Sports Fellowship Program: Educational Program Goals

Educational Program Overview

Because of our subspecialist training and interests, our experienced faculty combine to provide in depth and broad  fellowship training in all aspects  sports medicine.  This includes not just the surgery but; prevention, diagnosis, treatment rehabilitation and reconditioning of injuries incurred by athletes.  This educational experience has proven to be sufficiently advanced to allow you to acquire complete competency as a specialist in orthopaedic sports medicine.  The fellowship consists of both academic and technical educational components.

• The academic component emphasizes a scholarly approach to clinical problem solving, self-directed study, teaching, development of analytical skills and surgical judgment, and research.
• The technical component ensures the ability of you to skillfully perform the procedures required for practice of the subspecialty.

Educational Goals: Technical component

General Goals

The fellowship is designed to provide the following : …

1. supervised training in the operative and other technical skills integral to orthopaedic sports medicine. Upon completion, you will be expected to understand the indications, risks, limitations and execution of  commonly performed  and advanced procedures.
2. an opportunity to assume continuing responsibility with appropriate supervision for patients and athletes with acute and chronic injuries and to observe the natural course of athletic injuries and the effects of various therapeutic modalities on their outcome.
3. the opportunity to work on site not only with football but with a variety competitive athletic teams at the first contact care level, as well as in the clinic as the consultant providing secondary and tertiary level care.
4. emphasis on the pathology and biomechanics of athletic injuries and the effects of injury on the athlete, including both physical and psychological manifestations. Appropriate utilization of laboratory tests, physical modalities, and operative procedures for the diagnosis and treatment of athletic injuries is also stressed.
5. extensive experience working as a medical team member with orthopaedic surgeons,  primary care physicians,  athletic trainers, physical therapists and physicians assistants with related experience in prescribing appropriate recommendations for treatment modalities and in monitoring patient progress.

Specific Objectives

The fellowship will provide sufficient opportunity for you to achieve the competency necessary to provide comprehensive sports medicine care in the following specific areas:

1. Acute care of injuries from athletic competition and how to deal with those injuries on the athletic field including provision of first contact level care and/or triage
2. Taking an effective history and performing appropriate  physical examination techniques for acute musculoskeletal sports injuries.
3. Management of chronic orthopaedic sports injuries.
4. Differentiating between sports injuries requiring immediate surgical treatment and those that can be treated nonoperatively.
5. Recognizing the factors that determine the urgency required in treatment of  sports injuries, to prevent undue delay in diagnosis or treatment ..
6. Management/triage of non-orthopaedic problems that occur in sports medicine
7. Establishment and maintenance of a panel of  consultants with expertise and  committed to providing priority care upon request.
8. Ordering and interpreting laboratory investigations , particularly imaging studies utilized for diagnosis of sports injuries, including specific views, tomograms, bone scans, arthrograms, computerized axial tomography scans, and magnetic resonance imaging.
9. Managing acute and chronic pain with an understanding of complex regional pain syndromes.
10. Pharmacology of common drugs, especially those related to pain control, control of acute inflammation, anesthetics and antibiotics.
11. Therapeutic modalities and  rehabilitation techniques , offered in the physical therapy/athletic training room, how to use/judge the appropriateness and efficacy of a treatment plan.
12. General and sport specific reconditioning programs complete with establishment of return to play criteria.
13. Strength and conditioning programs; efficacy in enhancing performance and prevention of injury vs. associated risks.
14. Efficient employment of a sports injury reporting/monitoring system to maximize health care team member communication
15. Arthroscopic and open surgical procedures for the spectrum of sports related injuries of shoulder/elbow/knee/foot/ankle.
16. Wound healing including physiology of scar formation as well as ligament/tendon repair and reconstruction techniques.
17. All aspects of ligament, meniscus and articular surface injuries, healing , autograft and allograft biologic repair and reconstruction.
18. Post trauma and post surgical complications including stiffness and infection and other wound problems.
19. Long term sequelae of joint injury, management alternatives and the effectiveness of preventive measures.
20. The psychological effect of injuries on athletes and how to deal with them and when to refer to consultants for management.
21. Sports equipment, particularly protective devices intended to allow the athlete to continue to compete, including helmets, protective pads, knee braces, ankle and foot orthotics, etc.
22. Practice management methods including; referral base establishment, ethics, procedure coding and electronic assistance.

Educational Goals: Academic Component      

Staff Responsibilities

1. We recognize that graduate medical education must take place in an environment of inquiry and scholarship, it is intended that our staff optimizes the environment to allow the sports medicine fellow to participate in the development of new knowledge, learn to evaluate research findings, and develop habits of inquiry as a continuing professional responsibility.
2. We recognize that the responsibility for establishing and maintaining an environment of inquiry and scholarship rests with our teaching staff. Towards that end, we intend that each staff member demonstrates broad involvement in scholarly activity.

1. This activity includes active participation of the teaching staff in clinical discussions, rounds, and conferences in a manner that promotes a spirit of inquiry and scholarship. The term scholarship implies an in-depth understanding of basic mechanisms of normal and abnormal states and the application of current knowledge to practice. More specifically, this includes:
   • Participation in weekly sports medicine  and  research conferences.
   • Active participation in regional or national professional and scientific societies, particularly through presentations at the organizations' meetings and publication in their journals.
   • Participation in research, particularly in projects that are funded following peer review and/or result in publication or presentations at regional and national scientific meetings.
   • Offering of guidance and technical support (e.g., research design, statistical analysis) for fellows involved in research.

Fellow Responsibilities:

Specific Objectives

Reading Schedule

• Utilize standard sports medicine texts and journals to prepare for conferences, cases and presentations.
• Read articles on entire spectrum of sports medicine as define by the AOSSM outline.
• Read articles pertinent to operative cases, clinic patients, or training room injuries.
• Read current articles in preparation for weekly Sports Medicine conference ( Thursdays ).
• Read articles in and update teaching file with worthy articles as each topic is reviewed in conferences.
• Perform literature search and review articles pertinent to the research project(s).

Conferences
Attend and participate appropriately in all department and sports medicine service conferences regularly

Departmental conferences: (Mon-Tues 6:30-8am) be ready to provide SM + gen. orthopaedic input when appropriate

• Basic Science/clinical topic presentations (Mon)
• Fracture conference (Tues)

Orthopaedic (Black and Purple team) Sports Medicine Service Case Presentations (Thursday 6:30-7am)

• Select topics from current/filed classic cases.           
• Assign residents to specific topics for their case presentations and relevant literature in conference.
• Attempt to rotate topics to cover AOSSM SMF educational outline over course of year (see below)
• Be the primary discussant for at least every fifth presentation.
• Read and be prepared to discuss all relevant articles
• Distribute the assigned articles to all attendees at least two days in advance.
• Notify secretary in charge of conference schedule of
  • Articles to be added to the Residents and/or Sports Fellow teaching file
• Referenced articles to be e-mail distributed to all attendees at least two days in advance
• Photos-x-rays-illustrations of cases to be added to teaching files.

Multidisciplinary Sports Medicine Center Conference  (Thursday 7-8am)
Orthopaedics resident/fellow presentations scheduled monthly

• Select topics from current/filed classic cases.           
• Assign residents to specific topics for their presentations
• Attempt to rotate topics to cover AOSSM SMF educational outline over course of year (see above)
• Be the primary discussant for at least every fifth presentation .
• Read and be prepared to discuss relevant literature for all topics
• Notify secretary in charge of conference schedule of
  • articles to be added to the Residents and/or Sports Fellow teaching file
  •  referenced articles to be e-mail distributed to all attendees at least two days in advance
  • photos-x-rays-illustrations of cases to be added to teaching files.

Tuesday Coaches Meeting (830- 930 am )
During the football season , fellow assisting with the football team will attend with the head team physician , head AT, head Coach, head Strength and Conditioning coach to review care plan for the week.

Tuesday Black Team Indications conference ( 12-130pm )
Fellow will attend and participate in these rounds on a weekly basis

Tuesday afternoon Arthroscopy Skills laboratory (3-5 pm )
The fellow with supervision of the Director of the lab, will schedule , organize, and teach the residents on the Black/Purple team and participate in the weekly skills laboratory .

Annual Sports Medicine Symposium

• Attend and participate in  conference and associated activities
• Prepare and present at least one lecture assigned by faculty.
• Organize, assign, and prepare case presentations with live or video  demonstration of exam/diagnostic/operative/end result findings when appropriate

Teaching Activities

Fellows will provide consultation with faculty supervision and have clearly defined educational responsibilities for fellows, medical students, and allied health personnel in the clinic, operating room and at the bedside.  These teaching experiences correlate basic biomedical knowledge with the clinical aspects of the subspecialty. Clinical experience includes inpatient and outpatient opportunities to observe, manage, operate, and follow patients with a wide variety of sports medicine problems.

Research Activities

• You will be expected to review and critique at least one manuscript submitted for publication in a peer reviewed journal per month.
• Participate in literature search, review and at least rough draft writing of an invited chapter or article.
• You must participate in at least one basic and/or clinical research project with a goal of at least one publishable article submitted to peer reviewed journal
• You will learn to design, implement, and interpret research studies under supervision by qualified faculty.
• You will be provided adequate time and facilities to carry out research activities.
• You will provide progress reports at the regularly scheduled meetings of the sports medicine research team in order to receive constructive criticism.