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Primary Care Sports Medicine Fellowship

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Primary Care Sports Medicine Fellowship

Curriculum/Policies

Mission

To advance Sports Medicine through the training of future leaders in the field.

Description

The Primary Care Sports Medicine Fellowship Program is a one-year ACGME accredited fellowship program sponsored by the Department of Family Medicine and Department of Orthopaedics at Jackson Memorial Hospital and UHealth Sports Medicine. The fellowship is primarily a one-on-one learning experience. The program has 6 longitudinal block rotations allowing for both continuity as well as diversity. During each rotation, the fellow will gain experiences in sports medicine, orthopaedics, division I athletics and family medicine. Each fellow also will have required experiences with sports radiology, sports cardiology/physiology, and physical therapy. Furthermore, academic endeavors are expected and supported through national and local conferences, individual mentoring, and local workshops.

Faculty

Dr. Thomas Best is the program director responsible for the fellowship program. Additionally, educational experiences are gained by working directly with the program’s faculty (listed below) and supported by Michelle Jagessar, the program coordinator.

Thomas Best MD, PhD – Fellowship Director Stephen Henry DO – PCSM Faculty Carolyn Kienstra MD – PCSM Faculty Lee Kaplan MD – Sports Orthopedics Michael Baraga MD – Sports Orthopaedics Julianne Munoz MD – Sports Orthopaedics Seth Dodds MD – Hand Orthopaedics Amiethab Aiyer MD – Foot/Ankle Orthopaedics Gillian Hotz PhD – Sports Concussion Luis Feigenbaum DPT, ATC – Physical Therapy Jean Jose MD – Musculoskeletal Radiology Robert Myerburg MD - Cardiology

Clinical Rotations

Longitudinal experiences are divided into six 2-month clinical blocks. All blocks include sports medicine, orthopaedics, academic time, and primary care experiences. Each block will also include other experiences including athletics, physiology/cardiology, sports radiology, physical therapy, surgery, and elective time.

Primary Care Sports Medicine

Rotation Goal

The fellows will be able to consistently and accurately evaluate, diagnose, and manage patients presenting with primary care sports medicine illnesses and injuries. Fellows should plan on meeting with their assigned faculty member prior to beginning the rotation to discuss expectations.

Objectives

By the end of this rotation, you will be able to perform all of the following skills (Based on the 6 ACGME Competencies):

  1. Patient Care that is compassionate, appropriate and effective for the treatment of both musculoskeletal and primary care issues for athletes at all levels of training and competition.
  2. Medical Knowledge – enhance knowledge about established and evolving biomedical, clinical, and cognitive issues, as well as the application of this knowledge as it pertains to primary care sports medicine illnesses and injuries.
  3. Practice Based Learning involving the investigation and evaluation of care for patients, the appraisal and assimilation of scientific evidence, and improvements in patient care of primary care sports medicine illnesses and injuries.
  4. Interpersonal and Communication Skills that result in the effective exchange of information and collaboration with patients, their families, and the entire health care team (physicians, athletic trainers, physical therapists, nurses, nutritionists, psychologists, auxiliary staff).
  5. Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to patients of diverse backgrounds in the primary care sports medicine setting.
  6. Systems-based Practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care in the primary care sports medicine setting.

Orthopaedic Sports Medicine

Rotation Goal

The fellows will be able to consistently and accurately evaluate, diagnose, and manage patients presenting with orthopaedic sports medicine injuries. Fellows should plan on meeting with their assigned faculty member prior to beginning the rotation to discuss expectations.

Objectives

By the end of this rotation, you will be able to perform all of the following skills (Based on the 6 ACGME Competencies):

  1. Patient Care that is compassionate, appropriate and effective for the treatment of orthopedic issues for athletes at all levels of training and competition.
  2. Medical Knowledge – enhance knowledge about established and evolving biomedical, clinical, and cognitive issues, as well as the application of this knowledge as it pertains to orthopedic sports medicine illnesses and injuries.
  3. Practice-Based Learning involving the investigation and evaluation of care for patients, the appraisal and assimilation of scientific evidence, and improvements in patient care of orthopedic sports medicine illnesses and injuries.
  4. Interpersonal and Communication Skills that result in the effective exchange of information and collaboration with patients, their families, and the entire health care team (physicians, athletic trainers, nurses, physical therapists, nutritionists, psychologists, auxiliary staff).
  5. Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to patients of diverse backgrounds in the orthopedic setting.
  6. Systems-based Practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively on other resources in the system to provide optimal health care in the orthopedic setting.

Musculoskeletal Radiology

Rotation Goal

The fellows will be able to consistently and accurately evaluate, order and interpret musculoskeletal diagnostic images.

Objectives

By the end of this rotation, you will be able to perform all of the following skills:

  1. Evaluate the quality of imaging studies
  2. Order appropriate imaging studies to answer clinical questions
  3. Consistently and correctly interpret X-ray and MRI studies

Sports Concussion

Rotation Goal

The fellows will be able to confidently and accurately diagnose and coordinate management of sport-related concussions.

Objectives

By the end of this rotation, you will be able to perform all of the following skills:

  1. Evaluate the athlete with a suspected concussion
  2. Order appropriate studies (e.g. CT, MRI) to help answer clinical questions
  3. Participate in the formulation of a management plan for the concussed athlete
  4. Perform serial evaluations and treatment recommendations for the concussed athlete

Primary Care Offices

The RRC requires that all sports medicine fellows continue to practice medicine in their primary field of training during the fellowship program. The goal is to maintain your skills as a primary care physician. There is a required half-day clinic per week.

Since you will have your own schedule of patients, a minimum of 4 weeks notice will be required for non-emergent leaves of absence. Any emergent leaves of absence must be communicated verbally with the lead physician at your office and must be approved by the program director.

Procedure Logs

You will be required to keep a procedure log of all procedures in which you perform and assist. These may include but not limited to the following: joint injection/aspiration, I & D, casting, splinting, and compartment pressure testing. Please bring your procedure log with you at your quarterly evaluation session. The final procedure log will be signed at the completion of the fellowship by the program director.

Feedback and Evaluation

Rotation evaluations will be collected from all attending staff with which you are assigned (including office rotations and the UM athletic department). These will be collected via New Innovations or hand written form. Evaluations will also be collected from nurses, AT’s, PAs, PTs, and other involved staff. Four times yearly you will have a scheduled evaluation review and progress review with Dr. Best and the Fellowship Competency Committee. The fellow will be evaluated using the ACGME Sports Medicine Milestones at 6 months and at the final evaluation. At any time that you are having a problem with a rotation, attending, staff or patient, please contact Dr. Best immediately.

You will also have the opportunity to evaluate each faculty member you work with. We value your feedback and expect these to be completed in a timely manner.

Professionalism

A fellow is a direct extension of the UHealth Sports Medicine Institute. As an extension of a larger group, it is important to be a professional in all situations. Doctor-patient relationships and student-teacher relationships are critical to all medical situations. Intimate or personal relationships with student athletes or athletic training students are unacceptable.

Director’s Meeting

The program directors will meet with the fellows on Fridays 1:00 – 2:00 pm. @ the Sports Med Conference room following Fellow’s Sports Clinic. This meeting will focus on didactic review of sports medicine material and will include CAQ question discussion and review. This meeting is mandatory and fellows should contact Dr. Best if they are unable to attend.

Academic & Educational Experiences

Journal Club

Journal club sessions are required monthly experiences as part of the teaching conference. The goal of the journal club is to become able to critically analyze medical literature for its quality, strength of evidence, and impact on practice. These sessions will be assigned by the director on a monthly basis. Fellows will be required to select an appropriate journal club article from the recent literature. This article must be delivered electronically or in paper to Dr. Best no less than one week prior to the journal club. Please select articles that are recent (less than 6 months old).

Weekly Conference/Grand Rounds

Weekly teaching conferences will be required and should be at the quality of a national professional presentation. The first thing we ask is that all talks be as evidence-based as possible. That should include a review of the recent literature, where appropriate, and any new issues that may have surfaced at national meetings in the last year. Each fellow will be required to present cases with associated evidenced based teaching points during the year. Fellows will be assigned a faculty mentor for all presentations and the faculty mentor must approve all presentations one week prior to presentation date. See the attached schedule of times, presenters, topics, and locations. Attendance is mandatory, and everyone is expected to be on time.

*Conferences/Travel Policy

National conferences are valuable educationally and are a required portion of your fellowship. Each fellow is required to attend the ACSM or AMSSM annual meeting. Other conferences are optional and include ACSM/AMSSM advanced team course, and the AMSSM research conference.

You will have 20 workdays (Mon - Fri) for the year for vacation plus the two (2) day weekend (total of 8 weekend days). With approval of director/chief of service, you may be given leave with pay to attend educational conferences/seminars or to take exams. All days off must be approved by the program director. A travel request form AND an application for leave form must be completed and given to the program coordinator no less than 6 weeks prior to your planned leave. For any reimbursed expenses you must provide all receipts to the program coordinator following your return.

Elective Rotations

Each fellow will have elective rotations throughout the fellowship year. Elective rotations should be approved by Dr. Best and may include one of the following: Research, Exercise Physiology, EMG/PM&R.

Research/Publications

Each fellow will be required to complete one systematic review on a topic of choice with the program director. The guidelines will be presented at the research conference in the fall. Submission for publication is an expectation of this assignment. Fellows will also be asked to contribute to other publication opportunities as they arise. These must be approved by the program director.

National Meeting Presentation

Each fellow is required to submit an abstract or case for presentation at the ACSM or AMSSM national meeting. This requirement must be approved by the program director and should be completed prior to deadlines established by each meeting.

Outside Employment/Moonlighting

Fellows are not allowed to engage in employment outside of the fellowship or moonlighting during the fellowship year. This allows the fellow to attend to all required fellowship experiences and avoids conflicts with RRC requirements.

Weekly Education Schedule

Monday 6:45 a.m. – Fellow’s conference
Tuesday 7:15 a.m. – Radiology conference
Wednesday 7:15 a.m. – Primary Care Sports Meeting
Friday 1:00 p.m. – 2:00 p.m. - Meeting with Dr. Best

Quarterly visiting professor – Fellows will be expected to attend the quarterly Sports Medicine institute visiting professor lecture. As part of the visiting professor’s itinerary there will be required reading around the visitor’s lecture as provided by Dr. Best.