Medical Student Procedure Log - ANS 606

Please tally the procedures in which you were involved during this rotation.

New consults:a. Pain Clinic __________________________

b. Inpatient pain service __________________________

Follow up visits:a. Pain Clinic __________________________

b. Inpatient pain service __________________________

Invasive procedures:

Trigger point injections __________________________

Sacroiliac joint injection __________________________

Epidural steroid injection __________________________

Epidural daily management __________________________

Ultrasound guided blocks __________________________

Others ________________________________________________________

Number of full days spent working with fellow/resident/ attending preceptors _________

Number of conferences attended __________________________

Please use the following space to comment on the rotation. You may keep this anonymous. Specifically, it would be helpful if you could provide specific feedback on any residents, fellows, and/or attendings with whom you have worked. Thank you!