Pain Medicine Residency

mani rajarathinam

Dr. Manikandan (Mani) Rajarathinam, Pain Medicine Postgraduate Education Director

Pain Medicine was recognized by the Royal College of Physicians and Surgeons of Canada as a designated subspecialty in March 2014 and, with the first program of its kind in Canada, Schulich Anesthesia & Perioperative Medicine enrolled its first two Pain Medicine Residents in July of 2014. The twenty-six block, two-year program will train candidates to be experts in the prevention, evaluation, diagnosis, treatment, and rehabilitation of painful conditions across the spectrum of acute pain, cancer pain and chronic non-cancer pain.

During the program, residents will also be exposed to unique experiences surrounding the treatment of chronic pain in the community such as ODSP advocacy and Opioid Dependence.

Curriculum and Duration of Training

Starting from July 2023, our training curriculum has been updated in accordance with the latest Royal College training requirements for the Competence by Design Curriculum in Pain Medicine.

Training progression occurs as residents demonstrate competence and advance through the various stages of the Competence Continuum. The Pain Medicine residency program is designed to span two years, without a prescribed timeframe for each stage. The duration of training in each stage may vary based on factors such as individual resident progress, availability of teaching and learning resources, and program implementation differences. Ultimately, the faculty of medicine, the competence committee, and the program director have the discretion to determine the duration of training in each stage.

For program guidance, the Royal College Specialty Committee in Pain Medicine suggests the following course of training for planning learning experiences and schedules:

  • Transition to Discipline: 1-3 months
  • Foundations of Discipline: 2-6 months
  • Core of Discipline: 6-12 months
  • Transition to Practice: 1-3 months

Our Pain Medicine residency program meticulously structures its rotations to fulfill the training requirements set forth by the Royal College. These requirements outline the specific training experiences that are required, recommended, and optional for Pain Medicine residents.

The Pain Medicine residency program incorporates a range of required, recommended and optional training experiences in line with the guidelines outlined by the Royal College. The required training experiences include:

  • Multidisciplinary pain clinic
  • Service or facility performing interventional procedures for pain management
  • Service providing acute pain and chronic pain consultation to inpatient, emergency department, and intensive care settings
  • Service providing cancer pain and palliative care consultation
  • Pediatric pain medicine clinic or service
  • Operating room for resuscitation, intravenous insertion, and airway skills (for entry routes other than Emergency Medicine and Anesthesiology

Selectives

In addition to the required experiences, the program also incorporates recommended and optional training experiences suggested by the Royal College. These include:

  • Psychiatry clinic (recommended)
  • Addiction medicine clinic (recommended)
  • Community-based pain clinic
  • Neuromodulation program
  • Participation in the provision of psychotherapy for pain management
  • Neurology or headache clinic or service
  • Neurosurgery clinic or service
  • Physical medicine and rehabilitation clinic or service
  • Rheumatology clinic or service
  • Participation in legal clinics and third-party assessment

Our training curriculum ensures that all the required and recommended experiences are included to provide a comprehensive education in Pain Medicine. These experiences are carefully designed to meet the guidelines set by the Royal College. As for the optional experiences, we are fortunate to have access to these opportunities. Trainees will have the opportunity to explore and participate in these optional experiences as per their individual preferences, providing them with well-rounded and customized training in Pain Medicine.

Remuneration

Payment of residents is scaled according to their respective residency year. Information can be found here

Windsor rotation details (travel and accommodation) are available here.

Application Information

Applications for Pain Medicine Residency must now be submitted via the Canadian Residency Matching Service (CaRMS) website through the Medicine Subspecialty Match. 

The following timelines are applicable for the upcoming match for Pain Medicine residency positions starting on July 1, 2025 in Canada:

July 11, 2024:           Application open through CaRMS online
August 19, 2024:       Deadline: Reference submission
August 20, 2024:       Deadline: Submission and assignment of applications and documents
Aug 31 - Sep 22:       Interview period
October 2, 2024:       Ranklist submission deadline for Programs
October 10, 2024:     Ranklist submission deadline for Applicants
October 23, 2024:     Match day (results made available)

Interview date for Pain Medicine at Western University:
TBD  

Interviews will be conducted via video conference using Zoom.

For questions about the Pain Medicine residency program at Western University please feel free to contact 

Charlotte Sikatori McLain

Education Coordinator
London Health Sciences Centre - University Hospital
339 Windermere Road, Room B3-411
London, Ontario, Canada, N6A 5A5
Phone: 519-685-8500, ext. 75813

Pain Medicine Residency Program Committee

The Pain Medicine Residency Program Committee is responsible for assisting the Residency Program Director (PD) in the planning, organization, and supervision of the Program. The committee must review both the overall and specific educational objectives of each component of the Program on an annual basis as structured to reflect and encourage development of the CanMEDS roles.

The Committee also ensures that admission, evaluation, remediation, appeals, and all other relevant processes are effective and consistent with University Guidelines.

Membership includes physician specialists in anesthesia, psychiatry and addiction medicine, neurology, palliative care, pediatrics, rheumatology, physical medicine and rehabilitation, and psychology and an elected resident representative.

Chair:
Dr. Manikanden Rajarathinam

Members:
Dr. Jonathan Brookes
Dr. Collin Clarke
Dr. Heather Getty
Dr. Eldon Loh
Dr. Shiraz Malik
Dr. Stephen Morrison
Dr. Dwight Moulin
Dr. Raju Poolacherla
Dr. Geoff Bellingham
Dr. Qutaiba Tawfic
Dr. Tuoyo Awani
Dr. Robert McKay
Ms. Charlotte Sikatori McLain

Resident Representative:
Dr. Abdulrahman Alboog

Pain Medicine Residency Program Highlights

2021 - 2023

Dr. Singh completed her Pain Medicine training with us after her Internal Medicine residency and joined London Spine Centre where she is currently practicing interventional pain management. Dr.Singh presented her scholarly project as a poster at the Canadian Pain Society Annual Meeting in Montreal in 2022, which was well-received by attendees. The project was later published as a review article titled "Stellate ganglion block beyond chronic pain: A literature review on its application in painful and non-painful conditions" by Singh, Heena and Rajarathinam, Manikandan in the Journal of Anesthesiology and Clinical Pharmacology in March 2023. Dr.Wong joined us in 2021 after Anesthesia residency in Halifax, Nova Scotia. His scholarly project on "Ultrasonography for facet joint interventions in chronic spinal pain; A narrative review" was published in the Canadian Journal of Pain in May 2023. Dr.Wong is currently practicing Pain Medicine and Anesthesia as a Consultant at St John, New Brunswick.

In 2022, our former program director, Dr. Bellingham, was honored with the Pain Medicine Teacher of the Year award. The same year, our Department warmly welcomed Dr. Mo Misurati as a Consultant in Pain Medicine and Anesthesia. Dr. Misurati completed his Royal College training in Anesthesia and Pain Medicine in the UK. Within his first year of joining our team, he was recognized with the Pain Medicine Teacher of the Year award in 2023. Starting from July 2023, we made the transition to the Competence by Design (CBD) curriculum, and Dr. Sonny Cheng is the first resident to embark on this inaugural CBD program.

2018-2021 

More of our Pain Medicine trainees successfully completed the program and embarked on their Pain management careers in different parts of the country. Dr. Cook, a physiatrist by background, helped develop a new Pain management centre in the Waterloo region where he serves as the director. Dr. Alfasi has remained in Ontario and is affiliated with the U of Ottawa. Dr. Phillips and Dr. Leung went on to practice Pain Medicine and Anesthesia in British Columbia. Dr. Deng, also a physiatrist, has an Interventional Pain practice in Alberta. Dr. Beaudoin pursued a Neuromodulation fellowship in Switzerland soon after finishing his Pain residency and has returned to Quebec to practice Pain management. In 2020 we welcomed Dr. Singh, who finished an Internal medicine residency and joined our program. In 2019 the Royal College accreditation review for our Pain Medicine residency program was deemed to be within acceptable compliance with the Standards of Accreditation. Many thanks to Dr. Bellingham for all his great efforts and leadership in shaping up this well-rounded program during his tenure as Program Director. Dr. Bellingham handed over the directorship of the Western University Pain Medicine residency program to Dr. Rajarathinam in 2021 who is a two-time Teacher of The Year awardee in the Pain Medicine residency program.

2017

We have been fortunate to have continued growth of our residency program over the past year. For the first time, we have had both funded positions occupied by resident learners in both the first and second years of training.

In keeping with the multidisciplinary nature of the specialty, the Pain Medicine residency has also seen an expansion of the scope of resident entry specialties. In 2017 we accepted trainees from physiatry and neurosurgery in addition to anesthesia trainees.

Enhanced funding to our pain clinic from the Ministry of Health and Long Term Care, allowed us to expose our residents to more multidisciplinary care of chronic pain patients. Our residents are now fortunate to work in a clinic with a variety of health professionals including psychologists, occupational and physical therapists, social workers, pharmacists, and nursing staff. This multidisciplinary environment will serve to promote this model of care in the future as our graduates adopt this standard in their own future practices.

Development of educational initiatives has become a strength within the Pain Medicine Residency program. Resident scholarly projects have focused on education taking the forms of a book chapter on the role of the sympathetic nervous system on pain pathways, an online learning module on complex regional pain syndrome, and a fluoroscopy simulation project for spine interventions.

Our graduates have demonstrated success in their new positions as accredited pain medicine subspecialists in their communities. Both Dr. Pariser and Dr. Phillips have contributed to the development and maintenance of pain medicine programs in Nanaimo and Prince George B.C., respectively. As a new subspecialty residency, we are starting to see one of its main goals fulfilled in training leaders of best practice in pain medicine for Canadian communities.

With more Pain Medicine residencies becoming accredited, the future looks bright for pain medicine practice in Canada. Our department has been making a significant contribution in this regard hosting the first Pain Medicine residency in Canada. I thank all of those who continue to support and teach our residents in this growing specialty. 

2016
The past year has marked another milestone for the Pain Medicine Residency at Western University. Both of our inaugural residents, Dr. Michael Pariser and Dr. Amjad Bader, completed their training and successfully challenged the Royal College Pain Medicine examination. As such, they both have the distinction of being trained as Canada’s first accredited Pain Medicine Subspecialists.

On a national level, this subspecialty-training program has gained momentum as other universities gain accreditation for their Pain Medicine Residency programs. To strengthen all of our training programs, the program directors have collaborated to deliver lectures and workshops on a national level. This relationship has led to quarterly national videoconferencing teaching sessions that focus on teaching CanMEDS roles relevant to pain management. Again, Western University has acted as a leader hosting the first of such videoconferences with Dr. Carole Orchard speaking on interprofessional collaboration within pain clinics.

The St. Joseph’s Pain Clinic has also been fortunate to receive funding from the Ministry of Health and Long-Term Care to enhance the care delivered to patients through increased physician services and allied health. This is welcome news to our community but also serves as an opportunity for the residents to benefit from an enriched clinical environment.

With the increased funding, Western University Pain Medicine residents will have increased opportunities to be exposed to interventional techniques in addition to collaborating and learning from allied health colleagues. Residents will have opportunities to work with and learn from a pain clinic pharmacist, social worker, and a number of psychologists, physiatrists, and occupational therapists.

The residency is also grateful for the tremendous work put forth by our Program Administrator, Charlotte Sikatori McLain. Over the past year, Charlotte has settled in to become an integral component to the smooth running of the program.

The work of the Pain Medicine Residency Committee has been effective at achieving the goal of launching Canada’s first Pain Medicine Residency. We look forward to improving the program further for future trainees and to continue to act as leaders and collaborators for Pain Medicine education in Canada.

2015-2016
Feedback from our initial residents has been excellent. As training has progressed, success of the program is reflected in the growth of their skills and knowledge as pain management specialists. We have seen our residents develop in their ability to lead and collaborate as advocates for those in pain. This is reflected in their scholarly work from developing an information night program for new patients and their families to performing quality assurance analysis on the interventional techniques being performed by the clinic. The Pain Medicine Residency Committee wishes to thank our Program Administrator, Lori Dengler, for the time and effort put forth establishing the administrative frameworks to run the curriculum. As Lori transfers to her new role of Program Administrator for the Anesthesia & Perioperative Medicine Residency, we welcome Charlotte Sikatori as the Pain Medicine Residency’s new Program Administrator.

The work of the Pain Medicine Residency Committee has been effective at achieving the goal of launching Canada’s first Pain Medicine Residency. We look forward to improving the program further for future trainees and will continue to act as leaders and collaborators for Pain Medicine education in Canada.

2014-2015
Western University successfully completed its inaugural year of Pain Medicine resident training in June 2015 within the Department of Anesthesia and Perioperative Medicine. The Pain Medicine Residency program follows successful completion of Royal College entry specialties including anesthesia, physical medicine and rehabilitation, neurology, and psychiatry. Our first trainees to enter the program have done so after completion of Royal College certified anesthesiology programs. The foundation of clinical training has been maintained at the Pain Clinic located at St. Joseph’s Health Care, which achieved accreditation for operational excellence in the fall. The multidisciplinary nature of the clinic includes social work, physiotherapy, psychology, interventional pain techniques, and exposure to consultants from different specialties, all of which have provided a rich learning environment for our residents to achieve competency in the CanMEDs roles.

The St. Joseph’s Pain Clinic has allowed our trainees to work within the biopsychosocial model of pain management, the current gold standard of patient care. In addition to this, the program has offered diverse training opportunities as the residents have gained exposure to consultation liaison psychiatry, addiction medicine programs at the Windsor Campus, cancer pain management at the London Regional Cancer Center, and functional neurosurgical clinics at University Hospital.