Orthopaedic Spine Fellowship

Educational Goals and Objectives

The one year additional fellowship training requires its fellows to obtain competence in the six areas listed below to the level expected of a new practitioner. Below are defined the general competency that the fellow is expected to achieve, along with the specific knowledge, skills, behaviors, and attitudes required to achieve competency in this area:

Fellows are expected to demonstrate:
1. Patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health; they must
  - Gather essential and accurate information about the patient.
  - Make informed diagnostic and therapeutic decisions based on patient information, current scientific evidence, clinical judgment, and patient preference.
  - Carry out patient management plans.
  - Prescribe and perform competently all medical procedures (invasive and non-invasive) considered essential for the scope of practice.
  - Counsel patients and families.
  - Provide effective health maintenance and anticipatory guidance.
  - Use information technology to optimize patient care
Medical Knowledge about established and evolving biomedical, clinical, and cognate sciences, as well as the application of this knowledge to patient care;
1. Clinic/Emergency Room
  - Demonstrate continued competency of all learning objectives outlined for the junior resident including the ability to discuss the indications for non-operative and operative treatment of spinal disorders.
  - Demonstrate competency in interpretation of imaging studies including: x-rays, CT scans and MRI.
  - Formulate a complex differential diagnosis related to spine complaints including primary and secondary diagnostic considerations.
  - Select appropriate secondary diagnostic procedures/imaging modalities to confirm/refute the differential diagnosis.
  - Discuss the indications for possible surgical procedures and select appropriate procedures from among the potential choices.
  - Evaluate post-operative spine patients, recognize and discuss in depth the various potential complications of surgical treatment of spinal disorders. Demonstrate familiarity with the appropriate management of these problems including the indications for revision surgery.
2. Operating Room
  - Demonstrate the ability to perform an instrumented cervico-thoracic-lumbar fusion including exposure of the entire spine both anteriorly and posteriorly with supervision.
  - Perform a decompression of neural elements under supervision from anterior/posterior approach.
  - Describe and identify the anatomic components relevant to exposure of the anterior, cervical, thoracic, thoraco-lumbar and lumbar spine.
  - Discuss potential alternative strategies to deal with possible intra-operative complications such as loss of fixation sites or dural tears.
Practice-based learning and improvement that involves the investigation and evaluation of care for their patients, the appraisal and assimilation of scientific evidence, and improvements in patient care; they must
- Analyze practice experience and perform practice-based improvement activities using a systematic methodology.
- Locate, appraise, and assimilate evidence from scientific studies related to their patients’ health problems.
- Obtain and use information about their own population of patients and the larger population from which their patients are drawn.
- Apply knowledge of study designs and statistical methods to the appraisal of clinical studies and other information on diagnostic and therapeutic effectiveness.
- Use information technology to manage information, access on-line medical information; and support their own education.
- Facilitate the learning of students and other health care professionals.
Interpersonal and communication skills that result in the effective exchange of information and collaboration with patients, their families, and other health professionals; they must
- Communicate effectively to create and sustain a therapeutic relationship with patients and families.
- Work effectively with others as a member or leader of a health care team or other professional group
Professionalism, as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to patients of diverse backgrounds; they must:
- Demonstrate respect, compassion, and integrity; a responsiveness to the needs of patients and society that supersedes self-interest; accountability to patients, society, and the profession; and a commitment to excellence and on-going professional development.
- Demonstrate a commitment to ethical principles pertaining to provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices
- Demonstrate sensitivity and responsiveness to a diverse patient population, including, but not limited to diversity in gender, age, culture, race, religion, disabilities and sexual orientation.
Systems-based practice, as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of health care, as well as the ability to call effectively call on system resources to provide care that is of optimal value.
- Know how types of medical practice and delivery systems differ from one another, including methods of controlling health care costs and allocating resources.
- Practice cost-effective health care and resource allocation that does not compromise quality of care
- Advocate for quality patient care and assist patients in dealing with system complexities
- Partner with health care managers and health care providers to assess, coordinate, and improve health care
- Understand the reciprocal impact of personal professional practice, health care teams, and the health care organization on the community/society

The fellow will be required to complete a research project equal to the caliber that can be submitted and presented at a National Meeting.

The fellow will participate in the education of the residents and medical students.

This page was last updated on: October 15, 2009.

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