Mark A. Frankle, MD, Fellowship Co-Director
Mark A. Mighell, MD, Fellowship Co-Director
Kaitlyn N. Christmas, BS, Fellowship Coordinator
Florida Orthopaedic Institute
Florida Hospital Carrollwood, Tampa General Hospital—Level 1 Trauma Center and St. Joseph’s Hospital , 13020 Telecom Parkway
Tampa, FL 33367
Duration: 1 academic year
Rotation: 3-4 month rotations between two Attending physicians over a 12 month period
Number of Fellows: 3 fellows per year
The Florida Orthopaedic Institute (FOI) is the largest orthopaedic group in the state of Florida offering experts in every orthopaedic subspecialty. FOI provides exposure to a high volume tertiary referral practice exclusive to shoulder and elbow reconstruction and fracture management.
The Foundation for Orthopaedic Research and Education (FORE) was founded by the surgeons at FOI in 1999 as part of their commitment to providing world-class orthopaedic care to their patients. The foundation was established as a way to improve the care of patients with musculoskeletal disorders through research and education.
FORE is comprised of 4 departments: clinical research, biomechanical research, surgical skills training, and continuing medical education. Each department is staffed by specialty trained research and educational coordinators, biomechanical engineers, statisticians, faculty supervisors, and departmental assistants. The FORE campus houses a biomechanical research laboratory for testing orthopaedic devices and materials, as well as a surgical skills laboratory for training fellows and other surgeons on the latest surgical techniques and devices on cadaveric specimens.
The shoulder and elbow fellowship at Florida Orthopaedic Institute provides exposure to a high volume tertiary referral practice exclusive to shoulder and elbow reconstruction and fracture management. With over 2700 new patient visits, 13,000 clinic visits, the fellows are given ample exposure to the entire spectrum of shoulder and elbow disorders, including shoulder arthroplasty, arthroscopy, open reconstruction, fracture management, elbow arthroplasty, arthroscopy, ligament reconstruction, and fracture management. The Shoulder and Elbow Fellowship provides an opportunity to actively participate in over 1,200 cases per year split evenly between arthroscopic and open surgery. The Fellow evaluates patients in three weekly clinics and participates in shoulder and elbow operative cases with the attending surgeons on the Florida Orthopaedic Institute Shoulder Service. In addition to clinic and surgery, fellows take part in a weekly 2 ½ hour educational conference with their attending physicians, members of the clinical research team, engineers from the biomechanics department, and a statistician. During the conference, clinical cases are reviewed. Fellows are challenged to identify disease pathology and various treatment options. Clinical research projects are designed and updated, assuring ample progress is being made. Basic science projects are discussed, often with presentations of various anatomical computer simulations of shoulder anatomy and kinematics. FORE provides consultation, hardware, software, and facilities where the research takes place. Fellows have the opportunity to work on product research and development.
This fellowship program has a strong academic focus in that the program requires participation in regular journal club meetings and requires that the fellow complete a research project as a first author, with a manuscript to be submitted to a peer-reviewed journal at the end of the year. While one project is required, fellows often work on multiple projects during their time at FOI/FORE. Research projects can be either clinical or basic science. Fellows are given full access to the biomechanics lab onsite. Each fellow presents a project at the ACCME accredited annual Orthopaedic Research Day conference sponsored by the Foundation for Orthopaedic Research and Education (FORE). Fellows are also required to attend one other ACCME accredited conference (usually the course hosted by the fellowship director) for CME credit.
These requirements provide a tremendous learning experience in terms of evaluating medical literature and research, as well as designing an experiment around a research question and hypothesis. The fellow works with the attending physicians and Foundation for Orthopaedic Research and Education (FORE) scientists to design the protocol for their research project. We are a private practice and do not rely on Medicaid subsidies to support the fellowship. This Program is also unique in that there is no physical distinction between the clinic and research departments, making constant ongoing research a reality. The Foundation of Orthopaedic Research and Education is located in the lower level of the main clinical office of the Florida Orthopaedic Institute. This ensures each aspect of the fellow’s education is seamlessly integrated and easily accessible. The fellows work closely with the research staff throughout the length of the project.
By the end of the fellowship year the fellow should have gained knowledge, increased competency and improved performance in the following:
- understanding of shoulder/elbow anatomy and biomechanics
- assessment and management of upper extremity pathologies
- distinguish between pathological and normal variations
- obtain medical history
- develops patient care plans
- determines appropriate diagnostic tests
- understand disease processes that benefit from surgical management and the various surgical techniques
- interpret imaging tests
- demonstrates interpersonal skills required for patient care
- competency in repair of soft and bony tissues
- proper arthroscopic assessment of shoulder/elbow pathology
- grasping current literature
- attends conference
- attends journal club meetings
- Attends at least one ACCME accredited conference
- Completed clinical research project
The fellow will take general orthopaedic emergency room call for a community hospital 1-2 times each month.