Primary Care Sports Medicine Fellowship

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.

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 orthopaedic issues for athletes at all levels of training and competition.
2. Medical Knowledge to enhance knowledge about established and evolving biomedical, clinical, and cognitive issues, as well as the application of this knowledge as it pertains to orthopaedic 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 orthopaedic 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 orthopaedic 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 orthopaedic setting.

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.

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.

You will be required to keep a procedure log of all procedures in which you perform and assist. These may include but are not limited to the following:

• joint injection/aspiration
• I & D
• casting
• splinting
• 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.

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, ATs, PAs, PTs, and other involved staff.

Quarterly, 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 six 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. There will be a year-end evaluation with faculty. Fellows also provide feedback to faculty on ways to improve fellowship.

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.

The program directors will meet with the fellows on Fridays 1 – 2 p.m. at the Sports Medicine 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.

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 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 schedule of times, presenters, topics, and locations. Attendance is mandatory, and everyone is expected to be on time.

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.

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.

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.

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.

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.

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 1–2 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.