Navy PA Graduate Training: Orthopedics

Ortho Fellowship Brief: 

Current Point of Contact: LT Dustin Berry, ; 757-953-1876

History:

• The US Navy Orthopaedic Physician Assistant Fellowship and Additional Qualification Designation (AQD 6HL) was approved in December 2000 with the first Navy PA attending the US Air Force Orthopaedic Physician Assistant Residency at Malcolm Grove Medical Center.
• In 2001, the Navy Orthopaedic Physician Assistant Fellowship at Naval Medical Center Portsmouth was started, and in 2010, we became fully accredited by the Accreditation Review Commission on Education for the Physician Assistants (ARC-PA).
• There are multiple postgraduate medical education programs at Naval Medical Center Portsmouth. Our PA fellows take full advantage of working side-by-side with Orthopaedic Surgery residents, staff surgeons and Physician Assistants.

Mission:

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.

Curriculum:

12 month program of instruction that emphasizes the practical development of specialized knowledge and clinical skills in Orthopaedic Surgery.
PA Fellows rotate through various subspecialties, including:

• Sports Medicine, 8 wks
• Hand, 8 wks
• Foot and Ankle, 4 wks
• Trauma, 12 wks
• Spine, 4 wks
• Joint Reconstruction, 8 wks
• Pediatrics, 4 wks

Instruction is provided by higher level residents, staff surgeons, and Physician Assistants.

Didactics:

• PA Fellows attend and participate in weekly conferences, formal lectures, journal clubs, and monthly morbidity and mortality meetings.
• PA Fellows also receive supervised instruction in cadaver dissection to enhance their knowledge of surgical anatomy, clinical evaluation, and treatment of orthopaedic injuries.
• Knowledge level is assessed throughout the year with end-of-rotation exams.
• PA Fellows also attend the AOTrauma Basic Fracture Course. This is a 3.5 day course where PA fellows and PGY-2 residents learn basic concepts of fracture care. Location is variable. In recent years, courses have been in San Diego and Atlanta. You can expect to receive 30-35 Cat 1 CME’s for this activity.

Clinical:

Each week, PA Fellows can expect to spend

• 2 days in clinic, evaluating new and follow-up patients and perioperative care.
• 2 days in the operative room, assisting with operative treatment and working with the surgeon and OR staff
• 1-2 days each week on call to receive acute orthopaedic trauma consultations
• PA Fellows will also become proficient with inpatient care

Standard of care remains within the scope of practice as a Physician Assistant under the supervision of an orthopaedic surgeon. All fellows will be credentialed for care at NMCP prior to start of program.

Admission:

• We are seeking career military Physician Assistants who are motivated and have a great desire to learn and become a part of the Orthopaedic Surgery team.
• Candidates are selected through the Medical Service Corps Duty Under Instruction (MSC DUINS) Board annually.
  • See BUMEDINST 1520.40A for procedures
  • For specific eligibility requirements, see BUMEDNOTE 1520 published annually each spring
• All applicant packages will be forwarded to PA Orthopaedic Fellowship Selection Committee. The committee will be composed of the Program Director, Medical Director, and 2 senior orthopaedic surgeons. They will review all applications and conduct interviews of each applicant. Completed packages will need to be submitted to the Specialty Leader by the date specified in BUMEDNOTE 1520 of that year. They will then be submitted to the DUINS board for consideration.
• Specific requirements are published annually and include:
  • Must be an active duty Navy Physician Assistant, along with current NCCPA Certification
  • Must meet Navy standards for permanent change of station
  • To be eligible for the next class, the applicant’s projected rotation date must be within the FY of the July start date to be eligible.

Planning:

*PRD does not have to be exactly in this window, contact the Ortho POC for more details

Additional Requirements:

• Officers selected for DUINS who fail to select for promotion will be dropped from the program.
  • Officers already enrolled in DUINS who fail to select for promotion will be considered for continuation in the DUINS program on a case-by-case basis.
• Maintaining Navy fitness standards is the responsibility of each Fellow. You must remain within Navy physical readiness standards. Failure could result in disenrollment from the program

Admission:

Tentative schedule of events:

• Mar-Apr: interviews conducted at NMCP with packages
• Jun: all packages submitted to Specialty Leader and then DUINS Board for review and selection
• Sept/Oct: results are published
• Fellowship begins the following July

Program Completion:

• At program completion, each fellow 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 Category 1 CME hours through AAPA
  • Most importantly, you will continue your practice as an integral part of the Surgeon-PA team as a fellowship trained Physician Assistant in Orthopaedic Surgery.
  • The work and effort you put into your education will be intense, but the knowledge and skills you acquire are priceless.

After Completion:

You will be obligated to return service of 2 years following completion of the program.

FAQ's:

• Location
  • Portsmouth Virginia
• Can I bring my family?
  • Yes, previous fellows have typically stayed within 30 minutes of the hospital. On-base housing at any of the surrounding Navy bases is an option depending on availability.
• Are quarters for geo-bachelor available?
  • No, all fellows will be responsible for their own residence.
• Will we be able to take leave during the year?
  • Yes, fellows will be able to take a total of 2 weeks leave during the year
• What is the typical uniform of the day during fellowship?
  • Your daily “uniform” will be OR scrubs with long lab coat. You will need to purchase your own shoes and lab coat. Scrubs are supplied by NMCP. Navy seabag must be maintained at all times.
• How do I set up for an interview?
  • Start by letting us know your interested as soon as possible. We will need to ensure you are eligible and schedule you for an interview. Interviews will be set up to take place at NMCP some time in March or early April. Packages will need to be completed and submitted to the Program Director prior to your interview.
  • Please let the Orthopaedic PA Program Director know of your intention to submit an application NLT January of the year you want to interview. Contact information is at the end of this presentation.
• Can’t I just interview over phone or video conference?
  • Possibly. For those that are deployed or located overseas, we will facilitate an interview by alternate means. If you are INCONUS, however, a face-to-face interview is required. As part of the interview process, you will receive a tour of the facilities and meet with current PA Fellows, residents and staff.
• When will I be eligible to apply?
  • Please refer to the current BUMEDNOTE 1520 for eligibility. You can always contact the Ortho PA Fellowship Director directly. If selected, when do I start
• When should I apply? When does the fellowship start?
  • The Ortho PA class starts on or around 1 July each calendar year, interviews/packages will need to be completed and submitted by the spring. Please let the Ortho PA Program Director know of your intention to apply as soon as possible. Expect selection results to be published around October of the corresponding FY. If selected, you can expect to check-in to NMCP to begin training the second or third week of June and complete by the following June.
• How many PA Fellows are selected?
  • Determined by BUMED, though typically there are 2-4 candidates selected each year.
• When is the application package due?
  • Completed applications must be submitted to the Specialty Leader by the date published by BUMED. It is anticipated that it will be 1 June, however, you should verify this date via the BUMED NOTICE 1520 to be published in the spring, along with other requirements.
  • That being said, completed applicant packages will need to be submitted to the PA Orthopaedic Program Director prior to your interview.
• What types of things will need to be included in the package?
  • CO endorsed letter of request
  • Motivational statement
  • CV
  • Copies of fitness reports, 5 yrs past
  • Letters of Recommendation
  • Copy of OSR/PSR
  • Other supporting documents, awards, certificates, etc (See the BUMEDNOTE 1520 for complete details)
• After completion, is all the hard work worth it?
  • Absolutely without a doubt – yes. There is no better life in medicine than Orthopaedic Surgery.
• How do I know if I would be interested?
  • There are a number of Navy PA’s out there who have completed the training, have a love for orthopaedic surgery, and always have good insight to give into what the training is like and what life is like after training. Contact any one of them, they are glad to help.

If you have any additional questions, please contact LT Dustin Berry, ; 757-953-1876