Spine & Sports Musculoskeletal Medicine Fellowship Program for Physiatrists

Link to University of Pennsylvania Website

Download Fellowship Brochure

Fellowship Requirements & Application Process

Submit Application Materials

Mission & Fellow Curriculum & Expectations

Education

Research

Teaching

Patient Care

Weekly Schedules

Prior Fellows

Learning Objectives

 

Dear Fellowship Applicant,

Thank you for your interest in the Penn Spine & Sports Musculoskeletal Medicine Fellowship at the University of Pennsylvania.  The fellowship is twelve months long and includes clinical care, interventional care, teaching, and research experiences. 

Requirements for consideration for the Spine & Sports Musculoskeletal Medicine Fellowship at Penn include:

1.      Completion of an accredited North American Physical Medicine & Rehabilitation residency

2.      Personal Statement

3.      Curriculum vitae

4.      Three letters of recommendation, with at least two being from your academic institution

 

Elective rotations are not required to be considered for the fellowship, but can be arranged if desired. 

 

Applications due July 15th.   Submit Application Materials via email to Rebecca Rushin at rushinr@uphs.upenn.edu

 

Interviews will be granted only following receipt of all application materials.  Invitations for interview will be extended in late summer. 

Selection of the fellows will occur in the late summer/early fall according to agreed common offer date.  For the right candidate, fellowships can be arranged 2-3 years in advance.

You may contact my senior secretary, Rebecca Rushin, at rushinr@uphs.upenn.edu or at (215) 662-3298 if you have any questions.  Once again, thank you for your interest in the program.  I hope that the following outline provides you some details of the curriculum.

 

Chris Plastaras, MD                                        

Penn Spine Center Director

Spine & Sports Musculoskeletal Medicine Fellowship Director

Chief, Division of Musculoskeletal Rehabilitation

 

Ground Floor White Building

Hospital of the University of Pennsylvania

3400 Spruce Street

Philadelphia, Pennsylvania 19104

(215) 662-3298


 

MISSION

To provide spine and musculoskeletal medicine education to academically inclined physiatrists who wish to bring clinical excellence to other academic centers.

 

FELLOW CURRICULUM & EXPECTATIONS 

EDUCATION

a.      Exposure to acute, subacute, and chronic musculoskeletal & spine pathology.

b.      Exposure to shadowing musculoskeletal physical therapist at scheduled clinics.

c.      Opportunity to learn fluoroscopically guided spinal injections under direct attending supervision at scheduled clinics.  Depending on the skill progress of each fellow, opportunity to do more complex procedures as appropriate:

                                                            Cervical, Thoracic, Lumbar epidural injections

                                                            Cervical, Thoracic, Lumbar selective nerve injections

                                                            Cervical, Thoracic, Lumbar facet joint injections

                                                            Cervical, Lumbar Medial branch blocks

                                                            Sacroiliac joint injections

                                                            Intraarticular hip, knee, and shoulder  injections

                                                            Radiofrequency procedures

                                                            Lumbar Discography

                                                            Lumbar intradiscal therapeutic procedures

d.      EMG’s: Maintain and sharpen electrodiagnostic skills –

e.       Supervise medical students and PM&R residents clinically and didactically.

2)      Opportunity to set up half day clinics with orthopedic surgeons, neurosurgeons, sports medicine physicians, radiologists.

3)      Opportunity to see patients in the Penn Sports Medicine Center

4)      Opportunity to volunteer for medical coverage of University of Pennsylvania Athletics (Lacrosse, Volleyball, Wrestling, Soccer, Gymnastics, Field Hockey, Women's Basketball)

5)      Opportunity to volunteer for medical coverage for the Penn Relays

6)      Opportunity to volunteer for pre-participation physicals 

RESEARCH

1)   Adopt and work on a significant musculoskeletal research project at Penn Spine Center.

2)   Prepare for and give Grand Rounds style presentation

3)   Write a publishable chapter or article

TEACHING

Each fellow is expected to:

1)      Organize journal clubs

2)      Teach and supervise University of Pennsylvania School of Medicine PM&R residents and medical students on rotation

PATIENT CARE

Each fellow is required to participate in:

1)      Penn Spine Center outpatient clinics both independently and directly supervised by attending.

2)      Penn Spine Center procedure clinics directly supervised by attending.

3)      Electrodiagnostic examinations both independently and directly supervised by attending.

4)      Weekend inpatient call ~8 times per year; some may be holiday weekends.

5)      Checking messages/voice mail on a regular basis.  All patient care related phone calls should be returned within one working day.

SAMPLE WEEKLY SCHEDULE

 

Mon

Tues

Wed

Thur

Fri

7AM

   

Procedures

Procedures Interventional Radiology

 

7:30 AM

Penn Spine Center Clinic

Penn Spine Center Clinic

Penn Spine Center Clinic

Penn Spine Center Clinic

Penn Spine Center Clinic (own clinic)

1 PM

Procedures

Procedures

Academic

Procedures

Penn Spine Center Clinic (own clinic)

5-6 PM

Penn Spine Center Add On Clinic (own clinic)

EMG (own clinic)

Penn Spine Center Add On Clinic (own clinic)

Penn Spine Center Add On Clinic (own clinic)

 

                ●Procedures with Attending             ●Clinic with Attending       ●Fellow (Own) clinic

  

BENEFITS

FELLOWS TRAINED WITH DR. PLASTARAS and current location
Paul Lento, MD – Temple University
Ed Hanada, MD – Dalhousie University
Jennifer Reed, MD – Spine Center Director, Eastern Virginia Medical School
Lee Wolfer, MD – San Francisco, California
Brad Sorosky, MD – Desert Spine & Sports, Phoenix, AZ
Wesley Smeal, MD – Alegent Health Sports and Spine, Nebraska
Gary P. Chimes, MD, PhD – University of Pittsburgh
Paula Dawson, MD - University Hospital of the West Indies, Jamaica
Shana Margolis, MD - Rehabilitation Institute of Chicago
D.J. Kennedy, MD - University of Florida
Christopher Visco, MD - Columbia University

Anand Joshi, MD, MHA - Duke University

Donald Macron, MD - East Carolina University

Seth Schran, MD  -  New York

Natacha Falcon, DO -  Rothman Institute

 

LEARNING OBJECTIVES

Medical Knowledge - Relating to the patient with regional mmusculoskeletal pain complaints:

o       Enhance knowledge of Anatomy as it pertains to the patient with regional musculoskeletal complaint

o       Formulate differential diagnosis for patients with regional pain complaints

o       Identify indications, advantages, and limitations for electrodiagnostic studies and radiographic imaging modalities (x-ray, bone scan, MRI, Diagnostic ultrasound, CT, discography, etc)

o       Identify indications for percutaneous interventional (spinal/joint injections, radiofrequency ablation, etc) treatment

o       Understand risks of injection treatments

o       Identify conditions that require urgent surgical referral

o       Demonstrate proficiency in reading x-rays of major joints and spine

o       Demonstrate proficiency in identifying structures on spine MRI’s

o       Understand current exercise guidelines of the American College of Sports Medicine

o       Understand clinically relevant anatomy and biomechanics

o       Understand physiologic effect of exercise on soft tissues

o       Understand physiologic effect of therapeutic modalities on soft tissues

o       Understand the degenerative cascade of the spine

o       Understand mechanical diagnosis/treatment (McKenzie assessment), manual and functional rehabilitation approaches

o       Review components of the Spine & Sports Medicine Resident Rotation Discrete Learning Objective List with residents on service

Patient CareExposure to treatmment of common musculoskeletal complaints

o       Understanding of ethical use of interventional procedures

o       Demonstrate proficiency in gathering essential information and accurate patient information

o       Develop and implement patient management plans

o       Formulate reasons and thought process behind making decisions about diagnostic and therapeutic interventions

o       Compose exercise/therapy prescription with specific diagnosis and recommended emphasis of treatment

o       Synthesize an appropriate medical and rehabilitation problem list and care plan for a patient in the outpatient setting

o       Experience with performing peripheral joint injection under sterile technique safely

o       Experience with performing spinal injection procedures under sterile technique safely

o       Experience with using fluoroscopy in a safe manner

o       Experience with performing electrodiagnostic tests, interpreting data, and formulating electrodiagnostic impression

o       Understand the role for complementary/alternative medicine

Interpersonal & Communication Skills

o       Communicate effectively and demonstrate caring/respectful behaviors with patients and staff

o       Demonstrate appropriate positioning in relation to the patient in the exam room to facilitate good rapport with patients

o       Demonstrate ability to articulate the risks and benefits of different treatment options to patients

o       Present information to patients, family members, caregivers & other health care providers in an effective manner.

o       Establish trust and maintain positive rapport with patients

o       Demonstrate effective listening skills.

o       Promote teamwork in the clinical setting.

o       Complete documentation and chart notes in a legible & timely manner.

o       Ability to read spine & sports journal club article, assimilate content and communicate its meaning to staff and colleagues.

Professionalism

o       Understand ethics involved in treating patients with acute and sub-acute pain.

o       Demonstrate sensitivity and responsiveness to age, culture, disability and gender of patients and colleagues

o       Consider effects of personal, social and cultural factors in the disease process and patient management

o       Demonstrate reliability, punctuality, integrity and honesty in all interactions with patients and colleagues.

o       Accept personal responsibility for own actions & decisions

o       Apply sound ethical principles in practice (e.g., informed consent, confidentiality, veracity, provision or withholding of care)

o       Prepare for and have prompt attendance appropriately dressed to regularly scheduled clinics, spine and sports journal clubs and didactic sessions.

Practice-Based Learning & Improvement

o       Compare use of surgical, percutaneous interventional procedures, and other non-operative treatment methods in the context of patient satisfaction, efficacy, and cost-benefit.

o       Demonstrate skill in supervising junior trainees in information gathering, decision-making, and patient management.

o       Evaluate and/or modify own practice based on feedback from others

o       Use information technology to appraise & assimilate evidence from scientific studies to enhance patient care outcomes

o       Use information technology to collect patient care information and perform patient care documentation

o       Identify appropriate assessment & measurement tools to evaluate functional status or outcomes of interventions

o       Participate in regularly scheduled spine and sports journal clubs including article review, presentation, and discussion in the context of clinical practice

Systems-Based Practice

o       Appreciate care provided to the person with musculoskeletal pain related complaints in context of larger health care system

o       Understand financial and quality of life implications for the patient and society

o       Advocating quality patient care and assisting patients in dealing with system complexities

o       Partner with health care managers as appropriate to assess, coordinate, and improve health care and how these activities impact system performance

o       Demonstrate the role of the physiatrist and concept of team approach to care, working effectively/collaboratively as leader of the team

o       Summarize the physician’s role in advocating for patient care needs

o       Summarize the physician’s role in disease management across the various levels of care in the health system in a cost effective manner.

o       Demonstrate how to access various community resources on behalf of the patient

o       Demonstrate integrity and responsibility in interactions with insurance and/or disability-oriented agencies