With the healthcare landscape changing rapidly these days, patients are becoming more and more savvy and invested in their healthcare decisions. The accessibility of information on the internet has played a huge role in this shift: people are trusting their friends on social media to make recommendations; we gather information about specific conditions and diseases on various websites; and many review sites exist, where you can read about someone’s firsthand experience with their health care provider.
As providers, we are often meeting well-informed patients. You have done your research. You have diagnosed your condition, and you have drafted a course of treatment. Despite this fairly new research process, patients do still frequently ask, “What is a fellowship?” This article will explain what a fellowship is and why patients should care.
The education and training required to become an orthopaedic surgeon takes a minimum of 13 years: Four years of undergraduate studies (college), four years of medical school, and five years of residency. Orthopaedic residency programs vary by school, but typically begin with non-orthopaedic rotations (or assignments), which may include emergency surgery, rheumatology, plastic surgery, critical care surgery. After these rotations, the focus is on general orthopaedics and will include orthopaedic rotations, in hospitals, other clinical settings outside of hospitals, in a classroom, and possibly on research projects.
The majority of orthopaedists are surgeons, so it is crucial to also sharpen surgical skills because these procedures require impeccable hand-eye coordination. The more experience, the better. The intent of residency is to become as well-rounded as possible, with knowledge and experience spanning across many different facets of orthopaedics. After residency, the physician has the choice of whether or not to pursue additional education via a fellowship, or proceed directly into practice.
A fellowship is the highest level of training available to a physician. It is optional additional training in a sub-specialty, designed to enable physicians to develop skills in a more narrow area, or sub-specialty, taking his or her expertise one level higher. A fellowship typically exposes the physician to the most complex cases within their chosen sub-specialty.
Fellowship training is typically one year and often has a research component mixed in with the surgical and clinical training. Orthopaedics is a diverse specialty, so pursuing a fellowship allows the physician to narrow their focus to reach a higher level of proficiency and knowledge about an area of practice. This allows them to provide better care for patients needing attention in their sub-specialty.
According to Becker’s Healthcare, the most popular sub-specialty areas within orthopaedics are as follows:
• Adult Reconstruction
• Sports medicine
• Adult spine
• Foot and ankle
Why should this matter to the patient?
Remember the saying “practice makes perfect?” A physician who specializes in a certain area will organically have more experience in their chosen field than someone who doesn’t have a sub-specialty. Research has shown that providers who specialize in a particular area and see a high volume of patients will have better patient results. As of late, more orthopaedic physicians are choosing to pursue a fellowship. Orthopaedics is an incredibly competitive field, therefore the additional training can differentiate one provider from the next.
We encourage patients to ask their providers about his or her training, focus, and experience with a recommended procedure or surgery. Do not be afraid to speak up and ask questions. A provider worth his or her salt will gladly answer these types of questions if the patient expresses an interest. We strive to make the best recommendations for our patients, and we tend to see the best outcomes when the patient is a partner in the decision making process.
John D. Burrow, DO is a Joint Revision and Reconstruction Fellow who practices at Orthopaedic & Spine Center in Newport News, VA. To learn more about Dr. Burrow or OSC, go to www.osc-ortho.com or call us for an appointment at 757-596-1900.