The University of Kentucky Pain Medicine Fellowship is a 12-month ACGME-accredited program built around high-volume, multidisciplinary, procedure-focused training. Fellows rotate through multiple clinical environments including our primary multidisciplinary pain center, dedicated fluoroscopy suites, surgery center, and hospital-based settings. Clinical exposure includes bread-and-butter outpatient pain care as well as complex spine and advanced interventional pain management. Fellows care for a broad mix of patients with degenerative spine disease, vertebrogenic pain, sacroiliac joint dysfunction, neuropathic pain, cancer-related pain, chronic postoperative pain, spasticity, and headache-related disorders. Our program emphasizes both diagnostic precision and procedural decision-making, allowing fellows to develop confidence in patient selection, clinic efficiency, and longitudinal pain management.

Fellows receive extensive hands-on experience in fluoroscopy-guided, ultrasound-guided, and operative pain procedures. Training includes epidural steroid injections, medial branch blocks, radiofrequency ablation, joint and bursa injections, diagnostic and therapeutic ultrasound procedures, and regenerative medicine techniques including platelet-rich plasma and prolotherapy. Fellows also participate in advanced procedures such as spinal cord stimulation, dorsal root ganglion stimulation, basivertebral nerve ablation, sacroiliac joint fusion using multiple trajectories, minimally invasive lumbar decompression, intrathecal drug delivery systems, kyphoplasty/vertebral augmentation, interspinous stabilization, endoscopic spine surgery, and intradiscal procedures. The fellowship includes exposure to cadaver labs, simulation, and formal industry-supported certification pathways in selected advanced procedures.

Fellows have opportunities to participate in research, quality improvement, case reports, presentations, and scholarly projects throughout the year. Our faculty are involved in national research collaborations, clinical trials, educational course development, and guideline authorship. Fellows regularly participate in journal club, case-based discussions, morbidity and mortality review, and structured didactics. They present at regional and national meetings yearly and engage in projects that support academic growth, board preparation, and future career development. The program also provides access to institutional academic resources including library support, journal access, and Board Vitals.

Our goal is to graduate confident, surgically proficient pain physicians who are prepared to thrive in any practice environment. Graduates have gone on to academic, hospital-employed, VA, and private practice positions across the country. The fellowship supports career development through individualized mentorship, practical discussions on job selection and contracts, procedural autonomy, alumni engagement, and exposure to the business aspects of pain medicine. We also place a strong emphasis on building a lifelong professional network through faculty relationships and an active alumni community.

We describe the fellow experience as high-volume, supportive, and highly collegial. Our schedule is designed to maximize procedural and clinic exposure while maintaining a predictable workday, typically from 8:00 AM to 4:00 PM, with no nights, weekends, or in-house call. Fellows benefit from strong nursing, advanced practice providers, scheduling, and administrative support, allowing them to focus on clinical growth and technical development. Lexington also offers an excellent quality of life, with a family-friendly environment, low cost of living, strong schools, outdoor recreation, and an increasingly vibrant food, arts, and cultural scene.

What sets our program apart is the combination of high procedural volume, broad multidisciplinary training, and meaningful exposure to advanced minimally invasive spine and neuromodulation procedures during a single fellowship year. Fellows actively participate in a full range of modern interventional and surgical pain procedures rather than only observing or selectively assisting. Additional distinguishing features include integrated certification pathways for selected advanced procedures (sacroiliac joint fusion, dorsal root ganglion stimulation, basivertebreal nerve ablation [first fellowship in the country to offer this], spinal simplicity product line, minimally invasive lumbar decompression, dedicated cadaver labs and simulation experiences, strong faculty national engagement, and a mission centered on preparing graduates to excel in any practice setting. Our program is designed to build both technical excellence and practical readiness for contemporary pain medicine.