1. What is Pain Medicine?
In 2010, Pain Medicine was formally recognized as a subspecialty in Canada by the Royal College of Physicians and Surgeons of Canada. The application for specialty status was initiated in 2007 with the understanding that while Anesthesiology would be the parent specialty, the curriculum would train clinicians in a multidisciplinary setting.
The new two-year Pain Medicine residency training program in Canada will train leaders in education, research and clinical practice pertaining to the prevention, diagnosis, treatment and rehabilitation of the spectrum of acute pain, cancer pain and non-cancer pain problems. Accurate diagnosis, essential to the development of a rational treatment plan, requires training in neurological and musculoskeletal exam techniques. Administration of nerve blocks, if recommended, must be incorporated into a comprehensive treatment plan which also draws on pharmacotherapeutic knowledge of opioids, anti-convulsants, and anti-depressants and comprehensive treatment aimed at rehabilitation and behavioral management. In many cases the physician practicing in this subspecialty will be the medical director of a multidisciplinary team, and hence must be versed in pain management/relief methods employed by team members who are physician or allied health professionals.
The creation of Pain Medicine as a new subspecialty should not only improve patient access to appropriate pain management by increasing the number of well-trained physicians, but also improve patient outcomes by promoting and disseminating best practice guidelines for the treatment of acute pain, chronic non-cancer pain and cancer pain in both community and academic settings. In addition, interdisciplinary research collaboration will promote new areas of enquiry, and funding bodies will identify pain as a higher research priority.
The September 25, 2014 issue of the Canadian Medical Association’s CMAJ, "New Residency Program for Pain Specialists" highlights the needs and launch the first Pain Medicine Residency in Canada. In an interview with the CMAJ, Dr Patricia Morley-Forster, Chair, Special Committee on Pain Management at the RCPSC, noted "we were able to demonstrate that there was a wealth of knowledge out there about how to treat pain that was not being taught to doctors. This unmet need would take two full years of doctor training." The full journal article is available here: new_residency_program_for_pain_specialists.pdf (223.39 KB)
2. The University of Toronto and the multiple participating departments are very large. Will residents get "lost" in the system?
No! We have a small number of residents in the program. Each site has a rotation coordinator who is responsible for all aspects of education and resident well-being at each site. The program director meets with each resident bi-annually and more frequently when necessary.
3. Can I do electives out of the city/ country?
Electives can be completed out of Toronto providing that the elective will provide the resident with a relevant educational experience. Residents would be expected to identify appropriate sites and supervisors, develop a set of objectives and have these approved by the program director.
4. Will I need a car?
Almost all regular rotations take place at the fully affiliated teaching hospitals which are easily accessible by public transit. Some rotations in community settings may require travel.
5. Is there an opportunity to get credit for required blocks/rotations already completed in my primary residency?
Some of the designated blocks for Pain Medicine, may be undertaken concurrently within the entry discipline, subject to approval by both program directors. Any credit for such blocks will be assessed after acceptance into the program. No formal determination of such credit can be completed prior to acceptance into our program.
6. How do I apply?
Please see our Pain Medicine Application Information Page available here.
7. What is the format and content of the Pain Medicine exam ?
Information on the examination format can be found here