The duration of training is two (2) years divided into 26 blocks of 4 weeks. Depending on the Pain Medicine resident’s previous training in their primary specialty, a number of credits (up to a maximum of 13) can be applied to the Pain Medicine residency training. Credit from previous training will be considered by the Program Director with the final decision made by the Office of Specialty Education at the Royal College (please refer to section 3 for additional details regarding this process). Credits from the primary specialty cannot be established before the start of the Pain Medicine residency program.

The Pain Medicine residency training program is comprised of the following mandatory rotations:

• Multidisciplinary Adult Pain Centre (13 blocks)
• Pediatric Pain (1 block)
• Acute Pain (1 block)
• Cancer Pain (1 block)
• Neurology (1 block)
• Psychiatry (1 block)
• Addiction (1 block)
• Musculoskeletal/Rehabilitation or Rheumatology (1 block)

Six (6) blocks to be chosen from one or more of the following selective rotations:

• Anesthesiology

• Adolescent Medicine
• Bioethics
• Community-based experience in Pain Medicine
• Diagnostic imaging
• Education/curriculum development
• Gastroenterology
• Interventional Pain Medicine/neuromodulation
• Obstetrics and Gynecology
• Orthopedic/spine surgery
• Palliative care service
• Public Health and Preventive Medicine
• Research methodology/biostatistics
• Sleep medicine

Other rotations relevant to training in Pain Medicine as approved by the Program Director. A rigorous academic curriculum has been developed in the Multidisciplinary Pain Centre and within the mandatory rotations and includes: academic half days, electronic learning modules, weekly difficult case rounds and resident-guided scholarly work. Pain Medicine residents are expected to participate in and publish a research project during their training.

Residents who wish to have some of their previous training considered towards their prospective residency training should first discuss this with their future Program Director. The Program Director will determine if the previous training is relevant to the current training. There must be a provision in the specialty requirements in order for previous training to be considered.

The Program Director must ensure that a resident’s performance warrants a recommendation for credit and that training time can be reduced and that the resident will still meet the competencies and requirements in the specialty and be successful at the certification examinations.

To process a request for credit the Royal College Credentials unit must receive:

• An application for assessment of Canadian training from the resident with the one-time fee for an additional specialty (they do not need to repay this fee when they apply by the deadline, the year prior to that in which they will sit the certification examination)

• A written recommendation from the Program Director outlining the credit recommended, under which section of the specialty requirements this should be applied to and the anticipated end of training date. The recommendation letter must be sent to the Postgraduate Dean to obtain his/her support (both signatures can be on one letter or 2 separate letters).

Once all of these are received, the request is reviewed and the Royal College issues a decision to the resident which is copied to the Program Director and Postgraduate Dean.

Of note, Program Directors are under no obligations to recommend credit for a resident if they feel that it is not appropriate to do so.

Pain Medicine is a new medical subspecialty concerned with the prevention, evaluation, diagnosis, treatment and rehabilitation of the whole spectrum of acute, chronic, non-cancer and cancer pain. Canada recently joined the US, UK and Australia in recognizing Pain Medicine as a subspecialty and is aligned with population needs, health care costs and the core values developed by the Canadian Pain Society.

The general goals of the Pain Medicine Residency Program are to train well-rounded subspecialists working in multi-disciplinary teams on the diagnosis, management and rehabilitation of pain in patients of all ages presenting with a spectrum of acute and chronic pain arising from conditions that may be medical, surgical, cancer-related or traumatic. Residents will also be involved in the diagnosis and comprehensive management of conditions associated with pain such as sleep disorders, mental health disorders and substance dependence.

As per the general standards of the Royal College applicable to all residency programs, the role of the Pain Medicine Residency Program Committee (PMRPC) is to assist the residency program director in the planning, organization and supervision of the Pain Medicine Residency Program at the University of Ottawa.

Mandate

Its mandate is to ensure that the Pain Medicine Residency Program at the University of Ottawa prepares residents to be expert consultants in the prevention, evaluation, diagnosis and rehabilitation of the whole spectrum of acute, chronic, non-cancer and cancer pain.

PMRPC’s Purpose

1. To develop and regularly review rotation-specific objectives, rotation evaluations, resources and facilities to ensure that residents attain all competencies as outlined in the objectives of training (OTR) for a pain medicine residency.

2. To develop, implement and monitor policies related to subspecialty training in pain medicine to ensure that the program meets the Royal College general standards of accreditation and the specific standards of accreditation (SSA) of a pain medicine residency.

3. To select the best candidate(s) for admission to the Pain Medicine Residency Program.

4. To oversee the evaluation and the promotion of trainees according to the policies of the Postgraduate Medical Education Committee at the University of Ottawa.

5. To organize remediation or probation for any resident experiencing difficulties meeting the appropriate level of competence according to the policies of the Postgraduate Medical Education Committee at the University of Ottawa.

6. The committee shall consist of a representative from each participating site and each major component of the Pain Medicine Residency Program. Committee members may serve a dual purpose representing the site and the rotation.

   • Program director of pain medicine residency

   • Medical director of TOH Pain Clinic (Multidisciplinary)

   • The Royal Ottawa hospital representative

   • Élisabeth Bruyère hospital representative

   • The Ottawa Hospital Rehabilitation Centre

   • Allied Health Care representative

   • Pain medicine research representative

   • Multidisciplinary pain clinic rotation(s) representative

   • Acute pain rotation representative

   • Pediatric pain rotation representative

   • Musculoskeletal rotation representative

   • Neurology rotation representative

   • Palliative care rotation representative

   • Psychiatry and addiction rotation representative

   • Pain medicine resident elected representative (Year 1)

   • Pain medicine resident elected representative (Year 2)

Resident members will need to be excused from meeting discussions should there be confidential issues raised regarding their resident peers.

Responsibilities of the Membership

1. Assist the PMR program director in the development and implementation of rotation-specific objectives for all mandatory and selective rotations.

2. Assist the PMR program director to evaluate and improve (if necessary) the educational and clinical training requirements of the residency.

3. Assist the PMR program director in the timely collection and review of training evaluations in CanMEDS format for each rotation.

4. Assist the PMR program director to advertise, review and select candidates for the residency program.

5. Assist the PMR program director in conducting a review process with an action plan when the performance of a resident is rated as unsatisfactory or if a formal complaint is lodged against a resident.

6. To review and approve the program budget generated by the program director and coordinator.

7. Review resident ITERs and comment on their fitness to take the Royal College pain medicine examination.

8. To discuss and debate any issues that arise related to the residency for which the PMR program director specifically requests input.

1. The committee shall consist of a representative from each participating site and each major component of the Pain Medicine Residency Program. Committee members may serve a dual purpose representing the site and the rotation.

   • Program director of pain medicine residency

   • Medical director of TOH Pain Clinic (Multidisciplinary)

   • The Royal Ottawa hospital representative

   • Élisabeth Bruyère hospital representative

   • The Ottawa Hospital Rehabilitation Centre

   • Allied Health Care representative

   • Pain medicine research representative

   • Multidisciplinary pain clinic rotation(s) representative

   • Acute pain rotation representative

   • Pediatric pain rotation representative

   • Musculoskeletal rotation representative

   • Neurology rotation representative

   • Palliative care rotation representative

   • Psychiatry and addiction rotation representative

   • Pain medicine resident elected representative (Year 1)

   • Pain medicine resident elected representative (Year 2)

Resident members will need to be excused from meeting discussions should there be confidential issues raised regarding their resident peers.

Pain medicine residents are remunerated based on their level of training. Further information can be found on the CaRMS website.

The Pain Medicine Residency Program will accept applicants from the following specialties: Anesthesiology, Physical Medicine and Rehabilitation, Neurology, Psychiatry, Rheumatology and Emergency Medicine. In addition, the Royal College Pain Medicine Subspecialty Committee will give applicants from other disciplines special consideration. The program is currently offering one residency spot per year. Please apply through the CaRMS online matching system.

Re-entry candidates need to consult with each school for acceptance.

• Pain Medicine at the Royal College

• The Canadian Pain Society