Dr Luke Murtagh recently completed pain medicine training at Royal Adelaide Hospital. He is now qualified in both pain medicine and anaesthesia
Why did you choose to train in pain medicine?
As part of my anaesthetics training, I spent 5 weeks in our pain management unit at Royal Adelaide Hospital. What appealed to me was the in-depth patient contact, and the opportunity to build a longer lasting relationship and rapport with patients compared with anaesthesia. I also found it an interesting challenge, and thought it would complement my anaesthetics practice.
What do you like most about the specialty?
The extreme satisfaction you get when you’re able to successfully treat a patient who is highly distressed with inadequate pain management and a high level of dysfunction, and you see them transform as a person. Although we don’t always win and our work is challenging, when you have a success story, it’s incredibly rewarding.
I would consider pain medicine one of the most complete specialties. It also gives you a different perspective on medical management. It’s about focusing on the person and their standard of living and level of function, as opposed to focusing on a single pathology and treating it.
What did you like about the training program?
As pain medicine is an add-on specialisation, it requires at least 1 extra year. It was nice not having to go through the rigours of another 5-year training program (like anaesthesia). I liked the variety of training which spanned procedural intervention, assessing patients with the pain unit psychiatrist, multidisciplinary assessments, and simple initial consultations. The training program was also focused on a clinic with normal business hours, so my lifestyle was more stable and reliable. I only had to work one in six weekends, with no on-call.
Is there anything you disliked?
Managing patients with chronic pain, especially those with complex psychosocial issues, can be emotionally draining. This includes managing inappropriate opiate prescribing, or dependence. However, with experience, you learn how to keep your emotions in check. You appreciate that it is the patient who has the problem, and you become increasingly confident in what you can achieve with the skills and knowledge that you have. The assessment was rather stressful. It involves four exams over 3 days, and in many ways was more challenging than the anaesthetics exams.
What are your future plans?
I intend to continue to work mainly in anaesthesia, but plan to do at least 1 day a week in pain medicine over the longer term, and possibly move more towards the interventional side of pain medicine. I also have a strong interest in perioperative pain management.
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