The Lena Sefton Clark Endowed Fellowship in Pediatric Orthopedics (a joint Rady Children’s/University of California, San Diego School of Medicine program) is designed to expose the orthopedic surgeon who has already completed a formal orthopedic surgery residency program to subspecialty training in pediatric orthopedic surgery.
I. General Description and Goals
Our one-year program combines both clinical training and research. Clinical training will encompass all areas of pediatric orthopedics, including trauma, acute infections, scoliosis, and neuromuscular disease. In the research area, the fellow is expected to complete a research project of publishable quality during the fellowship period.
Rady Children’s Hospital-San Diego provides a unique opportunity for a broad practical exposure to pediatric orthopedics for the following reasons:
- Rady Children’s is the sole pediatric teaching hospital associated with the University of California, San Diego School of Medicine. Orthopedic residents from that program together with orthopedic residents from the Naval Regional Medical Center, San Diego and the Wilford Hall Air Force Medical Center (San Antonio) receive their pediatric orthopedic training at Rady Children’s.
- The training program is located in a broad-based general pediatric hospital, which provides exposure to pediatric musculoskeletal trauma and infections in addition to traditional, elective pediatric orthopedics (scoliosis, neuromuscular disease, hip and foot disorders, etc.).
- The training program provides exposure to a nationally recognized staff of full-time pediatric orthopedic surgeons.
- Opportunities exist for clinical and research exposure to scoliosis in the comprehensive scoliosis clinics, as well as participation in both animal research projects and biomechanical testing studies in the Scoliosis Biomechanics Laboratory (Dr. Peter Newton, Director).
- San Diego has a dynamic orthopedic community, which includes an outstanding research program in all areas of orthopedics directed by Steven Garfin, M.D., UC San Diego Orthopedics Department Chair, as well as a sophisticated level of clinical orthopedic practice in all orthopedic subspecialties. This exposure occurs at weekly orthopedic grand rounds and basic-science seminars.
II. Description of Clinical Training and Research Program
A. Formal sessions, classes, and seminars
1. Grand Rounds and basic science conferences sponsored by University of California, San Diego School of Medicine held weekly – one hour.
2. Pediatric orthopedic journal club held weekly – one hour.
3. Educational sessions on a wide range of pediatric orthopedic topics held weekly following Journal Club – one hour.
4. Surgical indications conference held weekly – 1.5 hours.
5. Pre-operative (Monday) and post-operative (Friday) X-ray review of all surgical cases held weekly – two hours
6. Specialty research conferences (hip, sports, scoliosis, neuromuscular, trauma) – one hour
B. Daily Activities
These may include:
- Morning surgical floor rounds
- Pediatric orthopedic clinics
- Rady Children’s specialty and multidisciplinary clinics, including scoliosis, hip, muscle disease, spasticity, spinal defects, and adult cerebral palsy
C. Documentation of Exposure to Orthopedics, Pediatrics, etc.
The trainee will work closely with full-time pediatric orthopedic surgeons: Dennis R. Wenger, M.D., Director, Pediatric Orthopedic Training Program; Scott J. Mubarak, M.D., Director, Orthopedic Clinical Program; Henry Chambers, M.D., Director, Motion Analysis Laboratory, Peter Newton, M.D., Director of Scoliosis Service, C. Douglas Wallace, M.D., Director of Orthopedic Trauma Service and Pediatric Hand Surgery Service, Maya Pring, M.D., Burt Yaszay, M.D., Eric Edmonds, M.D., Harish Hosalkar, M.D., and Andrew Pennock, M.D.
D. Patient Follow-up and Contact with Parents
Patient follow-up will occur through the trainee’s regular attendance at clinics with family contact as an integral part of this process. Additional follow-up and family contact may be required for the trainee’s clinical research project.
E. Research Involvement
A wide variety of clinical and basic research projects can be pursued, utilizing the ample clinical volume and broad-based laboratory facilities of our center. In addition to a clinical research project, the trainee may be involved in current areas of research within the orthopedic department that include:
- Ultrasound analysis of the infant hip
- Three-dimensional analysis of hip disorders in children
- Treatment of hip disease using 3-D CT data
- New concepts of hip containment in Legg-Perthes disease
- Hip impingement disorders
- Hip preservation surgery
- Correlation of pulmonary function with scoliosis in paralytic disorders
- Growth and development in patients with idiopathic scoliosis
- Three-dimensional analysis of spine geometry
- Thoracoscopic approach to scoliosis surgery
- Development of thoracoscopic spinal instrumentation
- Research into non-fusion surgical correction techniques for scoliosis treatment
3. Sports Medicine
Our sports division has a strong interest and expertise in sports medicine in children, adolescents, and young adults. This division includes three of our ten faculty who are performing sports medicine nearly full time. Two additional faculty spend almost half of their time providing high quality sports medicine care. Areas of expertise include:
1. Cruciate ligament injuries
2. Meniscal injuries
3. Cartilage and joint surface injuries
4. All other areas of sports medicine expertise
4. Foot and ankle disorders
Our department is one of the world’s leaders in both clinical treatment and research regarding foot disorders in childhood. Special areas of expertise include:
1. Corrective surgery for flat foot
2. Corrective surgery for cavus foot deformity
3. Management of tarsal coalitions
4. Complex correction of ankle and foot deformities
5. Motion analysis – cerebral palsy
Our Hospital is a recognized center for cerebral palsy with expertise in many areas:
1. Gait abnormalities and extremity function disorders
2. Hip disorders in cerebral palsy
3. Scoliosis and spinal deformity in cerebral palsy
4. Complex neuromuscular conditions involving both cerebral palsy and related conditions
III. Facilities Used in the Training Program
Rady Children’s Hospital-San Diego
IV. Personnel Involved in the Training Program
Peter O. Newton, M.D.
Chief, Orthopedic Research
Director, Scoliosis Program
C. Douglas Wallace, M.D.
Medical Director, Orthopedic Trauma
1994-1995 Pediatric Orthopedic Fellow
Henry G. Chambers, M.D.
Medical Director, Motion Analysis Laboratory
1989-1990 Pediatric Orthopedic Fellow
Andrew T. Pennock, M.D.
Maya E. Pring, M.D.
2002-2003 Pediatric Orthopedic Fellow
Burt Yaszay, M.D.
Karen Noble, M.B.A, Coordinator,
Pediatric Orthopedic Training Program
Tracey Bastrom, M.A.
Research Program Manager
Joanna Roocroft, M.A.
Carrie Bartley, M.A.
J.D. Bomar, M.P.H.
Christy Farnsworth, M.S.
Assistant Research Scientist
V. Description of Evaluation of Training Program and Trainee
The trainee will be given a written evaluation by the preceptor at the end of each rotation and upon completion of the fellowship, as well as an evaluation of the individual’s clinical research project.
The fellow will have the opportunity to evaluate his/her experience with us as well. We appreciate feedback so we can change and improve the program as needed.
VI. Total Number of Trainees in the Department
Ten orthopedic residents from University of California, San Diego Medical Center and five residents each from the Navy and Air Force rotate through Rady Children’s annually, with four residents present at any given time. In addition, there is one research resident from UC San Diego who is at Rady Children’s for a full year.
The fellowship total compensation is approximately $70,000, plus benefits, per year. Benefits include:
- Health insurance for fellow and dependents
- Health spending account
- Academic educational expenses ($3,500)
- Relocation expenses up to $2,000
- DEA and California licensing fees
VIII. Medical Licensure
A valid California medical license and DEA certificate are required. The expense of obtaining these will be covered by the program.
- Fellowship Program
Dennis R. Wenger, M.D., Director