Sports Medicine Fellowship

Overview

The Sports Medicine Fellowship at Massachusetts General Hospital provides clinical and academic experience in the orthopedic care of athletes, including the diagnosis and surgical management of athletic injuries. Fellows learn foundational and advanced surgical techniques, as well as the latest nonsurgical approaches, for treating athletes, with a particular focus on the joints of the shoulder, elbow, hip, knee, foot and ankle. Mass General is the #1 research hospital in America, with the country’s largest hospital-based research program, and all Fellowship instructors are members of the faculty at Harvard Medical School.

Fellowship instructors also serve as team doctors for prestigious New England professional and collegiate sports teams, including the New England Patriots, New England Revolution, Boston Bruins, Boston Red Sox, Harvard University, Boston College and more. Three fellows are selected for the Mass General Sports Medicine Fellowship Program each year. Each fellow gains clinical and research experience specifically designed to prepare fellows for leadership careers in both private and academically affiliated hospital sports medicine practices.

The Mass General Sports Medicine Fellowship is accredited by the Accreditation Council for Graduate Medical Education (ACGME) and approved by the Arthroscopy Association of North America (AANA) and the American Orthopaedic Society for Sports Medicine (AOSSM). This enables graduating fellows to apply and sit for the certificate of added qualification in Sports Medicine.

Curriculum

The Fellowship’s core curriculum includes instruction in shoulder, elbow, hip, and knee arthroscopy, with weekly didactic lectures. Sample lecture topics include:

• Athletic medical conditions (non-surgical)
  • Cardiovascular health
  • Concussions and traumatic head injuries (TMI)
  • First Aid and on-the-field treatment of injuries, e.g. catastrophic cervical spine injuries
  • Heat exhaustion
  • Steroid use
• Bicep, triceps, and elbow treatment and surgery
• Cartilage regeneration techniques
• Ligament reconstruction
• Meniscal repair and transplantation
• Musculoskeletal imaging, including MRI and ultrasound
• Patellofemoral treatment and surgery
• Shoulder repair and reconstruction
  • Arthroplasty
  • Instability (arthroscopic and open surgeries)
  • Rotator cuff repair and associated soft tissue procedures
  • Tendon transfers
• Tendon repair and reconstruction
  • Abductor tendon repairs (endoscopic)
  • Achilles tendon reconstruction techniques (minimally invasive)
  • Extensor mechanism of the knee
• Traumatic brain injuries (TBI)

The Sports Medicine CORE Conference, held jointly with the Mass General Brigham Department of Physical Medicine and Rehabilitation, provides lectures on rehabilitation of the injured and post-surgical athlete, return-to-play criteria, and non-operative protocols for the injured athlete.

Outside courses Fellows will participate in:

• Orthopedic Summit on Evolving Techniques (OSET Boston)
• Stryker Shoulder Bioskills Lab
• New England Shoulder and Elbow Society
• Sports Fellows interviews
• Red Sox physicals and Spring training trip
• Arthrex National Fellows Course
• Arthroscopy Association of North America (AANA) National Course
• AANA Hip Arthroscopy Course
  • DePuy Synthes Sports Medicine MGH Bioskills Shoulder Lab
• Stryker National Fellows Course
• MGB Sports Fellows Research Day and program review
• American Orthopaedic Society for Sports Medicine (AOSSM) National Course

Friday 6 AM Conference: Fellows meet weekly to review coverage responsibilities and duties, discuss interesting clinical cases and ongoing research, conduct morbidity and mortality conferences, and journal.

Thondike Lectureship: In 2008, Mass General orthopedic surgeon and sports medicine specialist Bert Zarins, MD, was named the Augustus Thorndike, MD, Distinguished Professor of Orthopaedic Surgery. The late Dr. Thorndike, also a Mass General surgeon, is considered to be the father of sports medicine in the United States. Each year, Dr. Zarins invites an international expert in sports medicine to deliver the Thorndike Lecture to current fellows. The invited speaker delivers a lecture on the sports medicine topic of their choosing.

CORE Competencies: The sports fellowship program teaches six CORE competencies:

• Patient care: The ability to be precise and compassionate with patients in obtaining a focused medical history and conducting a thorough physical examination is crucial for distinguishing between bone, joint and muscle injuries and diseases and providing proper diagnosis.
• Medical knowledge: Competence in this area requires a sound knowledge of anatomy, the fundamentals of biomechanics including the mechanical basis of injury and rehabilitation, and the type and availability of various appliances that may be needed. The program has several didactic components in which trainees present and discuss material including journal club, sports medicine conferences, and research conferences.
• Practice-based learning: Practical experience and the development of proficiency in the non-surgical management, surgical procedures, and post-surgical rehabilitation of sports injuries will be acquired at the level appropriate to the trainee.
• Systems-based practice: Trainees receive instruction in the basic principles of management so that they can effectively staff and manage an office, clinic, or large practice group.
• Professionalism: The trainee must understand the trust placed in them by their patients and by society, and they must always justify that trust. The patient’s welfare must always be placed above all other pressures, especially for pro athletes who may be pressured to return to play before they are ready. Systems-based practice: Trainees receive instruction in the basic principles of management so that they can effectively staff and manage an office, clinic, or large practice group.
• Interpersonal and communication skills: The ability to interact effectively and collegially with medical, surgical, and rehabilitation personnel involved with the care of the patient is critical to providing optimal care and providing the necessary inter- and intradepartmental collaboration. Beyond medical considerations, the trainee must learn to communicate effectively with athletes, coaches, parents, third-party payors, and others about the diagnosis and management of the long-term effects of athletic injuries.

Clinical Experience

Complex shoulder: Rotations with Jon JP Warner, MD, and Bassem Elhassan, MD, offer unique training in the full spectrum of shoulder pathologies, complex reconstruction and arthroplasty. Mass General serves as a quaternary referral center for shoulder tendon transfers. An informal rotation in arthroscopic and open management of the thrower's shoulder is offered with Evan O’Donnell, MD, that includes opportunities to care for the Boston Red Sox. Fellows also work with Robert Nascimento, MD, Head Team Physician and Medical Director for Boston College.

Complex knee: Fellows train alongside Peter Asnis, MD, Eric Berkson, MD, Ian D. Hutchinson, MD, Lars Richardson, MD and Miho Tanaka, MD, PhD, on all aspects of athletic knee care, including acute and chronic multi-ligamentous knee injuries, complex cartilage restoration, meniscal transplant and meniscal preservation techniques and osteotomies.

Sports Foot and Ankle: Fellows spend time focused on athletic foot and ankle injuries with George Theodore, MD.

Hip Arthroscopy: Fellows have focused hip rotations with Scott Martin, MD, as well as supplemental conferences on the full spectrum of arthroscopic hip surgeries.

Sports imaging, including MRI and Ultrasound: Core lectures include training in advanced MRI techniques from our radiology experts and ultrasound training from our physiatrists.

Women’s Sports Medicine: Through our multidisciplinary clinical program, co-directed by Miho Tanaka, MD, PhD, Elizabeth Matzkin, MD, and Kelly McInnis, DO, fellows are exposed to coordinated and comprehensive care of the female athlete.

Pediatric Sports Medicine: The Department of Orthopaedic Surgery at Mass General includes two specialists in pediatric sports medicine (Nikolaos Paschos, MD, PhD, and Giovanna Medina, MD, PhD), who are available for elective rotations.

Rotation Schedule

The three Mass General Sports Medicine Fellows spend roughly two months in each rotation. There are three rotations that repeat in the second half of the academic year, enabling fellows to return to each in order to perfect their skills.

See below for an example Fellowship rotation schedule:

In the example rotation schedule, fellow one rotates with Dr. Martin three days a week for surgical and clinical training in shoulder, knee, and hip arthroscopy, and also assists with medical coverage for the New England Patriots. Fellow one also rotates with Dr. Theodore two days a week for training in foot and ankle surgery, and one day with Dr. Asnis, on ACL instruction and skills required to interact with professional athletes through coverage for both the Boston Bruins and Boston Red Sox.

Fellow two rotates with Dr. Berkson, three days a week for surgical and clinical training in simple and complex knee surgery including osteotomies, multi-ligament reconstruction, meniscal transplants, and cartilage repair. Fellow two also does shoulder surgical training two days a week with Dr. Warner splitting one of those days with Dr. Elhassan.

Fellow three rotates four days a week with Dr. Nascimento, receiving clinical and surgical training in shoulder and knee in addition to assisting with the Boston College Eagles. Fellow three also rotates with Dr. Tanaka, one day a week with training in complex patellofemoral surgeries and the opportunity to assist with the New England Revolution.

Fellows two and three also alternate a six-month rotation working with Harvard University Health Services in a sports clinic every Wednesday. All three fellows are credentialled to electively cover any of the Harvard University teams.

The last rotation of the year is an elective rotation, where the fellows choose the area they will focus on in their practice. This elective also provides sufficient flexibility for fellows to scrub in on unusual cases performed by any faculty member during this period.

Below are example case logs from one fellow in the 2022-2023 Fellowship. This Fellow worked on more than 450 cases during the Fellowship:

Sports Team Coverage

The Mass General Sports Medicine Fellowship is unique in the depth and breadth of experience it provides Fellows, as they work with some of the most elite collegiate and professional sports programs in the country. Fellows assist Mass General sports medicine clinicians who serve as team doctors with the following athletic programs:

• Boston Bruins
• Boston College
• Boston Red Sox
• Harvard University
• Local private & public high schools
• New England Patriots
• New England Revolution
• Northeastern University
• Bridgewater State College

Research Experience

Research is an integral part of the Fellowship, and, because of its relationship with Harvard Medical School, Mass General offers trainees a wealth of resources they can leverage to develop and pursue research interests, including innovative orthopedic laboratories and two major research libraries, Mass General’s Treadwell Library and the Harvard University Medical Library.

Below is a sampling of orthopedic research laboratories sports medicine Fellows can access:

• New in January 2024 - The ENABLE LAB, located at the Charlestown Navy Yard, is a 4000-square-foot facility dedicated to orthopedic and sports medicine research. This will have a Bioskills lab with 6 state-of-the-art arthroscopy towers for further training on complex hip arthroscopy (c-arm and cadaver hips), elbow reconstruction, knee osteotomy, multi-ligament reconstructions, as well as all other arthroscopic procedures. The facility also includes a dedicated biomechanics lab with Instron machine, Vicon motion analysis cameras and a cadaver shoulder/knee simulator. It will also house a staffed cell biology lab investigating bone-to-tendon healing and biologic research.
• Center for Sports Performance and Research (CSPaR): The Mass General Brigham Center for Sports Performance and Research offers a science-based approach to the training of sport and tactical athletes, conducting innovative research to enhance and sustain athletic performance and aid fast and effective athlete recovery
• Foot & Ankle Research and Innovation Laboratory (FARIL)

Fellows work with a faculty advisor to complete at least one original scientific or clinical research project in an area of interest. Once completed, Fellows present their findings at Mass General’s Sports Medicine Thesis Day and to program faculty at graduation. Fellows will also practice basic research principles like navigating an IRB, identifying and responding to RFPs, and manuscript submission for publication.

How to Apply

In order to be eligible for the Mass General Sports Medicine Fellowship, applicants need to have received their medical degree and completed an accredited residency program.

Applications for the Fellowship are accepted via the American Orthopaedic Society for Sports Medicine (AOSSM) Fellowship Match. No other application materials are necessary beyond those required by the Match. Currently, applications to Orthopaedics Fellowship programs through the Match must include the following:

• CAS Application
  • Complete the Personal Info form
  • Submit the Required Supplemental form
• Personal Statement
• CV
• USMLE Step 1/COMLEX 1 or equivalent
• Letter of Good Standing
• Three (3) letters of reference

Visit the AOSSM website to view more information about the Match and to apply. For questions or more information about the Mass General Sports Medicine Fellowship, email Wendy Ames at wames@mgb.org.