ABEM Pain Medicine study plan

Map the ascending nociceptive pathways and descending modulatory circuits using a hand-drawn schematic, then explain each relay from memory.

Differentiate A-delta, C, and Abeta fiber properties in a comparison table covering conduction velocity, threshold, and clinical sensation.

Explain peripheral and central sensitization mechanisms and connect each to at least two bedside findings.

Build 60 spaced-repetition cards on receptor, channel, and neurotransmitter targets such as Nav1.7/1.8, TRPV1, NMDA, GABA-A, and mu-opioid receptors.

Relate pharmacokinetic principles to analgesic onset, duration, and accumulation risk for opioids, NSAIDs, and adjuvants.

Compare mu, kappa, and delta opioid receptor pharmacology, intrinsic activity, and adverse-effect profiles in a matrix.

Calculate equianalgesic conversions and adjusted doses for renal or hepatic impairment using worked examples with every step shown.

Identify CYP450 and transporter interactions that alter analgesic exposure, then rank five high-risk combinations.

Structure a pain history capturing onset, quality, radiation, modifiers, function, psychosocial factors, and red flags.

Interpret validated instruments such as the NRS, DN4, Pain Catastrophizing Scale, and PHQ-9, and state their limits across populations.

Differentiate nociceptive, neuropathic, nociplastic, and mixed presentations using 12 constructed vignettes.

Select first-line pharmacotherapy for each pain mechanism and justify choice, titration, and monitoring.

Map fluoroscopic and ultrasound anatomy relevant to facet, epidural, nerve block, and sympathetic procedures.

Explain indications, contraindications, consent elements, and complication management for five core procedures.

Compare contrast use, sedation, anticoagulation, and infection-control precautions across procedure types.

Rehearse a structured pre-procedure timeout and post-procedure monitoring plan.

Apply diagnostic reasoning to failed response, persistent pain, and suspected complications after intervention.

Interpret imaging and electrodiagnostic findings in context while avoiding overreliance on tests.

Construct a differential for radicular, facet-mediated, sacroiliac, and myofascial pain.

Evaluate procedure candidacy using risk-benefit analysis and shared decision-making.

Design a graded exercise and functional restoration plan matched to pain mechanism and baseline function.

Explain CBT, acceptance and commitment therapy, mindfulness, and pain neuroscience education, then match each to patient goals.

Screen for yellow flags and substance-use risk, then select appropriate multidisciplinary team members.

Set SMART functional goals and measurable outcomes for a six-week program.

Audit a pain practice workflow for controlled-substance safety, prescription monitoring, and diversion prevention.

Apply informed consent, capacity, confidentiality, and boundary-setting principles to three ethical scenarios.

Explain documentation, coding, and quality-reporting requirements for common pain services.

Build a complication and emergency response protocol for sedation, local anesthetic systemic toxicity, and opioid overdose.

Integrate mechanism, assessment, pharmacologic, interventional, behavioral, and safety reasoning across mixed vignettes.

Rehearse rapid recall of high-yield tables and decision rules under timed conditions.

Review all logged misses and rewrite each as a one-line rule plus a trigger.

Complete a final self-assessment and schedule maintenance review.