CSES Fellowship

Information & Brochure

Shoulder, Elbow, and Sports Medicine Fellowship

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General Statement

The goals and objectives of the service are to educate the fellows in all areas of shoulder and elbow surgery and sports medicine. This will be achieved through didactic sessions, literature review, oral presentations, patient examination and surgical treatment. In addition, access to cadavers and the arthroscopy laboratory will further enhance the residents’ and fellows’ understanding and technical skills during their respective rotations.

In addition, the goals of the rotation are to:

1. Help the fellows develop interpersonal skills needed to effectively engage patients and family members to enhance communication and education.

2. Develop competency in management of the orthopaedic inpatients including administration, quality improvement and leadership through the use of effective verbal and written communication skills.

3. Acquire medical knowledge about established and evolving biomedical, clinical, cognitive sciences and demonstrate the competent application of this knowledge to patient care.

4. Demonstrate practice-based learning and improvement that involves investigation and evaluation of patient care, appraisal and assimilation of scientific evidence and improvements in patient care.

5. Demonstrate interpersonal and communication skills that result in effective information exchange and teaming with patients, their families, and other health professionals.

6. Demonstrate professionalism as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.

7. Demonstrate system-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care and ability to effectively call on system resources to provide care that is of optimal values.

Fellows:

1. Primarily responsible for the care and management of all patients on the service

2. Interact daily with the residents and attending staff regarding in-patient care

3. Will spend 3 month rotations with attendings (LUB;WNL;CSA;EC) to optimize private office opportunities
   
   Monday – Office
   Tuesday – Research/Shoulder Clinic
   Wednesday – OR (LUB)
   Wednesday – OR (EC)
   Thursday – OR (WNL)
   Friday – OR (CSA)
   

4. Participate in indications conference to be prepared for surgery

5. Will have increasing autonomy in the operating room as the year progresses but will never be unsupervised

6. The attending surgeon will assign roles of 1st assistant, 2nd assistant

7. The primary responsibility for education in the operating room is with the residents

8. Coordinate the management and care of patients from shoulder/sports clinic (VC-3) on Tuesdays 9:00am

9. Will have a mid-year evaluation and an end-year evaluation
   a. Review the operative experience
   b. Review the overall impressions of the fellowship
   c. Review the interactions between the residents and fellows
   d. Review research progress

10. Ongoing education of the residents and medical students

Educational Experience

1. Indications Conference
   a. Every Tuesday from 1:00pm – 2:00pm
   b. All cases presented for that week (WNL, CSA, EC)
   c. Must have charts, xrays, MRI, etc… available (should be ready Friday)
   d. Goals: to understand proper alternatives, indications and plan for patient care

2. Fracture Conference
   a. Every Thursday 6:30 am
   b. All fracture/trauma cases from shoulder/sports service should be presented by operating surgeon

3. Shoulder, Elbow and Sports Medicine Core Curriculum
   a. Every Tuesday at 6:00am
   b. Didactic lectures given by Attendings, Visiting Attendings, and Fellows (2/year)

4. Shoulder, Elbow and Sports Medicine Service Conference
   a. Every Friday 6:30 am
   b. Junior resident will present all bony cases of the week
   c. All xrays, MRIs, pertinent materials should be present
   d. The junior resident should gather all of this material on the OR day and save it for Friday’s conference and for Fracture conference (in the case of fracture/trauma).

5. Shoulder, Elbow and Sports Service Walk Rounds
   a. Every Friday 7:00 am
   b. Junior resident will present concise (yet complete), accurate history of patient: Pertinent demographics, pre-operative history, physical examination, pertinent pre-op treatment; then present the operation performed (please know WHAT OPERATION WAS PERFORMED!) and most importantly, present the plan for physical therapy: It should be understood that this information is to be known by the junior resident prior to that morning’s rounds.
   c. Senior residents should know what operation was performed and be prepared to discuss it further if necessary

6. Shoulder, Elbow and Sports Medicine Clinic (Vanderbilt – Tuesday 9:00am)
   a. All patients must be discussed/treated with the attending (WNL/CSA)
   b. Residents will develop an increasing autonomy over the course of the rotation (and year) but all charts must be signed by an attending
   c. The fellows will serve an increasingly autonomous role as the year progresses in the management and care of the patients; however, all charts must be signed by an attending and the attending must be present during clinic hours

Reading Materials

1. Selected classic references

2. Bigliani, The Shoulder: Operative Technique

3. Warner, Iannotti, Gerber: Complex and revision problems in shoulder surgery

4. Iannotti and Williams: Disorders of the shoulder: Diagnosis and management

5. Neer, The Shoulder

6. Journal of Bone and Joint Surgery

7. Journal of Shoulder and Elbow Surgery

Fellow Evaluation

Will be based on performance in all areas and successful achievement of the goals and objectives.

Revised 10/23/09