Stunning Surgical Technique Salvages Limbs….HSS Moves to Brazil?…Prestigious and Lucrative Delmas Prize Awarded!…Accreditation Game Change in the Works…Put Trauma BACK into OR Education!…Allan E. Inglis, M.D. joins HSS…and more.
Accreditation Game Change in the Works
An educator active in the orthopedic realm tells OTW, “On everyone’s lips now is the Accreditation Council for Graduate Medical Education’s (ACGME) announcement of the Next Accreditations System, or NAS, which will significantly change how we educate and train future surgeons. For the longest time while the goal was to train doctors, the reality was that programs often focused on administrative tasks and things they needed to do to get accredited…they got away from what is essential to teaching orthopedic surgery.
“The laser focus going forward will be on educational excellence—and holding programs accountable for that. Programs are going to have to step back and say, ‘What exactly do we need to teach residents?’ Then they will have to measure what has been taught. I think that this measuring component will be the most difficult thing to tackle…orthopedic surgeons are very talented, but are not necessarily great evaluators. One huge area is an enhanced focus on observation. How exactly do you observe someone in the OR to ensure that he or she is learning? How programs are visited, how they are accredited…all that and more will be changing.”
Stunning Surgical Technique Salvages Extremities
Two surgeries and the patient can keep his limb. Benjamin Taylor, M.D. of Orthopaedic Trauma & Reconstructive Surgery in Ohio has recently published his work, “Induced Membrane Technique for Reconstruction to Manage Bone Loss, in the Journal of the American Academy of Orthopaedic Surgeons. Dr. Taylor tells OTW, “Managing segmental bone loss often involves multiple surgeries, and can lead to prolonged recovery times, poor patient outcomes, and even amputation. A two-stage technique—which could save limbs—uses induced biologic membranes with delayed placement of bone graft.
“The first stage involves putting a polymethyl methacrylate spacer into the defect to produce a bioactive membrane. After the cement is removed the membrane remains and protects the bone grafts. Patients go home four days later and return in about six weeks for the second surgery, which involves removing the bone cement. During this process the membrane stays in place and it will end up being filled with its own bone graft. We are getting terrific results thus far, and are seeing that this membrane stimulates the bone graft to fully consolidate and heal. This is a very simple yet effective way of salvaging extremities with bone loss.”
Allan E. Inglis, M.D. Joins HSS
This New York institution is welcoming home one of its own. Dr. Allan Inglis, a native New Yorker who trained at HSS, is its new assistant attending orthopedic surgeon. Dr. Inglis, also a clinical assistant professor of orthopedic surgery at Weill Cornell Medical College, focuses his practice on the surgical treatment of arthritic conditions in adults and is involved in the custom design of joint replacements in the most difficult cases. Dr. Inglis graduated from Cornell Medical School and interned at the Virginia Mason Hospital in Seattle. He also trained at the Royal National Orthopaedic Hospital in London, the EndoKlinik in Hamburg, Germany, and the Kerlan-Jobe Orthopaedic Clinic in Los Angeles.
Put Trauma BACK into OR Education
The Orthopaedic Trauma Association (OTA) is redefining what it is to provide an OTA sanctioned trauma fellowship. Dr. Robert Probe, president of the aforementioned organization, tells OTW, “Recent years have seen an explosion in the number of graduating orthopedic residents that choose to extend their education with fellowship training in trauma. As the number of fellowships expanded to meet this demand, it became increasingly difficult for interviewing applicants to be assured that all of the fellowships they were considering were of the highest quality.”
Just in the last few days we have revamped the criteria for programs that want to be part of the OTA match program…criteria that expand and strengthen the fellowship experience. First of all, each fellow’s trauma log should reflect that he or she has performed 400 CPT procedures per year. On the program side, institutions must demonstrate that they have a base volume of certain procedures so that we know the fellows are in a satisfactory learning environment. As for specifying the number of XYZ cases that a fellow should do annually, we are getting there. We must first examine the data from the log books in more depth before we mandate anything specific. The Board also came to the decision that programs should have on staff—for the first fellow—two active members of the OTA. For each additional fellow one active OTA member should be present.
In the deliberation of these changes, the OTA was respectful of the need to preserve educational innovation and unique program identities but did feel as though the ultimate beneficiary of this process would be those future patients being cared for by our graduating fellows.”
Prestigious and Lucrative Delmas Prize Awarded!
Professor René Rizzoli, professor of medicine at University Hospitals of Geneva and head of the service of bone diseases at the Department of Rehabilitation and Geriatrics, has been awarded the Pierre Delmas Prize.
The award is given by the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) and the International Osteoporosis Foundation (IOF)—with the support of Servier. The prize, valued at 40.000 EUR, is awarded to an individual investigator for outstanding and major scientific contributions to the study of bone and mineral diseases.
The award is named after the late Pierre Delmas, professor of Medicine and Rheumatology at the University of Lyon, France, who made major contributions to basic and clinical research in the field, and, was the founding President of IOF. René Rizzoli is Vice Chair of IOF Committee of Scientific Advisors (having chaired the Committee for its first eight years) and is former president of the Swiss Association Against Osteoporosis. He is presently member of the IOF Executive Committee, and also chairs the Scientific Advisory Board of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis.
HSS’s Rodeo Hits Rio!
The Brazilians rang and the luminaries at HSS answered the call. Scott Rodeo, M.D., co-chief of the Sports Medicine and Shoulder Service at Hospital for Special Surgery (HSS), tells OTW, “A Brazilian managed healthcare provider, Amil Par, reached out to us over a year ago and asked that we advise them on how to manage a world class private orthopedic hospital. Since then, Brazilian administrators and orthopedic surgeons have made several trips here to learn how we handle everything from nursing to material management. And along with my colleague, Laura Robbins, Ph.D., senior vice president for education and academic affairs, I just returned from Rio de Janeiro where they are preparing for the grand opening of their institution, known as Hospitalys.
“The Brazilians leading this effort are top orthopedic surgeons, and will have little trouble learning how to organize a great institution. What will be challenging for them, however, is if they wish to replicate the culture of HSS. HSS is unique…a relatively small, specialty hospital where everyone from the division chief to the nurse’s aid is on the same page—and enthused about being a part of the HSS family. They are going in the right direction, however. We visited with physical therapists, neurologists, and physiatrists who will be part of Hospitalys and I was very impressed with how they work together.
“To further their efforts, we are looking at creating a web-based learning environment whereby we could share our meetings and lectures in real time. Additionally, their doctors will likely come to HSS for several weeks or months to further their clinical or research training. And the timing of all of this couldn’t be better. Brazil is hosting the 2014 World Cup and the 2016 Olympics, and Hospitalys is aiming to make sports medicine a focus of their efforts.”
