docCOuRSE DIRECTORS FACuLTy Comprehensive Review Course
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COuRSE DIRECTORS FACuLTy Comprehensive Review Course
Comprehensive Review Course and Cadaver Workshop ( B asic , I n termediate , a n d C omprehe n si v e I n ter v e n tio n al Pai n M a n a g eme n t E x ami n atio n P reparatio n C o u rse ) F ebr u ar y 1 8 - 2 0 , 2 0 1 1 M emphis , T n . Description, Purpose and Target Audience This 2½-day review course and workshop is designed for interventional pain physicians, for a review, skills improvement or to assist in preparation for Comprehensive Interventional Pain Management Examination qualifications. ASIPP offers the most in-depth, comprehensive, and individualized programs available in interventional pain management, featuring maximum hands-on training with cadavers in a state-of-the-art facility and maximum ability to interact with other participants. Participants will experience a comprehensive and intense learning opportunity, focusing on interventional pain management techniques. • Each cadaver station is limited to a maximum of 8 participants. • Participants can choose the level of participation: basic, intermediate, or Comprehensive Interventional Pain Management Examination Preparation Course. • C-arms and state-of-the-art equipment are utilized in this course. Participants are requested to dress in casual attire or scrubs. Leaded aprons and thyroid shields will be provided. However, participants are advised to bring their own protective eyewear. The workshop is offered to improve the delivery of multiple aspects of interventional pain management. The desired outcome is to integrate multiple aspects of interventional pain management in treating your patients so that patients have better outcomes and reduced side effects. Outcome Physicians should be able to integrate multiple aspects of interventional pain management techniques in patient treatments so that patients have better outcomes and reduced side effects. C o u rse D irectors Laxmaiah Manchikanti, MD Chairman of the Board and CEO, ASIPP Medical Director Pain Management Center of Paducah Paducah, KY Ramsin M. Benyamin, MD Immediate Past President, ASIPP President, Millennium Pain Center Bloomington, IL Clinical Associate Professor Department of Surgery University of Illinois College of Medicine Urbana-Champaign, IL Allan T. Parr, MD President, ASIPP Medical Director Premier Pain Center Covington, LA F ac u lt y David A. Bryce, MD Board of Directors, ASIPP President, Wisconsin Society of Interventional Pain Physicians Advanced Pain Management Clinical Associate Professor of Anesthesiology University of Wisconsin Madison, WI Ricardo M. Buenaventura, MD Medical Director Pain Relief of Dayton Centerville, OH Clinical Associate Professor of Anesthesiology Accreditation Statement The November workshop is a CME activity that has been planned and implemented in accordance with the Essential Areas and Policies of the Accreditation Council for Continuing Medical Education through the Joint Sponsorship of the Institute for Medical Studies and the American Society of Interventional Pain Physicians. The Institute for Medical Studies is accredited by the ACCME to provide continuing medical education for physicians. Americans with Disabilities Act & Special Services Organizers fully comply with the legal requirements of the Americans with Disabilities Act and the rules and regulations thereof. If any participant in these educational activities is in need of accommodations, please contact the organizers at (270) 554-9412 at least 10 days prior to each conference. Cadaver Workshop Site Medical Education & Research Institute 44 South Cleveland, Memphis, TN 38104 MERI is a non-profit institute located in the heart of the downtown medical center in Memphis, Tennessee. The 27,000-square-foot facility houses 3 anatomic teaching laboratories; 7 private, high-security research suites; and an auditorium equipped with the most state-ofthe-art audiovisual systems available. Category I Credit™ The Institute for Medical Studies will determine these educational activities for up to 20.10 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity. University of Wisconcin Advanced Pain Management Madison, WI Ray d’Amours, MD Executive Director, California Society of Interventional Pain Physicians Universal Pain Management Palmdale, CA Richard S. Epter, MD Director At-Large, Georgia Society of Interventional Pain Physicians Medical Director Augusta Pain Center Augusta, GA Ira Fox, MD Anesthesia Pain Care Consultants Fort Lauderdale, FL Hans C. Hansen, MD Director at Large, ASIPP President, North Carolina Society of Interventional Pain Physicians Medical Director The Pain Relief Centers, PA Conover, NC Standiford Helm II, MD President Elect, ASIPP Pacific Coast Pain Management Center Laguna Hills, CA Stephen Watson, MD, PhD Innovative Pain Solutions Springfield, OH Robert Masone, MD President, Ohio Society of Interventional Pain Physicians Spinal Technology And Pain Center Lancaster, OH Ricardo Nieves, MD Director At-Large, Colorado Society of Interventional Pain Physicians Colorado Spine, Pain and Sports Medicine Fort Collins, CO Francis Riegler, MD President, California Society of Interventional Pain Physicians Universal Pain Management Palmdale, CA Andrea M. Trescot, MD Director Pain Medicine Fellowship Program Professor Anesthesiology and Pain Medicine University of Washington Seattle, WA Vikram Patel, MD ACMI Pain Care Algonquin, IL Arthur S. Watanabe, MD Board of Directors, ASIPP President, Washing Society of Interventional Pain Physicians Spinal Diagnostics Liberty Lake, WA American Society of Interventional Pain Physicians COmpREhEnSiVE REViEw COURSE And CAdAVER wORkShOp (Basic, intermediate, and comprehensive interventional pain management examination preparation course) February 18-20, 2011 memphis, tennessee Cadaver Lab – Saturday and Sunday Up to 20.10 AMA PRA Category 1 Credits LAB COURSE LEVELS BASIC 1. Caudal epidural injections 2. Lumbar interlaminar epidural injections 3. Lumbar transforaminal epidural injections 4. Sacroiliac joint injections 5. Lumbar facet joint intraarticular injections 6. Lumbar facet joint nerve blocks 7. Lumbar facet radiofrequency neurotomy INTERMEDIATE 1. Lumbar discography 2. Lumbar sympathetic blocks and hypogastric plexus blocks 3. Celiac plexus blocks and splanchnic nerve blocks 4. Cervical and thoracic interlaminar epidurals 5. Thoracic facet interventions (intraarticular, medial branch blocks, and radiofrequency neurotomy) 6. Cervical facet joint interventions (intraarticular, medial branch blocks, and radiofrequency neurotomy) 7. Percutaneous adhesiolysis CoMpREhENSIvE INTERvENTIoNAL pAIN MANAgEMENT ExAMINATIoN 1. Caudal epidural, interlaminar epidural, and percutaneous adhesiolysis 2. Lumbar transforaminal and lumbar discography 3. Lumbar facet joint interventions (intraarticular, facet joint nerve blocks, and radiofrequency neurotomy) and sacroiliac joint injections 4. Thoracic facet joint interventions (medial branch blocks and radiofrequency neurotomy) and thoracic interlaminar epidural injections 5. Cervical facet joint interventions (medial branch blocks and radiofrequency neurotomy) and cervical interlaminar epidural injections 6. Spinal cord stimulation lead placement 7. Sympathetic blockade (stellate ganglion, lumbar sympathetic blocks and celiac plexus blocks) ComPrehenSive DiDaCTiC review CourSe FRIDAy February 18, 2011 7:00am–8:00am REgISTRATIoN AND BREAkFAST AT MARIOTT 8:00am–8:45am Introduction to ASIpp and Board preparation Review Laxmaiah Manchikanti, MD 8:45am–9:30am Imaging for Interventionalists – Fluoroscopy, Radiation Safety, and Needle placement Arthur Watanabe, MD An Algorithmic Approach to interventional pain Management: Evidence Based or Comparative Effectiveness? Laxmaiah Manchikanti, MD 9:30am–10:15am 10:15am–10:45am 10:45am–5:45pm BREAk BREAkouT SESSIoNS The schedules for the three breakout sessions; Basic, Intermediate, and Comprehensive IpM Exam prep can be found on the following page. Each breakout session will share the early schedule above. ComPrehenSive DiDaCTiC review CourSe FRIDAy February 18, 2011 BREAkouT SESSIoNS BASIC INTERMEDIATE IPM EXAM PREP All lectures cover: History, Clinical Presentation, Relevant Anatomy, Technical Aspects, Complications, Evidence, and Patient Selection of each intervention 10:45am–11:30am Caudal epidural injections Lumbar Discography Caudal epidural, Lumbar interlaminar epidural, and Percutaneous adhesiolysis Andrea M. Trescot, MD Ramsin M. Benyamin, MD Standiford Helm II, MD Lumbar Sympathetic and hypogastric Plexus blocks Lumbar Transforaminal epidural and Lumbar Discography David Bryce, MD Ramsin M. Benyamin, MD Lumbar interlaminar epidural injections 11:30am–12:15pm Hans C. Hansen, MD LuNCH 12:15pm–1:15pm Sacroiliac Joint injections Celiac Plexus and Splanchnic nerve blocks Andrea M. Trescot, MD David Bryce, MD 1:15pm–2:00pm 2:00pm–2:45pm Lumbar Transforaminal epidural injections Cervical and Thoracic interlaminar epidurals Richard S. Epter, MD Standiford Helm II, MD Lumbar Facet Joint interventions (intraarticular, Facet Joint nerve blocks, and radiofrequency neurotomy) and Sacroiliac Joint injections Hans C. Hansen, MD Spinal Cord Stimulation Lead Placement Arthur Watanabe, MD BREAk 2:45pm–3:15pm Lumbar Facet Joint injections 3:15pm–4:00pm Thoracic Facet Joint interventions (intraarticular, medial branch blocks, and radiofrequency neurotomy) Thoracic Facet Joint interventions (medial branch blocks , radiofrequency neurotomy and intercostal nerve blocks) and Thoracic interlaminar epidural injections Arthur Watanabe, MD Arthur Watanabe, MD Andrea M. Trescot, MD Lumbar Facet radiofrequency neurotomy Cervical Facet Joint interventions (intraarticular, medial branch blocks, and radiofrequency neurotomy) Sympathetic blockade (Stellate ganglion, lumbar Sympathetic blocks and Celiac Plexus blocks) Hans C. Hansen, MD Richard S. Epter, MD Standiford Helm II, MD Troubleshooting and Complications for beginners Percutaneous adhesiolysis Ramsin M. Benyamin, MD Standiford Helm II, MD 4:00pm–4:45pm 4:45pm–5:45pm Cervical Facet Joint interventions (medial branch blocks and radiofrequency neurotomy) and Cervical interlaminar epidural injections Ramsin M. Benyamin, MD hanDS-on CaDaver WorkShoP SATuRDAy February 19, 2011 6:45am–7:00am Shuttles depart for MERI facility from Mariott to the Meri facility 7:00am–7:45am Registration and Breakfast 7:45am–8:20am Introduction 8:30am–1:00pm Hands-on Cadaver Workshop 1:00pm–2:00pm Lunch Provided 2:00pm–5:00pm Hands-on Cadaver Workshop 5:00pm Participants rotate through multiple stations Participants rotate through multiple stations Shuttles depart for Marriott Memphis hanDS-on CaDaver WorkShoP SuNDAy February 20, 2011 6:45am–7:00am Shuttles depart for MERI facility from Mariott to the Meri facility 7:00am–7:45am Registration and Breakfast 7:45am–8:20am Introduction 8:30am–12:15pm 12:15pm Hands-on Cadaver Workshop Participants rotate through multiple stations Meeting Adjournment Shuttles depart from Mariott to the airport Comprehensive Review Course and Cadaver Workshop ( B asic , I n termediate , a n d C omprehe n si v e I n ter v e n tio n al Pai n M a n a g eme n t E x ami n atio n P reparatio n C o u rse ) F ebr u ar y 1 8 - 2 0 , 2 0 1 1 M emphis , T n . Registration Form REGISTRATION INFORMATION Please complete the enclosed registration form and return to ASIPP with payment (your application will not be processed if payment does not accompany registration form). ASIPP reserves the right to cancel this Workshop and/or Review Preparation Course upon reasonable notice and will assume no financial obligation to registrants for cancellation of the course for reasons beyond its control. Registration fees will be refunded. However, costs incurred by the registrants, such as airline or hotel fees or penalties, are the responsibility of the registrants. Registrants who are not accepted into this workshop will receive notice by mail with their returned checks. Please print exactly as you wish your name to appear: ________________________________________________________________________________________________ Name (First) (Middle Initial) (Last) (Degree) ________________________________________________________________________________________________ Organization ________________________________________________________________________________________________ Address ________________________________________________________________________________________________ City StateZip IMPORTANT: Please answer all the questions: Primary Specialty Certification: m Anesthesiology m Neurosurgery m Physiatry m Other: ___________________ Pain Medicine Subspecialty Certification: m m m m American Board of Anesthesiology American Board of Pain Medicine American Board of Interventional Pain Physicians Fellow of Interventional Pain Practice (FIPP) Specialty Designation: m 09 - Interventional Pain Management m 72 - Pain Management m Other: ______________________________________ Percentage of Interventional Pain Management practice: m 0% m 1-25% m 26-50% m 51-75% m > 75% Years in Interventional Pain Management practice: m 0 m 1-5 m 6-10 m > 10 Please select one of the following: ________________________________________________________________________________________________ Phone Cell Fax ________________________________________________________________________________________________ Email Registration Fee for Comprehensive Review Course and Cadaver Workshop Early Bird - On or before January 27, 2011: m $2,200 Member m $2,500 Non-Member Regular - After January 27, 2011: m $2,500 Member m $2,800 Non-Member Special Rates for Fellows and Residents Early Bird Regular m $500 m $600 Payment Method (Please check one): m Mastercard m Visa m American Express m Discover m Check ______________________________________________________________________________________________ m Basic m Intermediate m IPM Exam Prep Credit Card Number Security Code (Back of Card) Exp. Date Total number of procedures performed during past year: LOCATION ASC HOPD ______________________________________________________________________________________________ Office name On Card Caudal Epidural _____ _____ _____ Stellate Ganglion Blocks _____ _____ _____ Thoracic Sympathetic Blocks _____ _____ _____ Lumbar Discography _____ _____ _____ ________________________________________________________ m Enclosed (Payable to ASIPP) Sacral Transforaminal Epidural _____ _____ _____ Lumbar Sympathetic Blocks _____ _____ _____ (Your application will not be processed if payment does not accompany registration form) Caudal Epidural _____ _____ _____ Lumbar Facet Joint Blocks _____ _____ _____ Thoracic Interlaminar Epidural _____ _____ _____ Cervical Interlaminar Epidural _____ _____ _____ Cervical Facet Joint Blocks _____ _____ _____ Cervical Radiofrequency _____ _____ _____ Thoracic Joint Blocks _____ _____ _____ Thoracic Radiofrequency _____ _____ _____ Lumbar Radiofrequency _____ _____ _____ Lumbar Transforaminal Epidural _____ _____ _____ Hypogastric Plexus Blocks _____ _____ _____ Sacroiliac Joint Injections _____ _____ _____ Pyriformis Block _____ _____ _____ Percutaneous Adhesiolysis _____ _____ _____ ______________________________________________________________________________________________ Authorized Signature (required on all credit card orders) Check Number Return completed form to: ASIPP, 81 Lakeview Drive, Paducah, KY 42001 or Fax to (270) 554-5394 ACCOMMODATIONS: I will be staying at: m The Memphis Mariott m Other __________________________________ (Please Specify Location) Three Ways To Register 1. On-line: For convenience and faster registration, register at www.asipp.org/meetings 2. Fax: Fax this registration form to 270.554.5394 with your Visa/MasterCard/ Discover/American Express information 3. Mail: Mail this registration form with payment—check or Visa/MasterCard/Discover/American Express information— to: ASIPP, 81 Lakeview Drive, Paducah, KY 42001 CANCELLATION POLICY: ASIPP reserves the right to cancel this course upon reasonable notice and will assume no financial obligation to registrants for cancellation for reasons beyond its control. Registration fees will be refunded. However, costs incurred by the registrants, such as airline or hotel fees or penalties, are the responsibility of the registrants. Registrants who are not accepted into this course will receive notice by mail with their returned check. ASIPP requires a 30-day notice of cancellation. Cancellations must be submitted in writing and received by January 18, 2011. An administrative fee of $200 will be assessed. Cancellations after January 18, 2011 but prior to January 25, 2011, will forfeit 50% of their registration fee. No cancellations accepted after January 25, 2011. Refunds will be sent after the conclusion of the meeting.
