Clinical Rotation in the Pain Service

The Stony Brook Fellowship in Psychosomatic Medicine includes specific time dedicated to training in pain management. The clinical curriculum includes training in the evaluation and treatment of acute pain in the inpatient hospital setting, as well as the treatment of chronic pain in the ambulatory care setting, both with an emphasis on treating persons with comorbid pain and psychiatric illness. The training experience in acute pain management includes a one-month immersion block, in which time is spent with both the Anesthesia, Acute Pain Management service, directed by Chris Page, MD, and with the Behavioral Pain Service provided by attending psychiatrist, Dr. Robert Vincent. In both of these settings, fellows will participate in consultations to primary medical and surgical teams to help them manage pain in the inpatient hospital setting. Training in the management of chronic pain and the interface with psychiatric illness occurs in the Stony Brook Center for Pain Management.

The Department of Anesthesia, Acute Pain Service, consists of a staff of physicians and nurse practitioners that provide full time care for inpatients with both surgical and non-surgical pain. Functioning as both a consultative and regional anesthesia service, the service aids in the care of patients with a wide variety of painful conditions. The service provides teaching of anesthesia residents as well as physician residents rotating from other departments and medical students.

The Behavioral Pain Service of Dr. Robert Vincent, is a hospital consultative and outpatient follow-up program, which specializes in the non-interventional treatment of pain in persons with comorbid psychiatric and addictive disorders. Fellows in Psychosomatic Medicine will develop expertise in conducting comprehensive pain evaluations, gain greater knowledge and clinical expertise in the administration of both non-opiate and opiate treatment of pain, including the use of patient controlled analgesia, and develop expertise in the impact of psychiatric co-morbidity in the management of pain.

Training in chronic pain management and the interface of psychiatry occurs at the Center for Pain Management. The rotation is led by Brian Durkin, MD, an attending anesthesiologist and the director of the center, in collaboration with Patricia Tsui, PhD, a full-time psychologist at the center with subspecialty expertise in pain medicine. The Center for Pain Management has served Long Island as a regional expert in pain management since 1982. The population served has high rates of psychiatric co-morbidity, and the program uses the bio-psychosocial model of medicine to treat chronic and acute pain, to provide palliative care, and to improve the functionality and quality of life of patients. The team works in partnership with area physicians to offer consultations, diagnoses, plans of treatment and multidisciplinary care before returning the patient to his or her primary care doctor.  Psychological services, led by Dr. Tsui include psychological evaluation as well as individual and group therapy interventions aimed to help patients live better with chronic pain.  Fellows in Psychosomatic Medicine will co-lead a CBT for pain group with Dr. Tsui, as well as evaluate and follow longitudinally a group of patients with pain and comorbid psychiatric illness or addiction.