Ortho Sports Medicine San Diego Medical Center - Curriculum

Goals and Objectives

Our primary educational goal is for each fellow to achieve independence and competence in the advanced care of the injured athlete. All interactions between fellows and staff are designed around this educational objective.

Clinical Experiences and Rotations

Instead of traditional rotations, the fellows work alongside each faculty in their practices throughout the entire year. Additionally, the fellows begin developing their own panel of patients to build their own practice under the mentorship of faculty.

In clinics, the fellows work in parallel with a faculty member. The fellow has their own progressive schedule of patients to evaluate and treat, and the faculty have dedicated mentoring time for working together to examine, review imaging, and develop a treatment plan for each patient. Throughout the year, this allows the fellows to more independently run their own clinic while still under the direct supervision of a faculty member.

For patients that are scheduled for surgery, the fellows present their preoperative plans at indications conference each week with the faculty group. Throughout the year, this allows fellows to grow in their understanding of indications, surgical options, and technical planning for independently running their own operating room.

In the operating room, fellows are paired with a faculty member and share the surgical schedule for the day, with some cases being scheduled from the faculty panel and some from the fellow panel. This allows the fellow to learn from each faculty different ways of approaching cases and progressively gain the autonomy to perform their own surgical procedures while under direct supervision. Throughout the year as the fellows advance in their surgical skills and autonomy, the fellows start to book full OR days with their cases and first assist. While still under direct faculty supervision, the goal over the year is to allow fellows to feel comfortable on the first day when they enter a practice of their own.

Our health system is a closed system meaning that our group takes care of the full range of injuries and pathologies for which our members seek care. This means fellows will be exposed to and learn to treat traditional arthroscopic sports shoulder (rotator cuff, instability) and knee (ACL, multiligament injuries, meniscus, and cartilage) pathologies, as well as learning hip arthroscopy, open shoulder reconstruction and arthroplasty (anatomic and reverse, including reverse for fracture), and osteotomies. The weekly acute sports clinic provides regular access to assessing acute injuries including traumatic tendon injuries, and there are also opportunities for working with the faculty who perform fracture care.

Unique Aspects to the Program:

• Fellows develop their own panel of patients, representing a broad spectrum of sports-related conditions, for whom they are responsible throughout the year. The non-rotation based, year-long structure of the program provides continuity of clinical care and learning from training room and initial clinic evaluation to surgical indication and treatment, through postop rehabilitation and ultimate return to function.
• No night or weekend call.
• Team care at the high school, college, and local professional team levels is provided in the training room and on the field in conjunction with fellowship staff physicians.
• In addition to the core curriculum, fellows may choose on an elective basis to work with fellowship-trained subspecialists in total joint replacement, foot and ankle, pediatrics, hand and trauma.

General Clinic Schedule

• Three OR days per week
• 1.5 clinic days per week
• Half-day research
• Thursday 6am core sports teaching conference, 7am Radiology rounds/case presentations, Clinic
• Fall Friday evening team coverage (high school football)
• Fall Saturday training room, college football team coverage
• Spring professional indoor soccer team coverage

Teaching program

• Weekly Sports Medicine curriculum and Musculoskeletal Imaging Weekly surgical indications conference
• Sports Medicine Journal Club monthly
• Evening labs for practicing and learning arthroscopic and open techniques, staffed by faculty
• Offsite collaborative CME programs including a quarterly Southern California collaborative lecture/lab series, an annual articular cartilage repair workshop, and the annual Sports Medicine Fellows’ Symposium

Research opportunities

Fellows spend a half-day each week doing research. Each fellow participates in discussions and preparation of written reviews of manuscripts and grant proposals with staff members. Each fellow is expected to complete a research project or to participate in the preparation of a scholarly paper, according to his or her interests and abilities.

Serving the Community

Under the supervision of fellowship staff, the fellows participate in the care and the evaluation of athletic injuries on the field, in the training room, and in clinic. The fellows and faculty serve as liaisons in accepting Kaiser Permanente Health Plan members referred from all athletic programs in the San Diego area.