Advanced Pain Training

1 Year Advanced Pain Training











Why pursue a career in Pain Medicine?


Pain is the commonest presenting symptom and the management of patients in pain is a basic skill required of all doctors. So why specialize in pain medicine? The burden of pain in the UK is huge and surveys estimate that up to 20% of adults in Europe are suffering from significant long term pain3.  Specialist multidisciplinary pain management services are critical to lightening the heavy burden that chronic pain places on both the patients themselves and the NHS as a whole.


Pain physicians require an open mind and a wide skill set. Patients with chronic pain can be a challenging group who are often emotional, angry or distressed. Communication and empathy are key and the specialty provides daily opportunity to work in a vibrant multidisciplinary environment where interpersonal skills are of upmost importance. Patients have often complex medical problems i.e. multiple co-morbidities and issues with poly-pharmacy.

















Training in Pain Medicine


In the UK, acute pain and some chronic pain are included in the Anaesthetic training basic level core competencies between CT1-2. Intermediate pain training consists of a 4-12 week block (minimum 20 half day sessions) at ST3-4 (compulsory for all anesthetic trainees). Higher Pain training consists of a further 3 month block at ST5+ This is an optional part of anesthetic training but essential to those trainees wishing to undertake advanced training.


Advanced pain training consists of continuous 12 month block at ST6-7. This is an essential requirement to practice as a Pain Medicine Consultant or Advanced Pain Lead. During this time training is focused on gaining experience in consultation skills, pain procedures and learning to manage a pain clinic. Advanced trainees are also encouraged to spend time in the clinics of allied specialties such as rheumatology and neurosurgery.



Advanced Fellow in Pain Medicine at BLSA


The fellowship at BLSA provides ample opportunity to work as part of a multidisciplinary team consisting of pain consultants, specialist nurses, clinical psychologists, physiotherapists and acupuncturists. Patients often have a broad range of pain conditions including musculoskeletal pain, neuropathic pain, headache and cancer pain. There are opportunities to attend regular multidisciplinary meetings with Breast Oncology, Clinical Psychology, Spinal Surgery, Rheumatology, Neurology, Urology and Gynaecology.


The interventional provisions are continuing to advance and there is opportunity to gain hands-on experience in a variety of neuromodulation techniques including spinal cord stimulators, occipital nerve stimulators, SIMPLICITY and Botox for migraine.





Fellows with an academic interest are encouraged to participate in the ongoing clinical research projects accessible through close links with the Pain and Anaesthesia Research Center under direct supervision Dr Vivek Mehta.



Weekly Timetable & Induction Pack


This can be found as a PDF here


How to apply


Jobs available are advertised twice yearly in March and October on the Oriel website, under ‘Vacancies’ then ‘Specialty/ Sub-specialty” followed by ‘Pain Management’ from the drop-down menu.


For further information please contact Dr Jayne Gallagher (Clinical Director for Pain Services) or Dr Vivek Mehta (LPMES)








This post provides applicants with the opportunity to pursue one year of subspecialisation and gain unrivalled clinical experience in Pain Medicine rotating between St. Bartholomews/ The Royal London Hospitals and Whipps Cross Hospital.


What is pain medicine?


Pain medicine involves the management of patients with acute and chronic pain. This is usually managed as part of a multidisciplinary team using a biopsychosocial model. Pain can be categorized as Acute (e.g. postoperative), Chronic (e.g. phantom limb pain) and Cancer pain (e.g. infiltration of tissue by tumour).

Pain doctors also require good technical skills to deliver pain management procedures such as nerve root injections or implantation of spinal cord stimulators. This involves the challenge of learning new skills such as guided manipulation of needles using x-ray fluoroscopy. There are increasing numbers of high tech interventions available in the treatment of chronic pain including radiofrequency ablation and neuromodulation.


Pain medicine is a fast developing field and provides a daily intellectual challenge. It provides the opportunity to work closely as part of a multidisciplinary team and offers a good amount of successful treatment options. It is a specialty that offers a varied working environment and opportunities to work in theater, clinic, wards and even laboratory environments.