Yury Khelemsky, MD
Program Director, Pain Medicine Fellowship Icahn School of Medicine at Mount Sinai
Content organized by:
Sabrina Sabrina Oukil, MD Resident Physician, CA-2/PGY-3
Department of Anesthesiology & Perioperative Care University of California, Irvine
1. Where do you see the future of pain medicine heading over the next 5 to 10 years?
Our reliance on opioids as a mainstay of pain management has been waning over the last decade. Pain management will continue to evolve as a more interventional specialty, however, a thorough understanding of medication options (both opioid and non- opioid), as well as other modalities such as physical therapy will remain important. It's impossible to predict reimbursement (which often drives popularity of procedures), however given that major payers would like to decrease opioid prescription, it is likely that reimbursement for alternative analgesic modalities (procedures) should stabilize.
2. What type of residents do you recruit or expect to be successful at your program?
Residents who are leaders and can take initiative do well in this program. This program prepares residents to enter the workforce as fully functioning pain physicians and in order to achieve this milestone, it is essential for trainees to actively participate in the process.
3. What is most important to you in an application?
There isn't one area that is most important, however the initial screen takes into account USMLE scores, strength of residency program, and involvement in the "pain world" (i.e. research, presentations at meetings, book chapters, etc.)
4. Any advice on letters of recommendation?
Letters should be from pain physicians. Unless there is something exceptional to disclose, letters should be brief and simply state that the applicant is recommended without any reservations.
5. What do you think are the biggest Do's and Don'ts during interviews?
It is important to balance presenting yourself in a professional manner while allowing the program to assess your interpersonal skills.
6. What do you think applicants should look for in a fellowship program?
Well-rounded training. It's not about the number of stims, etc. It's about your ability to understand which patients can really benefit from procedures. Having said that, it is important to have a high procedural volume in order to understand fluoroscopic and ultrasound anatomy. A strong didactic curriculum is also a must - which requires engagement of the entire faculty. In addition to a robust didactic curriculum, our program is developing a procedural simulation curriculum, the first of its kind anywhere in the US. The program's track record in placing fellows into jobs they desire should also be considered. Finally, an understanding of the business and administrative aspects of practice are a must.
7. What career paths have former fellows at your program taken?
Our fellows have gone on to both private practice and academic jobs. Academics will likely allow you (or require) to do both anesthesiology (if that is your primary specialty) and pain for an extended period of time, while private practice tends to be more conducive to developing a focused pain practice. Teaching residents and fellows is another obvious distinction. It is not difficult to switch from one type of practice to another, but there is a multitude of factors including compensation, lifestyle and teaching responsibility, among others, that one would have to consider.
8. How has your career path or overall career opportunities changed since finishing your fellowship?
I have grown tremendously as a pain physician and have come to appreciate the ongoing nature of this development. As I progress through my career I have narrowed my focus on providing exceptional personalized care for my patients (with a focus on interventional neck pain and headache) and a superb, well rounded training program for the fellows.
Date of Publication: Fall 2018