Curriculum

Educational Curriculum
During the first two to three months, you will be responsible for completing a list of educational clinical objectives. The remainder of the curriculum is driven by patient-care issues and guided by the supervising consultants. Consultants will regularly refer you to articles and reference books to obtain information relevant to the care of patients.

Formal instruction in musculoskeletal ultrasound is also available to interested fellows, who will work with Dr. Jay Smith for this training.  Dr. Smith has established a curriculum for interested fellows to acquire basic skills in musculoskeletal ultrasound, including interventional techniques.

A full sports medicine library is located within the Sports Medicine Center to complement the learning experience. This library is stocked with the latest sports medicine texts and instructional videos, as well as models to practice peripheral injection techniques.  In addition, you will have full access to the Mayo Medical Libraries, including over 1000 electronic journals and sophisticated literature search capabilities.

Finally, the curriculum includes a wide variety of complementary educational experiences as outlined below.

Clinical Training
sports related injuries or musculoskeletal problems that adversely affect a patient's ability to exercise or maintain general fitness. The focus will be primarily musculoskeletal, although all aspects of a general sports medicine practice will be encountered (i.e. exercise physiology, neurology, endocrinology, pulmonary and other medical aspects of sports). These patients will be seen in the Sports Medicine Center from 8 a.m. to 5:30 p.m., Monday through Friday.

You will rotate with Physical Medicine & Rehabilitation (PM&R) and orthopedic consultants during the first two to three months of the fellowship. During that time, you will be introduced to procedures of the Sports Medicine Center and Mayo Clinic in general.  You will see patients of the consultant with whom you are rotating. The consultant will review the history and physical exam findings and see the patient with you. You will receive instruction on obtaining pertinent history of sports injuries, physical exam findings and techniques, and in the use and interpretation of appropriate diagnostic imaging and related testing.

• Indications for operative and nonoperative treatment of injuries
• Appropriate use of modalities and scientific rationale
• Prescription of targeted stretching techniques
• Prescription of specific strengthening techniques
  - Isometric, isotonic, isokinetic, etc.
  - Concentric/eccentric
  - Open kinetic chain/closed kinetic chain
• Proprioceptive/Neuromuscular control retraining
• Principles of functional progression
  - Treatment plan modification
  - Return to play criteria
• Indications for additional objective testing (i.e. KT2000, Cybex, gait analysis, etc.)
• Prescription of various orthoses
• Appropriate use of diagnostic/therapeutic injections pertinent to sports-related injury
• Use of ultrasound for diagnosis of musculoskeletal conditions
• Ultrasound-guided injections

You will also learn the appropriate indications for consulting with our sports psychology counselor (and through this interaction, the psychological impact of sports injuries), nutritionist, and other medical and surgical specialists.

You also will participate in:

• Coverage of area high school football games
• Multi-team local tournaments
• National and regional sporting events which regularly occur in Rochester
• The annual Med-city Marathon
• Pre-participation examinations of local high school students and Rochester Community and Technical College
• High school wrestling weight certification

Rotations
The majority of your time will be spent in the Sports Medicine Center. After the first three months, you may participate in various electives such as:

• Hand Clinic
• Foot Clinic
• Manual Medicine Clinic
• Movement Disorder Clinic
• Pain Clinic
• Musculoskeletal Clinic
• Radiology
• Spine Center
• Arthritis Clinic
• Sports Medicine Orthopedics (rotate with the orthopedic sports medicine specialists)
• Peripheral Injection Clinic
• Rotation with a physical therapist

Didactic Training
A weekly sports medicine conference occurs each Friday morning.  The format of this conference is typically case presentations, in which cases are presented and discussed by various Sports Medicine Center staff, including the fellow.  Sport Medicine Center journal club will occur quarterly in place of case conferences.  The fellow is responsible for the organization of the cases conferences as well as the Sports Medicine Center Journal Clubs.   

During the day-to-day activities of the fellowship, the fellow directly interacts with Sports Medicine Center staff, including supervising physicians, physical therapists, and athletic trainers. 

The fellow is also invited to attend monthly Sports Medicine Center rehabilitation discussion group, during which physicians, therapists, and athletic trainers meet to specifically discuss one or more aspects of sports rehabilitation.

In addition to the above, the Sports Medicine Fellow is provided with the following educational opportunities:

• PM&R Department Journal Clubs.   Musculoskeletal topics are covered at Journal Club on a monthly basis. 
• Weekly PM&R departmental educational conferences, each Friday at noon.
• Department of Orthopedic Surgery's Grand Rounds each Monday AM, during which general orthopedic topics are discussed.
• Participation as a teaching assistant during the PM&R Residency program's musculoskeletal physical examination skills course.
• Teaching of medical students and residents from the departments of PM&R, Internal Medicine, Family Medicine, Pediatrics, and Rheumatology who rotate through the Sports Medicine Center.
• Teaching learning objectives to PM&R residents weekly (after the first three months)
• Community teaching activities, such as lecturing at the local athletic clubs.

Research Training
You may participate in a research training course for clinicians, which is coordinated through the Center for Patient Oriented Research (CPOR) at the Mayo Clinic. This is typically scheduled in the fall.

Call Frequency
There is no call schedule. However, you are required to participate in sporting event coverage and pre-participation examinations as previously described. As implied, many of these activities will occur outside of normal working hours. However, all of your patient care duties, including athletic coverage, will not exceed the 80-hour/week limit.

Committee Assignments
You will sit on both the Research and Education Committees at the Sports Medicine Center.