Chronic Pain
Program Description
The Chronic Pain Enhanced Skills R3 position will prepare the physician for practice in a new and rapidly evolving field that is important for the management of the 1 in 5 Canadians living with chronic pain (1 in 3 over age 65). Besides being a symptom common to many health conditions, chronic pain is now described by the World Health Organization as a diagnosis in its own right. It is described as being either primary and secondary in nature, and best managed in a biopsychosocial context.
In response, the Canadian Pain Strategy, as endorsed by Health Canada, has called for the development of training programs including residencies and fellowships to train the next generation of physicians to take on leadership roles in addressing this demand.
Graduates will be prepared to take clinical and leadership positions in the implementation of the Alberta Pain Strategy, which envisions an integrated system of chronic pain management across all ages and regions and incorporating research and educational components. Primary Care Networks are envisioned to be an important partner in bringing this vision to life. Graduates will also be able to practice within and lead interdisciplinary teams with allied health clinicians.
Program Objectives
- The resident will be able to describe the taxonomy of chronic pain and its classifications, develop an understanding of the biopsychosocial processes involved in its development, and develop enhanced skills in history taking, physical examination and the development of a diagnostic formulation and treatment plan. The latter may include interdisciplinary care with allied health providers, and interventional approaches.
- The resident will become aware of community and provincial resources for chronic pain management as they currently exist and as they evolve.
- The resident will be introduced to local, provincial, and national organizations and programs serving this patient population and interested clinicians.
Program Overview
- This R3 program is delivered in 13 blocks over one year and housed at the Calgary Chronic Pain Clinic (CPC) at the Richmond Road Diagnostic and Treatment Centre.
- The CPC delivers care in an interdisciplinary model with allied health clinicians.
- Blocks 1 – 3 will be delivered on site as the resident develops a groundwork of knowledge and skills under preceptor supervision by physicians and allied health.
- Blocks 4 – 6 will build skills with external rotations through mental health and substance use disorders, rheumatology, and physiatry rotations.
At this time the resident will also begin participation in the Resident Clinic one half day per week, under supervision. Academic half days will be scheduled in coordination with the Royal College chronic pain residents also on site.
- Block 7 will introduce the Pediatric Pain Program at Alberta Children’s Hospital, and the Alberta Virtual Pain Program within the Alberta Pain Strategy.
- Blocks 8 and 10 provide elective time for the resident to explore learning opportunities that could include national or international exposures of individual interest as approved by the residency program committee; or local exposures such as Abdominal Pain, Sleep Disorders, Sports Medicine or Palliative Care
- Block 9 will provide advanced knowledge and skills in headache and post-traumatic headache management, at CPC as well as the Calgary Headache Management Program (CHAMP) at South Health Campus
- Blocks 11 and 12 will be provided in collaboration with local Primary Care Networks which already include pain management teams, the Chronic Pain Consult service at our teaching hospitals and the Transitional Pain Program at CPC.
- Block 13 is the final Transition to Practice phase, at which time any identified gaps in knowledge or missed exposures are addressed while the resident participates in a realistic clinical practice under supervision, including the resident clinic at a higher volume, phone consultation and virtual services.
Assessment
As a Tier 2 Enhanced Skills program for adult learners, assessment will be based on observed performance and feedback from physician and allied health faculty members at the Chronic Pain Clinic as well as external rotations.
Scholarly Projects
Residents will be expected to participate in the delivery of a limited number of academic half days, and the existing CPC journal clubs and other physician meetings, as appropriate. Several research projects are underway at CPC which invite resident participation.
Residents will be encouraged to attend the Pain Society of Alberta meeting usually held in October each year.