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The field of pain medicine specialises in addressing the prevention, diagnosis, and treatment of diverse pain conditions. Numerous institutions in India provide training in pain medicine. This article will explore the training centers and the problems in pain medicine training in India.
Basic Pain Medicine Training Incorporated in MD Anaesthesiology Curriculum
The updated MD Anaesthesiology curriculum, released by the National Medical Commission in September 2019, underscores the importance of training in chronic pain management for postgraduate students. The responsibility for ensuring proper instruction in this area lies with the heads of anaesthesiology departments and those overseeing pain clinics. The curriculum outlines that MD anaesthesiology postgraduates should acquire and demonstrate skills in managing chronic pain through various modalities, including medication, non-opioid analgesia, interventional techniques, and psychological approaches.
Training encompasses patient assessment, involving thorough history-taking, physical examinations, and the interpretation of diagnostic tests. Postgraduates are expected to classify pain types, distinguishing between acute and chronic, and further categorizing chronic pain as nociceptive, neuropathic, or mixed. Knowledge of pain pathways, theories, and principles of managing specific pain conditions, such as myofascial pain, low back pain, and neuropathic pain, is emphasized. Palliative care principles are also highlighted in the curriculum, ensuring a comprehensive approach to pain management.
One-Year Pain Medicine Training in Different Institutes in India
Numerous educational institutions in India offer specialized training in pain medicine through programs like the Post Doctoral Certificate Course (PDCC) and DM courses. Notable examples include Banaras Hindu University in Varanasi and Sanjay Gandhi Post Graduate Institute of Medical Sciences in Lucknow, both of which introduced one-year fellowship and certificate courses in pain medicine in 2008 and 2010, respectively.
Additionally, the Maharashtra University of Health Sciences (MUHS) in Nashik and D.Y Patil Medical College in Nerul, Navi Mumbai, initiated one-year pain medicine fellowship courses in 2016 and 2019, respectively. These initiatives reflect a growing recognition of the importance of specialized accredited certificate course in pain management across various medical institutions in India.
Fellowship In Pain Management - The West Bengal University of Health Sciences
The WBUHS offers a fellowship in pain management recognised by the West Bengal Medical Council. This is a one-year full-time residential course that trains doctors in the comprehensive management of pain. The course also provides hands-on training in the outpatient department, inpatient department, and operation theatre of the ESI Institute of Pain Management and RG Kar Medical College Kolkata.
PDCC in Pain Medicine (AIIMS) Mangalagiri
Its a one-year fellowship course offered by the All India Institute of Medical Sciences (AIIMS) Mangalagiri, Andhra Pradesh. The course aims to train doctors in the comprehensive management of acute and chronic pain, using pharmacological, interventional, psychological, and rehabilitative modalities. The accredited certificate course in pain management in India is open to doctors who have completed MD or DNB in Anaesthesia.
PDAF in Pain and Palliative Care Medicine SGPGI
The Sanjay Gandhi Postgraduate Institute of Medical Sciences in Lucknow offers a 2-year Post-doctoral Fellowship (PDAF) in Pain and Palliative Care Medicine through the Department of Anaesthesiology. This specialized program focuses on providing comprehensive services for patients experiencing acute or chronic pain. Established in 2002, the acute pain service aims to excel in postoperative pain relief, educate residents in acute pain management, and conduct clinical research in pain management and regional anesthesia.
Daily pain clinics and various pain procedures, including USG-guided and C-arm-guided interventions, are integral to the curriculum. Additionally, the institute's palliative care service, initiated in 2009, offers outpatient services, home visits, and a 24-hour helpline for patients in need
Doctorate of Medicine (D.M.) program in Pain Medicine
DM in Pain Medicine is a specialised course in India designed to equip medical professionals with the skills to effectively manage both acute and chronic pain. This three-year program mandates candidates to hold an MD or DNB in Anaesthesiology for eligibility. Admission is determined through a nationwide entrance examination administered by AIIMS, Rishikesh.
Indian Society for Study of Pain (ISSP) courses are also being conducted in some centers in India. Presently we have 15 seats for the one-year pain medicine training across 13 institutions in India. Many pain physicians have passed World Institute of Pain (WIP) certifications like Fellowship in Interventional Pain Practice (FIPP) and Certified Interventional Pain Sonologist (CIPS). Out of these, many of the courses are notified by the National Medical Commission [(NMC), earlier Medical Council of India (MCI)] but not recognised presently.
FNB in Pain Medicine - In 2020, a significant breakthrough occurred in Indian medical education with the inception of the Fellowship National Board (FNB) in Pain Medicine by the National Board of Examinations (NBE), New Delhi. It is a two-year program addressing the pressing need for specialised training in pain management within the Indian healthcare system. Its meticulously crafted curriculum aligns with the nuances of the country's healthcare setup, ensuring graduates are well-prepared to navigate the complexities of pain medicine. An essential prerequisite for admission is a background in anaesthesiology postgraduate certification, making DA, MD, or DNB compulsory minimum requirements.
This strategic criterion ensures candidates enter the program with a solid foundation in anesthesia principles, a fundamental aspect of specialized training in pain medicine. The accreditation of NBE-approved centers further underscores the program's credibility. Institutions such as Sir Ganga Ram Hospital, South Eastern Railways Central Hospital, and Tamil Nadu Government Multi Super Speciality Hospital have received accreditation, reflecting their commitment to maintaining high standards. The accreditation's validity periods indicate ongoing evaluation and adherence to prescribed standards, ensuring the program's continued excellence. - rewrite for an informative blog post in simple language.
Problems in pain medicine training in India:
Lack of uniformity in the pain medicine training curriculum.
The shortage of qualified instructors in pain medicine is a prominent issue in India.
Pain Management Residents find themselves working within Anaesthesiology Departments due to this scarcity of specialised teachers.
The absence of dedicated Pain Medicine departments and faculty within institutions is a notable challenge.
Despite the distinct nature of pain medicine, instructors in this field are often appointed within the Anaesthesiology department.
A lack of sufficient infrastructure further compounds the challenges faced in providing comprehensive pain management training.
About the Author -
Dr Debjyoti Dutta - Renowned for his expertise as a distinguished pain specialist and accomplished author, Dr. Debjyoti Dutta is associated with the Samobathi Pain Clinic and Fortis Hospital in Kolkata. Currently holding the position of registrar at the Indian Academy of Pain Medicine, Dr. Dutta specializes in musculoskeletal ultrasound and interventional pain management. His impactful contributions to the field are evident in noteworthy publications such as "Musculoskeletal Ultrasound in Pain Medicine" and "Clinical Methods in Pain Medicine," offering profound insights into effective pain management strategies. Beyond his clinical roles, Dr. Dutta serves as a faculty member for Asian Pain Academy Courses, playing a pivotal role in delivering high-quality pain management fellowship training in Kolkata, India. His unwavering dedication significantly contributes to the education and professional development of individuals in the field.
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