ACGME Sports Medicine Fellowships with Interventional Spine?

[JBM16BYU]

Hello,

I am looking for a comprehensive list of all of the ACGME-accredited sports medicine fellowships that have fluoroscopic interventional spine training built into them. I am already aware that most of the PM&R sports programs do, as well as a few family-run sports programs (ex. Utah, JPS, East Carolinas, Swedish, & Prisma Greenville). Which programs am I missing on this list?

Thanks!

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[Kissmyabjj]

I have been able to do lumbar fluoroscopic procedures throughout my fellowship, but I set the time up myself with a physician affiliated with the hospital network. I think it is a reasonable thing to ask for as an incoming fellow, especially if you have a PM&R background or already have some experience with fluoro.

 

[TheGreatestTrochanter]

Hello,

I am looking for a comprehensive list of all of the ACGME-accredited sports medicine fellowships that have fluoroscopic interventional spine training built into them. I am already aware that most of the PM&R sports programs do, as well as a few family-run sports programs (ex. Utah, JPS, East Carolinas, Swedish, & Prisma Greenville). Which programs am I missing on this list?

Thanks!

I don't believe that such a list exists.

Most (not all) of the PM&R programs have interventional spine as part of the training. (Mayo, Stanford, UC Davis for example don't)
The majority of the FM programs I talked to that would take PM&R applicants stated that they could find a way for you to get spine procedures if you wanted. If that is important to you, I would see if they have had a PM&R-trained fellow do this in the past to see if it is actually feasible and if the training is adequate. With some of the programs I spoke with at the AMSSM fellowship fair it sounded as if "yeah we have people that do spine injections at our health system, so I am sure you can inject with them". If that is an important attribute for your fellowship, those aren't the programs that will give you the best fit, I would stick to PM&R fellowships, and FM that have a dedicated PM&R track.

 

[JBM16BYU]

I don't believe that such a list exists.

Most (not all) of the PM&R programs have interventional spine as part of the training. (Mayo, Stanford, UC Davis for example don't)
The majority of the FM programs I talked to that would take PM&R applicants stated that they could find a way for you to get spine procedures if you wanted. If that is important to you, I would see if they have had a PM&R-trained fellow do this in the past to see if it is actually feasible and if the training is adequate. With some of the programs I spoke with at the AMSSM fellowship fair it sounded as if "yeah we have people that do spine injections at our health system, so I am sure you can inject with them". If that is an important attribute for your fellowship, those aren't the programs that will give you the best fit, I would stick to PM&R fellowships, and FM that have a dedicated PM&R track.

Thank you for this information. As a follow up, do you happen to know programs that have a dedicated PM&R track besides Utah, JPS, Swedish and Prisma Greenville?

 

[runfastnow]

To answer your question - very program specific. The Penn PM&R sports fellowship also offers spine built into the program (but not for the FM/IM spot). However, you should talk with previous fellows if possible to see what the true experience is. Some programs will "get you exposure" that is random, scattered days for the whole year while others will make a true effort to accommodate your interests and make you as competent as possible at the spine procedures the attendings do themselves.

 

[TheGreatestTrochanter]

Thank you for this information. As a follow up, do you happen to know programs that have a dedicated PM&R track besides Utah, JPS, Swedish and Prisma Greenville?

Only other one I know for sure is Cleveland clinic, Iowa will get you spine if you are PM&R. I had not heard of Prisma Greenville so you already know more than me! I think the above poster is spot on, "exposure" can be promised by many, which could mean shadowing a few days for a couple months. Very different than exposure that will make you competent. Good luck! Hard to get info for many of these fellowships.

 

[Reboa]

As a family medicine fellow ate the opportunities available and is it feasible to do interventional spine?

 

[deleted87716]

As a family medicine fellow ate [sic] the opportunities available and is it feasible to do interventional spine?

No. That's a surgical subspecialty.

 

[VA Hopeful Dr]

No. That's a surgical subspecialty.

FM can now do pain management fellowships which if we're comparing to image-guided injections seems like it might fall under the category of interventional spine.

 

[runfastnow]

As a family medicine fellow ate the opportunities available and is it feasible to do interventional spine?

Without having any spine (management, procedures, EMG, MRI interpretation) experience as a FM resident (assuming this is the case) it would be hard to progress from ground zero to appropriate of patient selection, decision trees for second and third procedures, and the performing of the various procedures in one year without substantial (likely a minimum of 1 full day per week of only spine clinic/procedures) time on the subject which could be detrimental the other aspects of a sports fellowship. Most PM&R and anesthesia residents have a fair amount of experience (2-3+ months) of dedicated spine/pain rotations before moving into fellowships and developing skills.

It would not be impossible though. Would just need to dedicate significant time and then find practice/health system that would grant privileges. ,

 

[timisdaman]

Without having any spine (management, procedures, EMG, MRI interpretation) experience as a FM resident (assuming this is the case) it would be hard to progress from ground zero to appropriate of patient selection, decision trees for second and third procedures, and the performing of the various procedures in one year without substantial (likely a minimum of 1 full day per week of only spine clinic/procedures) time on the subject which could be detrimental the other aspects of a sports fellowship. Most PM&R and anesthesia residents have a fair amount of experience (2-3+ months) of dedicated spine/pain rotations before moving into fellowships and developing skills.

It would not be impossible though. Would just need to dedicate significant time and then find practice/health system that would grant privileges. ,

Yup. If you want to do interventional spine, and you did a primary care residency, then you need a LOT of spine experience in fellowship - which would take away from your other MSK education.

 

[crunchymedicine]

As a family medicine fellow ate the opportunities available and is it feasible to do interventional spine?

Yes, especially if the fellowships go to 2 years. But you may also want to look at the NASS MSK fellowships which is functionally a sports and spine fellowship.

 

[TableMD]

I saw this on the fellowship and just Felt I had too many other fish to fry with what I wanted to get done during what is an otherwise very busy and intense year. Im not sure this makes sense for a nonPMR to do this, However perhaps a second fellowship that is just interventional spine wouldn’t make sense?

 

[runfastnow]

I saw this on the fellowship and just Felt I had too many other fish to fry with what I wanted to get done during what is an otherwise very busy and intense year. Im not sure this makes sense for a nonPMR to do this, However perhaps a second fellowship that is just interventional spine wouldn’t make sense?

Depends on what you want to do. It can be very hard to keep a balanced practice once people know you are "the back guy/gal". I did a fellowship with sports+spine and my practice is probably 60% spine/pain medicine related issues (which I am trying to keep in the 50-70% range). I'm happy with that right now, but can certainly see why people get burned out on it and only want to do "real" sports medicine (or only see back pain/radiculopathy in athletes or young/healthy people).

If you are not PM&R coming into fellowship and want to have a primary care FM/IM, sports, and spine practice then I don't see how you reasonably could accomplish all three. Perhaps if you knew you would have access/privileges to a fluoro suite and wanted to be able to do lumbar TFESIs and SI joint injections for your FM/IM primary care patients instead of referring those to PM&R or pain medicine, but that would be a lot of unnecessary training for a relatively small number of patients/procedures.