US Navy Orthopaedic Physician Assistant Fellowship

1. US Navy Orthopaedic Physician Assistant Fellowship LT Michael A. Mitchell, PA-C, MPAS Fellowship Program Director

2. History • The US Navy Orthopaedic Physician Assistant Fellowship and Additional Qualification Designation (AQD 6HL) was approved in December 2000 with the first Navy physician assistants attending the US Air Force Orthopaedic Physician Assistant Residency at Malcolm Grove Medical Center • Because of the increased training requirements, the Navy Orthopaedic Physician Assistant Fellowship was begun in 2001 at Naval Medical Center Portsmouth. In 2010, the Fellowship became fully accreditated by the Accreditation Review Commission on Education for the Physician Assistants, Inc (ARC-PA). • The Naval Medical Center Portsmouth is a tertiary military treatment facility with numerous post-graduate medical education programs including orthopaedic surgical residency • The Orthopaedic Physician Assistant Fellowship is modeled after the Air Force’s Orthopaedic Physician Assistant Residency and is a 12 month didactic, clinical and surgical Fellowship that trains the physician assistant in diverse orthopaedic clinical and surgical skill to assist in the management of orthopedic patients

3. Mission Statement • To train selected U.S. active duty Physician Assistants to provide comprehensive, high quality patient care and surgical assistance in the field of orthopaedic surgery through a balanced curriculum of academic, surgical exposure, clinical care and mentored self improvement.

4. Curriculum • This is a one-year program of instruction that emphasizes the practical development of specialized knowledge and clinical skills in orthopaedics including the subspecialties of Sports Medicine, Hand, Foot and Ankle, Orthopaedic Trauma, Spine, Total Joint and Pediatrics • The student practices within the scope of practice as a physician assistant under the supervision of an orthopaedic surgeon. Instruction is provided by staff instructors consisting of credentialed orthopaedic surgeons and orthopaedic physician assistants

5. Didactics • Throughout the 12 months of training, the PA attends weekly conferences of orthopaedic formal lectures, journal clubs, indications conferences and morbidity and mortality meetings. • A comprehensive reading list including orthopaedic basic science, general orthopaedic topics and orthopaedic specialty specific topics is provided. • The PA also receives supervised instruction in cadaver dissection of the musculoskeletal system to enhance the knowledge of surgical anatomy. • During training, the PA Fellow will received periodic written quizzes and formal examinations in general orthopaedic topics as well as in each orthopaedic specialty area

6. Clinical • The year consists of clinical rotations in each of the orthopaedic subspecialty clinics. • Rotations include general orthopaedics (Hand, podiatry, total joints, and orthoses), pediatric orthopaedics, and spine • Rotations also include outpatient clinic evaluations, perioperative care of orthopaedic surgical patients, surgical assisting and first trauma call responsibilities • The PA Fellow will assume responsibilities at the level of PGY-2 orthopaedic surgical resident. • At all times the PA Fellow will be under direct supervision of the orthopaedic staff

7. Additional • Call – expect every 4-5 nights • Clinic – 2 days per week • Operating Room – 2 days per week • Morning report daily with case presents to peers, residents and staff • Ward/Rounds: Daily • Quizzes after each rotation; rotations are 1-2 months

8. Entry Requirements • The US Navy Orthopaedic Physician Assistant Fellowship has the following admission requirements: • All applicants must be an active duty Navy Physician Assistant • All applicants must have at least two (2) years of primary care or Family Practice experience • All applicants must meet Navy standards for permanent change of station • All applicants must have current NCCPA Certification

9. Admission Process and Selection • The US Navy Orthopaedic Physician Assistant Fellowship seeks career military physician assistants who have demonstrated motivation in this specialty and who desire the challenges and rewards of practicing in Orthopaedic surgery • Candidates are selected through the Medical Service Corps Duty Under Instruction (MSC DUINS) Board annually • See BUMEDINST 1520.40A for procedures • All candidates will be interviewed by program director, medical director and senior orthopaedic surgeons and application packages will be reviewed • A report of the interview and recommendations by the program director is sent to the DUINS board via the PA Specialty Leader as part of the application package

10. Important dates • Applications due to specialty leader 01 Jun, one year prior to start date • Notification of selection: per MSC DUINS Board. Normally by September • Report date June • Program start date: 01 July

11. Credentials Awarded • Upon graduation, the Physician Assistant will receive certification of completion from the United States Navy Bureau of Medicine and Surgery (BUMED) • Orthopaedic PA supplemental credentials in accordance with BUMEDINST 6320.66D • 50 CME hours through AAPA

12. Obligation • Obligation time is 2 for 1. For the 1 year of training, you will owe 2 years as a Navy Orthopaedic physician assistant • Follow on tours will be discussed usually at the 6 month training mark

13. Expectations • BE PROFESSIONAL…. be polite and courteous to everyone at all times. • BE A TEAM PLAYER – pitch in and help the team in any way necessary to get the tasks accomplished. • COMMUNICATE – write clear notes, ensure proper follow-up • BE PROMPT– be on time for report, in clinic, in the OR and at lectures. • BE EFFICIENT – learn to prioritize and make things flow faster • BE AGGRESSIVE – show initiative and assume responsibility for your education • BE THOROUGH – DO NOT ASSUME ANYTHING when interviewing and examining patients. • BE PREPARED – read daily, anticipate questions you will be asked. Practice procedures, suturing, etc. • KNOW YOUR PATIENTS AND KNOW YOURSELF. • BE APPRECIATIVE AND TAKE GOOD CARE OF YOURSELF!

14. Responsibilities • Mandatory attendance at all training events • Be on Time! • Ask Questions • Read everyday

15. Questions? Bone and Joint Sports Medicine Institute Naval Medical Center Portsmouth, VA (757) 953-1845 or (757) 953-1814 Every day is different, so be fluid; flexible is too rigid!