Acute Pain Service

Program Directors, Dr. Kevin Armstrong and Dr. Qutaiba Tawfic

armstrong tawfic

The purpose of the Acute Pain Service (APS) program is to provide trainees with a broad range of knowledge skills and attitudes so as to be able to: 

  • Assess patients pre-operatively as it relates to risk of complex pain.
  • Initiate an appropriate pain management plan, commence appropriate treatment of pain and identify and liaise with the pre-op and intra-op teams to ensure appropriate and definitive care.
  • Assess postoperative patient under APS and commence, continue and alter pain management plans by using different modalities.
  • Identify complex pain patient and diagnose the most likely underlying problem.
  • Diagnose side effects related to pain medications and commence the needed action.
  • Being clinically and academically effective as a part of the Comprehensive Pain Management Program in Schulich School of Medicine and Dentistry and London Hospitals.
  • Participate in endeavours to educate patients, patient supporters, hospital providers (anesthesia, nursing, surgery), and primary health care providers.
  • Participate in scientific inquiry to challenges relevant to acute pain management

The program builds on the CanMeds roles recommended by the Royal College of Physicians and Surgeons of Canada. The APS fellowship program will deliver the training and experience needed for this by giving the fellow an opportunity to work and learn in both the post -surgical and non-surgical acute pain management. Also, fellows will get exposure to regional anesthesia and management of chronic pain/opioid tolerant patients, as the knowledge base and skill set of these specialties are closely related. These specialties interface in the multidisciplinary care of in hospital pain patients. By working in these specialties, the fellow will become familiar with the common acute pain presentations, their rapid initial assessment and treatment and how to determine what definitive care will be needed and how it should best be provided.

The delivery of a well structured training program in Acute Pain medicine will enable the fellow to work effectively, both individually and as part of a team in the care of the acute pain patient and develop a firm foundation for their future as APS specialist.

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Research

APS fellow will spend up to 1 day per week in research and educational activities (if approved in advance). This time is very much depending on the fellow’s commitment accomplishing the proposed activities. It is an expectation that, with supervision, APS fellows will play an active role in a research project during fellowship. This can include design, grant writing, ethics submission and conduct of a project. A number of courses in research methodology and statistics are available through Schulich School of Medicine and Dentistry.

Education

APS rounds are held at the departmental level throughout the year which will include journal discussions, case discussions, and didactic presentations. Fellows are expected to participate in these rounds to gain experience in presentation and teaching. Fellows are also expected to attend/participate in regional anesthesia and chronic pain rounds when possible. There is an opportunity to combine rounds for all the three subspecialties (APS, chronic pain and regional anesthesia). Fellow will be required to take an active role in resident and medical student’s education in acute pain management.

Fellowship Structure

  • Duration: The fellowship training program will be undertaken over twelve consecutive months and includes four weeks of vacation time.
  • Number of fellowship positions: 2
  • Sites: APS Fellow will be primarily allocated to LHSC (University and Victoria hospitals), with learning experience and the provision of service at any of the London acute care hospitals.
  • Leadership: This fellowship program is under the Comprehensive Pain Management Program- Department of Anesthesia and Perioperative Medicine-Western University.
  • Supportive specialties: Regional anesthesia program, multidisciplinary pain clinic and Palliative Care as a part of Comprehensive Pain Management Program.
  • On Call Duties: Weekend APS rounds 12-16 times per year

“I recently completed my Acute Pain Fellowship at Western University and it has been an exciting and interesting year for me. I was exposed to a variety of different cases going at the different hospitals and through this gained a good clinical experience in acute pain management. I was also able to maintain my general anesthesia skills and work in a supportive environment. The city of London, Ontario was a great place to call home for a year - it is a lovely city and a place where I met new friends and created nice memories.” - Dr. Lina Basri, Saudi Arabia

 “I have found my experience as an Acute Pain Fellow at Western University a well-rounded and enjoyable one. In the positive learning atmosphere of the Anesthesia Department and under supportive approachable pain staff, I had the opportunity to learn how to provide quality care to complex acute/chronic pain cases. Besides being involved in patient-centered pain management practice, I also actively participated in research, teaching, and providing anesthesia care to a diverse patient population in the ORs. Thank you all for this memorable year.” - Dr. Shaqayeq Marashi, Iran

Eligibility Requirements for Canadian and Foreign Medical Graduates

  • Candidates must possess a medical degree from a University recognized by the Medical Council of Canada (MCC)
  • Candidates must have completed an anesthesia residency that is recognized by the College of Physicians and Surgeons of Ontario (CPSO)
  • International Medical Graduates do not need to write additional exams, but must be approved by the PGE Office at Western University
  • English Language Requirement for IMGs: TOEFL-iBT required to achieve an overall score of no less than 93 with a minimum score of 24 in speaking; IELTS required to achieve a minimum score of 7 in each category. 
  • All non-Canadian trained anesthesiologists will be required to pass an assessment period taking place over the first 4 - 8 weeks in order to continue with the fellowship (‘PEAP’ – Pre-entry assessment period).
  • Please refer to the Application and Requirements page for a more detailed description

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