Fellows step up to learn more in Grand Rapids
OAM offers advanced training for orthopedic surgeons in foot and ankle care.
An advanced subspecialty training program in Grand Rapids is educating orthopedic surgeons in the foot and ankle field.
The Orthopaedic Associates of Michigan Foot & Ankle Center, an independent practice at 1111 Leffingwell Ave. NE, has been providing a 12-month didactic and practical subspecialty fellowship for board-eligible or board-certified osteopathic and allopathic orthopedic surgeons since 2006.
As of 2014, the Grand Rapids OAM Foot and Ankle Fellowship was one of 43 programs participating in the American Orthopaedic Foot & Ankle Society-sponsored Fellowship Match Program. The fellowship provides specialized training in foot and ankle surgery through a mentorship program comprising outpatient clinic, surgical procedures and research experience.
While rotating with an attending physician for a six-month period, fellows conduct new patient evaluations, deliver follow-up care for post-operative patients, and perform extensive reconstructive and trauma procedures.
Dr. John Anderson, a board-certified orthopedic surgeon and co-director of OAM’s fellowship program with Dr. Donald Bohay, said upon completing the formal education process of medical school and residency, physicians have a broad base of education to begin a practice of orthopedic care but also can go on for advanced training in a specific area through a fellowship program.
“Fellowships are just learning how to take care of the most complicated things within a subspecialty,” said Anderson.
“We both benefitted tremendously from our fellowship experience by going to an institution where they deal with a lot of complex problems, tertiary referral centers, problems sent from other orthopedic surgeons.”
Bohay, also a board-certified orthopedic surgeon, said the program teaches both the clinical practice of orthopedic foot and ankle and the didactic research of what they learn in the office and operating room.
“These doctors are intimately involved in the care of our patients. Of course they are guided, but they are with us all day — into the night if we have to — in the operating room and in the office, and each fellow rotates through each surgeon as a mentor,” said Bohay.
“They are ready to go into practice if they want to, but they choose to do this year of practice with us learning orthopedic foot and ankle.”
The OAM fellowship accepts three orthopedic surgeons for the year-long program, which begins Aug.1 for the 2015-2016 cycle. As a participant of the AOFAS-sponsored Fellowship Match Program, OAM receives interview applications through the third-party organization and, based on letters of recommendations, Anderson and Bohay then interview potential candidates.
“Most of the people that come through here, the letters are stellar. We are pretty liberal on the interview process because the candidates are so highly qualified, it would be hard not to interview all of them,” said Bohay. “We bring them to Grand Rapids, we interview them, give them a tour, they meet our staff, and they have time with all three of our fellowship mentors.”
Based on a ranking of potential fellows, physicians are matched with OAM’s program through the AOFAS-sponsored process and are brought on as junior faculty.
They are given a Continuing Medical Education budget to attend conferences and courses, and are paid a salary based on services billed throughout the year.
OAM grants a $56,000 stipend with benefits to the fellows, according to the AOFAS program list for 2016-2017.
Anderson said all of the foot and ankle fellowship programs are competing for the same talent, and the talent is competing for the best programs.
“There aren’t a lot of fellowships available because there aren’t a lot of people with the tertiary referral centers, the complex patients, the volume and people who are actively engaged in research,” said Anderson.
“You have a hard time drawing a fellow into your community unless you offer them an opportunity to do state-of-the-art care and you have a reputable program, a good reputation.”
As a tertiary referral center, Bohay said the patient volume of highly complicated problems makes OAM’s fellowship program somewhat unique.
“We have a blessing of abundance in our volume. The fellows want to see a lot of volume. They have one year to get everything they can out of it, so they want to see as many people as they can,” said Bohay.
“We have that opportunity, and I think we are one of the busiest fellowships in the country.”
Both Anderson and Bohay have presented at conferences across the world. Anderson said most of the doctors interested in coming to Grand Rapids to learn from them have heard a lecture or read their publications on foot and ankle orthopedics.
“We essentially have traveled the seven seas and have been to six of the seven continents lecturing about what we do here, and what we do here is a little unique in our industry,” said Anderson. “We publish a lot of our outcomes, we do a lot of research, and our research gets published in international journals and textbooks. Essentially, we have sold them a message that appeals to them and they want to come learn.”
OAM’s program also benefits the Greater Grand Rapids community and its health care institutions, including the Van Andel Institute and other local academic institutions, and exposes the physicians to the business aspects of running a medical practice.
“We live in Grand Rapids, and although the weather is a bit of a struggle, it is a good solid community. It is a beautiful, safe area for fellows to come with their families and it is a medical community embracing what we are doing,” said Bohay.
“The fellows are getting a practice experience — they are learning what it takes to be a good doctor in a practice … and the business aspect of medicine, which is not something that is taught in residency.”
Aspects of the business side include understanding how medical assistants manage patient flow, how secretaries maintain efficient patient check-in, how nursing staff delivers post-operative care, and billing and managing patient volume.
Anderson and Bohay launched the fellowship program after conducting several local courses focused on foot and ankle. Based on the level of interest, Bohay said they held a sponsored meeting in Puerto Rico and realized there was a need for advanced education in the field.
“We wanted to have a more personal experience to teach people who are at the beginning of their programs so they can go out and teach,” said Bohay. “We basically have a pyramid of people going out teaching what we do in foot and ankle that will far outreach what we would be able to do in a meeting in a year. The impact is exponential.”