Goals and Objectives

Our primary educational goal is for each fellow to achieve independence and competence in the advanced care of the injured athlete. All interactions between fellows and staff are designed around this educational objective.

Clinical Experiences and Rotations

During the first month, fellows follow staff closely in clinic and in the operating rooms. Fellows are observed in these settings to assess initial skill level and to develop a plan for the first quarter of their training. During this time, fellows begin developing a panel of patients, some of whom will need surgery. Fellows are mentored  in clinic and surgery during this period to help them assimilate all basic principles and techniques for knee and shoulder surgery.

Throughout the second quarter, fellows begin learning advanced techniques for arthroscopic and open knee and shoulder reconstruction. Opportunities will arise for management of elbow and ankle pathology in athletes; each such case will be treated with appropriate staff supervision.

In the third quarter fellows develop greater autonomy in operative and clinical care. During this time, fellows will perform reconstructive surgery with supervising faculty in an adjacent room, available for consultation on an as-needed basis.

The fourth quarter is devoted to fine-tuning the fellows’ skills and working electively with non-faculty staff in preparation for the transition to practice beyond graduation.

Fellows are provided assistance by Physician Assistants/ Nurse Practitioners, nurses, and office staffing equivalent to that of staff physicians. Extensive library support through full library staff, 24 hour library access and on-line resources. Collaboration with research facilities at Long Beach VA Medical Center, UC San Diego, Scripps Clinic and local cadaver lab facilities provided by DJ Ortho and Smith+Nephew.

Unique Aspects to the Program:

• No night or weekend call.

• Team care at the high school and college level is provided in the training room and on the field in conjunction with fellowship staff physicians.

• Fellows attend, with Drs. Donald Fithian and William Bugbee, a clinic for complex patellofemoral disorders at UC San Diego Private Outpatient Clinic.

• In addition to the core curriculum, fellows may choose on an elective basis to work with fellowship-trained subspecialists in total joint replacement, foot and ankle, pediatrics, hand and trauma.

Sample clinical week:

1. Monday: operating all day,


2. Tuesday morning: 7:00-9:00 a.m. core sports section teaching conference


3. Tuesday: clinic all day. (Second Tuesday evening of the month 6:00-9:00 p.m. is videoconference journal club and sports study group with participants from Northern and Southern California Permanente Medical Sports Medicine specialists).


4. Wednesday off for research, reading, writing, preparation of talks, etc.


5. Thursday operating room half-day, followed by half day in clinic.


6. Friday morning departmental conference 7:15-9:00 a.m. (fellow presents once per month) followed by morning clinic. Friday afternoon off for meetings with faculty, reading, preparation for evening team coverage, etc. Friday evening team coverage (day of the week varies with season)


7. Saturday morning training room (fall quarter only).

Teaching program (CME conferences with oversight by Physician Education and Research Office of Kaiser Permanente)

• Tuesday 7:00 – 9:00 a.m.
• Second Tuesday of the month 6:00 – 9:30 p.m.
• Offsite collaborative CME programs including a quarterly Southern California collaborative lecture/lab series, an annual articular cartilage repair workshop, and the annual Sports Medicine Fellows’ Symposium
• Quarterly Saturday wet lab surgical demonstrations

Research opportunities

Fellows spend one to three half-days per week doing research, reading or preparing scholarly work for publication and/or presentation.  Each fellow participates in discussions and preparation of written reviews of manuscripts and grant proposals with Dr. Fithian and Liz Paxton. Each fellow is expected to complete a research project or to participate in the preparation of a scholarly paper, according to his or her interest and abilities.

Serving the Community

Under the supervision of fellowship staff, the fellows participate in the care and the evaluation of athletic injuries on the field, in the training room, and in clinic. The fellows and faculty serve as liaisons in accepting Kaiser Permanente Health Plan members referred from all athletic programs in the San Diego area.

We also participate in the planning and medical support for community events such as the San Diego Marathon, the Special Olympics, and fund-raising events for various non-profit groups.