ANES 409 – Pain Management
Hanyang Kevin Hong – University of Sydney School of Medicine (Australia)
My dream specialty is anesthesiology. I’ve done an anesthesia rotation in New York, so I’ve seen anesthesia in the OR setting. For this reason, I picked this elective in order to see subspecialty anesthesia in an outpatient clinic setting, managing patients living with chronic panic. A lot of med students tell me they don’t want to go into anesthesia because they think there is no patient follow up or continuity of care. But I believe this elective would show them that anesthesiology is a very flexible and diverse specialty – more than just putting people to sleep during surgeries. If you want to have that continuity of care and work in an outpatient setting, you can choose to be a pain specialist. I also saw many procedures I wasn’t familiar with before. I got to spend a week at the UNC Spine Center and Neurosurgery Clinic– where I observed interventional pain management treatments such as medial branch block, radiofrequency ablation, spinal cord stimulator implant and trigger point injection for chronic pain. I think what’s most gratifying to me is when right after the procedure, the patient says “wow doctor, I have no pain now and I can walk! Thank you so much!”, or when a patient comes back to the clinic for follow up and tell us “thanks for putting me on the right medications doctor! Now I can finally go back to work and do the things I enjoy”. This is truly satisfying, and it has definitely drawn me closer to pursuing this specialty in the future.
This rotation has allowed me to gain more exposure to the specialty. More importantly, I was given more autonomy and responsibility than OR anesthesia! I spent two weeks at the UNC Pain Clinic, where I got to see 5-7 patients independently every day and talk about my diagnosis and plan of care with the attendings before composing a comprehensive note in EPIC. I am very proud that I correctly diagnosed a patient with complex regional pain syndrome on my last day of the rotation (of course with the help of our dear friend UpToDate). I also got to spend a week with the inpatient pain consult team. Pain management and anesthesia is usually not taught that well in medical school. I remember when I presented my very first patient’s plan of management, the attending looked absolutely mortified. But I think by week 4 I had built a pretty good knowledge base and foundation to manage patients presenting with common chronic pain issues. My attending even commented that he’d seen a significant improvement in me.
The course director Dr. Jowza made sure the students get individual attention from faculty, therefore she sent us two med students to different places each week in order to maximize teaching. The other student is a UNC student, and we communicated via text throughout this rotation. He was very nice- we met up after the first week to debrief about our experiences. We shared our very different med school experiences, and our mutual passion for anesthesiology. We attended didactic lectures together, went to anesthesia grand rounds, researched on interesting pain management topics and delivered presentations to the attendings and residents at the end of our rotation. It has been a very pleasant experience overall.
I would also like to mention that the Office of International Activities is so wonderfully organized and thoughtful! I felt very well informed during every step of my application. I appreciate the welcome breakfast and detailed orientation on the first day, as well as those UNC souvenirs. I also loved the International Visiting Student dinner, where we got a chance to bond with each other. We actually ended up hanging out together a lot outside of clinical hours. We went to watch the Duke vs. UNC game together, saw cherry blossom in Durham, practiced Step 2 CS, and met up for lunch a bunch of times. It was a lot of fun. I think a lot of international students who are rotating here are doing so in the hopes to get an interview for a residency position. Despite the fact that UNC’s anesthesiology does not consider IMGs for residency, I think it’s completely worth it to have this experience. I believe my experience at a prestigious institution like UNC-Chapel Hill will definitely strengthen my application this year, and it is something I can definitely talk about in interviews.