Since arriving in Boston on June 2019 to study pain management, anaesthesiologist Dr Sean Chetty is slowly settling into the new way of life – and is excited about what his Discovery Fellowship-funded year has in store.
“It’s been a steep learning curve and I’ve probably only been exposed to the tip of the iceberg so far, but I’m amazed at what is achieved by encouraging research in a busy clinical environment,” says Dr Sean Chetty on his first few months at Massachusetts General Hospital (MGH) in Boston.
Being gifted with the chance to impact the critical shortage of pain management skills in South Africa was totally unexpected for Dr Chetty, who arguably has the most clinical and research expertise in pain medicine locally. He reckons there are probably only five to 10 people in South Africa with the expertise to properly manage chronic pain.
Embracing opportunity through the MGH Fellowship Award
“My boss at the time asked me to represent our department at a local Discovery presentation to increase awareness of the Foundation Fellowship Awards. I was on call, but it sounded interesting. Walking back, I bumped into Dr Brian Allwood (a colleague at Tygerberg Hospital who won the MGH Fellowship Award in 2017). He was enthusiastic about his learnings there and urged me to apply. I said maybe, but it felt kind of tongue-in-cheek,” recalls Sean.
Paging through the Discovery Foundation booklet that weekend, his intent solidified. He put an application together and contacted MGH to locate a mentor – who called him a few weeks later to clarify certain things in his application. “It was a very casual, friendly chat – I was telling her why I like pain management, she said thanks, and that was that. The next thing I got a call to say I had it!”
‘There’s a silent epidemic of pain in SA’
It’s a strange anomaly that in a country with a huge burden of disease, nobody can legitimately call themselves a pain specialist. While pain management is recognised as a field of study by the Colleges of Medicine, the Health Professions Council of South Africa has yet to register it. To Dr Chetty, that’s “an abomination.” Bureaucratic
He feels that patients are cared for up to a point. As a specialist in Critical Care, he enjoyed looking after his patients post-operatively – but once they were recuperating in a ward, he never saw them again. “There’s a silent epidemic of pain in SA,” he asserts. “I think more thought needs to be given the patient’s quality of life. The problem is so big and affects every area of medicine.”
‘Sometimes patients just need someone to talk to’
Trained at the Wits University Chronic Pain Unit and head of the Clinical Department of Anaesthesiology and Critical Care at Stellenbosch University, Dr Chetty is passionate about promoting the bio psycho-social model of pain care.
“Rather than just a procedure and giving meds, we need to probe other aspects of the patient’s life that impact on their pain. What coping skills can we pass on; and how does their core musculature contribute to pain management? It’s also very much about rehabilitation and psychological management.”
“Amazingly, sometimes patients just need someone to talk to. With pain, stoicism does not make you stronger. Whether acute, traumatic or chronic pain, we need to educate our healthcare professionals to recognise and treat patients appropriately. Most pain can be managed at GP level,” he contends.
Learning from front-runners – to return and lead
Dr Chetty will spend at least a year at the trailblazing MGH Centre for Translational Pain Research. His Fellowship will involve pre-clinical research, especially around modulating neuropathic pain (pharmacological and interventional management); translational pain research and clinical observation of interventional pain procedures; and work in a pain laboratory (not available in South Africa).
He sees his role upon his return as holistically improving patients’ quality of life through teaching, research, prevention, care and advocacy. “The entire clinical work environment here is driven towards research and it’s something I definitely want to replicate back home,” he enthuses. “I hope to export appropriate systems to my South African work environment – and hopefully to the SA health system as wel!”
Funding education at Harvard Medical School's teaching hospital
The Discovery Foundation MGH Fellowship Award was introduced in 2013 in partnership with the prestigious Massachusetts General Hospital (MGH). Based in Boston in the United States, MGH is a clinical service and biomedical research facility, as well as the Harvard Medical School’s largest teaching hospital.
The award aims to develop the next generation of leaders in academic and clinical medicine in South Africa. It does so by enabling a talented specialist clinician and aspiring leader to experience the specialist clinical service and research environment at MGH, and to conduct cutting-edge clinical research in collaboration with colleagues at the hospital, over a one-year period. The award is valued at R2.1 million.
Investing in South African healthcare by rewarding excellence
The Discovery Foundation is an independent trust that addresses the critical shortage of healthcare resources in South Africa by training medical specialists for rural areas and subspecialists in fields of greatest need, as well as by developing academic medicine.
Over the past 12 years, the Foundation has invested over R210 million in grants to individuals and healthcare organisations. These grants include bursaries, research fellowships and support for teaching and research institutions.
Through its considered interventions, the Foundation is bringing quality infrastructure and services within the reach of many communities who have previously not had access. The Discovery Foundation has also committed to disburse another R300 million towards the training and support of 600 recipients by 2026. Learn more or apply here.
The Discovery Foundation MGH Fellowship Award – valued at R2.1 million – enables a specialist clinician to experience Harvard Medical School’s largest teaching hospital for a year. We caught up with our five Fellows here to learn what impact they’re making.
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Back home a year since returning from 12 months of Discovery Fellowship-funded training in America, Dr Allwood is thrilled that his new skills are saving lives. His mission: to raise the bar of medical excellence in SA.