Fellowship

FELLOWSHIP AND APPLICATION PROCESS

Thank you for your interest in the The Spine and Sports Center (TSASC) Interventional Spine & Sports Medicine Fellowship. The Spine and Sports Center is a dynamic outpatient physiatry group based in Houston, Texas. TSACS is committed to excellence in clinical and interventional training of Spine and Musculoskeletal medicine. Our fellows learn clinical evaluation and decision-making skills in Spine and general Musculoskeletal disorders, as well as acquire competence in fluoroscopy-guided spine interventions (lumbar, sacral, cervical and thoracic). Key elements of the fellowship training include electrodiagnostics, radiographic assessment, musculoskeletal ultrasound (for injection guidance and diagnostics), and business of outpatient practice. Our case mix is generally 70% spine, 30% general musculoskeletal/sports medicine.

In addition to spine procedures, there is physical examination skills, EMG’s and ultrasound-guided joint and soft tissue injections (including platelet-rich plasma therapies [PRP], amniotic stem cell injections and Bone marrow stem cell inections).

This program is ideally suited for those of you who seek training in the following:

• Basic and Advanced Interventional Spine Care
• Musculoskeletal and Sports Medicine
• Electrodiagnostics
• Musculoskeletal Ultrasound
• Business skills, billing and coding
• Practice Management/Building

We train a total of 1-2 fellows annually. Fellows begin their one-year training in July (sometimes August) and/or January.

Potential fellows will need to have completed an ACGME-accredited residency program in Physical Medicine and Rehabilitation, and be ABPMR board certified or eligible.

Requirements for consideration for the TSASC Interventional Spine and Sports Medicine Fellowships include the following:

• Completion of an American Physical Medicine & Rehabilitation residency or other residency with a minimum of three months of electrodiagnostic experience.
• Current Texas Medical and DEA licensures. These need to be current prior to your fellowship start date.
• Personal Statement and CV
• Three letters of recommendation, including one from your residency program director
• A picture in jpeg format to attach to your file

Interviews will be offered between May 1 and September 15 as completed application materials are received. After the material is reviewed, we will contact selected residents for an interview.

Duration:

One year.

The fellowship is 12-months long but can be extended to 15-months if agreed upon by the Fellowship Director and Fellow . Fellow starts in July, or mid-August. There is some flexibility to the start date with the approval of the Fellowship Director.

We are a member of the NASS (North American Spine Society) Interventional Spine and Musculoskeletal Fellowship Consortium and will be abiding by the September 15th common offer date. You may contact our fellowship coordinator at [javascript protected email address] or the fellowship director at [javascript protected email address].

Benefits:

• Competitive annual salary and benefits
• Paid malpractice insurance
• Up to five (5) days paid CME
• 2 weeks (10 days) vacation
• Health insurance coverage for fellow
• Paid professional license and appropriate dues

TRAINING:

The fellowship provides training in all aspects of Musculoskeletal Medicine and Interventional Spine Care including, but not limited to, fluoroscopically guided spine procedures, electrodiagnostics, musculoskeletal ultrasound, and the management of general musculoskeletal/pain disorders.

The fellow will feel very comfortable in the care of the spine, shoulder, knee and hip. The fellowships include high school football coverage, team physicals as well as coverage of local sports like the Houston Marathon. The fellowship training emphasizes the use of diagnostic and therapeutic cervical, thoracic and lumbosacral spine procedures. These include diagnostic and therapeutic epidural steroid injections, sacroiliac injections, facet procedures (including radiofrequency denervation), provocation discography, percutaneous intradiscal procedures. Training also includes regenerative medicine and the interpretation of MRI, CT and plain films. Emphasis is placed on selection of appropriate patients based on a comprehensive neuromusculoskeletal evaluation including history, physical examination and diagnostic image interpretation. When appropriate, therapeutic image guided procedures are incorporated into a comprehensive rehabilitation program.

Training also includes a thorough understanding of practical issues such as business skills, billing and coding to prepare physicians for private or academic practice. The practice also includes time spent in physical therapy to see how that is an integral part of a comprehensive conservative spine and musculoskeletal practice.

EDUCATION

• Exposure to acute, sub-acute and chronic musculoskeletal and spine pathology
• Opportunity to learn fluoroscopically-guided spinal injections under direct attending supervision at scheduled clinics
• Depending on the skill progress of each fellow, opportunity to do more complex procedures as appropriate:
• Cervical, thoracic, lumbar epidural injections
• Cervical, thoracic, lumbar selective nerve injections
• Cervical, thoracic, lumbar facet joint injections
• Cervical, thoracic, lumbar medial branch blocks
• Sacroiliac joint injections
• Intraarticular hip, knee, and shoulder injections
• Facet procedures (including radiofrequency neurotomy)
• Lumbar discography and intradiscal therapeutic procedures
• Tenotomies
• Percutaneous Disc Decompression
• Vertebroplasy
• Arthrograms
• Interpretation of MRI, CT and plain films
• Musculoskeletal ultrasound
• Opportunity to learn ultrasound guided injections
• Electrodiagnostic skills
• Opportunity for conference time (i.e. spinal procedure didactic conference such as AAPM&R, NASS, SIS, etc.)
• Management of general musculoskeletal/pain disorders and pain conditions.
• Musculoskeletal ultrasound
• Joint / bursa / trigger point injections
• Platelet-rich plasma (PRP) therapy
• Amniotic stem cell injetions
• Bone Marrow stem cell injections
• Sports Teams coverage include high school football, team physicals and the Houston Marathon

RESEARCH

• Adopt and work on a significant musculoskeletal research project
• Write a publishable article
• Fellows are expected to be involved in at least one research project during the fellowship, to be completed and submitted for presentation and/or publication.

TEACHING

Each fellow is expected to:

• Journal clubs are held to review the relevant literatures. Fellows take active part in journal clubs and must present every month.
• Teach and supervise residents and medical students on rotation
• Fellows take part in teaching medical students and residents
• The program encourages and supports fellows to participate in academy meetings, procedural workshops and other educational meetings throughout the year.
• Fellows rotate with a neuroradiologist and MSK radiologist reviewing cases
• In addition, opportunities exist to cover local high school teams and athletic events like the Houston Marathon

PATIENT CARE

Each fellow is required to participate in:

• Outpatient clinics both independently and directly supervised by attending
• Procedure clinics directly supervised by attending and as they progress they will have more indepedence
• Electrodiagnostic examinations
• Promptly return patient related phone calls and correspondence