Training in Mechanisms and Clinical Presentation of Pain

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Project Summary/Abstract The overarching goal of this training program is to train the next generation of pain researchers. We will continue to train both pre- (two per year) and post-doctoral (two per year) fellows in the fundamental principles of pain, as nociceptive signals arise and are modulated throughout the body and ultimately integrated in the brain to produce the sensory and emotional experience. We will continue to build on the training program developed through the first funding period of this grant around a combination of more formal coursework and less formal training experiences designed to provide not only a solid background in pain mechanisms and management, and a greater appreciation of the burden of pain, but in a variety of skills critical for career development including the use of cutting edge methodology, networking, presentations to both lay and expert audiences, and writing. We are committed to an integrated approach to the study of pain which is based on our belief that major breakthroughs in this field can only be achieved through multidisciplinary approaches. This is most clearly manifest in practice through interactions between [1] laboratories (horizontal integration) and [2] researchers and clinicians (vertical integration). Accordingly, horizontal and vertical integration are essential components of this training program, which consists of three core elements: 1) Research - Multidisciplinary research projects are not only encouraged, but expected, as is exposure to clinical management of pain/pain-related problems. Horizontal and vertical integration will be achieve both through the choice of project, shaped by a primary mentor with input from the executive committee, and through the formation of multidisciplinary mentoring committees which will include at least one clinical faculty member among a three to four-member committee. 2) Theory - Trainees participate in four required for-credit courses: Mechanisms and Clinical Presentation of Pain, Pain Journal Club, bi-weekly Current Research on Pain presentations, and Pain Models – Rationale, Testing and Interpretation, as well as the monthly Pain Seminar Series, where trainees interact with prominent pain researchers. These courses serve as a primary venue to address issues of scientific rigor and responsibility as well as reinforce issues associated with the responsible conduct of research. Post-doctoral trainees will obtain additional training through their participation in the patient/family education program developed by the chronic pain clinic and offered every six weeks as an educational resource for pain patients and families. 3) Practice - Trainees will be exposed to the assessment, diagnosis and treatment of chronic pain patients through two (and for post-docs three) primary venues: 1) The last third of the course Mechanisms of Clinical Presentation of Pain is directed at assessment diagnosis and treatment of specific subpopulations/aspects of pain patients (visceral, headache, geriatric, etc); 2) in the course Pain Perspectives trainees shadow pain physicians as they interview, diagnose and manage pain patients; and 3) Post-docs participate in the presentation of didactic material to Regional and Chronic Pain Fellows, as well as participate in the semi-annual pain management forum for all fellows (clinical and basic) in pain related training programs.