Clinical Rotation Details:

Name of Unit/Clinic: California Pain Medicine Center

Location:
UCLA Medical Center
100 UCLA Medical Plaza
Suite 750

Faculty: Joshua Prager, MD

Duration: 3 Months (M-Th)

Details:
Supervisors: Anesthesia and Neurology Attendings
Other Team Members: Palliative Care Fellows, Nurse

Objectives:

Participate with management and implantation of intrathecal medication delivery systems

Develop comprehensive management plans for cancer and complex pain patients

Manage and triage complication for post surgical pain treatments

Manage neurostimulation devices for pain

Become an intricate member of the pain

Assist in infusion of Ketamine per protocol for patients with intractable pain

management team for rehabilitation

Show proficiency with sterile techniques for surgical cases

Outline medication treatment options for complex pain conditions

Demonstrate proficiency for spinal injections to diagnose pain conditions

Name of Unit/Clinic: The UCLA Spine Center

Location:
UCLA - SM Orthopedic Hospital and Medical Center
1245 16th St, Suite 220

Faculty: David E. Fish, MD

Duration: 3 Months

Details:
Outpatient Musculoskeletal Pain and Spine Clinic (Wed, Thu, Fri)
Supervisors: PM&R Attending
Other Team Members: Medical Students, PM&R Residents
Interventional Spine Clinic (Tues, Wed PM)
Supervisors: PM&R Attending
Other Team Members: Medical Students, PM&R Residents
Electrodiagnostic Clinic (Mon)
Supervisors: PM&R Attending
Other Team Members: Medical Students, PM&R Residents

Objectives:

Develop pain management skills for patients with acute/chronic spine problems

Master surgical skills for interventions to treat spinal disorders

Develop skills for spinal injections to diagnose spine conditions

Manage implantation of intrathecal medication delivery systems

Develop comprehensive rehabilitation plan for spine pain management

Manage neurostimulation devices for spine pain management

Master interventional techniques for management of spinal compression fractures

Develop Electromyographic skills to help diagnose peripheral nerve pathology

Accurate interpretations of MRI and spine radiographs.

Teach medical students basic musculoskeletal examinations

Name of Unit/Clinic: WLA Chronic Pain Clinic

Location:
Greater Los Angeles Veteran Affairs
Health Care Systems,
West Los Angeles Health Care Center

Faculty: Quynh Pham, MD

Duration: 7 Months (Wed AM/PM and Thur PM)

Details: Multidisciplinary
Supervisors: Anesthesia, PM&R, Psychiatry , Psychology, Neurology (Wed) Attendings
Other Team Members: PM&R Residents, Nurse Practitioner, Pharmacist, Medical Students, Physical Therapists, Geriatric Fellows

Objectives:

Demonstrate proficiency in evaluation skills in patients with chronic pain conditions

Develop comprehensive pain management plan for pain conditions

Teach residents and perform diagnostic local injections for pain treatment

Learn biofeedback techniques for musculoskeletal pain treatment

Know basic psychological screening  evaluation tests for chronic pain patients and incorporate these  into treatment plan.

Manage opioids for treatment of chronic pain conditions

Identify signs of abuse of chronic pain patients

Demonstrate appropriate  patient selection for neurolysis

 and correct techniques for reconstitution and injection of medication

Name of Unit/Clinic: WLA VA Interventional Pain Service

Location:
Greater Los Angeles Veteran Affairs
Health Care Systems,
West Los Angeles Health Care Center

Faculty: Dr. Sanjog Pangarkar

Duration: 7 Months (Divided, Mon and Fri AM/PM)

Details:
Supervisors: Anesthesia Attendings, PM&R Attending
Other Team Members: Nurse Practitioners, PM&R Residents, Medical Students

Objectives:

Master interventional techniques for pain management

Manage treatment options for complications due to injections

Develop injection treatment plan for complex pain conditions

Write patient controlled anesthesia orders for post surgical pain management

Demonstrate evaluation techniques for acute post surgical pain management

Name of Unit/Clinic: WLA VA Inpatient Pain Consult Service

Location:
Los Angeles Veteran Affairs Health Care System, West Los Angeles Health Care Center

Faculty: Rebecca Ovsiowitz, MD

Duration: 7 Months (Divided, Service and Consultation—Daily in AM)

Details:
Supervisors: PM&R Attending
Other Team Members: Nurse Practitioners, Medical Students

Objectives:

Manage treatment options for complications due to injections

Manage treatment options for complications due to post surgical pain conditions

Develop PCA treatment plan for complex pain conditions

Write patient controlled anesthesia orders for post surgical pain management

Demonstrate evaluation techniques for acute post surgical pain management

Name of Unit/Clinic: Department of Anesthesia

Location:
Greater Los Angeles Veteran Affairs
Health Care System,
West Los Angeles Health Care Center

Faculty: Corey Downs, MD

Duration: Two-Week Rotation—(2 Days in Pre-Op Clinic, 8 Days with Anesthesia Staff)

Details:
Supervisors: Anesthesia Attendings
Other Team Members: Resident, Nurse Anesthetist

Objectives:

Understand the principles of administering regional/general anesthesia under supervision of staff

Understand acute fluid management concepts

Understand the mechanism of common post-anesthetic complications and their management

Understand the management of emergencies and complications during operative procedures

Properly place and verify placement of airway devises (ET tube and laryngeal mask airway)

Mask ventilate patients prior to establishing an airway devise

Place all necessary non-invasive monitoring devises to patients in the operating room

Develop proficiency in establishing venous access

Name of Unit/Clinic: Palliative Care Service

Location:
Greater Los Angeles Veteran Affairs
Health Care System,
West Los Angeles Health Care Center

Faculty: Deborah Moran, MD

Duration: 2-Week Rotation

Details:
Supervisors: Medicine attendings

Other Team Members: Resident, Fellows, Palliative Care Team

Objectives:

Understand opioid management in final days of life

Understand and practice end of life care to prevent undue suffering and pain

Understand coordinated care with severe disability and pain at end of life

Determine rehabilitation potential for terminal patients

Learn psychological support techniques for terminal patients