Narinder Grewal MD Discusses Pain Management Breakthroughs

Neurosurgery leaders have finally made curricular breakthroughs in pain management after many years of continuous efforts, according to Narinder Grewal MD, a California-based anesthesiologist with over 40 years of experience in the pain management field. They have designed a new approach to training neurosurgery residents and are now changing the curriculum at Columbia University Medical Center.

In 2009, neurosurgery boot camps were established to help prepare residents for the board exam and train them to provide better patient care. The focus is to fill in knowledge and skill gaps in resident training, especially in pain management. Neurosurgeons in training have to attend one boot camp at the beginning of their internship and one more before becoming a junior resident. According to Dr. Grewal, the person behind the establishment of these boot camps is Dr. Christopher Winfree, a neurological surgery assistant professor at the Columbia University College of Physicians and Surgeons in New York City.

Dr. Winfree designed a module for the boot camp that includes various topics about pain management in neurosurgery, including the different types of pain, how opioids work, neuropathic pain medications, chronic and acute pain management, treatment ladders, buprenorphine treatment, and caring for patients with opioid dependence. He has stated that the boot camps use extensive simulation labs with ICU crises where a mannequin is on a table with an ICU monitor.

To further formalize the residency training’s content, the Neurological Surgery Milestone Project was developed in 2013. The content addresses several areas, including professionalism, procedural skills, and interpersonal relationships with patients and colleagues. The project also facilitates resident assessment to ensure the progress of residents as they undergo their training.

Dr. Winfree has revolutionized the way neurosurgery is taught by getting away from passive learning and employing hands-on learning techniques. “We’re trying to get away from passive learning, because how many times have we all sat in lectures and retained probably 10 percent,” says Dr. Winfree. “When you have somebody study ahead of time and test them on it ahead of time, then show it to them in person, where they can sit one-on-one with faculty members in these sessions, and then you test them on it again, they have this stuff for life.”

“Every question has an explanation at the end,” he adds. “It’s self-assessment, but it’s not just yes, no, you got it right or wrong. The residents get an explanation as to why the answer is right or wrong.”

Instead of providing a long lecture, Dr. Winfree moderates 15-minute case studies addressed by residents training with him.

“We’re not having hour-long lectures, we’re doing 15 minute small group sessions to go over all of those things, and the residents are responding.”

Thanks to these curricular breakthroughs, neurosurgery residents can now receive better training and provide better care to individuals who suffer pain-related conditions.

To learn more about Dr. Grewal, visit


About Advanced Pain Management

Narinder Grewal MD is a board-certified anesthesiologist who operates his own pain clinic in Valencia, California as well as in other locations in the state. He has practiced pain management for almost 40 years now, and is currently affiliated with the Henry Mayo Newhall Memorial Hospital.

Narinder Grewal
Advanced Pain Management
Address: 23861 Mcbean Pkwy, Valencia, CA 91355, United States
Phone: (661) 288-5700