Best MSK US training institutions?

[RnH723]

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What are the best MSK US training institutions? Where do residents get the most exposure and opportunity to perform MSK US diagnosis and procedures? From MedBronc's posts, I gather that Mayo is excellent. Where else? Also, if I was to match with a program where MSK US is not a strong point, what would be my options in order to gain adequate exposure/opportunity while in residency?

 

[Taus]

I'm not aware of anywhere that compares to mayo in that regard....

Plenty of courses through aapm&r and others, as well as sports fellowships, for those without as much dedicated msk us training in residency

 

[MedBronc23]

Mayo: I'm not sure if anyone does 6 months of dedicated MSK, Anatomy, physical exam correlated with MSK US didactics their pgy2 year. Combined with MSK US and PE didactics x 6 months during PGY-3 and PGY-4 years. Additionally, we use MSK US diagnostically and clinically on our MSK
Sports Pain Hand EMG rotations and our peds and spasticity physicians are starting to do US elastography. We also have free reign to practice scanning on each other with various US machines and use for patient care (with supervision) on our inpatient rotations and continuity clinic in addition to the above procedures. We also have exposure to human cadaver lab to practice injections under US before we attempt on patients.

Our US training is probably only rivaled by Rad And ER residents who have it as requirement for training, but likely not getting 18 months (3-5 hours/3 weeks) of dedicated didactic training during residency

I have heard that Hopkins is doing US training. Also there are many physicians using US associated with residency programs including Spaulding Kessler Utah Colorado Emory VCU to name a few.

Other residents and fellows will have to comment on their experiences.

Agree, there are multiple opportunities through AAPMR (Dr. Finnoff's course) and AIUM to get training in US.

 

[DOctorJay]

Everything MedBronc said except instead of providers he means physicians.

 

[youngmd]

I keep hearing good things about Mayo's program and the amount of resident exposure to US and outpatient MSK. If this is true, what I don't understand is why they feel the need to select internal candidates for their sports program year after year. This is what senior residents in my program have told me anyhow (and it does seem to be true for the past several years). Does anybody know who ended up there this year? I ask because I am interested in applying next year and have been advised that my chance of getting in there is minimal to none if any internal candidates apply.

 

[DOctorJay]

Next year's fellow is an outside candidate who has some pretty incredible credentials from what I've heard. I think most programs that have one spot for their fellowship will frequently take a known commodity over an unknown so I don't think this is unique to Mayo. Our residents tend to be interested in the fellowship because there is greater emphasis on diagnostic US than during residency so they enhance those skills. I think the sports fellowship here has been very fair in interviewing a number of internal and external candidates and accepting the best one.

 

[MedBronc23]

Everything MedBronc said except instead of providers he means physicians.

I changed it for you bro...I know you hate that terminology...just like I hate patients being called clients....like I an insurance salesman or something

 

[MedBronc23]

I keep hearing good things about Mayo's program and the amount of resident exposure to US and outpatient MSK. If this is true, what I don't understand is why they feel the need to select internal candidates for their sports program year after year. This is what senior residents in my program have told me anyhow (and it does seem to be true for the past several years). Does anybody know who ended up there this year? I ask because I am interested in applying next year and have been advised that my chance of getting in there is minimal to none if any internal candidates apply.

I think the reason or many internal candidates accepted into Mayo's Sports program is the familiarity with US and sports medicine, and the opportunity for staff to build upon training in learned in the residency program, not teaching it from scratch. That said the outside applicant accepted this year did have a stellar resume from what I have heard as well, and a really nice guy. I do think the fellowship tries to take the best person for the position. Our internal applicant this year was stellar, but ended up at Utah's program which is also great, and will provide increased time for spine procedures compared to elective time only for this at Mayo's sports program. Unfortunately, many people come to Mayo because the program seems to like their own, and has taken a fair number of internal applicants from sports (3 in a row until now, 1 in 2010/2011 was outside applicant) pain ( 1-2 PM&R pain fellows for 4 offered spots to Anes, Neuro, PM&R, Psych), and we just took an internal Peds fellow (also stellar).

This goes back to why choosing residency is so important. Akin to getting to stay in house, Mayo residents that have not matched at a Mayo fellowship of choice usually have got their #2 choice, because of the connections with names in Pain and Sports and reputation of training has opened up doors in other fellowships at reputable institutions.

I am sure that Spaulding, RIC, Washington, Stanford, ect. look very favorably at their internal applicants as well...although sometimes it can be a detriment to be an internal applicant at some programs...just usually not at Mayo.

 

[GluteusMaximus]

Next year's fellow is an outside candidate who has some pretty incredible credentials from what I've heard. I think most programs that have one spot for their fellowship will frequently take a known commodity over an unknown so I don't think this is unique to Mayo. Our residents tend to be interested in the fellowship because there is greater emphasis on diagnostic US than during residency so they enhance those skills. I think the sports fellowship here has been very fair in interviewing a number of internal and external candidates and accepting the best one.

I was on the interview tour this year... including mayo.. definitely an outstanding program and second to none in terms of ultrasound at a fellowship level... i met lots of great people on the tour and i'm curious who ended up matching there?.. pm me if you dont want to post it in a open forum...

 

[stimuluspackage]

Does anyone know what the MSK ultrasound exposure is like at Pittsburgh? I loved their program, but am not sure about the level of exposure to ultrasound, spine procedures, etc.

To continue with the Mayo theme, are there opportunities to do away electives there during residency to get further exposure to MSK ultrasound that may not be provided at one's home institution? I know they have an annual course there as well.

 

[MedBronc23]

Does anyone know what the MSK ultrasound exposure is like at Pittsburgh? I loved their program, but am not sure about the level of exposure to ultrasound, spine procedures, etc.

To continue with the Mayo theme, are there opportunities to do away electives there during residency to get further exposure to MSK ultrasound that may not be provided at one's home institution? I know they have an annual course there as well.

My first thought is no (at least if you want hands-on) but I think we had a Canadian PM&R resident do an observer-ship. This might be something to look into further as I know residents from outside have rotated through orthopedics. I am just not sure of legalities, malpractice, liability insurance, ACGME rules at mayo or outside institution.

Best to contact ones own program to ask if they would let you go, than contact graduate school at Mayo to see what hoops you would have to jump through.

The AIUM US course hosted by Mayo annually is good. It really is a great intro with lots of hands on scanning on live models (hometown residents usually) and cadaveric hands on procedures.

PM me if anyone wants more info

 

[stimuluspackage]

My first thought is no (at least if you want hands-on) but I think we had a Canadian PM&R resident do an observer-ship. This might be something to look into further as I know residents from outside have rotated through orthopedics. I am just not sure of legalities, malpractice, liability insurance, ACGME rules at mayo or outside institution.

Best to contact ones own program to ask if they would let you go, than contact graduate school at Mayo to see what hoops you would have to jump through.

The AIUM US course hosted by Mayo annually is good. It really is a great intro with lots of hands on scanning on live models (hometown residents usually) and cadaveric hands on procedures.

PM me if anyone wants more info

Thanks a lot for the reply MedBronc. You are an invaluable member of this forum.

Does anyone have any insight into the MSK US or other procedural exposure at Pittsburgh?