2021 Curriculum learning syllabus: stage 3 special interest areas

• Group 1: 6 months to 1 year

Learning outcome

• Provides comprehensive management of patients with acute, acute on chronic, chronic and cancer related pain using physical, pharmacological, interventional and psychological techniques in a multidisciplinary setting

Key capabilities

Examples of evidence

Experience and logbook:

• experience of multidisciplinary approaches to managing inpatient and outpatient pain in a variety of setting including inpatient ward rounds, outpatient clinics, advanced interventional techniques, pharmacological therapies and pain management programmes
• a wide range of clinical assessments and formulation of management plans for adults and children with acute, acute on chronic, chronic and cancer pain seen in both inpatient and outpatient clinic settings
• a wide range of pain management interventional procedures for acute, chronic and cancer pain using landmark, ultrasound and X-ray guided techniques.

Supervised Learning Events (SLEs) can be used to demonstrate:

• ability to work within a multidisciplinary pain team, collaborating with other specialties in primary and secondary care and allied health professions such as physiotherapy, occupational therapy, nursing and clinical psychology
• leading inpatient ward rounds and pain MDT
• comprehensive assessment of adults and children presenting with acute, acute on chronic and cancer pain, applying a biospsychosocial model of care.
• assessment of pain in complex scenarios, including those with cognitive impairment, limited verbal interaction and settings such as intensive care
• formulation and review of management plans for adults and children presenting with acute, acute on chronic and cancer pain
• recognition of patients with pain who have psychological problems and who require psychological evaluation, and the ability to apply established treatments for the management of psychological distress in those with pain
• management of complex patients with painful conditions, including those requiring coordinated care with other specialties and agencies, such as transition from paediatric to adult health and social services or those with drug dependences or mental health conditions
• pharmacological management of acute, acute on chronic, cancer and procedural pain in all age groups with different co-morbidities
• management of inpatient acute pain including postoperative pain; infusion pumps including PCAs, wound catheters, epidurals
• ability to plan, undertake and follow up interventional procedures for acute, chronic and cancer pain, including management of complications
• advanced interventional techniques for the management of cancer pain including but not exclusively, percutaneous cordotomy
• management of external and internal implantable drug delivery systems, both peripheral and central, for the management of cancer pain
• impact of pain on occupation and aspects of daily living; support structures for these patients
• assessment of pain in the context of neuromodulation
• referral criteria and process for patients requiring assessment and treatment by specialised pain services, eg neuromodulation, paediatric chronic pain
• management of outpatient clinics and pain intervention lists, including appropriate prioritisation of referrals.

Personal Activities and Personal Reflections may include:

• national and international courses or conferences related to Pain Medicine
• presentation at relevant meeting eg abstract or free paper
• development of guidelines and policies related to inpatient and outpatient pain
• leadership training and demonstration of ability to lead an inpatient acute pain service including supervision of nurse led services
• ability to lead multi-disciplinary pain meetings
• attend service development meetings
• deliver pain training to other professionals
• quality improvement and research projects in Pain Medicine.
• Courses/e-learning/personal reading: Role of pain management programmes, basic concepts of welfare benefits, Equality Act 2010, Mental Capacity Act, legal aspects of reasonable adjustments in context of occupation, role of social services in supporting patients with disability, Misuse of Drugs Act 1971 and Misuse of Drugs Regulations 2001, the Controlled Drugs (Supervision of Management and Use) Regulations 2013, guidance for healthcare professionals on drug driving.

Other evidence:

• satisfactory MSF
• option to take FFPMRCA exam

Supervision level

• 4 - should be able to manage independently with no supervisor involvement (although should inform consultant supervisor as appropriate to local protocols).

Cross links with other domains and capabilities

• all generic professional domains of learning
• Perioperative Medicine and Health Promotion
• General Anaesthesia
• Pain