EM--> Sports Med Fellowship

[Frogger27]

Incoming M1 here. I lurk this board a lot and really appreciate how active it is and the insights you provide into your specialty.

I was just talking to a EM resident who said they were planning on applying to Sports Medicine fellowships. I had no idea that EM was a route to SM. What's the deal with this? Is this a way for some of the EM residents who want to have less shift work transition to a more primary care setting? Does it allow them to work more as a primary care physician but pick up EM shifts when they want? How would the lifestyle differ from a typical EM doc? Any advantages to being a sports med doc trained through EM? All insights appreciated!

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[bearstanley]

https://www.emra.org/uploadedfiles/emra/emra_publications/emra_fellowshipguide_v1_0816.pdf

 

[Frogger27]

https://www.emra.org/uploadedfiles/emra/emra_publications/emra_fellowshipguide_v1_0816.pdf

That was exactly what I was looking for, thank you!

Edit: If there are any EM/SM fellows/physicians or people who considered this route I would love to hear some more insights!

 

[Darth Doc]

That was exactly what I was looking for, thank you!

Edit: If there are any EM/SM fellows/physicians or people who considered this route I would love to hear some more insights!

EM doc at my program went to Brazil with the US Olympic wrestling team. The EM docs in Las Vegas have a contract to work the MMA fights (per their website). If you like EM and sports medicine, seems like a good way to go.

 

[Frogger27]

EM doc at my program went to Brazil with the US Olympic wrestling team. The EM docs in Las Vegas have a contract to work the MMA fights (per their website). If you like EM and sports medicine, seems like a good way to go.

That sounds like a pretty awesome gig being able to work the MMA fights. I have an interest in EM and sports med, so this does seem like a natural fit. Apparently there are only 8 EM-led SM fellowships in the country, one is actually at my institution.

It would be interesting to see how many EM docs pursue this fellowship each year. Couldn't find it in the charting outcomes. http://www.nrmp.org/wp-content/uplo...-Sports-Medicine-Match-Results-Statistics.pdf

 

[Tenk]

That sounds like a pretty awesome gig being able to work the MMA fights. I have an interest in EM and sports med, so this does seem like a natural fit. Apparently there are only 8 EM-led SM fellowships in the country, one is actually at my institution.

It would be interesting to see how many EM docs pursue this fellowship each year. Couldn't find it in the charting outcomes. http://www.nrmp.org/wp-content/uplo...-Sports-Medicine-Match-Results-Statistics.pdf

Not that many. Generally pays less per hour than EM. You should only do it if you love sports med and don't care about being compensated as much as EM.

 

[Frogger27]

Not that many. Generally pays less per hour than EM. You should only do it if you love sports med and don't care about being compensated as much as EM.

Would it be something like 3 days of sports med clinic and 1-2 EM shifts a week? I'm guessing you would be paid as an EM during your EM shifts and a primary care SM doc during those days?

What I had envisioned when I heard of this is someone working more EM as a young attending (when they can tolerate shift work better + want to make more money) and then gradually shifting more towards sports med as they get older. Obviously you would have to work a little of both throughout to make sure your skills don't diminish in either specialty.

 

[Tenk]

Would it be something like 3 days of sports med clinic and 1-2 EM shifts a week? I'm guessing you would be paid as an EM during your EM shifts and a primary care SM doc during those days?

What I had envisioned when I heard of this is someone working more EM as a young attending (when they can tolerate shift work better + want to make more money) and then gradually shifting more towards sports med as they get older. Obviously you would have to work a little of both throughout to make sure your skills don't diminish in either specialty.

They are two separate worlds. Most (not all) SM docs who aren't orthopods will usually work in a clinic associated with a group of orthopods so they can have operations done as needed. There is very little overlap with EM outside being at an academic facility where you work in two departments. Unfortunately the pay cut working academics would be far greater than just working 1099 and writing off your own health insurance, etc.

The problem with wanting to work part time in both (outside of academics) comes down to benefits. Most part time or per diem workers get no benefits and I'd imagine most ortho groups would want you to work full time for them. This would mean you would make far less money than EM. As a poster above alluded to above, many EM docs will work full time in EM and then cover sports events but the pay for this is usually not great and they just do it for fun, being ring side, and the prestige. Also, you don't necessarily have to be sports med trained for this if you have connections.

Ultimately I'm sure you could find some EM group and some clinic where you could work part time but we are talking a hefty pay cut and probably a lack of benefits outside the academic world. I was actually interested in sports med until I saw attending EM hourly and then I was like ya no thanks. I enjoy medicine but I enjoy not medicine 100x more so I work as little as possible to afford the life I want to live.

Hope that helps.

 

[Frogger27]

They are two separate worlds. Most (not all) SM docs who aren't orthopods will usually work in a clinic associated with a group of orthopods so they can have operations done as needed. There is very little overlap with EM outside being at an academic facility where you work in two departments. Unfortunately the pay cut working academics would be far greater than just working 1099 and writing off your own health insurance, etc.

The problem with wanting to work part time in both (outside of academics) comes down to benefits. Most part time or per diem workers get no benefits and I'd imagine most ortho groups would want you to work full time for them. This would mean you would make far less money than EM. As a poster above alluded to above, many EM docs will work full time in EM and then cover sports events but the pay for this is usually not great and they just do it for fun, being ring side, and the prestige. Also, you don't necessarily have to be sports med trained for this if you have connections.

Ultimately I'm sure you could find some EM group and some clinic where you could work part time but we are talking a hefty pay cut and probably a lack of benefits outside the academic world. I was actually interested in sports med until I saw attending EM hourly and then I was like ya no thanks. I enjoy medicine but I enjoy not medicine 100x more so I work as little as possible to afford the life I want to live.

Hope that helps.

Seems like the only way to reasonably make this work would be in an academic setting, even though you would be paid less than your academic/PP EM colleagues. Working at two places part time wouldn't make much sense from a financial standpoint. That was extremely informative, thanks for your insights!

 

[Dr Mantis Toboggan]

I know several who have gone this route primarily in academics. Generally it works out to about 2 days in clinic, 2 shifts in the ED, but a significant chunk of time also covering 6 AM practices, games, etc. In a lot of centers the non-ortho ends up the bitch of the department, covering the non-revenue sports, not getting respect, etc. Not always though.

 

[RustedFox]

Okay, I've thought this for awhile... I'm happy to be wrong; but I don't see what all the fuss is about with "sports medicine".

Primary argument: In a vein similar to "wilderness medicine", if there's a real question of safety or need for urgent intervention... the best course of care is "get them to the ED for imaging, reduction, etc." - "Get the hell out of the wilderness and to the ER" simply becomes "get the hell off of the sidelines and to the ER".

Secondary argument: I work in a shop that regularly hosts these "MudRunNOS+Beers-and-DragonBallZ" events nearby. I hate working those days. Every time I have to communicate with Chief FieldDickhead - the result is the same; "I don't care what you said. Homeboy is hurt. Great. Now get off the phone and I'll wait for the ambulance or car or whatever it is that's going to bring them to me." I see limited to no value in having a physician on the sidelines to look it over and say: "Yeah, you need to go. Kthxbye." 50% of those sent by MasterChief get sent right the hell out. 25% get sent right the hell out after their negative imaging. 25% need something done.

I am happy to be wrong, but I need to hear a good argument as to why "Sports Medicine" isn't another way of saying "I want to stand on the sidelines and wear a polo shirt and give some critical looks while the EMS crew arrives."

 

[Angry Birds]

My feeling is that there is no money in Sports Medicine, and that you should only do it if you really want to do Sports Medicine, not if you want to decrease your EM clinical workload. But, I may be wrong.

 

[joeDO2]

I agree about the sideline aspect of things. Not really worth the time unless you love doing it. The procedural aspect though could potentially be lucrative. I do know a guy who had a clinic setup and basically had all the PCPs in the area referring to him for sports med consults and ended up doing mostly ultrasound guided joint injections all day. In the right market I could see that doing quite nicely.

 

[Doctor-S]

Primary argument: In a vein similar to "wilderness medicine", if there's a real question of safety or need for urgent intervention... the best course of care is "get them to the ED for imaging, reduction, etc." - "Get the hell out of the wilderness and to the ER" simply becomes "get the hell off of the sidelines and to the ER".

@Frogger27 ... having done both, I agree with the sentiments of @RustedFox.

With a few exceptions, it's relatively straightforward to provide some level of care in a sports venue (or the wilderness) when an injury or ailment is truly mild and not close to being serious. At certain NCAA venues, the local emergency personnel are present. For more serious injuries, I want the patient to have the benefit of a well-equipped ER, with specialists available. Can't reduce a serious fracture nor image a traumatized brain from the sidelines or in the wilderness.

On the other hand, the sports medicine fellowships are great for advanced training and research opportunities (e.g., neuro/ortho). Very educational, very productive, very stimulating and very interesting - whether you're in EM, ortho, peds, neuro, etc. I wish you the very best of success. 🙂

 

[DrDrummer]

Okay, I've thought this for awhile... I'm happy to be wrong; but I don't see what all the fuss is about with "sports medicine".

I think the vast majority of what these people do isn't so much sideline stuff, it's clinic work for non-operative orthopedics, e.g. seeing people, diagnosing / getting imaging, sometimes doing injections, and referring operative injuries who have met the pre-requisite steps needed for reimbursement to the surgeons so you can make their practice that much more lucrative. Would be sort of nice to work with (I imagine) a lot of high-functioning young otherwise-healthy people, and having a nice work/life balance and banker's hours. Not something I'm particularly interested, but that's what my friends who are pursuing this route say.

 

[mvp2022]

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[Newyawk]

Any more thoughts on this? Just learned about this and seems interesting to prevent burn out especially cuz i love sports. Not down to be someones bitch tho

 

[Birdstrike]

Any more thoughts on this? Just learned about this and seems interesting to prevent burn out especially cuz i love sports. Not down to be someones bitch tho

You'd work in an ortho clinic most likely, doing non-operative ortho stuff. Knee, hip, elbow, wrist injections. Might be the team doc for sports teams, staffing sporting events. The sports med guy near me even does MRI arthrograms, which I didn't know until recently. I looked into maybe doing a sports medicine fellowship and think I would have liked it. I ended up doing a Pain fellowship instead, which has worked out well, but I think sports med could be a really good option for a lot of EM people. I think every EM resident should consider some kind of fellowship. I'm much more positive on EM fellowships now, than I was as a resident. Every EM doc I know that's done one, has benefited significantly from it, easily justifying the temporary sacrifice of salary. That includes people who've done Hyperbarics, Cardiovascular, Ultrasound, sports medicine, Hospice/Palliative, Tox and Pain. All of them all the option of reducing your shift work sleep disorder exposure and therefore can reduce burnout and improve quality of life.