JULY 18-21, 2019The Summit, A Dolce Hotel Cincinnati, OH

RESEARCH AND LEADERSHIP C O N F E R E N C E

A M S S M F E L L O W S2019

INCLUDING SPORTS TRAUMA AND EVENT MEDICINE (S.T.E.M.) AND INTRODUCTION TO SPORTS ULTRASOUND FOR FELLOWS

The American Medical Society for Sports Medicine gratefully acknowledges the following companiesfor their educa�onal grants in support of the Introduc�on to Sports Ultrasound for Fellows course.

facultyamssm REsEaRcH & lEaDERsHIP cONfERENcEPaul J. Gubanich, mD, mPH; conference chairpersonGiselle aerni, mDIrfan m. asif, mDKate E. Berz, DOScott Bonnette, PhDchad t. carlson, mDJeremy David close, mDRajwinder singh Deu, mDJed a. Diekfuss, PhDmichael Donaworth, mDJim Griffith, MBA, CAEmorteza Khodaee, mD, mPHstephanie Kliethermes, PhDGregory D. myer, PhD, cscs*DRebecca a. myers, mDKyle B. Nagle, mD, mPHRichard Okragly, mDmark V. Paterno, Pt, PhD, mBa, scs, atcstephen R. Paul, mDaditya Raghunandan, mDKatherine H. Rizzone, mD, mPHRobert m. siegel, mDJack Spittler, MD, MSKarin VanBaak, mDJason l. Zaremski, mD

INtRODuctION tO sPORts ultRasOuNDEmily E. Dixon, DO; chairpersonGiselle aerni, mDchad t. carlson, mDamanda chaney, DOJeremy David close, mDcarly Day, mDRajwinder singh Deu, mDDrew Duerson, mDlester s. Duplechan, mDBrian J. fuller, mDJeremy R. Girmann, DOamanda c. Goodale, DOPaul J. Gubanich, mD, mPHmederic m. Hall, mDJeffrey A. James, DOKimberly ann Kaiser, mD, mPHBrandon s. Kakos, mDmorteza Khodaee, mD, mPH Roger J. Kruse, mDRebecca a. myers, mDKyle B. Nagle, mD, mPHRichard Okragly, mDstephen R. Paul, mDKatherine H. Rizzone, mD, mPHJack Spittler, MD, MSHenry Stiene, MDKarin VanBaak, mDJason l. Zaremski, mD

SPORTS TRAUMA AND EVENT MEDICINE (S.T.E.M.)stephen W. Dailey Jr, mD; co-chairpersonRajwinder singh Deu, mD; co-chairpersonGiselle aerni, mDKate E. Berz, DOBret E. Betz, mDalissa marie conde, mDmichael Donaworth, mDPaul J. Gubanich, mD, mPHmorteza Khodaee, mD, mPHKyle B. Nagle, mD, mPHRichard Okragly, mDKatherine H. Rizzone, mD, mPHJack Spittler, MD, MSKarin VanBaak, mD

taRGEt auDIENcESports medicine fellows initiatingtheir fellowship training program

REsEaRcH & lEaDERsHIPcONfERENcE OBJEctIVEs

Research Conference Objectives:Upon completion of this course, the participant should be able to:• Understand basic research principles and methods.• Become familiar with resources that aid in the construction and implementation of a scientifically sound research project.• Develop an individual research project that could be implemented during the fellowship training year.• Network with other fellows in developing research and clinical ties.

Leadership Conference Objectives:Upon completion of this course, the participant should be able to:• Recognize the leadership role of a sports medicine fellow.• Understand the structure of AMSSM and how to get involved.• Participate in a fellows-only meeting led by the AMSSM Fellowship Class Representative.• Appreciate the leadership journey of a sports medicine leader.• Understand the career path of an academic sports medicine physician.

INtRODuctION tO sPORts ultRasOuND fOR fEllOWs OBJEctIVEs

Upon completion of this course, the participant should be able to:• Describe the principles of sports ultrasound.• Describe how to perform a systematic and regional musculoskeletal ultrasonographic examination of the knee, shoulder and high yield structures.• Identify the ultrasonographic appearance of tendinopathy and bursopathy about the knee and shoulder.

sPORts tRauma aND EVENt mEDIcINE(S.T.E.M.) OBJECTIVES

Upon completion of this course, the participant should be able to:• Provide a foundation for understanding issues related to the care of the athlete on the sideline.• Provide material to create appropriate action plans for sporting venues.• Network with other fellows, physicians and athletic trainers to obtain skills to care for the injured athlete.

suPPORtERsThe American Medical Society for Sports Medicine gratefully acknowledges the following companies for their educational grants in support of the Introduction to Sports Ultrasound for Fellows course.

cONfERENcE INfORmatION HOtEl accOmmODatIONs

sPORts tRauma aND EVENt mEDIcINE (s.t.E.m.) tHuRsDay aftERNOON (July 18, 2019)

1:30 P.M. - 6:05 P.M.The “Sports Trauma and Event Medicine (S.T.E.M.)” Course is designed to equip fellows to cover events and be prepared for emergencies on the sideline and during game coverage.

INtRODuctION tO sPORts ultRasOuND fOR fEllOWs

fRIDay aftERNOON (July 19, 2019) 1:00 P.M. - 7:00 P.M.

The AMSSM Fellows Research and Leadership Conference will include a six-hour session to give fellows an introduction to sports ultrasound by first discussing the fundamentals and then identifying normal and abnormal anatomy of the knee, shoulder and various other structures. Fellows will have the opportunity for hands-on scanning examination of the knee and shoulder with a 4:1 ratio of fellows to scanning faculty allowing each fellow individualized instruction.

fEllOWs REsEaRcH & lEaDERsHIP cONfERENcEfRIDay mORNING (July 19, 2019)

satuRDay (July 20, 2019)suNDay (July 21, 2019)

The AMSSM Fellows Research and Leadership Conference will begin with a morning session on Friday (July 19, 2019) and will continue on Saturday (July 20, 2019) and will conclude at 12:00 p.m. (noon) on Sunday (July 21, 2019).

REGISTRATION INCLUDES:• Conference and meeting materials• Continental Breakfast: Fri. - Sun.• Lunch: Fri. and Sat.• Social Events: Thurs., July 18 (6:15 pm): Cincinnati Reds vs. St. Louis Cardinals Fri., July 19 (7:00 p.m.): Appetizers/Cash Bar with AMSSM Board and Conference Faculty (on-site)• T-shirt

cONfERENcE REGIstRatION fEE• $300.00 AMSSM Fellowship Member • $350.00 Non-MemberAttending the AMSSM Fellows Research and Leadership Conference will require overnight lodging beginning on Thursday through Saturday nights. The hotel room block/negotiated rate will be available beginning on Wednesday night, July 17, 2019, at The Summit, A Dolce Hotel in Cincinnati, Ohio.

tHE summIt, a DOlcE HOtEl The Summit, A Dolce Hotel is the site for all of the educational sessions. A block of rooms has been reserved at the single/double occupancy rate of $149.00/night* (listed below) beginning on Wednesday, July 17, 2019. All reservations must be guaranteed with a deposit equal to the room rate (plus applicable taxes in effect at check-in, currently at 17.5%) for the first night of each reservation with a valid credit card. The room block group rate will be honored three (3) days before and three (3) days after the meeting dates based on hotel availability and must be requested when making your room reservation. Complimentary internet will be available in each guest room and in the meeting rooms. A sprinter van operated by the hotel can accommodate up to 15 guests at a time on a first-come, first-served basis to any destination within a five (5) mile radius of the hotel until 10 p.m. daily.

Room Type Room Rate

Single/Double Occupancy Rate $149/night**Room Rates do not include applicable taxes (currently 17.5%) in effect at the time of check-in.

Check-in: 4:00 p.m. ET | Check-out: 11:00 a.m. ET

ROOM RESERVATION DEADLINE: JULY 5TH OR UNTIL THE BLOCK IS FULL!Room and rate availability can only be guaranteed until July 5, 2019 OR UNTIL THE BLOCK OF ROOMS IS SOLD OUT, WHICHEVER COMES FIRST! Please make your reservation early.

tHE summIt, a DOlcE HOtEl5345 Medpace WayCincinnati, OH 45227(513) 527-9900 (Hotel Direct Phone Number)

maKING yOuR ROOm REsERVatION• ONLINE: Reservations can be booked, modified or cancelled on the following online customized website link: https://book.passkey.com/e/49928272 • BY TELEPHONE: Reservations can be made 24 hours a day by calling (866) 898-3567. When making your reservation, please reference the “amssm – 2019 Research and leadership conference” to receive the room block group rate.

HOtEl caNcEllatION POlIcyTo cancel a reservation, the deposit is refundable if yourcancellation is received at least twenty-four (24) hours prior to your scheduled arrival date; otherwise one night’s room and tax will be charged to the your credit card.

CINCINNATI/NORTHERN KENTUCKY INTERNATIONAL AIRPORT (CVG)23 Miles (Approximately 34 Minutes) from The Summit, A Dolce Hotel

suGGEstED tRaNsPORtatION – RatEs suBJEct tO cHaNGE (tip Not Included)Executive Transportation Shuttle $40 one-way/$70 round trip (859) 261-8841Taxi $57 one-way (513) 472-0408

OtHER NEaRBy aIRPORts & DIstaNcE tO tHE summIt, a DOlcE HOtElDayton International Airport (DAY) 63 miles 1 hour 23 minutesPort Columbus International Airport (CMH) 106 miles 1 hour 45 minutes

IMPORTANT CONFERENCE INFORMATION — PLEASE NOTE:• All conference handouts and materials will be available online prior to the conference. Please use these handouts to choose a “research question” and a “preliminary research idea”. The more you prepare, the more you can advance your project.

• Please come to the conference with a research project idea. All fellows will be required to develop an individual research project during the conference. It is expected that each fellow will present their research idea at the end of the conference.

• Please bring a laptop computer to this conference. If you are bringing a tablet or similar device, make sure you are able to create a PowerPoint or use similar program for your presentation.

• Conference dress is casual.

• NO PETS ALLOWED.

• All fellows should plan to attend the social event (MLB Cincinnati Reds vs. St. Louis Cardinals) on Thursday evening (July 18) as well as the social event with AMSSM Board and Faculty on Friday evening (July 19) with appetizers/cash bar.

• When making your airline reservations, please schedule a mid-afternoon departure on sunday, July 21 as the conference adjourns on Sunday at 12:00 p.m.

REGIstRatION INfORmatION

REGISTRATION DEADLINE: JULY 9, 2019

fEllOWs REsEaRcH & lEaDERsHIP cONfERENcEIncluding:

Introduction to Sports Ultrasound for Fellows and sports trauma and Event medicine (s.t.E.m.)

• $300.00 AMSSM Fellowship Member

• $350.00 Non-MemberPayment/registration form must be received by the July 9th registration deadline.

TO REGISTER FOR THE CONFERENCE: • Online registration is encouraged. You have the option to pay by check or credit card when registering online. A receipt will be generated upon completion of your online registration. When mailing your check payment to the AMSSM office, please include a copy of your online registration receipt.• OR, print and return the registration form along with your payment to the AMSSM office.

REGIstRatION cHEcK-IN fOR cONfERENcE matERIals

Registration/check-in for meeting materials will be available at The Summit, A Dolce Hotel at the AMSSM Conference Registration Desk on Thursday, July 18 from 1:00 p.m. - 1:30 p.m.

IMAGE/LIKENESS/VOICE RELEASEI understand and agree that, as a result of participating in an AMSSM conference, my image, likeness or voice may be recorded by photography, video or other medium. I hereby grant irrevocable and unrestricted permission to AMSSM and its representatives or assignees to use my image, likeness or performance in any medium and for any purpose. I hereby waive any right to inspect or approve such use of materials. Your submission of this registration form acknowledges acceptance of these terms.

cOuRsE REfuND POlIcyAll refund requests must be submitted in writing or emailed to Kristin Ragsdale and Michele Lane at registration@amssm.org by July 9, 2019. No refunds will be issued for requests received after this date. Refunds are subject to a $75.00 processing fee.

The planners and sponsors of this event claim no liability for the acts of any suppliers to this meeting, or the safety of any attendee at or while in transit to this event. The planners and sponsors reserve the right to cancel this event without penalty. Attendees who purchase non-refundable airline tickets do so at their own risk. The total amount of any liability of the planners and sponsors will be limited to a refund of the registration fee. Your submission of the registration form acknowledges acceptance of these terms.american medical society for sports medicine4000 West 114th Street, Suite 100Leawood, KS 66211(913) 327-1415 (Phone)(913) 327-1491 (Fax)kragsdale@amssm.orgwww.amssm.org

PROGRamtHuRsDay, July 18, 2019

1:30 P.M. - 6:05 P.M. SPORTS TRAUMA AND EVENT MEDICINE (S.T.E.M.)

1:00 p.m. - 1:30 p.m. Registration

1:30 p.m. - 1:40 p.m. Introduction Paul J. Gubanich, MD, MPH; Fellows Research & Leadership Conference Chair Stephen W. Dailey Jr, MD and Rajwinder Singh Deu, MD; Co-Chairpersons, S.T.E.M. Course

1:40 p.m. - 2:00 p.m. Preparation, Priority: Downed Athlete — Head, Heat, Heart Stephen W. Dailey Jr, MD

2:00 p.m. - 2:20 p.m. C-Spine and Spine Immobilization Rajwinder Singh Deu, MD

2:20 p.m. - 2:40 p.m. Sideline Orthopedics Jack Spittler, MD, MS

2:40 p.m. - 2:50 p.m. BREAKOUT TO WORKSHOPS

2:50 p.m. - 3:50 p.m. WORKSHOPS: SESSIONS (30-minute Rotations through Two Stations) – All Faculty

Station 1: cervical spine management

Station 2: Orthopaedic Emergencies

Station 3: Concussion Evaluation

Station 4: Airway/Cardiac Triage

3:50 p.m. - 4:00 p.m. REFRESHMENT BREAK

4:00 p.m. - 4:20 p.m. Facial Trauma – Face, Eye, Dental Giselle Aerni, MD

4:20 p.m. - 4:40 p.m. Chest Abdomen, GU Conditions and Trauma Bret E. Betz, MD

4:40 p.m. - 4:50 p.m. BREAKOUT TO WORKSHOPS

4:50 p.m. - 5:50 p.m. WORKSHOPS: SESSIONS (30-minute Rotations through Two Stations) – All Faculty

Station 1: cervical spine management

Station 2: Orthopaedic Emergencies

Station 3: Concussion Evaluation

Station 4: Airway/Cardiac Triage

5:50 p.m. - 5:55 p.m. Return for Closing

5:55 p.m. - 6:05 p.m. Question/Answer Session

6:05 p.m. Adjourn

6:15 p.m. Bus Leaves for Social Event (Included with conference registration) MLB Cincinnati Reds vs. St. Louis Cardinals (7:10 p.m. Game Starts)

PROGRamfRIDay, July 19, 20197:30 A.M. - 12:00 P.M.

amssm fEllOWs REsEaRcH & lEaDERsHIP cONfERENcE

6:30 a.m. - 7:30 a.m. CONTINENTAL BREAKFAST

7:30 a.m. - 7:45 a.m. Introduction of Faculty and Conference Overview Paul J. Gubanich, MD, MPH; Fellows Research & Leadership Conference Chair

7:45 a.m. - 8:05 a.m. Introduction to AMSSM, Leveraging Tools for Research and Professional Development Including the Collaborative Research Network Jim Griffith, MBA, CAE and Stephanie Kliethermes, PhD

8:05 a.m. - 8:25 a.m. An Overview of the Research Process Paul J. Gubanich, MD, MPH

8:25 a.m. - 8:45 a.m. Ways to Get a Meaningful Project Accomplished During a (Short) Year of Fellowship? Jack Spittler, MD, MS

8:45 a.m. - 9:05 a.m. What is the Best Way to Answer My Question? (Study Design) Rajwinder Singh Deu, MD

9:05 a.m. - 9:15 a.m. BREAK

9:15 a.m. - 10:15 a.m. Small Group Session 1 • Abstract Attack! • Developing a Research Question

10:20 a.m. - 11:05 a.m. Beyond the Numbers: Biostatistics for Sports Medicine Stephanie Kliethermes, PhD

11:05 a.m. - 11:25 a.m. Leadership, Looking Through Three Lenses Stephen R. Paul, MD

11:25 a.m. - 11:55 a.m. How to Optimize Collaborations with Your Physical Therapy Team: From Script to Sideline Mark V. Paterno, PT, PhD, MBA, SCS, ATC

11:55 a.m. - 12:00 p.m. Question/Answer Session

12:00 p.m. Recess

12:00 p.m. - 1:00 p.m. LUNCH (Included with conference registration)

PROGRamfRIDay, July 19, 20191:00 P.M. - 7:00 P.M.

INtRODuctION tO sPORts ultRasOuND fOR fEllOWs

1:00 p.m. - 1:05 p.m. Welcome and Introductions Emily E. Dixon, DO; Course Chairperson

1:05 p.m. - 1:25 p.m. Lecture: Basics of Sports Ultrasound: Physics Emily E. Dixon, DO

1:25 p.m. - 1:45 p.m. Live Demonstration Shoulder MSK Ultrasound Examination: Normal Shoulder Anatomy Brian J. Fuller, MD

1:45 p.m. - 2:05 p.m. Lecture: Pathology of the Shoulder Jeffrey A. James, DO

2:05 p.m. - 3:15 p.m. Hands-on Scanning: MSK Ultrasound Examination of Shoulder Scanning Faculty

3:15 p.m. - 3:25 p.m. BREAK

3:25 p.m. - 3:45 p.m. Live Demonstration Knee MSK Ultrasound Examination: Normal Knee Anatomy Henry Stiene, MD

3:45 p.m. - 4:05 p.m. Lecture: Pathology of the Knee Amanda C. Goodale, DO

4:05 p.m. - 4:25 p.m. High Yield Lecture: Achilles, Medial/Lateral Elbow, Gluteal Tendons Emily E. Dixon, DO

4:25 p.m. - 4:40 p.m. Ask the Experts Course Faculty

4:40 p.m. - 7:00 p.m. Hands-on Scanning: MSK Ultrasound Examination of Knee and High Yield Structures Scanning Faculty

7:00 p.m. Adjourn

7:00 p.m. Social Event with AMSSM Board and Faculty with Appetizers and Cash Bar (on-site)

PROGRamsatuRDay, July 20, 2019

7:45 A.M. - 5:00 P.M.amssm fEllOWs REsEaRcH & lEaDERsHIP cONfERENcE

6:45 a.m. - 7:45 a.m. CONTINENTAL BREAKFAST

7:45 a.m. - 8:00 a.m. Announcements

8:00 a.m. - 8:30 a.m. How to Write an Exercise Prescription? Irfan M. Asif, MD

8:30 a.m. - 9:00 a.m. Exercise Prescription for the Treatment and Management of Childhood Obesity Robert M. Siegel, MD

9:00 a.m. - 9:30 a.m. Building a Research Program in Sports Medicine: Pearls and Pitfalls of Multidisciplinary Collaborations Gregory D. Myer, PhD, CSCS*D

9:30 a.m. - 9:40 a.m. BREAK

9:40 a.m. - 11:00 a.m. Small Group Session 2

11:05 a.m. - 11:25 a.m. Presentation and Methods Review of Trending Orthobiologics Studies Paul J. Gubanich, MD, MPH and Roger J. Kruse, MD

11:25 a.m. - 11:45 a.m. How to Conduct an Effective Survey Study Katherine H. Rizzone, MD, MPH

11:45 a.m. - 12:00 p.m. Question/Answer Session

12:00 p.m. - 1:00 p.m. LUNCH (Included with conference registration)

1:00 p.m. - 1:30 p.m. President’s Talk Chad T. Carlson, MD

1:30 p.m. - 1:50 p.m. Now that Fellowship is Over, Now What? Jason L. Zaremski, MD

1:50 p.m. - 2:50 p.m. Obtaining Your First Sports Medicine Job Multiple Faculty including Chad T. Carlson, MD, Rebecca A. Myers, MD, Jason L. Zaremski, MD and others

2:50 p.m. - 3:00 p.m. BREAK

3:00 p.m. - 4:00 p.m. Small Group Session 3

4:05 p.m. - 4:25 p.m. Buzz Word Bingo Karin VanBaak, MD

4:25 p.m. - 4:45 p.m. The Art of Giving a Presentation Kyle B. Nagle, MD, MPH

4:45 p.m. - 5:00 p.m. Question/Answer Session

5:00 p.m. Recess

Evening Group Time – Independent Opportunity to Work on Presentations

PROGRam

suNDay, July 21, 20197:00 A.M. - 12:00 P.M.

amssm fEllOWs REsEaRcH & lEaDERsHIP cONfERENcE

6:00 a.m. - 7:00 a.m. CONTINENTAL BREAKFAST

7:00 a.m. - 8:00 a.m. Fellows Meeting Aditya Raghunandan, MD; AMSSM Fellowship Class Representative

8:00 a.m. - 8:35 a.m. Small Group Session 4: Small Group Presentation Prep

8:40 a.m. - 9:00 a.m. How Do I Get Published? Morteza Khodaee, MD, MPH

9:00 a.m. - 9:20 a.m. Mental Health: The Student Athlete Giselle Aerni, MD

9:25 a.m. - 10:25 a.m. Group Presentations (4 minutes each)/discussion – Winner Selected by Team Vote (leader has tie Breaker)

10:30 a.m. - 11:00 a.m. CONCURRENT SESSION: Shark Tank Semifinals – Best Group Presentations (5 minutes each)

11:00 a.m. - 11:15 a.m. BREAK

11:15 a.m. - 11:45 a.m. Final Four – Shark Tank Final Presentations (6 minutes each) – Judges to Award Final Prize

11:45 a.m. - 12:00 p.m. Wrap-up

12:00 p.m. Adjourn

facultyPaul J. Gubanich, mD, mPH; Fellows Research and Leadership Conference Chairperson; Associate Professor, Department of Pediatrics – Division of Sports Medicine, University of Cincinnati, College of Medicine; Director, Sports Medicine Fellowship Program, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio

Giselle aerni, mD; Assistant Director, York Hospital Sports Medicine Fellowship Program; Associate Director, York Hospital Family Medicine Residency Program, York, Pennsylvania

Irfan m. asif, mD; Professor and Chair, Department of Family and Community Medicine, University of Alabama Birmingham (UAB), School of Medicine, Birmingham, Alabama

Kate E. Berz, DO; Assistant Director, Pediatric Primary Care Sports Medicine Fellowship Program; Assistant Professor, Department of Pediatrics – Division of Sports Medicine, University of Cincinnati, College of Medicine, Cincinnati, Ohio

Bret E. Betz, mD; Clinical Instructor, Department of Emergency Medicine – Division of Orthopaedics and Sports Medicine, Cincinnati Chilren’s Hospital Medcal Center, Cincinnati, Ohio

Scott Bonnette, PhD; Research Fellow, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio

chad t. carlson, mD; Private Practice, West Des Moines, Iowa;President, American Medical Society for Sports Medicine

amanda chaney, DO; Family Medicine & Sports Medicine, Group Health – Clifton, TriHealth, Cincinnati, Ohio

Jeremy David close, mD; Associate Professor; Director, Primary Care Sports Medicine Fellowship Program, Jefferson University Hospitals, Philadelphia, Pennsylvania

alissa marie conde, mD; Pediatrician, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio

stephen W. Dailey Jr, mD; Co-Chairperson, S.T.E.M. Course; Assistant Professor, UC Health Orthopaedics and Sports Medicine and Emergency Medicine, University of Cincinnati, Cincinnati, Ohio; Director of Sports Medicine, Miami University, Oxford, Ohio

carly Day, mD; Head Team Physician, Purdue University, West Lafayette, Indiana; Board of Director; Chairperson, International/Inter-Organizational Relations Committee, American Medical Society for Sports Medicine

Rajwinder singh Deu, mD; Co-Chairperson, S.T.E.M. Course; Assistant Professor of Orthopaedic Surgery, Johns HopkinsUniversity School of Medicine, Baltimore, Maryland; Johns Hopkins Shoulder and Sports Medicine, Columbia, Maryland

Jed a. Diekfuss, PhD; Research Fellow, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio

Emily E. Dixon, DO; Introduction to Sports Ultrasound for Fellows Course Chairperson; Sports Medicine Chair, TriHealth Orthopedic & Sports Institute; Director, TriHealth Concussion Program; Faculty, TriHealth Primary Care Sports Medicine Fellowship Program, Cincinnati, Ohio

michael Donaworth, mD; Assistant Professor, Department of Orthopaedics and Sports Medicine, University of Cincinnati, College of Medicine; Team Physician, University of Cincinnati Athletics; Medical Director, Athletic Training Program, University of Cincinnati, Cincinnati, Ohio

Drew Duerson, mD; Clinical Associate Professor, Department of Pediatrics, Ohio State University, Columbus, Ohio; Sports Medicine Physician, Nationwide Children’s Hospital, Division of Sports Medicine, Westerville, Ohio

lester s. Duplechan, mD; Interim Director of Physical Medicine and Rehabilitation, University of Cincinnati, College of Medicine, Cincinnati, Ohio

Brian J. fuller, mD; TriHealth Orthopaedic and Sports Medicine; Team Physician, Walnut Hills High School, Cincinnati, Ohio

Jeremy R. Girmann, DO; physiatrist, Fairfield, Ohio

amanda c. Goodale, DO; Faculty, Family and Sports Medicine, TriHealth Bethesda Family Practice Center, Cincinnati, Ohio

Jim Griffith, MBA, CAE; Executive Director, American Medical Society for Sports Medicine

mederic m. Hall, mD; Associate Professor, Departments of Orthopedics & Rehabilitation, Radiology and Family Medicine, University of Iowa Sports Medicine, Iowa City, Iowa; Board ofDirector; Chairperson, Sports Ultrasound Committee, American Medical Society for Sports Medicine

Jeffrey A. James, DO; Premier Orthopaedics, Dayton, Ohio

Kimberly ann Kaiser, mD, mPH; Assistant Professor, Department of Orthopaedic Surgery and Sports Medicine and Family and Community Medicine, University of Kentucky HealthCare, Lexington, Kentucky

Brandon s. Kakos, mD; Sports Medicine Specialist, DMC Sports Medicine – Rehabilitation Institute of Michigan, Detroit, Michigan

morteza Khodaee, mD, mPH; Associate Professor, Department of Family Medicine and Orthopedics, University of Colorado, School of Medicine, Denver, Colorado

stephanie Kliethermes, PhD; Research Director, American Medical Society for Sports Medicine; Assistant Professor, Department of Orthopedics and Rehabilitation, University of Wisconsin – Madison, Madison, Wisconsin

facultyRoger J. Kruse, mD; Director, SPORTS CARE – ProMedica Toledo Hospital Primary Care Sports Medicine Fellowship Program; Head Physician, University of Toledo; Toledo, Ohio

Gregory D. myer, PhD, cscs*D; Director of Research & The Human Performance Laboratory, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center; Faculty, Department of Pediatircs and Orthopaedic Surgery, University of Cincinnati, College of Medicine, Cincinnati, Ohio

Rebecca a. myers, mD; Private Practice, Longs Peak Family and Sports Medicine, Longmont, Colorado; Associate Clinical Professor, Department of Family Medicine, University of Colorado, Denver, Colorado; Board of Director; Co-Chairperson, Education Committee, American Medical Society for Sports Medicine

Kyle B. Nagle, mD, mPH; Associate Professor, Department ofPediatrics/Orthopedics and Sports Medicine, University of Washington, Seattle Children’s Hospital, Seattle, Washington

Richard Okragly, mD; Director, TriHealth Primary Care Sports Medicine Fellowship Program, Cincinnati, Ohio

mark V. Paterno, Pt, PhD, mBa, scs, atc; Physical Therapist and Professor, Division of Occupational Therapy and Physical Therapy, Division of Sports Medicine, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio

stephen R. Paul, mD; Clinical Assistant Professor, Department of Family Medicine, Campus Health Service; University of Arizona, College of Medicine, Tucson, Arizona

aditya Raghunandan, mD; Fellow, Hospital for Special Surgery Interventional Spine and Sports Medicine Fellowship, New York, New York; Fellowship Class Representative to the Fellowship Committee, American Medical Society for Sports Medicine

Katherine H. Rizzone, mD, mPH; Assistant Professor, Departmentsof Orthopaedics, Rehabilitation and Pediatrics, University of Rochester Medical Center, Rochester, New York

Robert m. siegel, mD; Professor of Clinical Pediatrics, University of Cincinnati; Medical Director, Center for Better Health and Nutrition of the Heart Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio

Jack Spittler, MD, MS; Assistant Professor, Department of Family Medicine, Primary Care Sports Medicine, University of Colorado, School of Medicine, Denver, Colorado

Henry Stiene, MD; Director, TriHealth Primary Care Sports Medicine Fellowship Program; Medical Director; Team Physician, Xavier University, Cincinnati, Ohio

Karin VanBaak, mD; Assistant Professor, Department of Family Medicine, University of Colorado, Boulder, Colorado

Jason l. Zaremski, mD; Associate Professor, Division of PM&R, Sports Medicine & Research, Department of Orthopaedics and Rehabilitation; Co-Medical Director, Adolescent and High School Sports Medicine Outreach Program, University of Florida, College of Medicine, Gainesville, Florida

2 0 1 9 A M S S M F e l l o w s R e s e a r c h & L e a d e r s h i p C o n f e r e n c e INTRODUCTION TO SPORTS ULTRASOUND FOR FELLOWS • S.T.E.M. PRE-CONFERENCE THE SUMMIT, A DOLCE HOTEL • CINCINNATI, OHIO • JULY 18 - 21, 2019

R E G I S T R AT I O N F O R MPlease register online at www.amssm.org to reserve a place at the conference. By completing online registration, you have the option to pay by check or credit card. A receipt will be generated upon completion of your online registration. If you prefer to fax or mail in your registration, your spot is not guaranteed until your registration is processed. For mailed or faxed registration, please return this form below - type or print legibly. One form must be completed for each registrant. the registration deadline is July 9, 2019. Register early! Meeting space is limited. this conference is available to sports medicine fellows only.

BADGE AND REGISTRATION INFORMATION (Mailing address listed will be placed on the participants’ list)

Nickname/First Name

Full Name

Fellowship Program

Registrant’s Mailing Address Line 1

Mailing Address Line 2

City State/Province Postal Code Country (if outside USA)

Office Phone Cell Phone

REGIstRatION REcEIPt WIll BE EmaIlED tO tHE aDDREssEs lIstED BElOWRegistrant’s Email Address: Alternative Email Address:

Fellowship Director’s Email Address

REGISTRATION FEES • ADVANCE REGISTRATION DEADLINE: JULY 9, 2019tHuRsDay, July 18, 2019 — suNDay, July 21, 2019 AMSSM FELLOWS RESEARCH & LEADERSHIP CONFERENCE | INTRODUCTION TO SPORTS US FOR FELLOWS | S.T.E.M. COURSE

AMSSM FELLOWSHIP MEMBER......................................................................................................................................$300.00

NON-MEMBER............................................................................................................................................................... $350.00

PLEASE INDICATE YOUR LEVEL OF EXPERIENCE/TRAINING IN SPORTS ULTRASOUND BELOW

Beginner (no experience) Intermediate (a little experience) Advanced (comfortable in diagnostic ultrasound/basic injections)

sOcIal EVENts

Yes, I will attend the MLB Cincinnati Reds vs. St. Louis Cardinals game on Thursday, July 18, 2019...........................-Included-

Yes, I will attend the Happy Hour Appetizers/Cash Bar with AMSSM Board and Faculty on Friday, July 19, 2019.....-Included-

PHYSICAL OR DIETARY REQUIREMENTS (Please indicate with check mark below)

Physical/dietary restrictions (not food preferences) requiring accommodation in order to fully participate in the conference

Please explain: REfuND POlIcy aGREEmENt By attENDEECOURSE REFUND POLICY: All refund requests must be submitted in writing or emailed to Kristin Ragsdale and Michele Lane at registration@amssm.org by July 9, 2019. No refunds will be issued for requests received after this date. Refunds are subject to a $75 processing fee.

I agree and accept the Refund Policy as stated above. Attendee’s Signature:

METHOD OF PAYMENT (Check made payable to AMSSM) Fed. ID: 39-1715104

Visa MasterCard Discover American Express Total Payment

Credit Card Number Expiration Date (mm/yy)

Security Code (CVV) (last 3 digits on back; 4 digits on front of AMEX) Cardholder’s Billing Postal Code

Cardholder’s Name Cardholder’s Signature

SECURED REGISTRATION IS AVAILABLE ONLINE (Members must be logged in before accessing online registration form)

Return this form and payment to: AMSSM | 4000 W. 114th Street, Ste. 100 | Leawood, KS 66211 | Fax (913) 327-1491