Center for Athletic Medicine - Primary Care Sports Medicine Fellowship Program

Rotations:

• MSK Medicine (2 months)
• Sports Surgery (2 months)
• MSK Radiology (1 month)
• Orthopedic Trauma (1 month)
• Spine (1 month)
• Foot & Ankle (1 month)
• Hand (1 month)
• Pediatric Sports (1 month)
• Sports Physiology (1 month)
• Elective (1 month)

Rotation Descriptions:

MSK Medicine (2 months)

The first two months of the fellowship year will be spent with core faculty in primary care sports medicine clinics. The Fellows will work closely with faculty at a variety of practice locations. During these months, Fellows will see and evaluate new patients, hone their musculoskeletal examination skills, and learn new injection skills.

Rotation Objectives:

• Learn basic sports medicine injury diagnostic skills and management techniques
• Learn clinical x-ray interpretation skills
• Learn in-office ultrasound techniques for diagnosis and injection guidance
• Learn how to run a sports medicine clinic

Components:

• PCSM clinics with various faculty members
• Event coverage (pending event schedules)

Sports Surgery (2 months)

This rotation is designed to give the Fellow experience with orthopedic sports surgeons in the office and operating room settings. To maximize diversity of experience, the fellow will rotate with various surgeons during these months.

Rotation objectives:

• Further hone musculoskeletal examination techniques 
• Gain experience in determining indications for surgical intervention
• Learn surgical rehabilitation protocols for various procedures
• Gain experience in surgical post-operative care

Components:

• Orthopedic Surgery clinics with Sports Surgeons
• Surgical Suites at HFH facilities

MSK Radiology (1 month)

The Fellow will spend time with musculoskeletal radiologists in a hospital setting. Emphasis will be on reading x-rays, MRI, ultrasound, and CT scan of the extremities and spine, as well as proper utilization of these tests.

Rotation objectives: 

• Be familiar with the principles of interpreting x-ray, MRI, ultrasound, and CT scan
• Understand radiographic techniques
• Become familiar with invasive diagnostic procedures

Components: 

• Hospital musculoskeletal radiology department

Orthopedic Trauma (1 month)

From training with orthopedic trauma specialists, this rotation will prepare the Fellow to manage a variety of fractures, dislocations, and other traumatic musculoskeletal injuries.

Rotation objectives:

• Gain experience in the evaluation of traumatic musculoskeletal injuries
• Gain an understanding of appropriate use of diagnostic testing in the setting of musculoskeletal trauma. This will include experience in the interpretation of these tests
• Gain an understanding of the indications for surgery in trauma cases
• Gain experience in the treatment of nonoperative fractures, including splinting and casting techniques

Components:

• Orthopedic Trauma clinic at main hospital

Spine (1 month)

Here, the Fellow will familiarize themselves with therapy protocol for specific injuries and surgeries. Longitudinal exposure will give the Fellows the opportunity to follow injury rehab through the various stages and phases. Exposure to therapeutic modalities will be incorporated with lectures and talks on how they should be used. Intermittently Fellows will be exposed to physical medicine and rehabilitation specialist for office consultations.

Rotation Objectives:

• Be able to prescribe physical therapy for athletes tailored to their specific needs and injuries
• Learn principles of injury rehabilitation
• Fain experience with modalities and learn how to utilize them
• Understand the operation of a physical therapy clinic
• Gain exposure to surgical rehabilitation protocols

Components: 

• Physical therapists and facilities at CAM, West Bloomfield, Columbus
• Michelle Thibodeau, PT

Foot and Ankle (1 month)

The Fellow will spend clinical time and have the opportunity to spend operative time (if desired) with orthopedic foot and ankle specialists to hone their clinical examination and treatment skills for common injuries to the foot and ankle region.

Rotation objectives:

• Gain experience in the evaluation of musculoskeletal injuries and conditions of the foot and ankle 
• Gain an understanding of appropriate use of diagnostic testing for injuries/conditions of the foot and ankle, including experience in the interpretation of these tests
• Gain an understanding of the indications for surgery for sports injuries of the foot and ankle

Components:

• Orthopedic Foot and Ankle surgery clinics
• Surgical suites at Henry Ford Health facilities

Hand (1 month)

The Fellow will spend clinical time and have the opportunity to spend operative time (if desired) with orthopedic upper extremity specialists to hone their clinical examination and treatment skills for common injuries to the hand and wrist.

Rotation objectives:

• Gain experience in the evaluation of musculoskeletal injuries and conditions of the elbow, wrist and hand
• Gain an understanding of appropriate use of diagnostic testing for injuries/conditions of the elbow, wrist and hand, including experience in the interpretation of these tests 
• Gain an understanding of the indications for surgery for sports injuries of the elbow, wrist and hand
• Gain an understanding of the indications for a variety of injection treatments for musculoskeletal conditions of the elbow, wrist and hand and gain experience in administering these injections

Components:

• Orthopedic Hand surgery clinics
• Surgical suites at Henry Ford Health facilities

Pediatric Sports (1 month)

The Fellow will work with pediatric orthopedic surgical specialists and nonsurgical sports medicine specialists during this rotation. The orthopedic surgery component of this rotation will emphasize pediatric back and hip issues.

Rotation objectives:

• Understand the differences between the pediatric and adult MSK systems
• Gain experience in the evaluation of operative and nonoperative musculoskeletal injuries and conditions in pediatric and adolescent aged patients
• Gain an understanding of appropriate use of diagnostic testing for musculoskeletal injuries/conditions in the pediatric and adolescent age groups, including experience in the interpretation of these tests

Components:

• Pediatric orthopedic surgery clinic
• Dr. Moeller’s sports medicine clinic

Sports Physiology (1 month)

This rotation is designed to expose the Fellow to the principles of exercise physiology applied to the athlete. Fellows will be instructed on administering and interpreting exercise stress tests.

Rotation objectives:

• Learn the principles of exercise physiology 
• Learn how to prescribe a fitness program 
• Learn how to order, perform and interpret an exercise stress test

Components:

• Physiology lab with Steven Keteyian, Ph.D
• Cardiopulmonary lab at main hospital

Elective (1 month)

The final month of the Fellowship experience is an elective month but must be spent in a clinical setting. Most Fellows opt to spend additional time with their Primary Care Sports Medicine faculty in the outpatient clinic setting, but this is not mandatory. The experience can be divided into multiple areas if desired. The elective plan must be approved by the fellowship director by March 1 (unless they plan to spend the month with the PCSM faculty).

Longitudinal Experiences

Continuity Experience in Primary Specialty Area

It is required that Sports Medicine Fellows spend a half-day to a full-day each week in a clinical setting in their primary specialty area. Family Medicine, Pediatric and Internal Medicine trained Fellows spend a half-day weekly in the Family Medicine Residency clinic. Emergency Medicine trained Fellows will work one day weekly in the Henry Ford Emergency Department. PM&R trained Fellows will spend a half-day weekly in Spine Clinics with one of our Sports Medicine trained PM&R physicians. These clinics run from August through June.

Sports Medicine Fellow Clinic

Fellows will see their own panel of patients in Sports Medicine Clinic weekly, precepted by the program director. These clinics run from August through June.

University Training Room

Fellows will see athletes in their University Training Room weekly. The day and time will be dependent on the specific University to which the Fellow is assigned.

Game/Event Coverages

Throughout the year, Fellow will provide coverage services at a variety of community events, and high school, collegiate and professional games. Schedules of event coverage will be reviewed by the program director to ensure every Fellow’s schedule complies with ACGME duty hour regulations.

Each Henry Ford Sports Medicine Fellow will be assigned to cover their own specific High School and University, and will share professional coverage opportunities with their fellowship partners.

• High Schools: Allen Park High School, Bloomfield Hills High School, University of Detroit Jesuit High School.
• Universities: Lawrence Technological University, Oakland University, Wayne State University.
• Professional: Detroit Pistons, Detroit Tigers
• Other: Detroit Free Press/TCF Bank Marathon, Michigan Winter Special Olympics, Michigan Opera House.

Additional Education Events

Fellow Didactics

Fellows will attend a weekly didactic lecture, provided by PCSM faculty members.

PCSM Grand Rounds

PCSM Grand Rounds take place monthly (9-10 annually). A variety of guest speakers, and faculty members will provide lectures on various topics. Each Fellow will also provide a Grand Rounds lecture on a topic of their choice (must be approved by the program director).

Orthopedic Surgery Grand Rounds

Orthopedic Surgery Grand Rounds take place weekly, starting in August. Except when conflicting with PCSM Grand Rounds, Fellows will attend Orthopedic Surgery Grand Rounds. Along with a variety of MSK topics, these lectures include Quality Improvement, Patient Safety, and Clinical Practice topics.

Journal Club

PCSM journal club is meant to teach Fellows how to critically assess sports medicine literature. Medical and MSK topics will be included. Articles will be selected by the Fellows (must be approved by the program director). There are typically 6 journal club events through the year.

Ultrasound Workshops

Ultrasound workshops will give Fellows a hands-on experience in the use of point of care ultrasound of the MSK system. The workshops will be taught by PCSM faculty members in the Henry Ford Simulation Laboratory and Sports Medicine clinics.

Scholarly Activity

Research

Fellow will be expected to create a unique research project with the goal of completing the project during their fellowship year. Projects will be done in conjunction with the research department at Henry Ford Hospital. Access to the research development division of Henry Ford and statistical analysis is available. Fellows will be mentored in their projects by the program director, and other faculty members as appropriate. All projects require approval by the program director, and the process will begin after the Match, but before the official start of the fellowship year. The outcomes of the project should be written up with intent to publish.

Case Presentations

The Fellow will be expected to write a case presentation to be submitted for presentation at the American Medical Society of Sports Medicine conference in the spring of the fellowship year. Additional cases may be submitted for presentation at the American College of Sports Medicine or other meetings.

Flexibility

Significant time was spent establishing a structure for Fellows to follow. We do, however, encourage Fellows to pursue their specific interest in sports medicine. Fellows are encouraged to discuss ways to adapt rotations and schedules to meet his or her desires and needs. There is no real flexibility in the continuity clinics.