Jpocsc Chronic Pain Clinic

[Mariela Laflam]

TheChronic Pain Clinic at Jim Pattison Outpatient Care and Surgery Centre (JPOCSC) is the only specialized clinic in Fraser Health that offers pain management through assessment, education, specialized interventional procedures, and self-management techniques for people experiencing chronic pain. The clinical team includes Physicians, Nurse Practitioners, Physiotherapists, Occupational Therapists, Psychologists, Social Workers, Pharmacists and administrative staff. In recent years, this team won the prestigious John F. McCreary Award from UBC for Interprofessional Teamwork, an honour which clearly indicates how well this team collaborates together to enhance health care for their patients.

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Purpose: A multidisciplinary approach is recommended for patients with complex chronic pain (CP). Many multidisciplinary pain treatment facilities (MTPFs) use patient exclusion criteria but little is known about their characteristics. The objective of this study was to describe the frequency and characteristics of exclusion criteria in public Canadian MTPFs.

Methods: We conducted a cross-sectional study in which we defined an MPTF as a clinic staffed with professionals from three disciplines or more (including at least one medical specialty) and whose services were integrated within the facility. We disseminated a web-based questionnaire in 2017-2018 to the administrative leads of MPTFs across the country. They were invited to complete the questionnaire about the characteristics of their facilities. Data were analyzed using descriptive statistics and correlation measures.

Results: A total of 87 MTPFs were included in the analyses. Half of them (52%) reported using three exclusion criteria or more. There was no significant association between the number of exclusion criteria and wait time for a first appointment or number of new consultations in the past year. Fibromyalgia and migraine were the most frequently excluded pain syndromes (10% and 7% of MPTFs, respectively). More than one MPTF out of four excluded patients with mental health disorders (30%) and/or substance use disorders (29%), including MPTFs with specialists in their staff.

Conclusions: Multidisciplinary pain treatment facility exclusion criteria are most likely to affect CP patients living with complex pain issues and psychosocial vulnerabilities. Policy efforts are needed to support Canadian MPTFs in contributing to equitable access to pain management.

These include: the University of British Columbia, University of Calgary, University of Toronto, University of Ottawa, McMaster University and University of Western Ontario. For information on the Quebec programs, please see the National Pain Centre, McMaster University site that contains all information about all Pain Medicine Programs in Canada. This can be found on the following link: -medicine-residency/index.html.

Welcome to the Pain Medicine sub-specialty residency training program at the University of British Columbia, administered through the Department of Anesthesiology, Pharmacology & Therapeutics. The UBC Pain Medicine committee is excited to announce that we now accepting applications for two residents starting July 2019.

Pain Medicine is a new two-year sub-specialty residency training program accredited by the Royal College of Physicians and Surgeons of Canada (RCPSC). This program will offer unparalleled multidisciplinary learning opportunities leading to RCPSC certification in Pain Medicine.

Eligibility requirements include FRCPC certification (or in a program leading to certification) in the following areas: Anesthesiology, Emergency Medicine, Internal Medicine, Neurology, Pediatrics, Physical Medicine and Rehabilitation, Psychiatry and Rheumatology. Entry from other FRCPC programs such as Orthopedics, Neurosurgery and Palliative Care is possible in exceptional cases.

The University of British Columbia began the RCPSC Pain Medicine residency training in July 2016 where our residents are supported through diverse learning environments, by dedicated passionate teaching faculty, via broad research and leadership opportunities, and experience in innovative pain services and high functioning pain teams.

Our application criteria, process, and timelines are provided below. This website provides links for the sample rotation schedule for the 2 year program, the Goals & Objectives for each core rotation and sample electives. The full application process is detailed through CARMS. Please see -carms.ca.

Complete information on the Pain Medicine residency/eligibility/examinations process is also now available on the National Pain Centre, McMaster University site. To view this information please follow this link: -medicine-residency/index.html and through the CaRMs website. The key deadlines are listed below.

There are well over 100 faculty associated with the UBC Pain Medicine residency program with a breadth of clinical experiences, research activities, quality improvement projects and leadership positions.

The UBC Pain Residency Program is unique in enhancing competencies in longitudinal pain care through dedicated weekly resident clinics at each JPOCSC and GFS throughout most of year 2 during their elective blocks.

The multidiscipinary team experience is also unique to UBC in that a total of 7 blocks out of 13 multidisciplinary clinic blocks are completed at an outpatient tertiary pain clinic in Surrey located in the innovative Jim Pattison Outpatient Care and Surgical Cetnre (JPOCSC). A further 6 blocks are completed to support early intervention and sub-acute inpatient multi-dimensional pain care at the tertiary rehabilitation centre in Vancouver called GF Strong. Here the experiences gained will be with patients in the subacute period of one to six months after stroke, surgery, trauma and illness requiring rehabilation and transition to the community care.

The choice of electives is extensive and include orofascial medicine, UBC pharmacists clinic, sports medicine, pelvic pain, community pain clinics and ultrasound guided programs, palliative care, nurse practitioner services and interventional pain through radiology and pain clinic services.

Also, there are numerous opportunities to participate in province wide initiatives in education (e.g. Practice Support Program), leadership (Pain Medicine Physicians of BC) and advocacy (Pain BC Society).

Our academic day program is unique, and customized to the training needs of each trainee. The first Thursday of every month consists of Case Based learning afternoons facilitated by a dedicated multi-disciplinary Pain medicine faculty from across the province. Academic day topics for the other weeks are chosen by the trainee to complement their learning needs as they join resident groups in the academic day program topics of our core disciplines: physical medicine, palliative care, neurology, rheumatology, anesthesiology, pediatric, psychiatry and addiction medicine.

The UBC Pain Medicine residency program was designed specifically to capture the breadth of training experiences and settings to support the core competencies to manage the common and unique pain problems faced by pain specialists in the acute hospital setting through to the subacute period rehabilitation management through to transition to community and finally longitudinal care in various outpatient settings including community pain clinics.

Year 1 will solidify experiences in both outpatient and inpatient multidisciplinary team settings over 9 blocks specifically with the Jim Pattison Outpatient Care & Surgical Centre Pain clinic (JPOCSC) located in Surrey and the GF Strong (GFS) Rehabilitation centre located in Vancouver.

Year 1 will also integrate the core rotations of MSK, and neurology through a variety of outpatient clinics. The psychiatry/addiction medicine/sleep medicine rotations take place in an inpatient setting at Surrey Memorial Hospital, and outpatient settings with the UBC Sleep Disorders Program and Orionhealth rehabilitation and assessment centre.

Finally, to enhance competencies in longitudinal pain care, the resident will be attending a dedicated weekly resident clinic at each JPOCSC and GFS throughout most of year 2 during their elective blocks. This makes a total of 7 blocks outpatient MDC at JPOCSC and 6 blocks inpatient MDC at GFS.

The choice of electives is extensive and include orofascial medicine, UBC pharmacists clinic, sports medicine, pelvic pain, community pain clinics and ultrasound guided programs, palliative care, nurse practitioner services and interventional pain through radiology and pain clinic services. Examples of some Elective goals and objectives are attached for your reference.

Chronic pain (CP) affects one in five Canadians.1 This condition is commonly associated with psychological suffering, social difficulties, and deterioration in physical functioning.2,3 Treating CP can thus be a clinical challenge. Family physicians often feel insufficiently equipped to help these patients because they lack of expertise in pain management and/or have concerns about opioid use disorders.3,4 Patients with complex CP (e.g., pain causing major functional impairment) commonly require multimodal treatment modalities3,5 including physical and psychological ones. Indeed, multidisciplinary interventions are considered the optimal paradigm for the management of patients living with complex CP.6,7

To be considered as MPTFs, clinics had to: 1) advertise themselves as a specialized clinic or centre offering multidisciplinary services for the diagnosis and management of CP and 2) provide services from at least three healthcare specialties (including a medical specialty) whose services were integrated within the clinic or the centre staff.8,10 Both adult and pediatric MPTFs were eligible to participate.

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