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.
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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
– Trauma Clinic
• Mercy San Juan Medical Center
• Private offices
– Carmichael private office
Sutter Roseville Medical Center
Mercy San Juan Medical Center
Metro Map
Sacramento
Sutter Roseville Medical Center
Mercy
SanSan
Juan
Medical
Center
Mercy
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
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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
• “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
• 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
– Total volume 715
• Brian Drake
– Total case volume 805
• Lorrin Lee
– Total case volume 678
Private-practice Orthopaedic
Trauma Fellowship
• Advantages
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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
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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
– 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