The Provision of Stage 3 and SIA Pain Training: Guide for Trainers and Trainees

Published: 09/03/2021

Organisation of Pain Services offering Pain Medicine Training

  1. Pain services running training programmes must provide a multidisciplinary based pain management service that meets the standards set in the Core Standards for the Provision of Pain Management Services in the UK.
  2. Where more than one hospital or pain centre combines to create a comprehensive training programme, all the competencies outlined in the training curriculum must be achievable across the various sites within the allotted training time. On a triennial basis The Faculty of Pain Medicine (FPM) will ask RAPMs to review all centres in their region that provide Stage 3 Special Interest Area (SIA) Pain Training and complete Hospital Review Forms for each site. The information collected shows prospective trainers, trainees and consultants the training opportunities that are available in each region and ensures that the training posts meet necessary standards. Stage 3 SIA Pain Training summaries for each region can be found on the FPM website. 
  3. Where the training occurs in more than one hospital, the training centres together must offer a comprehensive training programme which meets all the requirements of the curriculum. The RAPM is responsible for ensuring that a comprehensive training programme is provided. 
  4. Stage 3 SIA pain training programmes must provide the trainee with access to local or regional pain management programmes. 
  5. At least one of the training centres must provide training in cancer pain and have links to a palliative care service. As a minimum recommendation, trainees are expected to spend sixteen sessions in cancer pain management. Trainees are expected to acquire core knowledge, skills and attitudes to enable them to assess patients who may need specialist cancer pain management, make timely and appropriate referrals for this type of care and provide immediate management of patients with cancer pain whilst they are waiting for specialist pain management.  
  6. Local or regional sub-specialist modules, including paediatric medicine and implantation of spinal cord stimulators and intrathecal drug delivery systems, should be available to Stage 3 SIA Pain Medicine trainees at a level required to support their training needs. Up to three months of Stage 3 SIA training in Pain Medicine may be dedicated to a subspecialty in a tertiary centre. The training provided would be over and above the core competencies a trainee training in Stage 3 SIA Pain Medicine would be expected to achieve.  It is not expected that trainees will be independently competent in these sub-specialties within their twelve-month training time – further post-CCT training will be necessary.
  7. In each centre involved in the Stage 3 SIA Pain Medicine training programmes there should be a well-defined weekly timetable in which the day to day training opportunities are clearly apparent. 
  8. There should be regular scheduled teaching sessions in addition to the interdisciplinary case conferences, morbidity and mortality sessions and clinical audit. These teaching sessions may include journal clubs, topic review or guest lectures. 
  9. The main centre must offer an active programme of teaching in Pain Medicine for undergraduate and postgraduate students (medical, nursing and allied healthcare professionals). Trainees should be encouraged to contribute to teaching and contributing and/or organising such programmes. 
  10. Formal teaching of Stage 3 and Stage 3 SIA pain trainees may be open to trainees in neighbouring regions. Trainees should also be encouraged to regularly review the FPM website and the trainee newsletter to keep up to date with any training issues and educational resources.  
  11. The main pain management facility should have permanent accommodation that includes designated office space for the secretarial, administrative and other support staff. 
  12. Appropriate rooms for consultation and treatment must be available. 
  13. In those centres undertaking more complex interventional Pain Medicine, in-patient beds should be available for patients who require admission under the care of the Pain Management Team. Normally such beds should be located on a ward where the nursing staff are familiar with the management of these patients. If designated inpatient beds for Pain Medicine are not needed then there must be a satisfactory arrangement for admitting patients into other beds when appropriate. 
  14. Adequate workstation/desk space and communications/IT provision should be provided to trainees.  This is particularly important to allow access of patient records, results, imaging and investigations.
  15. There should be library facilities.