joe123456789

10+ Year Member
Sep 8, 2006
34
0
0
Status
I was interested in hearing about anyones experience who has gone on to do a sports med fellowship after em. Do people still work in the ER primarily and then have clinic for a day or two a week or is it primarily sports medicine. Obviously this can vary from person to person, but I just wanted to know if there was a general structure for someone who has completed this training.
 

AmoryBlaine

the last tycoon
10+ Year Member
7+ Year Member
May 1, 2006
2,179
23
151
Status
Attending Physician
I think most of it is more team doc type of stuff.
 

Jarabacoa

non carborundum ilegitemi
10+ Year Member
Mar 24, 2005
906
24
251
Status
Attending Physician
This has been discussed a couple of times in the past:

http://forums.studentdoctor.net/showthread.php?t=617566

http://forums.studentdoctor.net/showthread.php?t=514930

And another thread on fellowships in general:

http://forums.studentdoctor.net/showthread.php?t=500836

My bias is that I can't see a sports medicine fellowship really adding much to the practice in the ED and I don't see a residency in EM really adding much to a sports medicine practice.

For example: Knee injury in ER: Main question is, "Is the quadriceps intact?" If it is, I don't care whether it is an ACL, a meniscal injury, or whatever. The differential diagnosis is irrelevant as there is no way I'm going to get an orthopedic surgeon to do anything about either injury for weeks. Immobilize and follow-up when the swelling is less and clinical exam is easier.

Shoulder injury in the ER: Is it dislocated? Everything else doesn't matter. Even a non-displaced fracture is going to get put in a sling and f-u as outpatient, because again, I can't get an orthopedic doc to do a thing about a rotator cuff injury for weeks.

My personal bias would be that a good FP residency would prepare you better for out-patient sport's medicine better than ER. Joint injections, trigger-point injections, including spinal root steroid injections would be the bread and butter of a good sport's medicine doctor and you just aren't going to get exposure to in ER residencies.
 

boo2

New Member
10+ Year Member
Dec 3, 2005
40
0
241
Status
I was interested in hearing about anyones experience who has gone on to do a sports med fellowship after em. Do people still work in the ER primarily and then have clinic for a day or two a week or is it primarily sports medicine. Obviously this can vary from person to person, but I just wanted to know if there was a general structure for someone who has completed this training.
I am still in fellowship but I signed a job with an EM group. The group is big enough that they support the interests of their docs. One of them has recently opened a sports med clinic at her hospital. I will likely do 1/2-1 day of clinic there per week and work 30hrs of EM/wk(considered full time average 3 shifts/wk). I interviewed with three EM groups total and each was supportive in the pursuit of developing sports. Another guy I know signed with an ortho group full time and will do EM shifts on the side. Two others do EM and a lot of mass event medical direction which brings publicity to their hospital- they don't want the committment of a clinic. Another does EM and US Soccer traveling abroad with the team sometimes, another EM and US Figure skating.

The field is young, and there are only a handful of EM/Sports docs out there meaning there is no general structure, its what you make of it/stumble upon. Opportunities are out there to combine both, whether its clinic, team game coverage, team training room coverage, mass events, occ med, etc.

I don't agree with those who say FP residency lends itself better to a sports medicine fellowship. My co-fellow is FM and we each bring different things to the table. In fellowship we EM folks definitely have to learn how to run continuity clinic and have to care about what is causing the knee pain even though its not broken. That comes with the territory- you do a sports fellowship because you have an interest in how to manage MSK issues and other sports issues beyond the emergent treatment. I personally have less interest(and admittedly less skill) in managing the diabetic athlete or other chronic medical issues(though I could if I had the desire) and will tailor my practice more to MSK complaints.

All in all its a young field with lots of room for growth. I have met several EM docs who have been out only for a few years telling me what a smart move it is to do a fellowship and how they wish they would have. Who knows what I will end up doing, but having options is nice. For now I want to continue to develop skills in both for the first few years until I figure out what the right balance is or if I just want to go in one direction.
 

EsTxDr

5+ Year Member
Aug 13, 2012
212
26
111
Texas
Status
Attending Physician
Sorry to pull up a dead thread, but I'm strongly considering a SM fellowship after residency and would love to hear from anyone who has done so. Would love to hear thoughts on the options (FM vs EM programs, exposure, applying, etc).