The MedStar Health—Union Memorial Hospital Fellowship Program in Foot and Ankle Orthopaedics
Our program is part of the strong tradition of individual apprenticeship, pairing one fellow with one faculty member. The program assures an exceptionally broad exposure to many approaches to foot and ankle surgery.
The goal of the Fellowship Program is to foster insight, understanding, and creativity with respect to all facets of treatment of foot and ankle disorders. This is provided through thoughtful and provocative interaction in a full-service, educationally conducive environment in the clinics, at the bedside, in the operating room, and in the biomechanics/cell biology laboratories.
We manage a broad variety of diseases and deformities of the adult and child's foot, encompassing the forefoot, hindfoot, and ankle with respect to diabetes, trauma, sports, arthritis, and tertiary reconstructive procedures.
Fellows benefit from working in the private clinics with one-on-one teaching. We have full-time orthotists, prosthetists, physical therapists, and nurses specifically trained in foot and ankle disorders. Approximately 1,900 foot and ankle surgical procedures are performed annually, providing the fellow an opportunity to participate in every aspect of foot and ankle reconstruction.
As product design and development from the foot and ankle faculty is ongoing, the fellow has the opportunity to learn about patents, intellectual property, and corporate interaction. A relationship with Johns Hopkins University's Biomedical Engineering department across the street allows the fellow the option of interacting with projects from design to prototype.
Additional collaborations with MedStar Institute, University of Maryland, Johns Hopkins, Goucher, and Georgetown provide opportunities for unlimited exposure to diverse educational and research centers.
The responsibilities of the fellows are broad. Each fellow will benefit from approximately ten months of clinical rotations and two months dedicated time in biomechanics or biologic laboratories. Approved clinical research projects can be performed throughout the year.
Prior to completing the fellowship, it is expected that a minimum of three papers will be prepared for publication in a peer-reviewed journal. Grant funding is available for these projects through the Orthopaedic Research Committee at MedStar Union Memorial Hospital and MedStar Health Research Institute.
We have an active teaching schedule with clinical, surgical, and laboratory teaching.
- Surgical procedures of the week are discussed at a weekly orthopedic conference, which includes case presentations and didactic lectures.
- There is a quarterly research meeting for the foot and ankle staff.
- A monthly orthobiologic journal club will focus on studies pertinent to our team (e.g., tendon tissue engineering, tenocytes, human adult mesenchymal stem cells).
- Evening lectures on foot and ankle topics are held for fellows and residents throughout the year.
- Fellows will attend several national and local courses on foot and ankle.
- While the fellows are not primarily responsible for resident education, the fellows participate in helping to fulfill our responsibility for resident education.
Each fellow takes call during the year. The call schedule will not impact on vacation, meeting, or sick time. The fellows share the emergencies and take backup call for the emergency room for foot and ankle trauma. Additionally, although the fellow may be on call for trauma, it is rare that he/she will need to be present in the emergency department or hospital, since the residents are primarily responsible for emergency patient care.
All fellows assigned to foot and ankle attendings will be responsible for all aspects of patient care. This will include completion of all post-operative orders, prescription, discharge summaries, and other necessary paperwork as well as rounding responsibilities.
If a resident is rotating on the foot and ankle service, then the duties are shared as appropriate. The fellow in the lab may have to cover the attending when a resident on the service is post call or off site for vacation or an academic conference.
Each fellow is allocated four weeks of vacation during their one-year training. However, only one week of vacation may be taken per quarter. Vacation may be taken conjunction with, but not in addition to, specialty meetings and national foot and ankle courses. Prior approval must be arranged with the Program Director to ensure adequate clinic, OR, and call coverage. All vacation plans are to be discussed as soon as possible with the attending staff to maximize patient care.
Performance feedback for the fellows is ongoing throughout the year, giving the fellow real-time feedback in conjunction with the clinical rotation. The fellow is also encouraged to participate in re-focusing or altering the formal and informal educational process during the year. At the end of each quarter, the fellow is given written evaluations.
A two-month block of time is made available to perform benchtop research. Clinical research occurs throughout the year. Collaborative research projects with investigators from the biomechanics or orthobiologics labs is encouraged. Collaboration with residents and biomedical engineering students is also an option.
The goal of the research rotation is to allow the fellow to gain knowledge regarding good scientific methods and to initiate and conduct a study in orthopedic research.
- Weekly foot and ankle conference (fellow's responsibility)*
- Participation in weekly resident's conference
- Monthly foot and ankle journal club
- Quarterly research meeting
- Quarterly surgical policy or performance improvement meetings
- Didactic lecture schedule in accordance with the MedStar Union Memorial Hospital residency academic schedule
- Trimester fellowship meetings
*At the weekly foot conference, the fellows present cases to the residents, attending staff, visiting specialists, physical therapists, podiatrists, and interested orthopedic surgeons in the community. Although many of the cases presented are generated from the clinical practices of the attending staff, it is mandatory for the fellows to present the patients on whom they operate at this conference.