Rady Children's Hospital San Diego | University of California, San Diego
Tel:  (858) 966-5822
Fax: (858) 966-8519
Email: orthoedu@rchsd.org

I. General Description and Goals of Training Program

This program is designed to expose the orthopedic surgeon who has already completed a formal orthopedic surgery residency program to subspecialty training in pediatric orthopedic surgery. The fellowship will include all areas of pediatric orthopedics, including trauma, acute infections, scoliosis, and neuromuscular disease. Rady Children’s Hospital provides a unique opportunity for a broad practical exposure to pediatric orthopedics for the following reasons:

A) We are the sole pediatric teaching hospital associated with the University of California San Diego (UCSD) School of Medicine. Orthopedic residents from that program together with orthopedic residents from the Naval Regional Medical Center, San Diego and the Wilford Hall Air Force Medical Center (San Antonio), receive their pediatric orthopedic training at Rady Children’s Hospital.

B)The training program is located in a broad-based general pediatric hospital, which provides exposure to pediatric musculoskeletal trauma and infections, in addition to traditional elective pediatric orthopedics (scoliosis, neuromuscular disease, hip and foot disorders, etc.).

C) Exposure to a nationally recognized staff of full-time pediatric orthopedic surgeons.

D) Opportunity for clinical and research exposure to scoliosis in the comprehensive scoliosis clinics, as well as participating in both animal research projects and biomechanical testing studies in the Scoliosis Biomechanics Laboratory  (Dr. Peter Newton, Director, as well as Drs. Dennis Wenger and Scott Mubarak).

E) General exposure to the dynamic San Diego orthopedic community which includes an outstanding research program in all areas of orthopedics, directed by Steven Garfin, M.D., UCSD Orthopedic Department Chair, as well as a sophisticated level of clinical orthopedic practice in all orthopedic subspecialties. This exposure occurs at weekly orthopedic grand rounds and basic seminars (which the fellow attends).

F) In addition, the fellow will be expected to complete a research project of publishable quality during the fellowship year.

Because of the wide exposure to all clinical topics and the need to complete a research project, the fellowship will be one year in duration.

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II. Description of Clinical Training and Research Program

A. Formal sessions, classes, and seminars:

1. Grand Rounds and basic science conferences sponsored by University of California, San Diego School of Medicine held weekly.
2. Pediatric orthopedic journal club held weekly - one hour.
3. Educational sessions on gait analysis and a wide range of pediatric orthopedic topics held weekly following Journal Club - one hour.
4. Surgical indications conference held weekly - 1.5 hours.
5. Pre-operative (Monday) and post-operative (Friday) x-ray review of all surgical cases held weekly - two hours.
6. UCSD Orthopedic Department Morbidity and Mortality Conference - held monthly at Rady Children’s Hospital.

B. Daily activities of trainee may include:

1. Morning ward rounds.
2. Surgery.
3. Pediatric orthopedic clinics at Rady Children’s Hospital Outpatient Clinic and in the Medical Office Building.
4. Monthly pediatric orthopedic clinics at San Diego, El Cajon, Chula Vista, and Vista Medical Therapy Units (MTU) (California Children’s Services - clinics for cerebral palsy and neuromuscular disorders). Fellow attends with staff pediatric orthopedist.
5. In addition, other Rady Children’s Hospital specialty and multi-disciplinary clinics are available for the trainee’s experience, including Muscle Disease, Spasticity, Spinal Defects, Adult Cerebral Palsy, Leg Length Inequality, Retts, etc.

C. Documentation of exposure to orthopedics, pediatrics, etc:

The trainee will work closely with full-time pediatric orthopedic surgeons: Dennis R. Wenger, M.D., Director, Pediatric Orthopedic Training Program; Scott J. Mubarak, M.D., Director, Orthopedic Clinical Program; Henry Chambers, M.D., Director, Motion Analysis Laboratory, Peter Newton, M.D., Director of Scoliosis Service, C. Douglas Wallace, M.D., Director of Orthopedic Trauma Service and Pediatric Hand Surgery Service, François Lalonde, M.D., Assistant Director of Research, and Maya Pring, M.D.

The trainee will also have the opportunity for interaction with other orthopedic attending physicians on staff at Rady Children’s Hospital and University of California, San Diego Medical School.

D. Patient follow-up and contact with parents:

Patient follow-up will occur through the trainee’s regular attendance at clinics with family contact as an integral part of this process.  Additional follow-up and family contact may be required for the trainee’s clinical research project.

E. Trainee’s involvement with United Cerebral Palsy affiliate and/or other community agency:

The trainee will be working in the context of the medical treatment team of California Children’s Services. In addition, he/she will participate in specialty clinics at Rady Children’s Hospital and University of California San Diego Medical Center, including participation in gait analysis at the Motion Analysis Laboratory.

F.  Research Involvement:

A wide variety of clinical and basic research projects can be pursued, utilizing the ample clinical volume and broad-based laboratory facilities of our center.

As well as an individual clinical research project, the trainee may be involved in current areas of research within the orthopedic department that include:

1. Hip:
   • Three-dimensional analysis of hip disorders in children.
   • Treatment of hip disease using 3-D CT data.
   • Correlation of 3-D CT data with motion analysis functional studies.
   • Ultrasound analysis of the infant hip.
   • New concepts of hip containment in Legg-Perthes Disease.
   • Managing hip instability in cerebral palsy.
2. Spine:
   • Correlation of pulmonary function with scoliosis in paralytic disorders.
   • Growth and development in patients with idiopathic scoliosis.
   • Three-dimensional analysis of spine geometry.
   • Crankshaft phenomenon following spinal fusion.
   • Thorascopic approach to scoliosis surgery.
   • Development of thorascopic spinal instrumentation.
   • Research into non-fusion surgical correction techniques for scoliosis treatment.
3. Other
   1. Motion Analysis:
      Cerebral Palsy and other conditions.
   2. Knee Disorders:
      Blount’s disease versus physiologic genu varum.
      Muscle-ligament interaction.
   3. Foot/Ankle Disorders:
      Anterior tibial tendon transfers to the os calcis in myelomeningocele patients.
      Calcaneal gait.
      Role of the anterior and lateral compartment muscles in level walking.
      Surgical correction of foot/ankle deformities in cerebral palsy.
   4. Intramuscular Pressure Studies:
      Compartment syndrome.
      Relationship of dynamic intramuscular pressure to muscle/tendon tension.
   5. Trauma:
      Restoration of growth by surgical removal of osseous bridge (Bright).
      Orthopedic management of the child with multiple injuries.

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III. Physical Facilities Used in the Training Program

Rady Children’s Hospital-San Diego. Other community agencies include California Children’s Services with clinics at Schweitzer, Sevick, and Greg Rogers Schools; Muscular Dystrophy Association, and United Cerebral Palsy Foundation.

IV. Personnel Involved in the Training Program

Dennis R. Wenger, M.D.
Director, Pediatric Orthopedic Training Program

Other full-time pediatric orthopedic staff:

Scott J. Mubarak, M.D. Director, Orthopedic Clinical Program Rady Children’s Hospital, San Diego	Henry G. Chambers, M.D. Medical Director, Motion Analysis Laboratory 1989-1990 Pediatric Orthopedic Fellow Rady Children’s Hospital, San Diego
Peter O. Newton, M.D. Chief, Orthopedic Research Director, Scoliosis Program Rady Children’s Hospital, San Diego	Maya E. Pring, M.D. Staff Physician 2002-2003 Pediatric Orthopedic Fellow Rady Children’s Hospital, San Diego
C. Douglas Wallace, M.D. Medical Director, Orthopedic Trauma 1994-1995 Pediatric Orthopedic Fellow    Rady Children’s Hospital, San Diego	Burt Yaszay, M.D. Staff Physician Rady Children’s Hospital, San Diego
Harish S. Hosalkar, M.D. Staff Physician Rady Children's Hospital San Diego	Eric Edmonds, M.D. Staff Physician 2007-2008 Pediatric Orthopedic Fellow Rady Children’s Hospital, San Diego
Andrew T. Pennock, M.D. Staff Physician Rady Children's Hospital San Diego

Other personnel:

Karen Noble, MBA Administrative Coordinator Pediatric Orthopedic Training Program	Tracy Bastrom, MA Research Program Manager
Molly Moor, BA Research Associate	J.D. Bomar, OTC Communications Coordinator

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V. Description of Evaluation of Training Program and Trainee

The trainee will be given a written evaluation by the preceptor at the end of each rotation and upon completion of the fellowship, as well as an evaluation of the individual’s clinical research project.

The fellow will have the opportunity to evaluate his/her experience with us as well.  We appreciate feedback so we can change and improve the program as needed.

 

VI. Total Number of Trainees in the Department

Ten orthopedic residents from University of California at San Diego Medical Center and five residents each from the Navy and Air Force rotate through Rady Children’s Hospital annually, with four residents present at any given time.  In addition, there is one research resident from UCSD who is at Rady Children’s Hospital for a full year.

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VII. Stipend

The fellowship stipend is $50,000 per year, plus a supplement to compensate for clinical activities by the fellow. In addition, benefits are provided, health insurance, malpractice coverage, etc.

• Academic expenses ($3,000).
• Relocation expenses up to $2,000 .
• DEA and California Licensing Fees.
• Trauma & Night Clinic pay.
   

VIII. Medical Licensure

A valid California medical license is required.  The expense of obtaining this license will be covered by the program.

 

IX. International Fellowships

We have established two possible tracks for international trainees:

• A six to twelve month fellowship: this option requires a Visiting Scholar J-1 visa (and all the requirements thereof) through the University of California San Diego. There is no direct patient contact, although the fellow will attend operating room sessions, clinics and teaching conferences, and will be involved in at least one research project.  Depending on the number of applicants, there may not be an opening for up to 24 months.
   
• A visiting surgeon “observership”: a period of one to three months is recommended for this option. The surgeon will observe pediatric orthopedic surgical procedures relating to trauma and reconstruction, attend our clinics and take part in all of our academic/teaching activities.

We request two letters of recommendation from physicians who are familiar with your work, and acceptance is dependent on position availability during the dates you request.

There is NO FUNDING available for either the international fellowship or observership, and you would be responsible for all costs (travel, housing, living expenses, etc.) associated with the training.

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