Characteristics of Orthopaedic Sports Medicine Fellowship Directors

Background: No study in the orthopaedic literature has analyzed the demographic characteristics or surgical training of sports medicine fellowship directors (FDs). Objective determinations as to what makes a physician qualified for this leadership position remain unclear; thus, it is important to identify these qualities as future physicians look to fill these roles. Purpose: To illustrate characteristics common among sports medicine FDs. Study Design: Cross-sectional study. Methods: The 2020 Accreditation Council for Graduate Medical Education Fellowship Directory was used to identify the FDs for all orthopaedic sports medicine fellowship programs in the United States. The characteristics and educational background data for FDs were gathered by 2 independent reviewers from up-to-date curricula vitarum, Web of Science, and institutional biographies and consolidated into 1 database. Data points gathered included age, sex, residency/fellowship training location and graduation year, name of current institution, length of time at current institution, time since training completion until being appointed FD, length of time in current FD role, and personal research H-index. Results: We identified 90 current orthopaedic sports medicine FDs. The mean Scopus H-index was 24.1 (median, 17). The mean age of FDs was 55.4 years; 87 of 90 (96.7%) were male and 3 (3.3%) were female; and 79/90 (87.8%) were White and 3/90 (3.3%) were African-American. The mean time to complete residency was 5.1 years (range, 5.0-6.0 years), and the most attended residency programs were the Hospital for Special Surgery (n = 9), the Harvard Combined Orthopaedic Residency Program (n = 5), and Duke University Medical Center (n = 4). The mean time required to complete a fellowship was 1.1 years (range, 1.0-2.0 years), and the fellowship programs that produced the most future FDs were the American Sports Medicine Institute (n = 11), the Steadman Hawkins Clinic (Vail) (n = 8), the Kerlan-Jobe Orthopaedic Clinic (n = 7), and the Hospital for Special Surgery (n = 7). The mean time from completion of fellowship to appointment as a FD was 12.8 years (range, 1-39 years). Conclusion: Women and minority groups are largely underrepresented among leadership positions in the field of orthopaedic sports medicine.

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Research Productivity of Foot and Ankle Fellowship Faculty

Foot & Ankle Specialist ◽

10.1177/1938640020970101 ◽

2020 ◽

pp. 193864002097010

Author(s):

Nathan Sherman ◽

Nathaniel Bridge ◽

Ansab Khwaja ◽

Peter Du ◽

Lisa Truchan

Keyword(s):

Research Productivity ◽

The United States ◽

Publication Productivity ◽

Foot And Ankle ◽

Level Of Evidence ◽

H Index ◽

Ankle Surgery ◽

Fellowship Programs ◽

The Mean ◽

Number Of Publications

Background Contribution to literature is critical for progress in the field of orthopaedics. No previous study has yet examined the academic productivity of foot and ankle surgery fellowship faculty. Purpose To evaluate the publishing productivity of foot and ankle fellowship faculty. Methods Faculty and program characteristics of orthopaedic foot and ankle fellowship programs across the United States and Canada were collected from American Orthopaedic Foot and Ankle Society (AOFAS) and program websites. Faculty publication productivity measures, including publications, number of publications in specific journals, number of citations, and Hirsch index (h-index) were gathered using the Scopus database. Results A total of 48 AOFAS foot and ankle surgery fellowship programs were identified with an associated 185 faculty members. The mean number of publications per faculty member was 44.9 (SD = 53.0; range = 0-323), with a mean h-index of 11.9 (SD = 10.6; range = 0-54). A total of 144 (77.8%) academic-affiliated faculty had a significantly greater number of publications ( P < .01), total citations ( P < .05), and publications in Foot and Ankle International ( P < .05), Journal of Bone and Joint Surgery ( P < .05), Clinical Orthopaedics and Related Research ( P < .05), and Journal of the American Academy of Orthopaedic Surgeons ( P < .05) compared to the 41 (22.2%) nonacademic faculty. There were no significant differences between measures of publication productivity between male and female faculty, except for maximum citations in a single article (67.1 vs 142.3; P < .05). Conclusions Academic-affiliated foot and ankle fellowship faculty have higher research productivity than nonacademic surgeons. The mean h-index of foot and ankle fellowship faculty was 11.9, which is lower than that reported in sports, joints, and spine fellowship faculty but higher than that reported for hand fellowship faculty. Level of Evidence: Level IV

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Foot and Ankle Fellowship Faculty Research Productivity

Foot & Ankle Orthopaedics ◽

10.1177/2473011420s00287 ◽

2020 ◽

Vol 5 (4) ◽

pp. 2473011420S0028

Author(s):

Ansab M. Khwaja ◽

Nathaniel Bridge ◽

Nathan Sherman ◽

Peter Z. Du

Keyword(s):

The United States ◽

Faculty Members ◽

Academic Productivity ◽

Foot And Ankle ◽

H Index ◽

Ankle Surgery ◽

Fellowship Programs ◽

The Mean ◽

Program Characteristics ◽

Number Of Publications

Category: Other Introduction/Purpose: Academic productivity within orthopaedic subspecialties is important in developing generalizable knowledge, challenging biases, and evolving practice management. Productivity is linked to academic status and can affect compensation. This study evaluated the research activity of faculty at foot and ankle surgery fellowship programs in the United States and associated Canadian programs. The primary objective was to describe the publishing productivity of American Orthopaedic Foot & Ankle Society (AOFAS) fellowship faculty. Methods: Program characteristics from orthopaedic foot and ankle fellowship programs across the United States and Canada were collected from AOFAS and each program’s respective websites. The studied faculty characteristics consisted of years in practice, academic rank, extent of training, and gender. Specific program characteristics were recorded, including Accreditation Council for Graduate Medical Education approval, academic affiliation, fellow research requirement, number of fellows, number of associated faculty members. Data analysis of faculty productivity (Publications, number of publications in specific journals, number of citations, and Hirsch index [h index]) was gathered using the Scopus database. Results: A total of 48 AOFAS foot and ankle surgery fellowship programs were identified with an associated 185 faculty members. The mean number of publications per faculty member was 44.9 (sd 53.0; range 0-323) with a mean h-index of 11.9 (sd 10.6; range 0-54). One-hundred and forty-four (77.8%) academic-affiliated faculty had a significantly greater number of publications (p<0.01), total citations (p<0.05), and publications in FAI (p<0.05), JBJS (p<0.05), CORR (p<0.05), and JAAOS (p<0.05) compared to the 41 (22.2%) nonacademic faculty. Nonacademic faculty maintained a h-index of 9.5 (95% CI 7-12), while academic faculty had a h-index of 12.6 (95% CI 11-14), which did not meet statistical significance (p=0.062). There were no significant differences between measures of publication productivity in male and female faculty, except for maximum citations in a single paper (67.1 vs 142.3; p<0.05) Conclusion: Academic-affiliated foot and ankle fellowship faculty have higher research productivity than non-academic surgeons. The mean h-index of foot and ankle fellowship faculty was 11.9, which is lower than that reported in sports, joints, and spine fellowship faculty but higher than that reported for hand fellowship faculty. The analyses presented can aid foot and ankle surgeons in assessing their academic productivity. [Table: see text]

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Unverifiable Academic Work by Applicants to Primary Care Sports Medicine Fellowship Programs in the United States

Journal of Graduate Medical Education ◽

10.4300/jgme-d-16-00059.1 ◽

2016 ◽

Vol 8 (5) ◽

pp. 767-770

Author(s):

Robert B. Stevens ◽

John R. Hatzenbuehler ◽

William W. Dexter ◽

Amy E. Haskins ◽

Christina T. Holt

Keyword(s):

United States ◽

Primary Care ◽

Sports Medicine ◽

The United States ◽

Medical Society ◽

Medical Librarian ◽

Conference Organization ◽

Fellowship Programs ◽

Medical Subspecialty ◽

Application Requirements

ABSTRACT Background In 2008, it was shown that 11% of applications to a primary care sports medicine program contained unverifiable citations for publications. In 2009, the American Medical Society for Sports Medicine changed the application requirements, requiring proof that all claimed citations (publications and presentations) be included with the fellowship application. Objective We determined the rate of unverifiable academic citations in applications to primary care sports medicine fellowship programs after proof of citations was required. Methods We retrospectively examined all applications submitted to 5 primary care sports medicine fellowship programs across the country for 3 academic years (2010–2013), out of 108 to 131 programs per year. For claimed citations that did not include proof of publication or presentation, we attempted to verify them using PubMed and Google Scholar searches, a medical librarian search, and finally directly contacting the publisher or sponsoring conference organization for verification. Results Fifteen of 311 applications contained at least 1 unverifiable citation. The total unverifiable rate was 4.8% (15 of 311) for publications and 11% (9 of 85) for presentations. These rates were lower than previously published within the same medical subspecialty. Conclusions After requiring proof of publication and presentation citations within applications to primary care sports medicine fellowship programs, unverifiable citations persisted but were less than previously reported.

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Outcomes in the Orthopaedic Sports Medicine Fellowship Match, 2010-2017

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967118771845 ◽

2018 ◽

Vol 6 (5) ◽

pp. 232596711877184 ◽

Cited By ~ 1

Author(s):

Mary K. Mulcahey ◽

Meghan K. Hayes ◽

Christopher M. Smith ◽

Matthew J. Kraeutler ◽

Jeffrey D. Trojan ◽

...

Keyword(s):

Sports Medicine ◽

Cross Sectional Study ◽

Fellowship Program ◽

Cross Sectional ◽

Match Process ◽

Match Rate ◽

Fellowship Programs ◽

The Mean ◽

Orthopaedic Society ◽

American Orthopaedic

Background: Sports medicine is one of the most competitive fellowships in orthopaedic surgery. Despite its popularity, fellowship applicants have limited understanding of the orthopaedic sports medicine fellowship match process. Purpose: To define key outcomes in the orthopaedic sports medicine fellowship match, including the overall match rate, number of programs filled, and number of applicants ranked by programs that filled between 2010 and 2017. Study Design: Cross-sectional study. Methods: This study utilized data regarding the orthopaedic sports medicine fellowship match collected by the American Orthopaedic Society for Sports Medicine (AOSSM) from 2010 through 2017. Applicant data included number of applicants, number of matched and unmatched applicants, and percentage of applicants matching into their top choices. Fellowship program data included number of programs participating in the match and number of applicants ranked by filled and unfilled programs. Results: Between 2010 and 2017, the mean number of orthopaedic sports medicine fellowship applicants was 244.8. On average, 92.0% of applicants matched into a fellowship program. The mean number of programs participating in the fellowship match was 92.9, with a mean of 219.9 accredited positions and 5.4 nonaccredited positions. Over the time period studied, a mean of 75.8% of programs matched all available positions. Programs that matched fully ranked 9.0 applicants per position, on average, compared with a mean of 6.5 applicants ranked per position among programs that did not fully match ( P = .0016). Conclusion: From 2010 to 2017, the number of applicants, positions available, overall match rate, and number of programs participating in the orthopaedic sports medicine fellowship match have remained consistent. The mean number of applicants per position ranked by fully matched fellowship programs was 9.0 compared with a mean of 6.5 applicants per position ranked by programs that did not fully match. These data may be helpful as we look to the future of orthopaedic sports medicine fellowship positions and the match process. In addition, this study reveals characteristics that divide sports medicine fellowship programs that fully match from those that do not. Applicants and/or fellowship program directors may utilize this information to modify their approach to the match process going forward.

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The Academic General Pediatrician: Is the Species Still Endangered?

PEDIATRICS ◽

10.1542/peds.104.s1.137 ◽

1999 ◽

Vol 104 (Supplement_1) ◽

pp. 137-142 ◽

Cited By ~ 1

Author(s):

Robert J. Haggerty ◽

Sydney A. Sutherland

Keyword(s):

United States ◽

Clinical Care ◽

Development Program ◽

Medical Schools ◽

The United States ◽

Direct Patient Care ◽

Full Time ◽

General Pediatrician ◽

Fellowship Programs ◽

The Mean

Objective. To determine the careers of graduates of the General Pediatrics Academic Development Program (GPADP) and the pediatricians from the Clinical Scholars (CS) Program 8 to 16 years after completion of their fellowship to assess the current state of the academic general pediatrician and to determine the current activities of divisions of General Pediatrics in US medical schools. Design. Analysis of questionnaire data from former fellows of the two programs, who trained during the years 1978 to 1988, as well as of data from questionnaires to all divisions of General Pediatrics (or their equivalent) in all medical schools in the United States. Population. Surveys were conducted of the 111 graduates of the GPADP and the 39 pediatricians from the CS program and all 127 US medical schools. Results. Of the 111 GPADP graduates, 101 were located, and 85 completed the questionnaire. Of 39 CS graduates, 36 were located, of whom 27 completed the questionnaire. Similarities were found between the two groups in percent being in academic positions (74%, GPADP vs 70.4%, CS), percent having achieved tenure (17.8%, GPADP vs 14.3%, CS), and percent of time spent in research (17%, GPADP vs 25%, CS). Considerable differences, however, were found in percent of time spent in direct patient care (35.7% time for GPADP and only 17.8% time for CS) and in direct teaching (25.1% time for GPADP and only 17.6% time for CS). The mean number of articles published was greater among CS professionals (21.4 vs 14 for GPADP, but not statistically significant), as was the mean number of research grants (6.75 by CS vs 4.02 by GPADP). The GPADP fellows had obtained more education grants and more service grants. Both groups were concerned about the lack of time and support for research. Few General Pediatrics divisions had ongoing academic fellowship programs. The current number of new fellows by divisions of General Pediatrics who are educated to do research is small. Only 30 related programs exist in all the medical schools in the United States. However, large divisions of General Pediatrics, responsible for large teaching and clinical service programs, are now in place in the majority of medical schools. This represents progress since 1978, when few generalists were in full-time academia. Conclusion. More than two thirds of both the GPADP graduates and CS professionals are now in academic departments. They have had modest success in obtaining grants, publishing articles, and achieving tenure, but large teaching and service demands and lack of research funds have made it difficult for both groups to be as productive in research as originally hoped. The field of Academic General Pediatrics now is established. It is the responsibility of graduates of these and similar programs to produce creative research and expand fellowship programs, as well as to do good clinical care, if a vigorous field of Academic General Pediatrics is to be achieved.

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Tamsulosin for treatment of unilateral distal ureterolithiasis: a systematic review and metaanalysis

CJEM ◽

10.2310/8000.2013.131012 ◽

2014 ◽

Vol 16 (03) ◽

pp. 229-242 ◽

Cited By ~ 6

Author(s):

Christian Malo ◽

Jean-Sébastien Audette-Côté ◽

Marcel Émond ◽

Alexis F. Turgeon

Keyword(s):

Systematic Review ◽

Data Extraction ◽

Meta Analysis ◽

Random Effect ◽

The United States ◽

Expulsion Rate ◽

Relative Risks ◽

The Mean ◽

Mean Time ◽

Random Effect Models

ABSTRACT Objectives: The lifetime prevalence of ureterolithiasis is approximately 13% for men and 7% for women in the United States. Tamsulosin, an α-antagonist, has been used as therapy to facilitate the expulsion of lithiasis. Whether it is a good treatment for distal lithiasis remains controversial. We conducted a systematic review and meta-analysis to evaluate the effect of tamsulosin on the passage of distal ureterolithiasis. Methods: A systematic search was conducted using MEDLINE, EMBASE, and Cochrane Central. Trial eligibility was evaluated by two investigators. All randomized controlled trials (RCTs) comparing tamsulosin to standard therapy or placebo for the treatment of a single distal ureterolithiasis ≤ 10 mm in adult patients with renal colic confirmed by radiographic imaging were included. Data extraction was conducted in duplicate. Primary outcome was the expulsion rate, and secondary outcomes were the mean time for ureterolithiasis expulsion, analgesic requirements, and side effects. Mantel-Haenszel random effect models were used, and heterogeneity was assessed using I2 statistics. Data were presented with relative risks (RRs). Results: The search strategy identified 685 articles, of which 22 studies were included. Combined results suggested a benefit for the expulsion of ureterolithiasis (≥ 10 mm) when tamsulosin was used compared to a standard treatment (RR 1.50 [95% CI 1.31–1.71], I2 = 70%). A decrease in the average time of expulsion of the ureterolithiasis of 3.33 days in favour of tamsulosin was observed (95% CI −4.23, −2.44], I2 = 67%). Conclusion: Tamsulosin increases the rate of spontaneous passage of distal ureterolithiasis (≤ 10 mm).

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The Cost Variability of Orthobiologics

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738119880256 ◽

2019 ◽

Vol 12 (1) ◽

pp. 94-98

Author(s):

Amit Mukesh Momaya ◽

Andrew Sullivan McGee ◽

Alexander R. Dombrowsky ◽

Alan Joshua Wild ◽

Naqeeb M. Faroqui ◽

...

Keyword(s):

United States ◽

Sports Medicine ◽

Platelet Rich Plasma ◽

Treatment Options ◽

The United States ◽

Median Income ◽

Level Of Evidence ◽

Significant Variability ◽

The Mean ◽

The Cost

Background: Mixed results exist regarding the benefit of orthobiologic injections. The purpose of this study was to assess the variability in costs for platelet-rich plasma (PRP) and stem cell (SC) injections and evaluate for variables that influence pricing. Hypothesis: There will be significant variability in the cost of PRP and SC injections throughout the United States. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Methods: Calls were made to 1345 orthopaedic sports medicine practices across the United States inquiring into the availability of PRP or SC knee injections and associated costs. In addition to pricing, the practice type, number of providers, and population and income demographics were recorded. Univariate statistical analyses were used to identify differences in availability and cost between variables. Results: Of the contacted offices that provided information on both PRP and SC availability (n = 1325), 268 (20.2%) offered both treatments, 550 (41.5%) offered only PRP injections, 20 (1.5%) offered only SC injections, and 487 (36.8%) did not offer either treatment. The mean ± SD cost of a PRP injection was $707 ± $388 (range, $175-$4973), and the mean cost of an SC injection was $2728 ± $1584 (range, $300-$12,000). Practices offering PRP and SC injections tended to be larger (PRP, 12.0 physicians per practice vs. 8.1 [ P < 0.001]; SC, 13.6 vs 9.7 [ P < 0.001]). Practices that offered PRP injections were located in areas with higher median household income ( P = 0.047). Variables associated with higher cost of PRP injections included city population ( P < 0.001) and median income of residents ( P < 0.001). Conclusion: While the majority of sports medicine practices across the United States offer some type of orthobiologic injection, there exists significant variability in the cost of these injections. Clinical Relevance: This study demonstrates the significant variability in costs of orthobiologic injections throughout the country, which will allow sports medicine physicians to appreciate the value of these injections when counseling patients on available treatment options.

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The Comparison of Postoperative Outcomes Open and Closed Reduction for Patellar Fractures

The Journal of Knee Surgery ◽

10.1055/s-0038-1676515 ◽

2018 ◽

Vol 33 (01) ◽

pp. 073-077

Author(s):

Si Young Lee ◽

Jun Young Choi ◽

Hyun Il Lee ◽

Jung Min Lee ◽

Jin Ho Cho

Keyword(s):

Surgical Treatment ◽

Closed Reduction ◽

Open Reduction ◽

Visual Analog Scale Score ◽

Significant Difference ◽

Special Surgery ◽

The Mean ◽

Patellar Fractures ◽

Postoperative Knee ◽

Hospital For Special Surgery

AbstractPatellar fractures account for approximately 1% of all human body fractures. This study aimed to compare the surgical outcomes of open reduction and closed reduction for patellar fractures. This retrospective study included 62 patients (63 cases) who underwent surgical treatment of patellar fractures from 2008 to 2013. Of the 63 cases, open and closed reductions were performed in 42 and 21 cases, respectively. Plain radiography was used to assess fracture healing. Comminuted patellar fracture was the most common fracture type in both groups. Tension band wiring and cannulated screw fixation were mainly used in the open and closed reduction groups, respectively. There was no significant difference in the modified hospital for special surgery score, visual analog scale score for pain, and range of motion between the two groups. The mean union time was 3.2 and 3.0 months in open and closed reductions, respectively. Postoperative knee stiffness was noted in five cases of open reduction and in three cases of closed reduction. One patient in the open reduction group had a refracture. There were no notable differences in treatment outcomes between open and closed reductions. Thus, closed reduction may not be inferior to open reduction as a surgical treatment for patellar fractures.

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Orthopaedic Sports Medicine Fellowship Interviews: Structure and Organization of the Interview Day

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967117741276 ◽

2017 ◽

Vol 5 (12) ◽

pp. 232596711774127 ◽

Cited By ~ 4

Author(s):

Brett D. Haislup ◽

Matthew J. Kraeutler ◽

Rishi Baweja ◽

Eric C. McCarty ◽

Mary K. Mulcahey

Keyword(s):

Sports Medicine ◽

Selection Process ◽

The United States ◽

Cross Sectional Study ◽

Average Score ◽

Cross Sectional ◽

Individual Interviews ◽

Fellowship Programs ◽

Orthopaedic Society

Background: Over the past few decades, there has been a trend toward an increasing subspecialization in orthopaedic surgery, with orthopaedic sports medicine being one of the most competitive subspecialties. Information regarding the application and interview process for sports medicine fellowships is currently lacking. Purpose: To survey orthopaedic sports medicine fellowship program directors (PDs) to better define the structure of the sports medicine fellowship interview and to highlight important factors that PDs consider in selecting fellows. Study Design: Cross-sectional study. Methods: A complete list of accredited programs was obtained from the American Orthopaedic Society for Sports Medicine (AOSSM) website. An anonymous survey was distributed to fellowship PDs of all Accreditation Council for Graduate Medical Education (ACGME)–accredited orthopaedic sports medicine fellowships in the United States. The survey included 12 questions about the fellowship interview and selection process. Results: Of the 95 orthopaedic sports medicine fellowship PDs surveyed, 38 (40%) responded. Of these, 16 (42.1%) indicated that they interview between 21 and 30 applicants per year. Eleven of the 38 fellowship programs (28.9%) have only 1 fellow per year at their respective program. Most programs (27/37, 73%) reported that between 0 and 5 faculty members interview applicants, and 29 of the 38 programs (76.3%) arrange for applicants to have ≥4 interviews during their interview day. Large group interviews are conducted at 36 of 38 (94.7%) sports medicine fellowship programs, and most programs (24/38, 63.2%) hold individual interviews that last between 5 and 15 minutes. The most important applicant criterion taken into account by PDs was the quality of the interview, with an average score of 8.68 of 10. Conclusion: The most significant factor taken into account by PDs when deciding how to rank applicants was the quality of the interview. Many orthopaedic sports medicine fellowship programs interview between 21 and 30 applicants per year, with each applicant participating in an average of 2 to 4 individual interviews per interview day and interviews commonly lasting between 5 and 15 minutes.

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Outcomes of Open Subacromial Decompression after Failed Arthroscopic Acromioplasty

ISRN Surgery ◽

10.5402/2012/806843 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Anand Pillai ◽

Vivek Eranki ◽

Joby Malal ◽

Gavin Nimon

Keyword(s):

New York ◽

Expected Improvement ◽

Functional Evaluation ◽

Subacromial Decompression ◽

Special Surgery ◽

Shoulder Scores ◽

The Mean ◽

Marginal Improvement ◽

Second Chance ◽

Hospital For Special Surgery

Aim. To prospectively assess the effectiveness of revision with open subacromial decompression in patients who had a previous unsatisfactory outcome with the arthroscopic procedure. Methods. 11 patients were identified for the study, who did not demonstrate expected improvement in symptoms after arthroscopic acromioplasty. All patients underwent structured rehabilitation. Functional evaluation was conducted using the Hospital for Special Surgery, New York, shoulder rating questionnaire. Results. M : F was 7 : 4. The mean age was 57 years. The average shoulder score improved from 49.6 preoperatively to 56 postoperatively at an average followup of 16 months. Two patients showed deterioration in their shoulder scores after revision while the rest showed only marginal improvement. All except one patient stated that they would opt for surgery again if given a second chance. Conclusion. In the group of patients that fail to benefit from the arthroscopic decompression, only a marginal improvement was noted after revision with open decompression.

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