Musculoskeletal and Sports Medicine Physical Medicine and Rehabilitation Curriculum Guidelines (original) (raw)
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On the Horizon: Defining the Future of Sports Medicine and the Role of the Physiatrist
PM&R, 2012
This is an incredibly exciting time for physiatrists who are interested in sports medicine. The science of exercise and sports medicine is novel when compared with that of other medical disciplines. Sports medicine specialists are at the forefront of an exciting wave of new research that will provide a better understanding of the mechanisms and prevention of injury, improve cutting-edge diagnostic and treatment protocols, and aid in the prevention and treatment of chronic disabilities by ensuring wider dissemination of the principles of sports and exercise medicine to the general population. Although many of us have been practicing sports medicine for the past several decades, the advent of physical medicine and rehabilitation (PM&R) subspecialty certification in sports medicine has created opportunities that were never before possible. As the science of sports medicine advances and its scope of practice expands, physiatrists must even more thoroughly understand the origins, evolution, and future of sports medicine specialization. THE STATUS OF ACCREDITED PM&R SPORTS MEDICINE FELLOWSHIPS When I decided to pursue sports medicine fellowship training 20 years ago, the options were limited. There were very few Accreditation Council for Graduate Medical Education (ACGME) sports medicine fellowships that would consider accepting PM&R candidates, and all of the fellowships within PM&R were nonaccredited and biased toward spine medicine, with a sprinkling of sports medicine exposure. In 2007, the American Board of PM&R granted a subspecialty in sports medicine that allowed PM&R physicians the opportunity to sit for subspecialty board certification in sports medicine. By 2008, the first PM&R directed sports medicine program had received accreditation, and, by spring 2012, there were 15 such accredited programs with 16 available positions. The National Resident Matching Program (NRMP) results for 2011 showed that 53 PM&R physicians had registered, 45 had entered certified rank lists, and 24 were matched; thus 47% of the candidates were unmatched. Although those numbers are discouraging, I know that a number of the applicants eventually found a position outside the match. In addition, 2 PM&R programs were accredited in 2012 and did not participate in the 2011 NRMP. In 2011, 194 accredited positions were available in primary care sports fellowships (internal medicine, family practice, emergency medicine, pediatrics, and PM&R) in the NRMP, the majority of which were through family practice. If we define strength by numbers, then clearly in PM&R we shall have more power as sports medicine professionals if more ACGME fellowships are available. This will be particularly important in 2013, when an increase in the number of PM&R applicants who apply for sports fellowships is anticipated because after 2013 only those who graduate from an accredited fellowship will be allowed to sit for the subspecialty board examination. However, it is encouraging that some of the other primary care fellowships are now accepting PM&R candidates and are thus increasing the potential number of fellowship positions. WHY PURSUE SPORTS MEDICINE FELLOWSHIP TRAINING? Sports medicine is a logical stepping-stone for PM&R physicians whose goal is to synthesize expertise in exercise medicine, rehabilitation, and human performance. Sports medicine, like PM&R, forces the physician to go beyond diagnosis, focus on functional assessment,
Development of a Novel Sports Medicine Rotation for Emergency Medicine Residents
Musculoskeletal complaints are the most common reason for patients to visit a physician, yet competency in musculoskeletal medicine is consistently reported as a shortcoming in medical education in the USA. Sports medicine clinical rotations improve both medical 0 0 9 2 0 0 9 2 students and residents musculoskeletal knowledge. Despite the importance of this knowledge, a standardized sports medicine curriculum in emergency medicine (EM) does not exist. Hence, we developed a novel sports medicine rotation for EM residents to improve their musculoskeletal educational experience and to improve their knowledge in musculoskeletal medicine by teaching the evaluation and management of many common musculoskeletal disorders and injuries that are encountered in the emergency department. The University of Arizona has two distinct EM residency programs, South Campus (SC) and University Campus (UC). The UC curriculum includes a traditional 4-week orthopedic rotation, which consistently rated poorly on evaluations by residents. Therefore, with the initiation of a new EM residency at SC, we replaced the standard orthopedic rotation with a novel sports medicine rotation for EM interns. This rotation includes attendance at sports medicine clinics with primary care and orthopedic sports medicine physicians, involvement in sport event coverage, assigned reading materials, didactic experiences, and an on-call schedule to assist with reductions in the emergency department. We analyzed postrotation surveys completed by residents, postrotation evaluations of the residents completed by primary care sports medicine faculty and orthopedic chief residents, as well as the total number of dislocation reductions performed by each graduating resident at both programs over the last 5 years. While all residents in both programs exceeded the ten dislocation reductions required for graduation, residents on the sports medicine rotation had a statistically significant higher rate of satisfaction of their educational experience when compared to the traditional orthopedics rotation. All SC residents successfully completed their sports medicine rotation, had completed postrotation evaluations by attending physicians, and had no duty hour violations while on sports medicine. In our experience, a sports medicine rotation is an effective alternative to the traditional orthopedics rotation for EM residents.
Recommendations for Enhancing Sports Medicine Fellowship Training
American Journal of Physical Medicine & Rehabilitation
applicable, text in italics describes the underlying philosophy of the requirements in that 6 section. These philosophic statements are not program requirements and are therefore not 7 citable. 8 9 Background and Intent: These fellowship requirements reflect the fact that these learners have already completed the first phase of graduate medical education. Thus, the Common Program Requirements (One-Year Fellowship) are intended to explain the differences. Introduction Int.A. Fellowship is advanced graduate medical education beyond a core residency program for physicians who desire to enter more specialized practice. Fellowship-trained physicians serve the public by providing subspecialty care, which may also include core medical care, acting as a community resource for expertise in their field, creating and integrating new knowledge into practice, and educating future generations of physicians. Graduate medical education values the strength that a diverse group of physicians brings to medical care. Fellows who have completed residency are able to practice independently in their core specialty. The prior medical experience and expertise of fellows distinguish them from physicians entering into residency training. The fellow's care of patients within the subspecialty is undertaken with appropriate faculty supervision and conditional independence. Faculty members serve as role models of excellence, compassion, professionalism, and scholarship. The fellow develops deep medical knowledge, patient care skills, and expertise applicable to their focused area of practice. Fellowship is an intensive program of subspecialty clinical and didactic education that focuses on the multidisciplinary care of patients. Fellowship education is often physically, emotionally, and intellectually demanding, and occurs in a variety of clinical learning environments committed to graduate medical education and the well-being of patients, residents, fellows, faculty members, students, and all members of the health care team. In addition to clinical education, many fellowship programs advance fellows' skills as physician-scientists. While the ability to create new knowledge within medicine is not exclusive to fellowship-educated physicians, the fellowship experience expands a physician's abilities to pursue hypothesis-driven scientific inquiry that results in contributions to the medical literature and patient care. Beyond the clinical subspecialty expertise achieved, fellows develop mentored relationships built on an infrastructure that promotes collaborative research. Int.B. Definition of Subspecialty Sports Medicine-Tracked Changes Copy ©2019 Accreditation Council for Graduate Medical Education (ACGME) Page 4 of 51 [The Review Committee must further specify] [The Review Committee's specification will be included in an upcoming focused revision to the Sports Medicine Program Requirements] Int.C. Length of Educational Program The educational program in sports medicine must be 12 months in length. (Core) * [Moved from Int.B.] I. Oversight I.A. Sponsoring Institution The Sponsoring Institution is the organization or entity that assumes the ultimate financial and academic responsibility for a program of graduate medical education consistent with the ACGME Institutional Requirements. When the Sponsoring Institution is not a rotation site for the program, the most commonly utilized site of clinical activity for the program is the primary clinical site. Background and Intent: Participating sites will reflect the health care needs of the community and the educational needs of the fellows. A wide variety of organizations may provide a robust educational experience and, thus, Sponsoring Institutions and participating sites may encompass inpatient and outpatient settings including, but not limited to a university, a medical school, a teaching hospital, a nursing home, a school of public health, a health department, a public health agency, an organized health care delivery system, a medical examiner's office, an educational consortium, a teaching health center, a physician group practice, a federally qualified health center, a surgery center, an academic and private single-specialty clinic, or an educational foundation. I.A.1. The program must be sponsored by one ACGME-accredited Sponsoring Institution. (Core) I.B. Participating Sites A participating site is an organization providing educational experiences or educational assignments/rotations for fellows. I.B.1. The program, with approval of its Sponsoring Institution, must designate a primary clinical site. (Core) I.B.1.a) The sponsoring institution must also sponsor an Accreditation Council for Graduate Medical Education (ACGME)-accredited residency program in emergency medicine, family medicine, pediatrics, or physical medicine and rehabilitation. (Core) [Moved from I.A.1.] Sports Medicine-Tracked Changes Copy ©2019 Accreditation Council for Graduate Medical Education (ACGME)
Education in Sports Medicine: A resident perspective
Canadian family physician Médecin de famille canadien, 1990
The relative frequency with which family medicine residents managed several sports-related problems, their level of comfort with each of the conditions, and the sources of information they planned to use to improve their knowledge or skills were studied. Pearson correlation analysis revealed that residents reported greater comfort with conditions they saw most often. Reading was the preferred information source regardless of the clinical problem. The choice of information source did not differ by the frequency with which the condition was seen by the resident.
Journal of Athletic Training, 2022
Context To enhance the quality of patient care, athletic training students (ATSs) should experience a wide variety of clinical practice settings, interact with diverse patient populations, and engage with patients who have a wide variety of conditions. It is unclear in what ways, if any, ATSs have diverse opportunities during clinical experiences. Objective To describe the characteristics of patient encounters (PEs) ATSs engaged in during clinical experiences. Design Multisite panel design. Setting Twelve professional athletic training programs (5 bachelor's, 7 master's). Patients or Other Participants A total of 363 ATSs from the athletic training programs that used E*Value software to document PEs during clinical experiences. Main Outcome Measure(s) During each PE, ATSs were asked to log the clinical site at which the PE occurred (college or university, secondary school, clinic, or other), the procedures performed during the PE (eg, knee evaluation, lower leg flexibility o...
A Teaching Unit in Primary Care Sports Medicine for Family Medicine Residents
Academic Medicine, 2001
The authors describe their experience in setting up a sports medicine teaching unit within a family practice center of a teaching hospital. The unit's patient population more closely resembles that of a typical family practice than that of a traditional musculoskeletal teaching clinic (e.g., orthopedics, emergency room). The teaching program includes direct observation of residents performing history taking and physical examinations through one-way mirrors, close supervision for each case, and a sports therapist who educates patients and residents about home exercise programs when physiotherapy within private clinics is not necessary or affordable. At the end