Allied Pain & Spine Institute is proud to offer a comprehensive 12-month clinical fellowship training position in interventional pain, spine, and musculoskeletal medicine, for the 2023-2024 academic year.

The fellow will be educated and trained in refining their clinical evaluation and decision-making skills in the spine and orthopedic/musculoskeletal disorders, as well as gain competence in a full array of the fluoroscopy-guided spine and peripheral interventions (cervical, thoracic, lumbar/sacral, peripheral nerve, and joint), including spinal and peripheral neuromodulation, and minimally invasive spinal decompression procedures. Other key elements of the fellowship training include electrodiagnostics, radiographic/MR imaging assessment, musculoskeletal and peripheral nerve ultrasound (for injection guidance and diagnostics), and regenerative medicine – including PRP, platelet lysate, and bone marrow aspirate. Learning to function within a multidisciplinary team-focused environment will be emphasized, and opportunities to work with and learn from several members of the multidisciplinary care team – including chiropractors, physical therapists, acupuncturists, pain psychologists, interventional physiatrists and anesthesiologists, and spine and orthopedic surgeons – will be available.

Clinic Responsibilities

The fellow evaluates and manages a wide range of physical medicine cases including spinal disorders and pain, joint and soft tissue disorders and pain, central pain (e.g., complex regional pain syndrome), and neuropathies. There will be significant exposure to occupational and sports medicine, with a mix of acute, subacute, and chronic cases, as well as some preventive/wellness care and performance and functional optimization.

Fluoroscopy-guided Procedures

The fellow’s training will involve a large number of fluoroscopically guided interventional cases over the course of the year. Fellows perform these cases under close guidance of faculty physicians, with increasing levels of independence and increasing exposure to advanced procedures as clinical training advances.

Upon completion, fellows are expected to be highly competent performing the following:

• Lumbar/sacral epidurals (transforaminal, interlaminar, and caudal)
• Cervical and thoracic epidurals (interlaminar and transforaminal)
• Lumbar facet procedures (medial branch blocks, RFA, intra-articular)
• Cervical and thoracic facet procedures (medial branch blocks, RFA)
• Selective nerve root blocks (lumbar, thoracic, cervical)
• Sacroiliac joint injections
• Large and intermediate joint intra-articular injections
• Spinal cord stimulator trials and implants
• Peripheral nerve stimulator trials and implants
• PRP and Bone Marrow Aspirate harvesting and injections

Other procedures the fellow can be expected to have exposure to include:

• Sympathetic and Ganglionic Blocks (cervical, lumbar, and sacral)
• Intercostal nerve blocks
• Intradiscal procedures (discography, percutaneous decompression, PRP/stem cells)
• Genicular, Cluneal, Suprascapular, and other peripheral nerve blocks and ablations
• Interspinous Spacer (Vertiflex) placement
• Minimally Invasive Lumbar Decompression (MILD)
• Minimally Invasive Posterior Sacroiliac Joint Fusion
• IV Ketamine infusions for chronic pain

Office-based procedures:

• Musculoskeletal Ultrasound – Ultrasound is used extensively for needle guidance in the peripheral joint, intramuscular/peritendinous, and peripheral nerve block procedures, as well as for diagnostic purposes
• Joint/bursa/trigger point injections
• Platelet-rich plasma (PRP) therapy
• Intra-articular hyaluronic acid injections

Other Clinical Skills:

• EMG/NCV (for PM&R and Neurology fellows) – Fellows will maintain and enhance electrodiagnostic skills throughout the fellowship. Fellows typically perform 2-5 EMG cases per week.
• Anesthesia (for Anesthesia fellows) – Fellows will perform some basic anesthesia practices to maintain and enhance these skills throughout the fellowship. This can include but not be limited to conscious IV sedation and/or MAC for pain/spine cases, nerve block procedures for orthopedic cases, and general anesthesia for simple orthopedic and spine cases in an ASC setting (no hospital coverage required).

Research and Education:

• Journal Clubs and case study reviews are held regularly to review the relevant literature.  Fellows take an active part in these presentations and are expected to present in monthly rotating topics.
• Fellows are encouraged (though not required) to be involved in at least one research project during the course of the fellowship, to be completed and submitted for presentation and/or publications.
• Fellows take part in teaching visiting medical students and PA students that may rotate through our clinics periodically.
• The program encourages and supports fellows to participate in regional or national academy meetings and conferences to further enhance their educational experience
• Upon completion of training, Fellows will be eligible and encouraged to sit for the American Board of Pain Medicine (ABPM) certification exam. Fellows should be aware that while this is a non-ACGME fellowship, ABPM is recognized by the Medical Board of California as equivalent to ACGME for board certification in Pain Medicine.

Application Process:

Potential fellows will need to have successfully completed an ACGME-accredited residency program in either PM&R, Anesthesia, or Neurology, and be board-certified or board-eligible by their respective specialty board, upon the start of fellowship training.  Applicants currently in residency must be in good standing at their respective programs and must have successfully completed USMLE Step 3 (or the COMLEX equivalent) in order to be considered.  Fellows must also apply for medical licensure in California (Medical Board of California) prior to the start of fellowship training.

We are currently accepting applications for the 2023-2024 academic year position.  To apply, please submit CV, personal statement, and at least two (2) letters of recommendation.

Selected candidates will be invited to interview with us.  An interview typically spans one full day, which allows ample time for the candidate to interact with current physicians, staff, and ancillary providers, and to observe our clinics and procedures. ***Please note that during COVID-19 emergency orders, we are adhering to any local, state, and national social distancing precautions, meaning that initial interviews may be conducted remotely, with on-site interviews being completed as pandemic mandates allow.

ABOUT US:

Allied Pain & Spine Institute (APSI) is a dynamic outpatient multidisciplinary medical practice with several offices located in the beautiful Silicon Valley / South Bay Area of California. Our dynamic and highly skilled providers help us deliver the most cutting-edge and evidence-based pain solutions available today.

We provide comprehensive consultation and multi-faceted care for acute and chronic pain conditions arising from virtually any part of the human physical body.  We offer compassionate and experienced management for a wide range of injuries including spinal, orthopedic, degenerative, industrial, repetitive strain, sport, and automobile/whiplash.  Emphasis is always on improving quality of life.

Most of our spinal procedures are performed at an affiliated Medicare-certified ambulatory surgery center adjacent to our main San Jose office, with office-based ultrasound-guided procedures performed at all locations. We also have a burgeoning and cutting-edge Functional Restoration Program that the Fellow will have an opportunity to participate in, as well as on-site digital/virtual-reality therapy and a newly revamped lifestyle and wellness program.  We are among the volume leaders in neuromodulation in the Northern California region, and pride ourselves in creating a highly personalized patient experience and in achieving industry-leading quality outcomes.