Orthopaedic Trauma Surgeons of Northern California Trauma Fellowship Program

Orthopaedic Trauma Surgeons of Northern California

Trauma Fellowship Program

Orthopedic Trauma Surgeons of Northern California

Northern California

Northern California

OTSNC Trauma Fellowship

• People

• Places

• Program

Trauma Fellowship Faculty

• Full-time faculty– Paul Gregory, M.D.

• Medical Director, Orthopaedic Trauma

• Mercy San Juan Medical Center

– Christopher Finkemeier, M.D.– Rafael Neiman, M.D.

• Co-Medical Directors, Orthopaedic Trauma

• Sutter Roseville Medical Center

Paul Gregory, M.D.

• High School: Sioux City, IA, 1980• Undergraduate: U of Nebraska, 1984,

BS, Chemistry• Medical School: U of Nebraska, 1988• Residency: U of Oklahoma, 1993• Fellowship: Tampa General, 1994• Practice

– Tampa, 1994-99– Carmichael, 1999-present

Chris Finkemeier, M.D.

• High School: Fullerton, CA• Undergraduate: UC-Irvine• Medical School: UC-San Francisco• Residency: University of Minnesota• Fellowship: UC-Davis, 1997• Practice

– UC-Davis faculty, 1997-2002

– Roseville, 2002-present

Rafael Neiman, M.D.

• High School: Fremont, CA

• Undergraduate: UC-San Diego

• Medical School: Tulane University, New Orleans

• Residency: Ochsner Clinic, New Orleans

• Fellowship: UC-Davis

• Practice: Roseville Orthopaedics, 2001

Places

• Sutter Roseville Medical Center– Trauma Clinic

• Mercy San Juan Medical Center

• Private offices– Carmichael private office

Metro MapSacramento

Sutter Roseville Medical Center

Mercy San Juan Medical Center

Sacramento and So.Placer Counties

Sutter Roseville Medical Center

Mercy San Juan Medical CenterMercy San Juan Medical Center

Sutter Roseville Medical Center

Sutter Roseville Medical Center

• Location – Roseville, CA• Accredited ACS Level II Trauma Center (1995)• Demographics

– 55,000 ER visits/yr, 1350 trauma patients/yr, 875 admissions per year

• Facilities– 280 acute care beds, built 1997, additional wing opened

2007

• Structure of Service– Acute Care Orthopaedic Service – organized, cohesive

service approach

Sutter Roseville Medical Center

SRMC Helipad

Sutter Roseville Medical Center

Sutter Roseville Medical Center

Mercy San Juan Medical Center

Mercy San Juan Medical Center

• Location – Carmichael, CA• Accredited ACS Level II Trauma Center (1999)• Demographics

– 60,000 ER visits/yr, 1250 trauma patients/yr, 750 admissions per year

• Facilities– 370 acute care beds

• Service Structure– All ortho acute care provided by one unified panel of

ortho surgeons

Fellowship Program

• History

• Philosophy

• Goals

• Weekly Schedule Template

• Hospital Staff Status

• Business Arrangement

Fellowship Program• History

– 1999 - MSJMC opens for trauma care• PRG becomes Orthopaedic Trauma Medical Director

– 2002 – OTSNC forms and commits to provide all orthopaedic trauma care for SRMC

• RN completes fellowship and joins Roseville Ortho (2001)• CF moves practice to Roseville (2002)

– 2005-2007 OTSNC develops vision for fellowship program between the 2 centers

– 2007 – OTA seeks commitment for additional fellowship programs (asks for at least 2 OTA members to be on faculty)

– 2010 First matched fellow starts (Fred Tonnos)– 2013 Program receives full OTA accreditation

Fellowship Program• Philosophy

– Mission statement• “The OTSNC fellowship shall be an advanced experience in

surgical care of musculoskeletal trauma of the extremities and pelvis which will enable the graduate to offer trauma patients the highest level of care available and to provide the orthopaedic community with leadership through experience, education, and research.”

– Practical application• Maximize exposure to surgical cases• Allow extensive one-on-one contact with faculty• Experience adequate time in patient evaluation and follow-up to

gain a full perspective of care including rehabilitation• Learn unique aspect of trauma care in a private-practice setting

Fellowship Program

• Goals– Education

• Gain confidence to competently treat all extremity and pelvic trauma patients

• Develop fund of knowledge to treat musculoskeletal trauma at a higher level

• Experience private practice trauma orthopaedics

– Research• Complete 1 clinical research project for OTA presentation and

publication

– Leadership• Integrate into network of orthopaedic trauma care providers• Work toward OTA membership

Surgical Case Volume

• Fred Tonnos– Total volume 715

• Brian Drake– Total case volume 805

• Lorrin Lee– Total case volume 678

Private-practice Orthopaedic Trauma Fellowship

• Advantages– Maximize direct attending contact– Separation from chain of command– Gain knowledge of managing private practice– Interact with private practice ancillary staff (PA’s,

ARNP’s, RN’s)

• Disadvantages– Minimizes teaching exposure– Lacks access to basic science, mechanical testing, and

cadaveric research projects

Fellowship Program• Weekly Schedule Template

– Daily schedule• Monday, Wednesday-Friday

– Manage SRMC ACOS service– Back up daily by core trauma faculty– Some Fridays covered by surgeons outside core group. Fellow will round, do cases, or

have free academic time.

• Tuesday– Grand rounds (when applicable)– MSJMC cases with P. Gregory, M.D.– SRMC trauma clinic

– Call responsibility• Wednesday – on-call SRMC• Thursday – on-call SRMC (2 out of 3, off prior to weekend) call• Fri-Sun – once every 3rd weekend

Fellowship Program

– Conferences• Monday AM

– Weekly fracture conference

• Thursday (1st each month) – SRMC trauma program peer review conference

• Thursday evening– Quarterly city-wide orthopaedic trauma fellow grand

rounds

Outside Conferences

• OTA Annual Meeting (Oct.)

• Stryker Pelvic Dissection Course (Nov.)

• Synthes Surgical Exposures Course (Jan.)

• AAOS Annual Meeting (March)

• OTA Fellows Conference (April)

Fellowship Program

• Hospital Staff Status– Credentialed with full orthopaedic surgery

privileges at MSJMC and SRMC

• Business Arrangement– One-year contract as employee physician

• Health insurance (pending changes due Obamacare)

• Malpractice coverage

OTSNC Trauma Fellowship

Thank You