Primary Care Pediatric Orthopedics and Sports Medicine Fellowship
Many childhood conditions of the musculoskeletal system can be managed without surgery, and our one-year non-accredited fellowship aims to train physicians to specialize in maladies of the pediatric skeleton. The objective is to develop specialists who envision a career that would involve partnering with a pediatric orthopedic surgeon(s) practice to help manage these children. In addition to the year-long exposure to fracture management, sports medicine, non-operative spinal issues, neuromuscular disease, foot and gait abnormalities, development dysplasia of the hip and Ponseti management of clubfeet, the trainee would also have access to in-office procedural training to undertake ultrasound-guided diagnosis and injections, fracture reductions, toenail ablations and wound care. The fellow will learn to recognize ‘normal’ and how to counsel families and children, as well as identify what can be safely managed versus what should be referred to our operative colleagues.
The fellow would be expected to complete a research project during his/her year and would have access to all the same training that the operative pediatric orthopedic fellows receive, including the ability to scrub in surgery, if desired. The clinic exposure would range across the sub-specialties within pediatric orthopedics in order to give the greatest breadth of training and would be under direct supervision of faculty. There would also be independent clinics to foster critical thinking and analysis of childhood musculoskeletal disease. Among the hands-on clinical exposure is the formal education that includes the bimonthly pediatric orthopedic journal club, monthly conferences (for sports medicine, hip disorders, spine abnormalities and neuromuscular disease), a weekly conference dedicated to surgical indications, a weekly conference dedicated to radiology indications, a weekly conference dedicated to the review of all cases treated at the institution (non-operative and operative) and a quarterly Morbidity and Mortality conference.
Our fellowship is divided into four teams, giving the trainee the opportunity to rotate with all faculty and gain exposure to all subspecialties. Team 1 is hip, spine and sports; Team 2 is foot/ankle and hip; Team 3 is sports, spine, limb alignment and tumor; and Team 4 is cerebral palsy, sports, hand, brachial plexus and clubfoot. All teams deal with trauma and fractures, and to augment exposure in these areas, the fellow will be assigned to fracture clinics that are managed by our mid-level providers at least once a week. The fellow would spend three months on each service. The first couple months of the fellowship would not include the independent clinics but instead would provide the opportunity to have cast-room experience to obtain hands-on experience in fracture reduction and casting technique. After the first rotation, this block will change to include the fellow’s own weekly clinic, adjacent to an attending’s clinic, to provide independence as well as assistance when required. The fellow will also rotate into daytime call so that he/she can get experience in orthopedic consult situations without having to take trauma call – which can be chosen if this experience is desired.