My pain management fellowship application essay
Toward the end of medical school, I had a tough choice to make: anesthesia residency vs. psychiatry residency. Anesthesia appealed to me for its synthesis of various branches of physiology, for its invasive procedures and hands-on practice style, and for the people I worked with in it. Psychiatry appealed to me for its long-term care relationships, for the satisfaction of caring for patients on the verge of catastrophe, and for its combination of behavioral and cutting-edge biochemical approaches. Both had fascinating use of pharmacology, and on a deeper level they filtered limited observable information through a heavy layer of theory to deduce "what's really happening." How could I satisfy all my interests? I decided on anesthesiology, and I've been happy in residency. In retrospect, though, my choice looks even better because it's given me entree to a subspecialty that touches on almost everything I enjoy in medicine: chronic pain management.
Anesthesiologists have picked up much of the responsibility for pain management because we have a broad understanding of physiology, we are experts at nerve blocks and analgesic use, and patient comfort is a primary goal for us, rather than secondary. But on the other hand, we've traditionally been strongly procedure-oriented, and we’re often unintentionally impatient with chronic conditions and the psychological aspects of disease. My broad range of apparently contradictory interests -- physiology, procedure practice, psychology, and psychopharmacology -- makes me especially suited for pain management practice. Though I enjoy placing blocks, pumps, and stimulators, I have enough background and breadth of interest to know that they’re not always enough. In particular, I'm strongly positioned to manage a multidisciplinary pain clinic and lead its members to focus together on the toughest pain problems, tractable and intractable.
My goal within the next few years is to lead a multidisciplinary pain clinic focusing on chronic pain. After seeing the functional rehab model in action during a month's elective at Alpha Omega Pain Medicine Associates in Palo Alto, I'm interested in applying it myself. At Alpha Omega, the focus is on workmen's compensation rehabilitation, a niche where it's economically feasible to give intensive care over several weeks; I may want to do something similar, or possibly try to affect more patients' care by consulting with insurers to have earlier influence on the treatment of chronic pain. In any case it will be important for me to understand both anesthesia's specific strengths in pain management -- medications, blocks, stimulators, etc. -- and our interactions with other specialties. Thus, fellowship training at a good multidisciplinary center will be vital for my plans.
I believe I’ll enjoy pain management, and that I’ll be a credit to the program I train at. I hope for an interview with you soon.
