Clinical Experiences & Rotations
Initially, fellows will see patients one on one with the attending. From this, the fellow will learn appropriate patient interaction skills and become proficient in the diagnosis of sports related injuries. As the year progresses, the fellow’s will begin to develop their own patient base. Although the attending will ultimately be responsible for these patients, the fellow will take primary responsibility for their care. The fellow’s will be expected to treat these patients as their own be able to make the appropriate diagnosis, develop a comprehensive treatment program, schedule the necessary intervention, perform the surgery, follow the patient post-operatively, manage complications and ultimately see the patient through to recovery. The fellow will also direct the patient’s physical therapy and communicate with coaches and trainers as necessary.
Duties in the operating room, like the clinic, will increase as the year progresses. At first, the fellows will assist the attending, thus learning by both observation and hands-on experience. As they become competent to perform a particular procedure, they will be allowed to perform these surgeries on their own with the attending acting as the assistant. Finally, as their surgical skills and confidence improve, they will be allowed to perform certain surgeries on their own, with the attending observing and intervening only when necessary.
This arrangement of gradually increasing responsibility is designed to transition the fellow from the level of a chief resident to the level of a highly competent orthopedic sports medicine practitioner. Even though the fellow’s level of autonomy will be increasing throughout the year, the fellows will never go unsupervised. The amount of direct attending intervention will be according to the individual skill level of the fellow. An attending will always be immediately available in both the clinic and operating room setting. Also, all surgical cases will be discussed prior to surgery at the weekly “Case Presentation Conference”.
The work week include two days of clinic, two days of surgery and one educational day. Call is scheduled four to six weekends a year. Our hospital is community hospital with no level 1 trauma. The fellow, like the staff, will take call with a physician’s assistant and orthopedic tech, and will have back up by the on call attending and a fellowship trained trauma surgeon. It is the belief of our staff that the call schedule described is the minimum amount required to maintain adequate competency for routine orthopedic trauma cases while not negatively impacting their sports medicine experience. No weekday call is required. The fellow will be paid for call at the staff rate.
Inpatient duties are limited to the appropriate post-operative care of the fellow’s patients requiring in-patient surgery. These cases will be rare, as most sports patients at our institution are treated on an outpatient basis. The fellow will make inpatient rounds while on call.