info on Sports Med

[kentnouri]

I am currently an MS-III interested in Sports Med and was wondering if anyone could list the top ten programs in the nation to do away rotations through. IS research a must to be competitive. I'm still a bit uninformed as to the residency and fellowships routes into Sports Med, IS there a difference between doing Family or PM&R before entering the fellowship? How competitive are the Sports med fellowships? What is lifestyle, pay, and career opportunities like? Thanks in advance.

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[AP]

It depends upon the route into sports medicine you want to take. You can do FP, IM, or ER, and then a 1-2 year Sports med fellowship (most do FP and/or ER, because you get exposed to more of a broad spectrum of conditions that are applicable to Sports Med). You can also do PM& R, and then a sports med fellowship, but keep in mind that you will only have expertise in the musculoskeletal aspect of Sports Med, not to mention that at least half of you patient load in residency will be TBI/SCI patients, so you will not be doing any sports med related things in that aspect. Finally there is Ortho surgery, and then a Sports MEd fellowship. Obviously, Ortho surgery will pay anywhere from 2-4 times as much as PMR and FP, which are almost the same, with PMR making a about 20 -40 percent more than FP. ER will be a bit more than FP/PMR, but if you are not doing lots of procedures at a ER sports doc, than you will make the same as the FP/PMR doc. And, accordingly, the hours you work are usually more for sugery than non-surgery, although you could conceivably work more if you wanted to in any of the fields. As far as doing away rotations, it all dependson how far you are willing to travel. For PMR, doing rotations at Kessler REhab in NJ or the REhab Institute in Chicago are the two best, followed by WAShinton Univ. , Spaulding rehab in boston, and NYU rusk. Kessler will probably give you the most sports/med exposure out of the bunch. There are tons of places for ortho, in NYC (Lenox, Hosp. for Jt. disease, Hospital for Special Surgery - prob. the best), as well as in Other major cities. Someone with more ortho experience can probably provide more info than I can. Most people will tell you that FP/ER sports med is the way to go for non-surgical and ortho surg the way for doing sports med surgeries. Hope that helps. But remember that gettinga ortho spot is much, much harder than getting a FP spot, and that getting a fellowship in sports med is extremely competitve as well. Lastly, doing sports med is probably, at least for the FP docs, only a small part of their practice, simply because athletes, at any level, make up a small percentage of patients.

 

[Stinky T]

Having expertise in musculoskeletal aspect of sports medicine is a huge component. Isn't this the basis for most sports injuries? Additionally, I would argue that EM and FP docs are not the best physicians to work up a sports injury. If you think that only half of a PM&R residency is dedicated to musculoskeletal medicine, what percentage do you think is dedicated to it in a EM or FP residency? The answer is significantly less. A PM&R residency includes gait analysis, EMG/NCS training, medical orthopedics, learning to do joint injections, spinal injections, etc. Learning to do these things requires a lot of knowledge about the musculoskeletal system and these oppoortunities just aren't available (or at least to a much lesser extent) in other residencies.

With regards to institutions which provide the best training for those interested in sports med.....Kessler, RIC, Spaulding, and Mayo are all excellent places. By itself, Kessler and RIC are probably the best places. However, Kessler doesn't have any electives and Spaulding has nearly a whole year of electives. This is a huge advantage in my mind because you can really create your own mini-fellowship and show your face at places you'd like to match at for fellowships.

Regarding pay, I don't think the salary for a FP vs. a FP doing some sports med is really that different. However, the differences between a Physiatrist doing inpatient TBI vs. one that does Medical Orthopedics/Sports Med, EMGs, Interventional Pain, etc. can often times be huge.

 

[AP]

I understand that you favor Harvard's program due to your involvement in it, but from speaking to other PM&R docs who went to Kessler, NYU, and a few others, they all seem to indicate that Kessler provides more outpatient rehab epxosure that focuses your time on musculoskeletal med. Also, other FP docs in sports med argue that that is a better route to go for basic sports med since they are are the ones covering high school football games and small to large college football programs as well as semi-pro teams. Not to say that physiatrists don't do this as well, just that for the most part its seems that the fellowship training in sports med- which, if I am correct, is an actual certification program, whereas in PM&R it is not - provides more emphasis on medical coverage for the entire spectrum of athletically-related medical conditions, and not just musculoskeletal (although I obviously agree with you that it is a huge component of injuries). Just another viewpoint.