Sports Medicine Fellowship Training Significantly Increases Sports Case Volume: An Analysis of ACGME Case Log Data from 2006 to 2019.
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ABSTRACT: Purpose
The purpose of this study was to determine the experiential benefit of completing a sports medicine fellowship for orthopaedic surgeons specializing in the treatment of sports injuries.Methods
Accreditation Council for Graduate Medical Education case logs were examined for sports medicine cases performed by orthopaedic surgery residents from 2006 to 2019 and for orthopaedic sports medicine fellows from 2010 to 2019. The average number of arthroscopic cases was evaluated for residents and fellows according to each body group. Additional data based on subcategorization of arthroscopic cases was analyzed as well. A Student t-test was conducted to compare the means between the groups.Results
Orthopaedic sports medicine fellows reported 274.9% more shoulder (260.6 ± 77.31 vs 94.8 ± 23.7, P < .0001), 685.6% more humerus/elbow (17.1 ± 6.14 vs 2.5 ± .508, P < .0001), 596.7% more pelvis/hip (41.4 ± 25.40 vs 6.9 ± 2.97, P < .0001), 188.1% more femur/knee (281.4 ± 57.85 vs 149.6 ± 34.09, P < .0001), and 264.1% more foot/ankle (16.9 ± 5.58 vs 6.4 ± .600, P < .0001) sports cases compared to orthopaedic surgery residents. Orthopaedic sports medicine fellows performed significantly more shoulder arthroscopy cases (126.8 ± 3.96 vs 86.0 ± 22.26, P = .032) and knee arthroscopy cases (179.4 ± 8.98 vs 101.75 ± 33.51, P = .015) than residents over a 5-year period.Conclusions
On average, orthopaedic sports medicine fellowships significantly increase sports case volume of orthopaedic trainees, especially in the upper extremity. Notable increases were in the shoulder, femur/knee, and pelvis/hip. We have demonstrated that orthopaedic sports medicine fellowships significantly increase exposure to sports medicine related cases.Clinical relevance
It is important for case volume to be evaluated across orthopaedic sports medicine fellowships because they must ensure that fellows receive adequate training in orthopaedic sports medicine.
SUBMITTER: Ibitayo AT
PROVIDER: S-EPMC8689202 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionThe purpose of this study was to determine which components of sports medicine fellowships are most important to applicants when reviewing fellowship websites during the application process.MethodsAn anonymous survey was distributed to 492 fellowship applicants from the 2017-2018 and 2018-2019 cycles. The survey included questions about the importance of including components of fellow education, recruitment, and experience on program websites. The weighted average of responses determined each component's rank, with 5 being "very important" and 1 being "not at all important." Responses were analyzed by application cycle, current position, and sex using the Wilcoxon rank-sum test.ResultsSixty-five applicants participated in the survey and completed the demographics section, resulting in a 13.2% response rate. According to participants, the most important components to include on fellowship websites were exposure to advanced operative sports medicine techniques (weighted average, 4.62), complexity of cases performed (4.52), and number of cases performed (4.50). Analysis demonstrated statistically significant differences in opinion between application cycles for flexibility for conducting a remote interview (P = .0074), jobs obtained by previous fellows (P = .019), national rank of department (P = .021), program's geographic location (P = .026), protected academic time (P = .038), current positions for criteria for fellows' performance evaluations (P = .028), program's geographic location (P = .0097), and protected academic time (P = .0079). There were statistically significant differences in opinion between current positions regarding flexibility for conducting a remote interview (P = .0026), jobs obtained by previous fellows (P = .012), and national rank of department (P = .0013).ConclusionsOrthopaedic sports medicine fellowship applicants believe that it is most important to include information about the volume and complexity of fellows' cases and their day-to-day commitments on program websites.Clinical relevanceThis information would enable applicants to identify programs that will support professional development and allow program directors to communicate expectations.
| S-EPMC8220630 | biostudies-literature
Project description:PurposeTo compare the surgical case volume for orthopaedic sports medicine fellows in the most recent classes with one another and in years preceding the pandemic.MethodsThe Accreditation Council for Graduate Medical Education case log reports of key procedures for orthopaedic sports medicine fellows during academic years 2018-2019, 2019-2020, and 2020-2021 were extracted. Comparisons between these years in adult, pediatric, and total case volumes were performed using a 2-sample t-test to detect significant changes in the average number of key procedures completed between consecutive years.ResultsThere was a significant decrease in the total number of cases completed by fellows during the 2020 academic year (P = .043) compared with 2019, immediately followed by a significant increase in case volume in 2021 (P < .001) (2019, 339 ± 123; 2020, 316.2 ± 108; 2021, 356.5 ± 117). There was a significant increase in adult case volume from 2020 to 2021 (2020, 295.7 ± 106; 2021, 332.9 ± 117; P < .001), whereas no trends were noted in pediatric case volume. Between the prepandemic year of 2019 and the first year of the pandemic, significant decreases were noted in case volume for several procedures, including multiligamentous knee injuries, knee instability and pediatric hip arthroscopy. From the first to the second years of the pandemic (2019-2020 to 2020-2021), significant increases were observed in case volume for rotator cuff, acromioclavicular instability, elbow instability, knee cartilage, and meniscal surgeries.ConclusionsOrthopaedic sports medicine fellows experienced significant decreases in volume for several key case categories between the year preceding the coronavirus disease 2019 pandemic and the first academic year during the pandemic. There were subsequent increases in cases between the first year of the pandemic and the second year, which may be associated with resuming elective surgical cases.Level of evidenceIV, retrospective database analysis.
| S-EPMC9117403 | biostudies-literature
Project description:PurposeTo survey orthopaedic sports medicine fellowship program directors to determine the current research productivity of both fellows and faculty in Accreditation Council for Graduate Medical Education-accredited orthopaedic sports medicine fellowship programs in the United States.MethodsAn anonymous 18-question survey was distributed via e-mail to all 95 Accreditation Council for Graduate Medical Education-accredited orthopaedic sports medicine fellowship program directors in the United States. Descriptive statistics were used for data analysis. Questions included whether fellows are required to complete a certain number of projects during their fellowship year and whether fellows have protected research time.ResultsOf the programs, 31 (33%) responded to the survey. Twenty-four programs (80%) require fellows to complete 1 to 4 projects. Twenty-one programs (71%) provide 4 to 8 hours of weekly protected research time. Twenty-four programs (77%) publish 1 to 2 manuscripts per fellow during the fellowship. Twenty-two programs (71%) have fellows work on 1 to 2 projects at a time. Annually, 26 programs (84%) give 0 to 5 podium presentations, 24 (80%) present 0 to 5 posters, and 15 (48%) report 0 to 5 publications. Twenty-four programs (77%) have research fellows and/or assistants to help with research. The presence of dedicated research assistants and more than 25 annual fellowship program publications were found to be useful screening data for more than 2 and more than 4 average publications per fellow, respectively.ConclusionsThe research productivity of orthopaedic sports medicine fellowship programs may be an important consideration for applicants. Applicants who desire to be productive in research during their fellowship year should consider programs with dedicated research assistants and/or programs that publish more than 25 times annually.Clinical relevanceThis is a descriptive epidemiologic study that helps define the research productivity landscape in orthopaedic sports medicine fellowships. A more accurate understanding of sports medicine fellowship research experience may facilitate a better match between a program's research expectations and an applicant's research interests.
| S-EPMC8365224 | biostudies-literature
Project description:PurposeTo evaluate the process of applying to orthopaedic sports medicine fellowships from the applicant's perspective, with a focus on number of program applications, interviews, interview day importance, and financial burden.MethodsAn anonymous electronic survey was distributed to all orthopaedic surgery residents who applied to orthopaedic sports medicine fellowships in the United States in 2016 and 2017. The survey contained 26 questions, with 10 pertaining to applicant demographics, accolades, and examination scores. A follow up e-mail was distributed at 2 and 4 weeks to increase participation.ResultsThe survey was distributed to 453 sports medicine fellowship applicants; 148 (34.1%) completed the survey. Of the respondents, 130 (87.8%) were male and 18 (12.2%) were female. When analyzing United States Medical Licensing Examination scores, respondents who scored above a 251 on Step 2 CK were more likely to receive more than 20 interviews compared with those who scored lower (P = .013). Previous collegiate or professional athlete status did not influence the number of interviews received. In total, 94 of 147 (64.0%) respondents applied to more than 20 programs, and 73 respondents (49.7%) attended between 11 and 15 interviews. The majority of respondents spent between $4001 and $6000 (49; 33.1%) throughout the application process. Interaction with faculty and case volume/complexity were the most important factors in ranking programs.ConclusionsThe majority of orthopaedic surgery residents pursue at least 1 year of fellowship training following residency, with sports medicine being one of the most popular specialties. The application process for sports medicine fellowships is complex, competitive, and a financial burden for applicants. Most applicants apply to more than 20 programs, spend between $4000 and $6,000 over the course of the application process, and value faculty interaction and case volume/complexity over other factors associated with a program.Clinical relevanceAs other surgical fellowships have detailed their application process from the applicant's perspective, there remains a need for increased transparency of the sports medicine fellowship application in order to offer additional insight and guidance for future applicants.
| S-EPMC8128989 | biostudies-literature
Project description:PurposeTo quantify social media use of professional sports team physicians on popular platforms and analyze differences between users and nonusers.MethodsTeam physicians for professional sports teams in the National Football League, National Hockey League, Major League Baseball, and National Basketball Association were identified and characterized based on training background, practice setting, and geographic location. Rates of social media presence on Facebook, Twitter, LinkedIn, Instagram, and ResearchGate were determined. Differences between social media users and nonusers were analyzed.ResultsIn total, 505 professional team physicians were identified across 4 major professional sports; 64.6% of physicians were orthopaedic surgeons. Of 505 physicians, 65.7% had a social media presence. More specifically, 21.8% had a professional Facebook page, 22.6% a professional Twitter page, 52.1% a LinkedIn profile, 21.4% a ResearchGate profile, and 9.1% an Instagram account. Fellowship-trained physicians (P = .008) had greater odds of having a social media presence.ConclusionsNearly two-thirds of professional team physicians have a social media presence, most commonly LinkedIn. Fellowship training is a significant predictor of sports medicine physician social media presence. Sports league affiliation, training background, practice setting, and geographic location are unrelated to social media presence.Level of evidenceIV, cross-sectional study.
| S-EPMC7879189 | biostudies-literature
Project description:Over the last year, coronavirus disease 2019 (COVID-19) has spread across the world as a global pandemic, bringing unprecedented changes to the healthcare landscape for patients and physicians. Medical trainees have been similarly affected, as medical schools throughout the United States have implemented remote learning-based curriculums and withdrawn third- and fourth-year students from in-hospital clerkships. Of particular importance is the impact of COVID-19 on current orthopaedic surgery residents applying to subspecialty fellowship programs. Because of the highly transmissible nature of the virus and current social distancing restrictions, orthopaedic sports medicine fellowship interviews are being held virtually during the 2020-2021 application cycle. This transition to videoconference interviewing may de-emphasize an applicant's unique personality or interpersonal interactions that are traditionally captured in a variety of settings during the interview day. In turn, this may lead to increased prioritization of various aspects of the application, such as the applicant's residency program, letters of recommendation, and research productivity. Matching to a sports medicine fellowship program is an inherently competitive process and the COVID-19 pandemic presents novel challenges to orthopaedic residents in their efforts to successfully match. The purpose of this review is to describe the changes made to the orthopaedic sports medicine fellowship interview process resulting from COVID-19 during the 2020-2021 application cycle and discuss how these changes may impact the future fellowship application process. This review discusses the changes made to the orthopaedic sports medicine fellowship interview process caused by COVID-19 during the 2020-2021 application cycle. This review also assesses how such changes may impact the future application process and proposes potential adaptations to the current virtual interview format if it should become the new standard moving forward.
| S-EPMC8365211 | biostudies-literature
Project description:PurposeTo determine the objective characteristics of fellowship directors (FDs) in orthopaedic sports medicine by focusing on the demographics, academic background, institutional history, research experience, and professional affiliations of FDs in this field.MethodsData was collected for each FD via institutional biographies or publicly available curriculum vitae (CV). The data collected for each FD included age, gender, race/ethnicity, previous training institutions, residency and fellowship graduation years, additional advanced degrees, military affiliation, institutional loyalty, year hired by current institution, career timeline, Scopus H-index, number of publications, and total number of citations.ResultsOf the 88 FDs, 87 (98.9%) were male and 1 (1.1%) was female. The mean age for all FDs was 54.7 years (± 9.1 standard deviation). The majority of FDs were White (n = 80; 90.9%). The mean Scopus H-index, total number of publications, and total number of citations were 22.5 ± 16.6, 90.0 ± 91.6, and 2773.9 ± 3962.9, respectively. On average, it took 9.5 ± 7.3 years from fellowship graduation until FD appointment. Additionally, the mean number of years of employment or affiliation with the current institution was 17.2 ± 9.4, and the mean number of years in an FD role was 10.9 ± 9.3.ConclusionOrthopaedic sports medicine fellowship directors are largely distinguished by their high level of research productivity and accomplishment. Additionally, orthopaedic training pedigree seems to play a role in FD role attainment, with a handful of orthopaedic residency and sports medicine fellowship programs producing a large percentage of current FDs. Finally, FDs are overwhelmingly white males with little female or minority representation.Clinical relevanceThis study outlines some of the most important characteristics among orthopaedic sports medicine fellowship directors and identifies racial and gender disparities within this population of leaders that may have detrimental effects on the field as a whole.
| S-EPMC8551397 | biostudies-literature
Project description:BackgroundMost value-based care educational interventions teach knowledge of cost but fail to recognize the interrelatedness of the Accreditation Council for Graduate Medical Education (ACGME) competencies of medical knowledge, patient care, practice-based learning and improvement, and systems-based practice.ObjectiveWe analyzed the impact on clinical decision-making of an educational curriculum that incorporated the spectrum of ACGME competencies.MethodsFive didactic sessions for a gynecologic oncology fellowship were modified to incorporate cost- and value-based care considerations for each clinical topic addressed. After discussion, the group of fellows identified 1 high-value and 5 low-value practices to target for improvement. The fellows then undertook a chart audit of clinical decisions occurring for patients seen in the outpatient clinics. The frequency of low- and high-value practices was compared before and after the educational intervention.ResultsA total of 126 patients with a cervical cancer diagnosis were seen by participants in the outpatient setting during the entire observation period. After the intervention, the occurrence of 3 identified low-value practices was reduced by 13% to 33%, demonstrating modest effect sizes (effect size ϕ = 0.2-0.3). One high-value practice (smoking cessation counseling) increased 100% after a fellow-initiated quality improvement project was undertaken. Two low-value practices, including routine surveillance imaging, remained unchanged.ConclusionsOverlaying value-based concepts in didactic conference teaching resulted in measurable changes in decision-making behavior. Engaging learners in a subsequent, focused quality practice review served as a vital part of their educational experience and allowed us to assess learner competency in its practical application.
| S-EPMC6919189 | biostudies-literature
Project description:PurposeTo understand the perceptions of program directors (PDs) and fellowship applicants regarding the virtual interview process for orthopaedic surgery sports medicine fellowship programs.MethodsAn anonymous online survey was distributed through the American Orthopaedic Society for Sports Medicine (AOSSM) to applicants and PDs of orthopaedic surgery sports medicine fellowship programs following the 2020-2021 fellowship application cycle.ResultsA total of 40 responses were received from PDs for a response rate of 47% (40 of 85) and 72 responses were received from applicants for a response rate of 27% (72 of 271). All of the surveyed PDs (40/40, 100%) agreed/strongly agreed that the applicant's interview carries significant weight in determining where an applicant is ranked on the match list. Fifty-eight percent (23 of 40) of PDs agreed/strongly agreed that virtual interviews negatively affected their personal connection with the fellowship interviewee. The presence of virtual interviews allowed 80% (57 of 71) of applicants to go on more interviews. Seventy-three percent (51 of 70) of applicants were able to save greater than $5,000 on travel expenses and 63% (25 of 40) of fellowship programs were able to save greater than $2,500 by conducting virtual interviews.ConclusionsVirtual interviews allowed fellowship programs and applicants to complete more interviews, but both PDs and applicants stated that interviewing in-person was important for applicants to meet faculty and tour the institution where they may be spending a year. In contrast, significant financial savings resulted due to the transition to virtual interviews. Finally, both PDs and applicants were in favor of having the option of interviewing virtually, suggesting that virtual interviews may continue to play a role in future application cycles.Clinical relevanceThis study may be valuable to fellowship programs that will continue to implement virtual interviews into future application cycles.
| S-EPMC9042780 | biostudies-literature
Project description:PurposeThe purpose of this study was to examine how the implementation of Accreditation Council of Graduate Medical Education (ACGME) case minimums in 2013 has affected the number of shoulder and knee arthroscopies performed by orthopaedic surgery residents during their clinical training.MethodsThe ACGME orthopaedic surgery case log data from graduation years 2007 to 2019 was used to evaluate the number of shoulder and knee arthroscopies performed. The mean and median number of cases performed per resident were compared for the years prior to implementation of the ACGME case minimum (2007-2012) and after (2013-2019).ResultsThe ACGME orthopaedic surgery case minimums resulted in a significant decrease in the mean number of shoulder and knee arthroscopies performed. The mean number of shoulder arthroscopies performed in the years before and after the case minimum requirement were 109.8 and 82.0 (P = .025), respectively. The mean number of knee arthroscopies performed in the years before and after the case minimum requirement were 178.6 and 124.8 (P = .006), respectively. Residents in the tenth percentile of cases performed still met the required ACGME case minimums each year. The mean total of all cases performed in the years before and after the case minimum requirement were 2045.5 and 1699.3 (P = .038), respectively.ConclusionsThe number of shoulder and knee arthroscopies performed by orthopaedic surgery residents significantly decreased after the implementation of ACGME case minimums, which may be due to underreporting of cases.Clinical relevanceThis study may demonstrate the effect of the implementation of the ACGME case minimums on the number of shoulder and knee arthroscopies performed by orthopaedic surgery residents.
| S-EPMC8220617 | biostudies-literature