The University of South Alabama Sports Medicine and Adult Reconstruction Fellowship

INTRODUCTION The University of South Alabama (USA) Sports Medicine and Reconstructive Surgery Fellowship is a graduate medical program designed to take place following the successful completions of an accredited residency training program. The Fellowship experience will offer 12 months of education beginning on August 1st and ending July 31st of the following year. The Fellowship will offer a broad-based sports medicine and adult reconstruction experience involving the shoulder, elbow, knee, and ankle. At the completion of the Fellowship, the Fellow should be competent in arthroplasty of the shoulder, elbow and knee. He/she will also be exposed to soft tissue reconstruction of the shoulder, elbow, kne3e, and ankle, as well as bone reconstruction and cartilage transplantation. The USA Sport Medicine Fellow will also take trauma call and be exposed to bone and soft tissue trauma of the upper and lower extremities, not including the spine and pelvis. INSTITUTIUONAL RESOURCES A. The University of South Alabama Medical Center and Department of Orthopaedic Surgery provides an environment and the facilities for acquiring the knowledge, skills, clinical judgment, and approaches that are essential to the practice of orthopaedic sports medicine. The program director, supporting faculty and staff, and the administration are fully committed to the educational program. B.

Resources: 1. USA Medical Center Hospital and operating rooms 2. USA Knollwood Hospital outpatient and inpatient operating rooms 3. USA Department of Orthopaedic Surgery Offices and Library 4. USA Department of Orthopaedic Surgery Biomechanics Laboratory 5. USA Department of Orthopaedic Surge3ry Cadaver and Arthroscopic Skills Laboratory 6. USA Athletic Department training room facilities 7. USA Sports Medicine and Knollwood Hospital physical therapy facilities 8. USA Computer Studies facilities

PROGRAM PERSONNEL I.

Program Director Albert W. Pearsall, IV, MD Associate Professor Director, Section of Sports Medicine & Shoulder Service Team Physician: 1. University of South Alabama intercollegiate and intramural athletics 2. Mobile Wizards Arena 2 Professional Football League Specialty: Sports Medicine, shoulder and knee

PROGRAM PERSONNEL II.

Additional Faculty Frederick Meyer, MD Professor and Chairman USA Department of Orthopaedic Surgery Specialty: Hand Surgery Sudhakar Madanagopal, MD Assistant Professor USA Department of Orthopaedic Surgery Specialty: Orthopaedic Trauma and Adult Reconstruction John Kovaleski, PhD Professor Department of Health Education and Exercise Science Specialty: Kinesiology and ankle mechanics

EDUCATIONAL GOALS I.

CLINICAL EXPERIENCE A. Understand the nature and variety of injuries occurring in athletics. B. Understand the biomechanics of athletic injuries and their prevention. C. Develop and understanding and treatment strategy for athletic injuries. D. Develop the educational and organization skills to become a team physician. E. Be able to diagnosis and treat athletically related ankle and foot injuries. F. Be able to diagnosis and treat complex injuries about the knee. G. Be able to diagnosis and treat complex injuries of the elbow. H. Be able to diagnosis and treat complex injuries of the shoulder.

EDUCATIONAL GOALS III.

SURGICAL EXPERIENCE A. Ankle instability reconstruction B. Elbow arthroscopy C. Elbow medial collateral and lateral medial collateral ligament reconstruction D. Knee arthroscopy E. Knee ligamentous reconstruction (ACL, PCL, LCL, MCL, PLC) F. Knee alignment reconstruction (osteotomy) G. Knee cartilage transplantation (autologous and allograft) H. Knee meniscal transplantation I. Knee patellar realignment and reconstruction J. Total knee replacement K. Unicondylar knee replacement L. Shoulder arthroscopy M. Arthroscopic shoulder subacromial decompression, distal clavicle excision, and rotator cuff repair N. Arthroscopic and open instability reconstruction O. The use of bone blocks in shoulder reconstruction P. Arthroscopic labral repair Q. Total and hemiarthroplasty shoulder replacement R. Fracture treatment of the ankle, knee, elbow, and shoulder

IV.

DIADACTIC EXPERIENCE A. Sports Medicine training room once a week B. Clinical conference once a week C. Grand Rounds once a week D. Journal Club once a month E. Sports Medicine Journal Club once a month F. Annual Primary Care Sports Medicine Course G. Annual Alabama Orthopaedic Meeting H. Orthopaedic biomechanics laboratory research experience I. Weekly orthopaedic research meeting J. Periodic sports medicine speakers brought in to lecture K. Orthopaedic clinic three times a week

CONFERENCE SCHEDULE A. B. C. D. E. F. G. H.

Basic science/ Trauma Sports Medicine conference: Monday: 2pm-3:30pm Grand Rounds: Friday 7:30am-8:30am Journal Club: Wednesday evening/ once a month Sports Medicine Journal Club: AAOS annual meeting AOSSM annual meeting USA Annual Primary Care Sports Medicine Course USA Annual Arthroscopic Skills Course

CLINICAL SCHEDULE

Monday Clinic: 8:30 am-4:30 pm

Thursday 8:30 am – 11:00 am

Friday 8:30 am – 11:00 am

]

OPERATIVE SCHEDULE Tuesday Knollwood Inpatient/ Outpatient 7am-5pm

Wednesday Knollwood Inpatient/ Outpatient 7am-5pm

Sports Medicine Fellow will take trauma call with the Residents several times a month. Dr. Pearsall performs approximately 300-400 cases per year.

PROGRAM RESEARCH AND SCHOLARLY ACTIVITY I. II. III. IV. V. VI.

VII.

Active participation with staff and residents in clinic, operating room, and conferences. Present a short sports medicine lecture at Monday conference once every 2 months. Present a full sports medicine lecture at Grand Rounds twice a year. Lead sports medicine Journal Club (AJSM, JSES) once a month. Participate in research conference once a week. Design, implement and interpret at least one research project for presentation at a National meeting and submit for publication in a peer-reviewed journal. Assist in the coordination and administration of the USA annual arthroscopic skills course.

PROGRAM RESEARCH AND SCHOLARLY ACTIVITY

Prior to the Fellow's arrival August 1st, an outline of research topics will be introduced to him/her. He/she will select the project(s) in which he/she is interested or submit a modification of a project for approval. In rare instances when the Fellow has a well-outlined research idea, this project may be implemented during his/her Fellowship year. After the project outline is decided upon, the Fellow will begin preparation by reviewing literature related to the project and discussing with Dr. Pearsall and the staff what will be involved. The pre-arrival preparation will make a smoother transition to the laboratory and facilitate the completion of the research project(s) with greater ease.

RESEARCH PERSONNEL AND FACILITIES

The USA Department of Orthopaedics has numerous opportunities for orthopaedic research. Fellow will be expected to take advantage of these resources to design, implement, and complete his/her research hypothesis. Faculty 1. Valentina Grishko, PhD Area of expertise: biomechanics 2.

John Kovaleski, PhD Area of expertise: exercise kinematics and physiology

3.

Glenn Wilson, PhD Area of expertise: anatomy and structural cell microbiology

4.

Robert J Heitman, PhD Area of expertise: statistics

Facilities The USA Department of Orthopaedics has two biomechanical laboratories for research purposes. The Moorer Building houses the cadaver and arthroscopic skills laboratory. At this facility, gross dissections of specimens, arthroscopic procedures, and biomechanical testing are performed. The Moorer laboratory also houses a computer driven, state of the art six degree of freedom testing apparatus that can be used for sophisticated biomechanical testing in multiple planes. The second laboratory is in the Department of Biomechanics, where an Instron machine is housed for various testing purposes. In addition to the biomechanical laboratories, the USA Department of Computer Science has instituted a database for entering and retrieving data on a variety of orthopaedic problems for which different surgical procedures are performed. This database is used to retrieve patient data to evaluate and analyze for publication. The Fellow will have his own office and desktop computer.

LIBRARY The Fellow will have access to the Department of Orthopaedics Library, as well as the University of South Alabama Medical School Library.

SPORTS MEDICINE EXPERIENCE

The University of South Alabama is a Division I NCAA School, with the following varsity sports: men's basketball, women's basketball, men's baseball, women's soccer, women's volleyball, men's track, women's track. USA also has a men's club football team, with the intent of advancing to NCAA Division II status

within the next 1-2 years. Dr. Pearsall is the team physician for all University teams, as well as the Mobile Wizards, an Arena 2 professional football team. This clinical volume provides an extensive opportunity for sports medicine pathology and treatment during the Fellowship.

RECONSTRUCTION/ RESURFACING EXPERIENCE Dr. Pearsall performs upper extremity joint reconstruction, including total shoulder arthroplasty, total elbow arthroplasty. In addition, he also performs total and unicondylar knee arthroplasty. Dr. Pearsall has one of the largest cartilage transplant practices in the country. To date, over 70 autologous, fresh allograft or frozen allograft transplants have been performed at USA. Such transplants are performed for full thickness (Outerbridge Grade III-IV) articular cartilage lesions of the knee and ankle. Many of these are performed in conjunction with other realignment or unloading procedures, including, tibial tubercle osteotomy. The Fellow will also receive extensive experience with straightforward and complicated knee, elbow and shoulder soft tissue and ligamentous reconstructions. The shoulder experience during the Fellowship includes primary and secondary instability reconstructions. These include arthroscopic and open capsular shifts and bone block procedures. Throughout the Fellowship, the Fellow will learn preoperative surgical indications for all procedures, as well as the post-operative therapy regimens that are required for a successful outcome.

PROCUDURE FOR DISCIPLINARY ACTION GENERAL/PERSONNEL POLICY VIOLATION Should the Fellow violate any of the general and personnel policies set forth, the Hospital Administrator for Graduate Medical Education will notify him/her by hand delivered or certified mail of the specific violation with any information pertaining to the alleged violation. Copies will also be forwarded to the Senior Hospital Administrator and the Coordinator for GME in cases of suspension or termination, and to the Fellowship Director of the Fellow's Department. Fellows may be reprimanded orally or in writing, suspended with or without pay, or terminated from employment. During an investigation of these matter, if it is deemed necessary by either the Hospital Administrator for Graduate Medical Education or the Fellowship Director or Program Director of the particular department, the Fellow may be placed on suspension with pay.

GRIEVANCE PROCEDURE FOR DISCIPLINARY ACTION GENERAL/PERSONNEL POLICY VIOLATION Fellows may appeal disciplinary actions for violations of general and personnel policies of the University of South Alabama or its Hospitals to the Hospital Administrator for Graduate Medical Education. The Staff Grievance and Appeals Process set forth in the Staff Employee Handbook is not applicable to Fellows. Appeals must be in writing and submitted within ten (10) working days of receipt of the letter notifying the Fellow of disciplinary action. The Hospital Administrator for Graduate Medical Education should respond in writing to the Fellow's appeal within ten (10) working days of receipt of the appeal. If the appeal is not settled to the Fellows' satisfaction, he/she may make an appeal to the Senior Hospital Administrator or his/her designee. The appeal must be in writing and must be submitted within ten (10) working days of the response from the Hospital Administrator for Graduate Medical Education. The Senior Hospital Administrator or his/her designee will then either hear the appeal or appoint a designee to hear the appeal. Any documentation or information that the Program Director, Fellowship Director or Hospital Administrator for Graduate Medical Education has relating to the matter to be appealed will be submitted to the Fellow. The Fellow may not be represented by legal counsel in the actual appeal hearing before the Senior Hospital Administrator or his/her designee, but may have persons available to speak on his/her behalf. The Hospital Administrator for Graduate Medical Education, the Program Director or the Fellowship Director of the Fellow's Department may present evidence with regard to the reason for the action to be taken. The decision reached by the Senior Hospital Administrator following the hearing is the

highest level of appeal available within the University of South Alabama Hospitals for disciplinary action resulting from violation of the General and Personnel Policies.

ACADEMIC DISCIPLINARY ACTION- EDUCATIONAL/CLINICAL PREFORMANCE

The preeminent reason for having Fellowship programs at the University of South Alabama Hospitals is for professional education and certification of successful completion of the programs so that Fellows may practice medicine and take board examinations in their areas of specialty training. Therefore, in the area of educational and clinical performance, the Fellow's performance is important and must be satisfactory. This experience also will include those related activities that are important to assure a successful and academically sound education for a physician. The related activities include, but are not limited to, appropriate license for the practice of medicine in the State of Alabama or other states where appropriate, the ability to carry out the instructions of the Fellowship Director, including any policy related to engaging in outside remunerative work, and the ability to abide by the policies of the applicable department and the bylaws of the professional staff of the University of South Alabama Hospitals.

PROCEDURE FOR ACADEMIC DISCIPLINARY ACTION In the event that a Fellow's performance in the educational or clinical program, as set forth above, continues to be unsatisfactory, the Fellowship Director or the Program Director will notify the Fellow, by handdelivered or certified mail, of the deficiencies and necessary remedial actions. If, in the opinion of the Fellowship Director, continued clinical activities of the Fellow are not in the best interest of patient care, the Fellow may be temporarily relieved of clinical responsibilities. The Fellow will be paid during this period of temporary relief of clinical responsibilities. Fellows may be reprimanded, placed on specific probation, suspended or terminated for unsatisfactory performance and/or unacceptable conduct in carrying out their clinical and education responsibilities in the Fellowship program. The recommendation for academic disciplinary action shall be proposed by the Program Director in writing to, and discussed with, the Fellow. For suspension and/or termination review and approval by the Fellowship Director and Vice President for Medical Affairs or his/her designee are required. A letter authorizing such academic disciplinary action is required and shall be sent to the Fellow by certified mail or hand-delivered. Any Fellow put on probation, suspended or terminated by a department; copies of the letter authorizing such academic disciplinary action should be forwarded to the Senior Hospital Administrator and the Coordinator for GME.

SALARY / VACATION

The USA Sports Medicine and Adult Reconstruction Fellow will be licensed as a USA Faculty member at the Instructor level during his Fellowship. Current (2005-2006) stipend is set at $47,835 / year with a comprehensive health insurance, malpractice and benefits package provided by the University of South Alabama. The Fellow will receive 4 weeks of paid vacation during training, with no more that 2 weeks to be taken consecutively. The Fellow will travel to 1 conference per year, in addition to any conference in which he is the presenting author of a paper.