Pain Management Fellowship

Thank you for inquiring about the Pain Medicine Fellowship at Virginia Mason. We offer a 12-month experience in pain management, which is organized through the Department of Anesthesiology and accredited by the Accreditation Council for Graduate Medical Education.

Two pain fellows are selected each year.

We are committed to providing a top quality experience for the fellow, with a balanced exposure to acute and post-operative pain management, chronic benign pain management and cancer pain management. Each fellowship is further tailored to meet individual objectives, with outside rotations and clinical pain research.

Overall, this makes for a congenial and stimulating academic environment.

Acute and Postoperative Pain Management:

Virginia Mason is a tertiary referral center for the Pacific Northwest. Anesthetics are administered for many complicated surgical cases and regional anesthetic techniques are utilized in the majority of these cases.

As a result, we have a busy post-operative pain service. Opportunity for research in the area of perioperative pain management is vast and the fellows are encouraged to participate.

We have a highly regarded anesthesiology training program, with 27 residents. In addition, we have three fellows obtaining additional training in regional anesthesia.

Chronic Benign Pain Management:

Chronic benign pain is optimally managed via a multi-disciplinary approach. The Interventional Pain Clinic at Virginia Mason sees a large number of patients with chronic benign pain referred for consultation as well as diagnostic or therapeutic nerve blocks.

The vast array of psychological, social and occupational issues that patients present requires a multi-specialty approach. When appropriate, the Interventional Pain Clinic works in conjunction with Physical Medicine and Rehabilitation and Psychology in the management of chronic benign pain. A highly developed group of physicians see these patients on a daily basis.

The Pain Medicine Fellow rotates with Physical Medicine and Rehabilitation, learning the practice and business of chronic pain management from the perspective not typically available in anesthesiology training programs.

Cancer Pain Management:

Virginia Mason operates a cancer center, and our relationship with the medical and radiation oncologists, as well as the palliative care team, provides a steady flow of patients with advanced cancer pain. Most of these patients are candidates for neurolytic blocks or implanted devices to deliver neuraxial pain medication.

Our cancer center continues to expand, and in conjunction with the Interventional Pain Clinic, is developing an organized and comprehensive approach to pain management for all patients. World-renowned pancreatic cancer surgery and oncology specialists draw a large number of patients to Virginia Mason for treatment of pancreatic cancer. We provide neurolytic celiac plexus blocks to many of these patients as well as ongoing consultative pain medicine care.

Other Rotations:

The Pain Medicine Fellows also have rotations in Diagnostic Radiology, Palliative Care and Psychiatry at Virginia Mason. In addition to pain management experience at Virginia Mason, fellows will spend one month at the University of Washington in the Headache Clinic. Several elective rotations to local institutions may also be pursued, depending upon the fellow's individual interests. These include pediatric pain management at Seattle Children's, and other opportunities.

An optional research elective is available for the fellow who is interested in planning a research project. We also encourage participation in quality improvement, with opportunities to work at different levels within the Virginia Mason Production System (VMPS).

Regional anesthesia skills are integral to pain management practice. A rotation in Regional Anesthesia is available. This rotation affords extensive exposure to thoracic epidural techniques as well as peripheral nerve blocks and peripheral nerve catheters.

Christine OryhanChristine Oryhan, MD
Program Director, Pain Medicine Fellowship

For additional information about our Pain Medicine fellowship program contact:

Becca Smith
Program Coordinator
Virginia Mason Graduate Medical Education
925 Seneca St.
Seattle, WA 98101
Phone: (206) 341-0716

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