Stage 2 (Intermediate) Pain Training

What is Stage 2 Pain Medicine training?

Stage 2 - previously known as 'Intermediate' Pain Training - is aimed at improving your whole approach to the management of pain. There is a lot more to managing pain than knowing how to write up painkillers or set up a PCA.

Your Stage 2 Pain module will improve your understanding of:

• the management of patients with acute, chronic, acute on chronic, and cancer pain
• multi-professional biopsychosocial pain management
• understanding of the risk factors for persistent post-surgical pain
• health inequalities and pain.

I want to be an anaesthetist, so how will Stage 2 Pain help me?

Understanding and knowing how to deal with some of the complex pain issues of hospital inpatients is a key anaesthesia skill and will make you a more rounded anaesthetist and one who is more responsive to patients in pain.

When do I complete Stage 2 Pain training?

Stage 2 Pain Training is in the middle 2 years of an anaesthetic training programme (ST4 and 5). Evidence for Stage 2 Pain training can be accumulated over the 2 years of this period of training. Some training programmes can provide this as a dedicated module.

Completing Stage 2 Pain training

This requires completion of a HALO by your Faculty Tutor in Pain Medicine or Regional Advisor in Pain Medicine.

Completion of a HALO requires the following evidence:

1. supervised learning events (ACEX, ALMAT, A-QIPAT, CBD, DOPS) to suggest level of supervision
2. personal activities
3. personal reflections
4. multiple trainer report(s) that include Pain.

Counting experience from outside the training programme towards a CCT

Anaesthetists joining the training programme may be able to have some of their prior UK experience count towards their CCT. RCoA guidance on this process can be found here.

If I enjoy my Stage 2 Pain Training, what comes next?

There is a comprehensive training pathway for Pain Medicine. Stage 3 Pain Training is available from ST6 and comprises at least 20 more sessions. This will contribute to developing a specialist interest in adult or paediatric inpatient Pain Medicine and building on the experience gained at Stage 1 and Stage 2 levels.

Trainees at Stage 3 level are often largely supernumerary to service demands and (within the constraints of the curriculum and the hospital) training can be tailored to your needs and other interests.

You might even find that it inspires you to undertake a Stage 3 Special Interest Area (SIA) in Acute Inpatient Pain and consider a carer with an interest in Acute Inpatient Pain, or Stage 3 Special Interest Area (SIA) in Pain Medicine and consider a career with an interest in Pain Medicine with the option of working within inpatient and outpatient settings. Stage 3 SIA Pain Training grants you eligibility to take the FFPMRCA Examination leading to Fellowship of the Faculty and the possibility of a Credential in Pain Medicine in the future.

Whilst not an essential requirement for a career in Pain Medicine, the post-nominals attained are widely respected as the mark of a true specialist. Feedback from trainees is very positive, with the exam viewed as a fair test of the knowledge required to practice Pain Medicine.
 

Does specialising in Pain Medicine mean moving away from Anaesthesia?

Although it is certainly a different area, with its own qualities, challenges and interests, the majority of Pain Medicine specialists also work as anaesthetists and find the two areas of practice not only complimentary but enhancing.

The modern approach to managing chronic pain is multi-disciplinary and multi-professional; within that model there is still a strong requirement for the diagnostic, therapeutic and procedural skills possessed by doctors who have undergone anaesthesia training.

Commissioners and service providers recognise this and value of the breadth of medical and surgical knowledge and leadership skills of anaesthetists trained to consultant level; posts are generally aimed at applicants with an anaesthesia background including Stage 3 SIA level pain training.

Commissioners and service providers recognise this and value of the breadth of medical and surgical knowledge and leadership skills of anaesthetists trained to consultant level; posts are generally aimed at applicants with an anaesthesia background including Stage 3 SIA level pain training.