This thread is interesting to me. I'm an ED attending 9 years out of residency, and I'm strongly considering going back to a sports med fellowship. I would be applying next year and starting 2026 in an ideal world. The info and recommendations given here have been awesome, like the books referenced by
@drg123 .
I think my exposure to injections and procedures is middle of the road, but definitely not as much as you guys in PM&R/pain or anesthesia. But I can hold my own with an ultrasound probe, and use it for tough vascular access regularly to help my nurses. I do anatomical nerve blocks for small procedures and my joint arthocentesis, plus, I have done a few handfuls of fascia iliaca blocks for hip fractures.
I've done some shadowing at a local D1 sports clinic and have seen the variety of patients that come in. I initially got interested in medicine during college when I joined the local ski patrol, and reflecting on that over the last year while discussing it with my wife, the MSK injuries and treatment are what really had my interest. Multiple friends and work exposures led me to pursuing EM as a career, but to be completely honest, I didn't have a great clinic exposure or role model to discuss other options.
Reasons I'm looking for a change:
1. Longevity. The ED is soul crushing, and something in society has changed post Covid that has made it worse for us. I don't want to do this for another 20-30 years. Sports med? I'd be happy to, especially since the town I'm in has none and I could provide a needed service. I've worked at smaller EDs and different locations, but I think I'm browned out from the ED itself and looking for something with less cortisol spiking for a better career and work enjoyment. I still love medicine.
2. Patient populations. The ED sees all comers. I definitely like being able to order what I feel is necessary and treat patients without worrying about insurance issues, but...it also leads to so much unnecessary testing when folks aren't able to have a discussion or think in a rational way during a crisis or at 3 a.m. I know the patients that I send out to 'follow up in clinic' are who the sports med patients will ultimately be, but I'm OK with that. I also am more interested in working with patients who want to get back to well, vs 'just gimme some more pills, doc.' I know some of the spine and chronic pain patients are like this as well, but with protocols and proper treatment, the answer can be, 'sorry we can't do anything else for you.'
3. I find that I like MSK complaints acutely, concussion management and follow up is an interest of mine, and, most importantly, I think I'd be good as a sports medicine doc. I like sideline/event medicine, and I like being to one folks turn to for help when issues arise (part of what drew me to EM).
Anywho, since this is a post about going back to fellowship after being in private practice, I have some questions for the hive mind here.
A. LORs - I'm thinking my current medical director, maybe my personnel director of the group (went to residency with them so I've known them for quite a while), and a long time friend who is also a sports med doc. Would a letter from my residency program director be helpful/necessary. He retired and my old Asst PD is in charge now, but would it matter 10 years out?
B. Is it even necessary? Am I being crazy? The directed knowledge is part of the reason I want to go back to fellowship, but also the networking. I think my competency and confidence in the field will be greater with a fellowship under my belt. Being a D1 or pro team doc would be cool, but I don't know that I need that, honestly. We have a local university with multiple teams, and our local ortho clinic has had a non op sports med ortho doc that and I think I could make that work for me.
C. Would I be better off just reading a few of the texts and going to conferences to make this switch? I'm just worried about job searching afterwards and actually getting anyone to hire me with only the EM cert and a proclaimed interested in SM.
Money isn't a huge deal, wife's loans are paid off, cars are paid off, we are DINKWADS and happy where we are. My loans will be under 6 figures by the end of the year, and hopefully paid off by the end of next year or before fellowship starts. Wife has a good/solid position and is on the hospital insurance plan I can slide onto.
Again, am I crazy? Also, tips/tricks/suggestions are definitely welcomed.
