How to Choose an online/offline Course or Fellowship in Pain

It takes a long time to understand the subject of Pain Medicine (popularly referred to as Pain Management or even Chronic Pain). This is because there is a lack of a globally accepted well-established curriculum for this comparatively newer specialty.

Historically, Anaesthesiologists have been at the forefront of the constant development of this subject. Many Anaesthesiology residents are now gradually opting for a full-time pain practice as a profession. Doctors of other specialties such as orthopedics, neurology, physical medicine, rheumatology, family physician, or radiology practice pain medicine in different countries, particularly when it comes to ‘pain procedures’.    

So, now the question comes how and where do you start?

In my opinion, online courses are the best way to get oriented with the subject. Reading the different resources for the next 6 months to 1 year is the next step. Then You need to go for offline or hands-on training. After that study and training go hand in hand lifelong for continuous development.

To choose the right course or training center, focus on the below-given points:

1.    Choose the Right Teacher:

A teacher must be a Full-time pain practitioner for at least 10 years. Review the CV.  

• Look for the publications to see if they are published in an indexed journal of high impact factor or a random open-access journal.

• The publications' topics are of chronic pain or not?

 The summary is, as for patient treatment, the quality of the treating doctor is more important than the facility, here also faculty is more important than the organization.

2.    Accessibility of the faculties

The teacher-student relationship is a long-term one. Teachers should be accessible when a student is in need. A Novice in the field needs more help and guidance mostly during the first few years of practice.

The summary is, that you can not ignore the follow-up part in treatment as well as teaching.

3.    Word of Mouth

Know from your peers directly who were taught by the same faculties. Online forums, social media groups, and professional networks can also be sources of information.

Online reviews might sometimes be deceiving as they are usually collected before a student completes the course or receives the certificate.

4.    Flexible and accessible

Nobody can guarantee that any resident who is at present interested in Pain Medicine will ultimately continue in this subject. He or she may opt for continuing in the parent branch. So, in this scenario, they need such a course which can be continued with the current job. Online courses should allow a student to learn at his or her own pace. Course materials, lectures, and resources should be easily accessible from various devices (like mobile, tab, etc.) and various platforms (like Android, iOS, etc.)

5.    Course Content and delivery

This is a difficult area for a newcomer to judge. The course should be a uniform mix of all the aspects like Diagnosis, Physical examination, Diagnostic Options, Reaching a Diagnosis, treatment options such as conservative as well as pain interventions. 

Delivery of the content is of utmost importance. A Live Interactive Class is always the best option. Teaching on volunteers or mannequins is usually preferred.

Interventions are to be learned from Videos or workshops. Learning on a simulator or cadaver is of the least value as they do not match a normal human body. This experience is the same as when learning the regional anesthesia techniques. 

6. Hands-on experience

As I have mentioned above, online orientation should be followed by hands-on experience. There are multiple options to choose from. Nobody allows you to do a procedure on a patient directly (as it is unethical), but you have the option to learn on volunteer and mannequin.

7.    Accreditation, Affiliation & Govt Registration

Unfortunately, the well-recognized courses (For example DM in Pain medicine, FNB in medicine) which may boost your career opportunities, have very limited seats. Fellowships provided by different organizations have the same value medicolegally (irrespective of individual claims). Medicolegally, after MBBS, you are authorized to treat all the patients that a Pain physician treats.

In summary, your aim should be to learn the subject from these courses rather than falling into the trap of Accreditation/ Affiliation, etc. 

8.    Investment vs return

[I kept this heading as sometimes someone wanted to know. Unfortunately, he thought it was a share market business]

The benefit of learning should not be judged by money or fame. When you successfully treat a patient who suffered a lot due to pain, You get inner happiness.