Musculoskeletal Medicine: Block 1

Rotation Goals and Objectives

  1. General Description
    1. Family Physicians practices vary to the extent that they provide musculoskeletal medical care. This curriculum will provide residents with an introduction to the skills expected of family physicians with active practices involving this area. This rotation will provide experience in the fields of sports medicine and occupational medicine.
    2. The resident will be precepted by a faculty member who works in the field of orthopedics, sports medicine, or occupational medicine. The faculty member with whom the residents work will generally be board certified physicians, but time will also be spent with athletic trainers, physical therapists and other allied professionals. The resident will work alongside the health care professionals and will be on a one to one basis so didactic material is delivered to the resident on an informal basis throughout the rotation. There are assigned readings, videos, and PowerPoint presentations that are also a part of the learning process.
    3. Residents are expected to follow their patients in the Family Medicine Center (FMC) during this rotation.
    4. Level: PGY 1 - 3 year
    5. Location: Office based rotation at FMC, Patient-Center Family Medicine (PCFM), orthopedic offices, and occupational medicine offices.
    6. Duration: One four week block
    7. Rotation Time: Full time rotation
    8. Time Spent at FMC
      1. PGY1: One half day per week
      2. PGY2 & PGY 3: Four half days per week
    9. Participation in the Family Medicine call pool is require during these rotations.
    10. Evaluation of Rotation
      1. The evaluation of the resident will be by the completion of an evaluation form by the attending physician or allied health professional.
      2. The resident will fill out a rotation evaluation upon completion.
      3. The knowledge, skills and competencies acquired during this rotation will be evaluated by Family Medicine attending as the resident provides longitudinal care to patients in the Family Medicine Center.
    11. The resident's performance on the American Board of Family Medicine In-Training examination will also be used to assess knowledge in this area.
    12. There is a weekly Sports Medicine didactic that meets every Monday at 12:15pm at the FMC as part of the Sports Medicine Fellowship curriculum. Various different sports medicine topics will be discussed. You are expected to attend.
    13. There is a monthly Sports Medicine Journal Club the 3rd Tuesday at 7am. You are expected to attend.
    14. Volunteer for at least two amateur sporting event with the sports medicine fellow, Dr. Hall, Dr. Islas or Dr. Stovak.
      • Available University of Nevada Athletic Events: Football, Volleyball, Soccer, Basketball, Baseball and Softball
      • High School football
      • Tahoe Rim Endurance Run - volunteer on medical team for event coverage.
      • Various other opportunities that arises randomly throughout the year.
      • Contact the Sports Medicine fellow for information, scheduling, dress code and sideline instructions.
    15. Read the articles. Be ready to discuss the articles you have read and ask questions with Dr. Stovak. Reading List: http://med.unr.edu/family-medicine/applicants/rotation-goals/musculoskeletal-medicine/reading-list
    16. Watch the You Tube videos on Musculoskeletal Joint Exam by Dr. Stovak and ask questions as needed of the faculty to work towards competence in performing the exams.
    17. Review the 2 PowerPoint presentations on Musculoskeletal Plain Film Radiology and take the test. Turn the test in to Dr. Stovak to be graded. A passing grade (70%) must be received before rotational credit is given.
  2. Patient Care skills to be progressing towards competency in after the 1st Block.
    1. Performance of sports, orthopedic and occupational history and clinical exam.
    2. The evaluation and treatment for common disorders for patients with sports related injuries.
    3. The evaluation and treatment for common disorders for patients with occupational injuries.
    4. Performance of a sports pre-participation history and physical.
    5. Develop an understanding of the utility of ultrasound in the diagnosis and treatment of musculoskeletal injuries.
  3. Medical Knowledge to be progressing towards mastery of after the 1st Block.
    1. An increasing knowledge base to care for the breadth of conditions that physicians confront when providing care for injured patients.
    2. An understanding of injury prevention for athletes and workers.
    3. An understanding of the impact of musculoskeletal chronic disease on patients.
  4. Practice Based Learning and Improvement to be progressing towards minimum lifelong skills attainment.
    1. Scientific evidence will be reviewed by the resident and attending physician in the context of their patients.
    2. The practical implementation of evidence-based medicine will be discussed as the medical decision making is reviewed.
    3. Information technology will be utilized by the resident as he or she is required to research topics as directed by the attending physician.
    4. The resident will also be evaluated on the steps they took during the rotation to improve the gaps in their medical knowledge, procedural skills, and patient care.
  5. Interpersonal and Communication Skills
    1. This competency is addressed longitudinally throughout the rotation.
    2. The resident will observe and be observed, taught and evaluated in the performance of obtaining patient histories, documenting histories, writing prescriptions, educating patients about diagnoses and treatment plans and prognoses, and interactions with patients, families, office staff and other physicians.
  6. Professionalism
    1. This competency is addressed longitudinally throughout the rotation.
      1. The attending physician will observe and assess the resident's sense of personal responsibility including attendance, promptness, motivation, completion of duties, and appropriate dress.
      2. Ethical and legal practice skills will be taught.
      3. Respect for cultural, age, and gender differences will be taught, observed and evaluated.
      4. The resident is expected to treat patients, families and colleagues with respect, understanding, empathy and honesty.
  7. Systems Based Practice
    1. This competency is addressed longitudinally throughout the rotation.
      1. The resident will learn to become aware of available resources and the cost effectiveness of testing and therapeutic options.
      2. The resident will gain an increasing understanding of the role of the patient, physician, support staff, and insurer in the health care environment.
      3. The resident will become aware of the available resources in our community as well as to the limitations of the resources in our community that our available to athletes or workers… physical therapists, occupational therapists, exercise physiologists, athletic administrators, athletic trainers, nutritionists, sports psychologists, strength and conditioning specialists, coaches, orthopedists, etc.