Dates: August 1 through July 31
Program training director: Jeffrey R. Bytomski, DO
Number of fellows: Three (ACGME)
The Duke Primary Care Sports Medicine Fellowship is a one-year ACGME-accredited program open to physicians who have completed residency training in the fields of family medicine, emergency medicine, pediatrics, or internal medicine.
The purpose of the program is to enable physicians to develop expertise in the area of sports medicine. Essential teaching and administrative skills are emphasized and are developed through the cooperation of a number of outstanding departments at Duke University Medical Center, including family medicine and community health, orthopaedic surgery, and emergency medicine, as well as the Duke University athletic department. The fellowship is housed within the sports division of the Department of Orthopaedic Surgery, which serves as the primary clinical site, and is ACGME-accredited through the Department of Family Medicine and Community Health.
A variety of exceptional educational experiences is offered and completion of the fellowship offers the privilege of sitting for the Certificate of Added Qualification in Sports Medicine.
We have three fellow positions per year:
- One primary care fellow from either FP, IM, or Peds
- One dedicated ED position
- The third fellow each year will take from either of the above categories based on the strength of the applicant pool
Training room and game coverage
Fellows care for athletes of all levels, high school through professional teams, in various training rooms throughout the year. A team approach to athletic care is emphasized, highlighting the essential aspects of clear communication between physicians, athletic trainers, parents and family, and coaches.
Training room and game coverages will be supervised throughout the year at the high school, collegiate, and professional levels by sports medicine physicians and orthopaedic surgery attendings. From a Division I perspective, the direct hands-on involvement in Duke Athletics is unprecedented, and a rare chance to become familiar with medical decision making in high-level athletics. During the fall fellows will cover both Duke and Elon University football, often dividing up home/away coverage experiences. Each fellow will also be responsible for a local Durham high school, and work closely with PT/ATC colleagues in caring for high school athletes. In the winter/spring months, fellows will cover both men’s and women’s basketball, men’s lacrosse, and have the opportunity to cover additional Olympic sports if interested.
Fellows work closely with their surgical colleagues often sharing many coverage as well as didactic experiences. Fellows will also work closely with the athletic training staff to triage orthopaedic injuries and provide medical coverage for the athletes at the various levels of competition
Didactics and conferences
Sports Medicine Conference is held each Friday morning at 7:00 AM. In this conference, attended by Orthopaedic faculty, Orthopaedic Surgery Residents, Orthopaedic Sports Medicine Fellows, and Primary Care Sports Medicine Fellows, the breadth of Sports Medicine is covered in a “Grand Rounds” type model. Additionally, Friday afternoons are protected didactic time specifically for the PCSM fellows. We are constantly working on keeping a didactic curriculum that suits the needs of the fellows. The long term focus is on CAQ board preparation, but a wide range of topics is covered each afternoon with participation of both fellows and faculty. Additionally, we have recently developed a new diagnostic ultrasound-specific didactic curriculum that emphasizes ESSR/AMSSM qualifications for diagnostic ultrasound. In addition to the previously mentioned didactics, fellows will get at least one-half day per month specifically for diagnostic ultrasound didactics. Lastly, the first Monday of each month we conduct radiology rounds, where one of our lead MSK radiology attendings offers a 1-hour lecture specific to improving skills within MSK radiology.
Historically, the PCSM fellows have been involved in the planning and medical coverage of one to two local endurance events. The specific events change annually, but ranges from marathons to Ironman Competitions to Spartan Races. Fellows will also participate in the coverage of various NCAA and ACC tournaments and events throughout the year as they might occur.
Fellows are expected to present lectures throughout the year to various audiences, including primary care physicians and staff, sports medicine/orthopaedic attendings, and the community. PCSM fellows are responsible for giving one lecture on a topic of choice at the group Friday morning conference “Grand Rounds” throughout the year. We also strive to offer 1-2 basic MSK lectures to primary care and emergency medicine residents each year, in an effort to build the “lecture repertoire” for fellows. Fellows are always encouraged to present at the national level, including the annual AMSSM and Southeastern ACSM meetings.
Research and publications
Fellows are required to finish one research project. Typically, opportunities to write and publish are available during the fellowship year. Fellows are broadly required to finish one research project throughout the course of the year. While this may sound daunting to some, the institutional support is second to none, with dedicated research faculty helping arrange the logistics of any idea a fellow might have. Projects can be as simple or as complicated as each fellow desires, with the goal being to produce something significant for each fellow to add to their CV. Each fellow should complete fellowship with a comfort level understanding how to pursue the processes of high-quality MSK research should they be interested down the road.
- Training room/call
There is no formal call for fellows, however, fellows should be available to attendings and athletic trainers, particularly for direct patient care. The 80-hour work week and mandatory 24 hour "off-call" periods will be strictly enforced by the program director.
Duke training rooms are held two evenings per week (each often lasting 30-60 minutes), and are divided amongst the three fellows.
- ACLS/BCLS certification
Fellows are required to have current ACLS/BCLS certification before rotations begin.
- CAQ examination
Fellows in good standing may sit for the CAQ examination at the conclusion of the fellowship year.
Our curriculum is unique in the fact that there is no ‘block’ type scheduling; instead, we offer a progressive rolling curriculum. Functionally, this means rather than having one month of hand/upper extremity, each fellow will work with each subspecialty attending several times per month. We feel this provides a longitudinal learning environment that improves retention and overall knowledge development. Additionally, our specific time allotments are flexible – this means if a fellow wants more time with PCSM faculty, or more time with Foot/Ankle – we can tailor schedules as the year goes on to individual needs.
Primary care sports medicine (PCSM)
Certainly the largest portion of fellow time will be spent with PCSM faculty, often approaching 50% of clinical time. This will rotate between faculty, and each fellow spends time with each core faculty every week. Clinics are held at the Duke Sports Sciences Institute and involve both acute and chronic care of musculoskeletal injuries as well as medical issues in athletes. Each clinic will offer a mix of urgent/fracture care, sports injuries, dedicated procedure visits, and imaging review. We have a particularly good mix of age variety, with some clinics offering a large volume of pediatric fracture care.
Ultrasound is a key component of all PCSM faculty clinics. Dr. Blake Boggess anchors the ultrasound curriculum at Duke SM. Each fellow averages about 1 clinic per week with Dr learning advanced diagnostic and interventional skills using MSK ultrasound. There is also expected involvement in both participating and teaching ultrasound courses both locally and regionally during fellowship tenure. Also, as noted above we have a specifically developed diagnostic ultrasound training curriculum that offers fellows a completely separate, protected didactic session monthly. Additionally, work is done to arrange for industry-based training with special procedures such as Tenex or stem cell injection therapy. Procedure volume is not an issue within our fellowship. Training will include a wide-range of ultrasound-based procedures including aspiration/injection of any joint, variety of tendon sheath and bursal injections, peripheral nerve hydrodissections, percutaneous tenotomy, Platelet Rich Plasma injections, both Adipose-derived mesenchymal stem cell as well as BMAC.
One of the longitudinal rotations involves spending time with radiology in the MSK reading room. Additionally, we have monthly radiology grand rounds as listed above. One of the focuses of this fellowship is to ensure adequate radiology skills for a sports physician to interpret his/her own images upon completion of training.
Fellows rotate on a longitudinal basis through the various specialties of orthopaedics with faculty at the top of their respective fields on a national level. Rotations available include:
- Surgical sports medicine
- Hand and upper extremity
- Foot and ankle
- Hip arthroscopy
- Non-operative spine (PM&R and orthopaedics)
Fellows spend at least one half-day in their primary care specialty per week. The FM fellow(s) see walk-in urgent care at the family medicine center one, half-day session per week, and the EM fellow(s) attend in the Duke ER for one 8-hour shift per week.
The current paid time off allowed per year is:
- Three weeks vacation per year
- Six personal/sick days per year
- Five days for job hunting/interviews
- Annual dates per ERAS/NRMP schedule
Time off and paid expenses for AMSSM Advanced Team Physician Course, AMSSM Fellows Conference, AMSSM National Meeting and Duke Sports Cardiology Conference
Various health and dental plans are available through the Duke University Health System. Health benefits are paid for the trainee, but spouses and dependents are an extra premium.
Lab coats, prescription pads, parking
Lab coats, prescription pads, and parking permits are provided through the housestaff office at no charge.
How to apply
Accepting applications: Annual dates per ERAS/NRMP Schedule
Match participation: NRMP
ACGME program number: 1273613065
Application deadline: October 1
We accept the Electronic Residency Application Service (ERAS) application only. Documents that can’t be submitted through ERAS should be emailed directly to Felecia Williams at email@example.com.
We typically hold three separate interview dates in October and November each year.
What you’ll need
- ERAS application (includes a photograph and three letters of recommendation)
- Letter from program director regarding graduation status or diploma for completion of residency
- Formal CV with documentation to verify presentations and publications
- Verification of USMLE/COMPLEX scores
As with everything in medicine, things are always evolving. We make every attempt to keep this page as up to date as possible, but it serves only as a guide to the Duke Primary Care Sports Medicine Fellowship. Actual requirements may change.
If you have any questions about the application process, please contact Felecia Williams at firstname.lastname@example.org.