SM Fellowship and maintaining clinical knowledge/skills

[KeikoTanaka]

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Hey all, just a general question.

During your 1-2 years doing a Sports Medicine fellowship, how do you keep up with your clinical skills? If you're interested in doing PCP work on top of SM after the fellowship, do you really have time in that year to somehow maintain what you've learned during residency, so when you're done, you're not completely lost? I know theres moonlighting, but is that super realistic for a FM Clinic where your continuity of care is kind of contingent on working more than 1 day a week and really being available for those followup appointments?

 

[Freezeout]

So I’m doing both now that I’m out of fellowship and for the first month or so it was tough getting back into the swing of things. Even though you don’t use it, you’ll be surprised how much you retain fro primary care. The toughest thing was getting refreshed on all the new screening guidelines...for me anyway.

 

[galactus]

Do both + inpatient post fellowship. Honestly outside of the 1/2 day of primary care a week from fellowship, I did a fair amount of primary care issues for the teams I covered on top MSK issues. Did Nexplanon on some softball players, managed A LOT of ADD/ADHD on the college athletes I covered, even admitted an athlete for acute appendicitis (we even rounded!). Your primary care skills don't go away, especially if you are the PCP for your athletes and their coaches!

 

[teacherman84]

Our 1/2 day if continuity FM clinic was essentially student health so I did some moonlighting (mostly urgent care) , which I think helped a bit but it was still an adjustment back to the rest of FM. I def spent some extra time spinning up on higher risk areas like OB and inpatient med, and had someone with me for things like vasectomy, which I hadnt done in>1 year.

I remember at the end of PGY3 being so ready to escape and do only sports/ MSK , but I really missed the rest of it during fellowship.
Now sports time is the highlight of my week... but I like staying pretty full scope for now.

 

[YourMD]

I'm interested in doing a SM fellowship and practicing full scope FM as well. Can you guys give specifics regarding your work week, day to day schedule, and salary?

 

[teacherman84]

I'm interested in doing a SM fellowship and practicing full scope FM as well. Can you guys give specifics regarding your work week, day to day schedule, and salary?

I'm faculty at an FM residency where we practice full scope FM. We have 2 half days of sports med clinic and 2 half days of concussion/fracture clinic which is shared between 3 sports trained faculty. I have my FM clinic 1-2 half days/week. The rest is spent precepting resident clinic (a lot of MSK issues as were a military clinic...a lot of young and relatively healthy folks who are forced to workout for work) or precepting procedures like vasectomy, derm procedures, stress tests. I do overnight call a few night/month for inpatient/OB and a full week covering the inpatient service several times/year.
Awesome variety, despite small time in dedicated sports clinic I am dealing with sports 5 days a week via residents, including diagnostic US scans, guided injections. Pay is abysmal compared to civ counterparts...but they paid for school so ive got a lot less debt.

 

[Freezeout]

I work Monday through Friday 7:30 to 4 (in terms of clinic visit times). Friday I actually cut off at 3 pm and will dolly cut if off a little earlier going forward. We’re still figuring out my templates and such. I probably do 80% family Med and 20% sports. I’m hoping to push it to 70/30 or 60/40 in the future. A lot of my sports practice so far is concussions. I only do outpatient. No hospital, nursing home and no game coverage. I’m currently on salary guarantee for $250k and will be production based after this is up. Still working on getting an ultrasound in clinic which will drive my sports volumes up a bit I hope.

 

[YourMD]

Extremely insightful! Thanks a lot guys.