PainSA is a chapter of the International Association for the Study of Pain. Our mission is to improve all aspects of pain management in Southern Africa.

EPM: February 2020 Newsletter

Welcome to the first Essential Pain Management newsletter of 2020.


It is the Chinese Year of the RAT, so EPM with its Recognise Assess and Treat system is off to an auspicious start!


EPM’s relationship with the World Federation of Societies of Anaesthesiologists (WFSA) is developing strongly, with WFSA’s funding contacts helping to support EPM in Africa.


In Papua New Guinea (PNG), where EPM started, we have recently reviewed its progress with our PNG pain champions. There have been some very pleasing results with regard to feedback from participants, sustainability and breadth of the country covered. A report on this progress will likely be published in the journal Anesthesia & Analgesia in the next few months.


Port Moresby, PNG – September 2019

EPM around the world

Worldwide, EPM has now been delivered in 61 countries. Many countries are now running sustainable EPM programs.

EPM UK – Dr Helen Makins

There is exciting news from the UK, as we have had agreement that the EPM RAT structure will be incorporated into the Foundation programme curriculum for doctors working in their first two years following graduation from medical school. We anticipate that this will dramatically increase the use of the RAT structure amongst doctors in the UK. We are now starting work on a learning package, including face-to-face and electronic resources to deliver this. Our team of regional leads for EPM around the country are facilitating incorporation and use of the RAT structure on a local level.


Allied healthcare professionals are also using EPM, with increasing popularity amongst nurses and physiotherapists. We have had a number of opportunities at national meetings for our nursing colleagues to encourage uptake, by describing their personal use of the course and by giving top tips on using the materials and running the sessions.


Our former UK lead and more recent deputy lead for EPM UK, Dr Mike O’Connor, has recently retired from his EPM role and we are truly grateful for his enthusiasm and dedication, which has undoubtedly enabled us to make such significant progress in the UK. We welcome Mike’s newly appointed successor, Dr Sibtain Anwar to the team, who I have no doubt will help us to keep up the momentum.


Thank You, Dr Mike O’Connor

Mike tells us that he will be retiring from his EPM activity, so we would like to take this opportunity to thank Mike for the tremendous support that he has given to EPM over a number of years. Quite some time ago Mike travelled to Melbourne for an EPM planning meeting and was a terrific contributor. At this meeting he took on the role of manager (or controller!) of the pre-post-test multiple-choice questions following which he developed a spreadsheet to help us collate and monitor the results. Mike also showed himself to be a proof-reader extraordinaire for the EPM manuals and was a co-author of the EPM Lite teaching materials. Mike came up with the idea of using whiteboards for participants of EPM courses to write feedback, he christened this the “Delphi wall” technique. Perhaps his most significant legacy has been the delivery of EPM Lite into medical schools in the United Kingdom and more recently into the UK National Health Service trusts. Mike was also a key player during the introduction of EPM Lite into Hong Kong. For all these reasons we wish to thank Mike wholeheartedly for his contributions and wish him well in his future endeavours, and hope he keeps an eye out for EPM.


EPM Hong Kong

Our colleagues in Hong Kong have also made significant progress with their aim to cover frontline workers in most of the public hospitals in Hong Kong. They hope to present papers at both the International Association for the Study of Pain (IASP) World Congress on Pain in Amsterdam and the World Congress of Anaesthesiologists in Prague this year.


EPM Thailand

Our nursing colleague (Srisuda Ngamkham) in Thailand reports that at the Boromarajonani College of Nursing Sawanpracharak Nakhonsawan (BCNSPRNW), Nokhonsawan, the teaching faculty attended a one-day EPM program on November 7, 2019 in order to gain more pain knowledge and learn how to use the RAT Model. The faculty have been teaching the RAT model to nursing students for approaching patients with pain. At the end of the academic year, they plan to evaluate the competency of pain management in nursing students. As well as the standard nursing competencies, we plan that the BCNSPRNW will produce nurses who have excellent competency in pain management.


Africa (UK EPM Advisory Group) – Dr Clare Roques The UK EPM Advisory Group at the Faculty of Pain Medicine of the Royal College of Anaesthetists continues to facilitate EPM workshops overseas. In collaboration with the WFSA and funded by the Tropical Health Education Trust (THET) EPM was introduced to The Gambia with a workshop run in conjunction with the Anaesthetists’ Society at The Gambia’s first annual congress in November. We continue to partner with the charity Mercy Ships running yearly EPM workshops, most recently to Senegal (part-funded by the Association of Anaesthetists). Many other workshops are in the final planning stages including in Sudan and Sierra Leone. We have set up a WhatsApp group for local champions across the Africa region which has been very active and has helped members share stories of EPM successes and challenges. Building on previous projects self-funded workshops have been run or planned in many countries including Kenya, Rwanda, South Africa, Uganda and Pakistan.


EPM India – Dr Vijay Palanisamy

In the second-half of 2019 two premier teaching institutions in India organised EPM Instructors workshops. These workshops helped to cross the 300 mark for the number of instructors in India.


There was a WFSA-sponsored EPM Instructors workshop held at the Employees State Insurance Corporation Super Specialty Hospital, Hyderabad on June 2019. Dr. Kalyani, Professor of Anaesthesiology, organised a well-received workshop that saw 25 medical and allied health professionals attending the full-day workshop on the first day and 20 attending the Instructors workshop on the second day. The final day saw 90 participants from nursing and physiotherapy attend an EPM-Lite workshop.


St. John’s National Academy of Health sciences, Bangalore, organised an EPM Instructors workshop for November 2019. Lead by Dr. Sangeeta Das, the workshop had 30 participants from various disciplines of medicine on the first day, 25 instructors on the second day and 100 delegates from nursing and physiotherapy for the EPM-Lite workshop on the last day.


Konaseema Institute of Medical Sciences at Amalapuram in rural Andhra Pradesh was one of the first institutions in India to take up EPM-Lite workshops for the under-graduate medical students. This is usually held as part of the academic and cultural festival organised by the students. The Dean, Dr. Kameswara Rao, a firm supporter of EPM-Lite, helped organise it for the fifth year, with 85 delegates from various medical schools enrolling for EPM-Lite.


EPM Philippines – Dr Dolma Santos

The Pain Society of the Philippines has been very busy during 2019 with nine cascade programs run throughout the archipelago. They have been able to provide EPM for nearly 500 participants, mainly doctors and nurses but also pharmacists and other health care workers.

They started a bit late during the year, with the first EPM course held in April at the Philippine General Hospital.


For 2020, their first visit will be in battle-scarred Marawi City, the capital of Lanao del Sur in Mindanao. The request for an EPM workshop in Marawi has been long-standing owing to a number of difficulties, however the team will be heading out in March and hope to share details of a successful workshop with you soon.

Philippines 2019
First Latin American EPM instructors’ Summit – Dr Carolina Haylock-Loor

“Let’s RAT” was in the opening sentence for opening the First Latin American EPM Instructors Summit held in Buenos Aires, Argentina, during the Confederation of Latin American Societies of Anaesthesiolgy meeting, September 24th, 2019.


The joy of achievements, the enthusiasm of the meeting, and being able to continue working to help relieve pain in our region, was the atmosphere breathed in the meeting.


The instructors were anaesthesiologists from Mexico, Costa Rica, Honduras, Venezuela, Peru, Argentina, and from New Zealand Dr Wayne Morris, co-author of the EPM Essential Pain Management Course.


The instructors shared their experiences over the seven years since the EPM course arrived in Latin America in 2012. In order not to lose the concept, our participants used the RAT modality, Recognizing the courses taught in their countries and those regions yet to be covered, Analysing local and regional obstacles in the spread of the course, and how the instructors were Treating and trying to overcome these barriers.


New and updated resources such as the EPM App, online videos, and updated educational material were presented. These resources allow us all to speak the same language for pain management. Instructors shared the need for monitoring and evaluation of the course to continue to achieve changes in medical care to the patient suffering pain. The support from WFSA and ANZCA for the dissemination of EPM in the region was also acknowledged and appreciated.


Regarding the future of EPM in Latin America, all agreed on the importance of running the course in medical and nursing schools, using EPM Lite.


At the end of the summit, each faculty received a USB with the updated EPM teaching materials in Spanish, English and French and committed more than ever to “Let’s RAT.”

Buenos Aires, Argentina – September 2019


EPM workshops

EPM workshops reported in the last six months

Please note, only programs reported using the online tool are acknowledged .

The online reporting tool is available here. We encourage all instructors to use the easy-to-complete online reporting tool.


Potential and confirmed 2020 workshops



Sierra Leone


Southern Africa


Sri Lanka – January 2020
Amman, Jordan – November 2019
Ho Chi Minh City, Vietnam – September 2019

EPM resources – what’s new

EPM Slides in Arabic

Courtesy of Professor Abdullah Kaki from Jeddah, Saudi Arabia


If you would like a copy of the slides please .


EPM App – Ramesh Menon

The EPM Mobile Application (“EPM App”) has had an extensive technical makeover is now available on both Android and iOS stores. The update features a new home screen and information in four languages. It hosts a completely revamped formulary with concise information on an extended range of medications that can be also be accessed directly from the Assessment page. The full EPM Manual is included in a reader-friendly layout.


For a printable copy of this or past newsletters please visit the ANZCA website 


Collaboration EPM is fortunate to receive ongoing financial support from ANZCA, the ASA, the Ronald Geoffrey Arnott Foundation, WFSA, RACS and the ANZCA Research Foundation

Courses delivered by the EPM UK Working Group have been funded by Association of Anaesthetists of Great Britain and Ireland Foundation and The Royal College of Anaesthetists.

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