Orthopaedic Trauma Surgeons of Northern California Trauma Fellowship Program

Orthopedic Trauma Surgeons of Northern California

Northern California Northern California

OTSNC Trauma Fellowship People Places Program

Trauma Fellowship Faculty Full-time faculty Paul Gregory, M.D. Medical Director, Orthopaedic Trauma Mercy San Juan Medical Center Christopher Finkemeier, M.D. Rafael Neiman, M.D. Co-Medical Directors, Orthopaedic Trauma Sutter Roseville Medical Center

Paul Gregory, M.D. High School: Sioux City, IA, 1980 Undergraduate: U of Nebraska, 1984, BS, Chemistry Medical School: U of Nebraska, 1988 Residency: U of Oklahoma, 1993 Fellowship: Tampa General, 1994 Practice Tampa, 1994-99 Carmichael, 1999-present

Chris Finkemeier, M.D. High School: Fullerton, CA Undergraduate: UC-Irvine Medical School: UC-San Francisco Residency: University of Minnesota Fellowship: UC-Davis, 1997 Practice UC-Davis faculty, 1997-2002 Roseville, 2002-present

Rafael Neiman, M.D. High School: Fremont, CA Undergraduate: UC-San Diego Medical School: Tulane University, New Orleans Residency: Ochsner Clinic, New Orleans Fellowship: UC-Davis Practice: Roseville Orthopaedics, 2001

Places Sutter Roseville Medical Center Mercy San Juan Medical Center Trauma Clinic Mercy San Juan Medical Center Private offices Carmichael private office

Metro Map Sacramento Sutter Roseville Medical Center Mercy San Juan Medical Center Metro Map Sacramento

Sacramento and So.Placer Counties Sutter Roseville Medical Center Mercy San Juan Medical Center Mercy San Juan Medical Center Sacramento and So.Placer Counties

Sutter Roseville Medical Center

Sutter Roseville Medical Center Location – Roseville, CA Accredited ACS Level II Trauma Center (1995) Demographics 55,000 ER visits/yr, 1350 trauma patients/yr, 875 admissions per year Facilities 280 acute care beds, built 1997, additional wing opened 2007 Structure of Service Acute Care Orthopaedic Service – organized, cohesive service approach

Sutter Roseville Medical Center

SRMC Helipad

Sutter Roseville Medical Center

Sutter Roseville Medical Center

Mercy San Juan Medical Center

Mercy San Juan Medical Center Location – Carmichael, CA Accredited ACS Level II Trauma Center (1999) Demographics 60,000 ER visits/yr, 1250 trauma patients/yr, 750 admissions per year Facilities 370 acute care beds Service Structure All ortho acute care provided by one unified panel of ortho surgeons

Fellowship Program History Philosophy Goals Weekly Schedule Template Hospital Staff Status Business Arrangement

Fellowship Program History 1999 - MSJMC opens for trauma care PRG becomes Orthopaedic Trauma Medical Director 2002 – OTSNC forms and commits to provide all orthopaedic trauma care for SRMC RN completes fellowship and joins Roseville Ortho (2001) CF moves practice to Roseville (2002) 2005-2007 OTSNC develops vision for fellowship program between the 2 centers 2007 – OTA seeks commitment for additional fellowship programs (asks for at least 2 OTA members to be on faculty) 2010 First matched fellow starts (Fred Tonnos) 2013 Program receives full OTA accreditation

Fellowship Program Philosophy Mission statement Practical application “The OTSNC fellowship shall be an advanced experience in surgical care of musculoskeletal trauma of the extremities and pelvis which will enable the graduate to offer trauma patients the highest level of care available and to provide the orthopaedic community with leadership through experience, education, and research.” Practical application Maximize exposure to surgical cases Allow extensive one-on-one contact with faculty Experience adequate time in patient evaluation and follow-up to gain a full perspective of care including rehabilitation Learn unique aspect of trauma care in a private-practice setting

Fellowship Program Goals Education Research Leadership Gain confidence to competently treat all extremity and pelvic trauma patients Develop fund of knowledge to treat musculoskeletal trauma at a higher level Experience private practice trauma orthopaedics Research Complete 1 clinical research project for OTA presentation and publication Leadership Integrate into network of orthopaedic trauma care providers Work toward OTA membership

Surgical Case Volume Fred Tonnos Brian Drake Lorrin Lee Total volume 715 Brian Drake Total case volume 805 Lorrin Lee Total case volume 678

Private-practice Orthopaedic Trauma Fellowship Advantages Maximize direct attending contact Separation from chain of command Gain knowledge of managing private practice Interact with private practice ancillary staff (PA’s, ARNP’s, RN’s) Disadvantages Minimizes teaching exposure Lacks access to basic science, mechanical testing, and cadaveric research projects

Fellowship Program Weekly Schedule Template Daily schedule Monday, Wednesday-Friday Manage SRMC ACOS service Back up daily by core trauma faculty Some Fridays covered by surgeons outside core group. Fellow will round, do cases, or have free academic time. Tuesday Grand rounds (when applicable) MSJMC cases with P. Gregory, M.D. SRMC trauma clinic Call responsibility Wednesday – on-call SRMC Thursday – on-call SRMC (2 out of 3, off prior to weekend) call Fri-Sun – once every 3rd weekend

Fellowship Program Conferences Monday AM Weekly fracture conference Thursday (1st each month) – SRMC trauma program peer review conference Thursday evening Quarterly city-wide orthopaedic trauma fellow grand rounds

Outside Conferences OTA Annual Meeting (Oct.) Stryker Pelvic Dissection Course (Nov.) Synthes Surgical Exposures Course (Jan.) AAOS Annual Meeting (March) OTA Fellows Conference (April)

Fellowship Program Hospital Staff Status Business Arrangement Credentialed with full orthopaedic surgery privileges at MSJMC and SRMC Business Arrangement One-year contract as employee physician Health insurance (pending changes due Obamacare) Malpractice coverage

OTSNC Trauma Fellowship Thank You