration of the Alan Edwards Pain Management Unit (AEPMU) of the MGH.Ìý
The Montreal Children’s Hospital Acute Pain Service (APS) is part of the MCH Department ofÌýAnesthesia and was created in 2001. This clinical service is offered to pediatric patients treated at theÌýMCH, mostly inpatients from the surgical and medical services.Ìý This service operates 24 hours daily, 7 days per week by a multidisciplinary anesthesia team.Ìý Patients are mostly from Montreal and its suburbs but also come from the Province of Quebec, other parts of Canada and the eastern United States for tertiary care (neurosurgery, cardiac, plastic, orthopedic surgery). The CPS-MCH team collaborates on a daily basis with the Acute Pain Service on the prevention of chronic post-surgical pain syndrome and on the early treatment of children with chronic pain recovering from surgical or medical conditions at the MCH.
DESCRIPTION: Ìý
1.ÌýÌýÌýÌýÌý Monday: the fellow will attend and participate in the CPS-MCH multidisciplinary meeting during the morning. The aim of this meeting is to review and discuss the active patients and the new referrals for the CPS-MCH. The morning meetings are also a forum for discussion of difficult patients from the clinic and wards, and consultants from other services and other centers frequently participate. The rest of the day the fellow will attend the chronic pain clinic. The clinic consists of an interdisciplinary evaluation of new patients, and in the follow up of active patients.Ìý
2.ÌýÌýÌýÌýÌý Tuesday: the fellow will round with the APS team including the APS MD or the APS nurse. The fellow will be encouraged to actively participate in the follow up of patients with complex pain conditions (chronic or acute) follow by APS and CPS. The fellow will also support the APS team on the care of patients with chronic conditions (e.g. acute on chronic pain, sickle cell, neuropathic pain, etc.) and on the prevention and treatment of chronic postsurgical pain.Ìý
3.ÌýÌýÌýÌýÌý Wednesday: the fellow will also participate in the non-clinical weekly activities of the CPSMCH.Ìý This includes communicating with referring or consultant physician, answering calls from patients or their family, contacting pharmacies, updating patients’ charts and answering any request for consultations by MCH physicians on the wards. Part of this day may be allocated to the APS.ÌýÌý
4.ÌýÌýÌýÌýÌý Thursday: Thursday morning will be dedicated to the interventional technique for pain control. The fellow will perform blocks or other analgesic interventions on chronic pain patients in the presence of the anesthesiologist on the team at the MCH. On Thursday afternoon she/he will attend the chronic pain clinic. The clinic consists in the interdisciplinary evaluation of one new patient or in the follow up of 2 to 6 cases.Ìý
5.ÌýÌýÌýÌýÌý Friday: this day will be dedicated to non-clinical activities, research activities and other academic endeavors.
Ìý
Educational activities
•ÌýÌýÌýÌýÌýÌýÌýÌý The fellow will participate in teaching anesthesiology colleagues at rounds about acute and chronic pain topics.
•ÌýÌýÌýÌýÌýÌýÌýÌý The fellow will participate in the education and support of nursing staff as needed in the field of acute and chronic pain.
•ÌýÌýÌýÌýÌýÌýÌýÌý The fellow will participate in Morning Department Rounds, Thursday Resident/Fellow Rounds and 91ÉçÇø Department of Anesthesia Journal Club.
•ÌýÌýÌýÌýÌýÌýÌýÌý Support will be provided to allow the fellow to attend a scientific meeting to present a paper or scientific exhibit subject to the following:Ìý
oÌý The research data to be presented was carried out by the Fellow whilst in theÌýDepartment of Anaesthesia at The Montreal Children’s Hospital o The meeting attendance shall be approved by the Department
•ÌýÌýÌýÌýÌýÌýÌýÌý The fellow will have access to the 91ÉçÇø, Montreal Children’s Hospital and Departmental libraries.Ìý The fellow will also have access to a computer.Ìý