Paediatric pain training and retraining
Dr Paul Rolfe recounts his journey into Pain Medicine after seven years as a consultant in his article, 'Training in Paediatric Pain Medicine'.
"... exposure to both Paediatric and Adult Pain Medicine is invaluable for those who wish to pursue an interest in specialist paediatric Pain Medicine. They are not completely separate entities; there are transferable skills to be learnt from each discipline. Rather like the sub-specialties of anaesthesia, the valuable experience is in learning
how to use more general principles, skills and knowledge and apply them to a specific population. "
The Faculty guidance on levels of competencies required for paediatric pain medicine, endorsed by the Association of Paediatric Anaesthetists of Great Britain and Ireland. The core competencies, for all Pain Medicine practitioners, are incorporated into the 2010 Advanced Pain Medicine curriculum. In addition, the Faculty published competencies for practitioners in pain medicine who are involved in a paediatric pain service or lead transition of adolescents to adult services. These form the basis for the optional 3 month component of Advanced Pain Medicine training.
Advanced Pain Medicine Trainees
All Advanced Pain Medicine trainees receive training in core paediatric competencies, although most will not provide a paediatric pain medicine service in their subsequent clinical practice. However, these specialists may occasionally need to be involved in paediatric pain cases and this core knowledge and understanding is important for initial management and making timely and appropriate referrals to specialised paediatric pain services.
Specialist Paediatric Pain Medicine Training
There are relatively few specialised paediatric pain medicine services and these are mainly located in specialist paediatric centres. The paediatric pain medicine specialists are usually paediatric anaesthetists who have undertaken advanced training, or the equivalent, in both paediatric anaesthesia and pain medicine. The number of these specialists is very small.
Following discussions with these Paediatric Pain Medicine Fellows, the Faculty advises the following training:
- 12 months Advanced Paediatric Anaesthesia training (which may include up to 3 months Paediatric Intensive Care) followed (or preceded) by:
- 12-15 months Advanced Pain Medicine training to include 9 months of Adult Pain Medicine and 3-6 months of the optional paediatric pain module.
- This proposed training would need ratification from the anaesthetic school, deanery and RAPM.
- It is likely some of the training will need to take place post-CCT.
- All trainees are advised to take the FFPMRCA exam.
Paediatric Pain Medicine Training after appointment to a consultant post
This applies to Paediatric Anaesthetists who wish to take up sessions in paediatric pain medicine or existing pain medicine consultants who wish to extend their practice to paediatric pain medicine.
The general principles outlined in the Faculty position statement on retraining in Pain Medicine.These consultants need to acquire the advanced level pain and / or paediatric pain medicine competencies required, and be in a position to revalidate in this area of practice. Advice should be obtained from the RAPM or Faculty, and considerable local support will be required over a sustained period for the consultant to acquire the competencies and experience equivalent to specialist paediatric pain medicine training outlined above.