Pain Management Clinical Experience
The primary focus of the Pain Medicine Training Program at the University of North Carolina Hospitals is to provide comprehensive, patient-centered, ethical, multidisciplinary training in pain medicine for physicians with anesthesiology, physical medicine and rehabilitation, neurology, or psychiatry as their primary specialty. We provide and teach the full spectrum of pain treatments ranging from cognitive/behavioral, through pharmacologic, injections, and advanced interventional therapies. Two or three annual fellowship positions are offered, and graduates of the program are eligible to sit for the pain medicine board certification exam in their respective primary specialty. The training program is administered through the Department of Anesthesiology, part of the University of North Carolina Health Care System.
The Health Care System is a not-for-profit integrated health care system, owned by the State of North Carolina and based in Chapel Hill. It exists to further the teaching mission of the University of North Carolina and to provide state-of-the-art patient care. A distinguishing characteristic of UNC Health Care is its association with the UNC-Chapel Hill School of Medicine, a nationally eminent research institution. From well-baby check-ups to chronic disease care to life-saving surgeries to cutting-edge gene therapy, UNC Health Care is improving health and treating disease across North Carolina. In addition to comprehensive medical, surgical and psychiatric care, UNC is a leader in health promotion and disease prevention.
UNC Hospitals is the cornerstone of UNC Health Care. It is a public, academic medical center operated by and for the people of North Carolina. People from all 100 North Carolina counties and throughout the Southeast are patients at the 757-bed facility - more than 36,000 each year. UNC delivers the best in interdisciplinary health care. Specialized patient care services include the Breast Center, Cardiovascular Program, Diabetes Care Center, Lung Center, Rehabilitation Center, Spine Center, Wound Management Program and Comprehensive Transplant Center. The medical center's extensive expertise in arthritis, digestive diseases, endocrinology, ENT, gynecology, hemophilia, infertility, rheumatology, and orthopaedics have achieved both regional and national recognition. UNC is home to the Lineberger Comprehensive Cancer Center, one of 40 National Cancer Institute-designated centers in the United States. The N.C. Cancer Hospital opened in August 2009 and is the clinical home of the UNC Lineberger Comprehensive Cancer Center. In addition, UNC Hospitals includes the North Carolina Children's Hospital, North Carolina Memorial Hospital, North Carolina Neurosciences Hospital, and North Carolina Women's Hospital.
The faculty of the Pain Medicine Training Program include:
- William S. Blau, MD, PhD, Professor of Anesthesiology Director, Pain Fellowship Training Program; Areas of Special Interest: Spine pain diagnostics and therapeutics; acute, chronic, and cancer pain; clinical use of chronic opioid therapy; interventional pain therapy; preventive analgesia.
- Dominika James, MD, Assistant Professor of Anesthesiology
- Manoj (Bobby) Subbarao Wunnava, MD, Assistant Professor of Anesthesiology; Areas of Special Interest: Neuromodulation therapies; perioperative pain management; treatment of Complex Regional Pain Syndrome; management of axial pain; interventional therapies for management of headache, intrathecal therapy for management of cancer pain.
- Sam A. McLean, MD, MPH, Assistant Professor of Anesthesiology, Director of Research
- LeKisha Y. Alesii, PhD, Clinical Assistant Professor/Clinical Psychologist
- Amy M. Goetzinger, PhD, Clinical Assistant Professor/Clinical Psychologist
In addition, there are ancillary faculty from related specialties who participate in the training of our fellows during clinical rotations within their specialties.
Our clinical services provide the core of the training program in pain medicine. They include:
- The Hospital Pain Service: This service provides daily management of patients with postoperative, post-traumatic, and other types of acute pain requiring specialized interventions such as epidural analgesia, other regional anesthetic techniques, or complex pharmacological management. Support is also provided to the operating rooms for placement of epidural catheters. A dedicated anesthesiology attending is assigned daily, along with one fellow. Consultations are also provided for complex inpatient pain management problems, and daily rounds are performed.
- UMC Pain Management Center: The Center is our community-based outpatient clinic for the management of chronic and cancer pain. We provide comprehensive, interdisciplinary, yet individualized approach to patient care, which draws upon the expertise of our faculty as well as consultants from other specialties. A three pronged approach to patient evaluation and management emphasizes pain control, psychological optimization, and rehabilitation.
- The University of North Carolina Spine Center: The Spine Center is an interdisciplinary clinic practice involving physician specialists from our program and from neurosurgery, orthopedic surgery, rheumatology and physical medicine and rehabilitation, as well as specialty nurses and physical therapists. The facility includes specialized procedure rooms with state of the art monitoring, interview rooms, and C-arm fluoroscopy. It serves as our base for interventional pain techniques, including trigger point injections, cervical and lumbar epidural blocks/steroids, sympathetic blocks, plexus blocks, peripheral blocks, joint injections, radiofrequency denervation, nerve root blocks, and spinal cord stimulator trials. We also offer OR-based, state-of-the-art interventional techniques, including implantation of spinal cord stimulators and intrathecal infusion pumps.
For most of the year, our trainees are assigned to one of these three clinical sites on a three-week rotating cycle. In addition, dedicated clinical experiences are provided during the year in the following specialty areas: anesthesiology (for non-anesthesiologists), neurology, physical medicine and rehabilitation, psychiatry, and palliative care.