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Brona Fullen looks back on her three years as European Pain Federation President:

Dear colleagues, 

I address you today for the final time as President of the European Pain Federation EFIC. To serve as President has been an honour and a privilege, not least as the first Physiotherapist and the first female in this role. As I hand over the baton to Prof. Luis Garcia-Larrea, it is time to reflect on my three years as President, to consider events we have navigated as an organisation, and the achievements we have made over this time.  

I can’t say I expected my Presidency to coincide with an unprecedented global pandemic and war in Europe on a scale not seen for generations. #Nevertheless, we rise to these occasions and must be prepared for what life throws at us. Looking back at the height of COVID-19, we must look at these moments as a salutary lesson on the need for flexibility to adapt, and the willingness to persevere when ‘normal life’ is suspended. While the health impacts and economic turbulence of the crisis are still being understood and felt, we can look at the European Pain Federation EFIC as an organisation that navigated these global challenges and remained effective. We will know that, should such circumstances return, that EFIC will be prepared and that our virtual presence can be as effective as our physical. The formation of the EFIC Academy out of this period is a legacy that I (and Prof. Bart Morlion) can be proud of. 

The return of military conflict in Europe is something that few of us expected in the 21st century. The immediate loss of life as well as the deterioration of social and economic development in Ukraine will not be soon forgotten. However, we can hopefully see an increasing European solidarity emerging from the war, as evidenced by the willingness of millions of Europeans to take in Ukrainian refugees at short notice. From our side, we did what we could with the resources available to us, providing Ukrainian healthcare professionals with free educational opportunities via the EFIC Academy and free access to the virtual component of the 2022 EFIC Congress. At the request of our colleagues in Ukraine, we also provided free educational materials on acute pain and trauma management, resources that were badly needed on the ground. I thank Prof. Kevin Vowles for his work in preparing these. 

Despite these global challenges, EFIC has continued to make progress in its mission, and I will now go on to list some achievements made during my time as President. My focus has been to progress EFIC as a multidisciplinary and multi-professional organisation as this is essential to its future. As I have done in previous reports, I will reiterate my four key priorities as President: 

  • Advancing our educational portfolio for physicians – increasing engagement with primary care colleagues & other health professionals 
  • Providing leadership in the development of EU and national health policies, including via the Societal Impact of Pain and the European Pain Forum 
  • Expanding our profile as a research hub; as a developer of position papers and as a research grant collaborator and partner 
  • Empowering and further engaging with chapter members 


Advancing our educational portfolio for physicians – increasing engagement with primary care colleagues & other health professionals 

The EFIC Academy, along with the associated Education Platform and Virtual Summits are surely the strongest realisation of EFIC’s interprofessional educational goals. The EFIC Academy is a popular project amongst clinicians in Europe, with a stable membership base that we expect to grow further over the coming years. The Academy has truly created a home for the various health professional groups within pain management, and we are creating motivated core teams around medicine, physiotherapy, nursing and psychology education. The project has expanded recently, providing our high-quality educational content in Spanish, German and Portuguese languages via subtitling. Hopefully further languages will come. 

The core curricula for the European Diploma in Pain Medicine and Pain Physiotherapy have been revised and a second edition of both have been recently published and endorsed by relevant professional organisations,. We are also branching further into undergraduate education, with a new curriculum for physiotherapy bachelor degree launched. The exam for the European Diploma in Pain Medicine (EDPM) has grown over the past two years, with over 60 exam registrants per year now expected. The European Diploma in Pain Physiotherapy is also growing and in May 2024 the first sitting of the European Diploma in Pain Nursing (EDPN) will be held under the energetic leadership of Felicia Cox and Dr Nadja Nestler. I thank Dr Emma Briggs for her contribution to EFIC over the past 3 years. Our engagement with primary care has started and hopefully has a bright future, especially with strong relations being established with the main General Practitioner organisation in Europe – WONCA Europe. 

Providing leadership in the development of EU and national health policies, including via the Societal Impact of Pain and the European Pain Forum 

Our impact on health policy is perhaps a less-well-known strength of EFIC as an organisation. At European level, the Societal Impact of Pain (SIP) platform has a reasonably long history, having been founded in 2009. However, since 2020, this project has been fully managed by the EFIC team, with an almost seamless transition and a deeper and more effective engagement with policy makers. The first major achievement in this regard has been the involvement of pain with the European Union’s flagship Beating Cancer Plan. We aim to repeat this success with the upcoming mental health strategy of the European Union. At national level, SIP has branched out into ‘national platforms’ in at least 10 countries. With motivated national platform leaders, these national platforms are taking the lessons of SIP Europe and aiming to influence policy makers in national capitals. The European Pain Forum also continues to be a success, integrating other scientific societies relevant to pain within our work. Recent projects have included the involvement of the forum organisations in the review of the pain medicine curriculum, their involvement in our research strategy development and a new definition of multimodal pain treatment. Formal endorsement of these projects will certainly strengthen their impact. Another key development in national health policy influence is our work to translate major EFIC outputs into languages other than English. This has happened recently with SIP position papers as well as our major clinical position papers. 

Expanding our profile as a research hub; as a developer of position papers and as a research grant collaborator and partner 

Of all the areas where progress has been made, expanding our role as a research hub is perhaps the area that has seen the most dramatic change. Under the leadership of Prof. Gisèle Pickering and with the support of our research projects advisor Dr. Mary O’Keeffe, EFIC now exhibits strong research project capabilities and the ability to express the position of the pain research community in Europe. Our lighthouse project has been the development of a ‘European Pain Research Strategy’, something which is common in other disciplines but for which EFIC has until now not produced. This strategy will help policy makers and funders understand the needs and priorities of the pain research community and hopefully dedicate more funding and attention to them. EFIC now also plays a strong role in existing EU research projects and funding. We are collaborators in five active consortia and have for the first time been successful in developing a funding proposal directly. We now have the capability to identify funding opportunities, develop proposals ourselves, and partner with academic institutions as is currently the case for a major Horizon Europe project. Our non-financial resources are also growing, with our mapping of the research expertise of the European pain science community. Such resources allow us to play a much stronger coordination role and will leave a legacy for EFIC in the coming years.  

Empowering and further engaging with chapter members 

The past three years have not been the easiest in terms of networking and engagement, as evidenced by the lack of an in-person EFIC Council meeting between 2020 and 2023. Nevertheless, numerous developments have hopefully helped strengthen our ties with chapter and chapter members. After a brief hiatus, we have returned to organising Pain Schools where EFIC chapter members have been the primary recipients of the funded places offered. These Pain Schools have been updated to take on a ’interprofessional’ format, and we are now opening up one new school per year to tender, with new topical proposals. We also hope to bring the Pain Schools further East to allow more people to access them in areas where such opportunities are harder to find. Our congress continues to provide discounted places for chapter members, along with chapter members being priorities in the distribution of financial aid. We are working to ensure that more chapter members are aware that the European Journal of Pain is available free-of-charge to them on the basis of their membership of an EFIC chapter. We have set up a process to allow EJP articles to be translated into national journals in languages other than English, hopefully broadening the reach of our scientific journal and allowing many more people to access this content in their own language. From here, we will codify and better promote these various benefits, so that EFIC chapter leaders have a clear selling point for new members in relation to EFIC. 

Congress and finances 

Perhaps the main area of concern for EFIC over the coming years is the role of our congress in our funding plans, and the overall economic picture affecting us all. Until the pandemic, it appeared possible that a long-term funding plan for EFIC could be predicated on an expectation that the congress could contribute around 50% of the funding required for EFIC’s activities. The pandemic’s immediate disruption, its economic aftereffects, and the highly competitive environment in which multiple meetings and organisations aim to claw back their audience, leaves us in a situation where previous assumptions need to be revisited. Along with the global picture, research and development in pain specifically is not in the strongest shape. Such factors mean that, while our congress remains an essential part of our activities, we cannot hold enormous financial expectations and must think creatively in our sustainability plans. Our Honorary Treasurer Prof. Patrice Forget and Executive Office are working hard to develop future plans to help respond to the deficits currently incurred. In recent years, the EFIC Academy and increased funding from research projects has helped boost our income, but these alone are not sufficient for us to feel comfortable.

One major development that I would like to note is the improvement of EFIC’s approach to ethics and transparency over my Presidency. While these steps began before my term, a renewed focus has been placed on them with the development of a new ethics and transparency policy, which should place EFIC in a robust position for the future. I thank Dr. Nevenka Krcevski Skvarc for her work on this. 


Thank-you and Welcome to our Next President 

Finally, I would like to say thank you to everyone who has made the past three years a success and working with them has been a real pleasure. 

To the Executive Board, Prof. Patrice Forget, Prof. Thomas Tölle, Dr Silviu Brill, Dr Magdalena Kocot-Kępska and Prof. Luis Garcia-Larrea for their support and guidance at every step. 

I would like to acknowledge our Committee leadership. Prof. Frank Huygen with vice-chair Professor Harriet Wittink have provided thoughtful leadership of our Education Committee, with an industrious set of working group chairs supporting. Prof. Paul Cameron and vIce-chair Prof. Patrice Forget have had the political focus to shepherd our Advocacy work, steering us through a period in which our policy input has increased. Prof. Gisele Pickering and vice-chair Prof. Thomas Graven-Nielsen have led during a period in which our research footprint has expanded enormously. I thank them all for their considerate and effective work over this term. 

I would like to thank both of our esteemed Editor-in-Chief of the European Journal of Pain, who spanned my term; Prof. Luis Garcia Larrea and now Prof. Didier Bouhassira. Whilst the journal’s successes are largely independent of the Federation and are the product of our Editorial Board and contributors, it is still pleasing to see them succeed over this period.  

The Executive office staff and congress organising team have been a pleasure to work with; Melinda Borzsak-Schramm, Angela Cano Palomares, Lauriane Nallet Khosrofian, Inbar Caspi, Dr. Mary O’Keeffe, Maya Ravinsky, Christina Papendick under Sam Kynman’s leadership. Christel Geevels, the heart of the Federation celebrated 14 years with EFIC this year and we are grateful to her for her many years of service. 

Thanks also to the 38 EFIC Councillors for promoting our activities, engaging with our projects and supporting our work. 

I would like to pass on my regards to the two Presidents of IASP during my term, Prof. Claudia Sommer and Prof. Catherine Bushnell. The EFIC-IASP relationship is important and requires regular nourishment. I hope our cooperation continues to build for the success of both organisations.  

Finally, my special thanks go to my family, friends and to my work colleagues in University College Dublin who have all supported me in this role.  

Looking forward, I wish our next President Prof. Luis Garcia-Larrea every success.  Luis has already stepped into the role of President when I was injured earlier this year for which I am most grateful. I look forward to fully supporting Luis’ vision for EFIC during my last year on the Executive Board and beyond my term. The Federation I know is in very secure hands. 

 Go raith maith agat (Thank you) 

Brona Fullen 

President, European Pain Federation EFIC