1. Orthopaedic Trauma Surgeons of Northern California
Trauma Fellowship Program

2. Orthopedic Trauma Surgeons of Northern California

3. Northern California
Northern California

4. OTSNC Trauma Fellowship
People
Places
Program

5. Trauma Fellowship Faculty
Full-time faculty
Paul Gregory, M.D.
Medical Director, Orthopaedic Trauma
Mercy San Juan Medical Center
Christopher Finkemeier, M.D.
Rafael Neiman, M.D.
Co-Medical Directors, Orthopaedic Trauma
Sutter Roseville Medical Center

6. Paul Gregory, M.D. High School: Sioux City, IA, 1980
Undergraduate: U of Nebraska, 1984, BS, Chemistry
Medical School: U of Nebraska, 1988
Residency: U of Oklahoma, 1993
Fellowship: Tampa General, 1994
Practice
Tampa,
Carmichael, 1999-present

7. Chris Finkemeier, M.D. High School: Fullerton, CA
Undergraduate: UC-Irvine
Medical School: UC-San Francisco
Residency: University of Minnesota
Fellowship: UC-Davis, 1997
Practice
UC-Davis faculty,
Roseville, 2002-present

8. Rafael Neiman, M.D. High School: Fremont, CA
Undergraduate: UC-San Diego
Medical School: Tulane University, New Orleans
Residency: Ochsner Clinic, New Orleans
Fellowship: UC-Davis
Practice: Roseville Orthopaedics, 2001

9. Places Sutter Roseville Medical Center Mercy San Juan Medical Center
Trauma Clinic
Mercy San Juan Medical Center
Private offices
Carmichael private office

10. Metro Map Sacramento Sutter Roseville Medical Center
Mercy San Juan Medical Center
Metro Map Sacramento

11. Sacramento and So.Placer Counties
Sutter Roseville Medical Center
Mercy San Juan Medical Center
Mercy San Juan Medical Center
Sacramento and So.Placer Counties

12. Sutter Roseville Medical Center

13. Sutter Roseville Medical Center
Location – Roseville, CA
Accredited ACS Level II Trauma Center (1995)
Demographics
55,000 ER visits/yr, 1350 trauma patients/yr, 875 admissions per year
Facilities
280 acute care beds, built 1997, additional wing opened 2007
Structure of Service
Acute Care Orthopaedic Service – organized, cohesive service approach

14. Sutter Roseville Medical Center

15. SRMC Helipad

16. Sutter Roseville Medical Center

17. Sutter Roseville Medical Center

18. Mercy San Juan Medical Center

19. Mercy San Juan Medical Center
Location – Carmichael, CA
Accredited ACS Level II Trauma Center (1999)
Demographics
60,000 ER visits/yr, 1250 trauma patients/yr, 750 admissions per year
Facilities
370 acute care beds
Service Structure
All ortho acute care provided by one unified panel of ortho surgeons

20. Fellowship Program History Philosophy Goals Weekly Schedule Template
Hospital Staff Status
Business Arrangement

21. Fellowship Program History 1999 - MSJMC opens for trauma care
PRG becomes Orthopaedic Trauma Medical Director
2002 – OTSNC forms and commits to provide all orthopaedic trauma care for SRMC
RN completes fellowship and joins Roseville Ortho (2001)
CF moves practice to Roseville (2002)
OTSNC develops vision for fellowship program between the 2 centers
2007 – OTA seeks commitment for additional fellowship programs (asks for at least 2 OTA members to be on faculty)
2010 First matched fellow starts (Fred Tonnos)
2013 Program receives full OTA accreditation

22. Fellowship Program Philosophy Mission statement Practical application
“The OTSNC fellowship shall be an advanced experience in surgical care of musculoskeletal trauma of the extremities and pelvis which will enable the graduate to offer trauma patients the highest level of care available and to provide the orthopaedic community with leadership through experience, education, and research.”
Practical application
Maximize exposure to surgical cases
Allow extensive one-on-one contact with faculty
Experience adequate time in patient evaluation and follow-up to gain a full perspective of care including rehabilitation
Learn unique aspect of trauma care in a private-practice setting

23. Fellowship Program Goals Education Research Leadership
Gain confidence to competently treat all extremity and pelvic trauma patients
Develop fund of knowledge to treat musculoskeletal trauma at a higher level
Experience private practice trauma orthopaedics
Research
Complete 1 clinical research project for OTA presentation and publication
Leadership
Integrate into network of orthopaedic trauma care providers
Work toward OTA membership

24. Surgical Case Volume Fred Tonnos Brian Drake Lorrin Lee
Total volume 715
Brian Drake
Total case volume 805
Lorrin Lee
Total case volume 678

25. Private-practice Orthopaedic Trauma Fellowship
Advantages
Maximize direct attending contact
Separation from chain of command
Gain knowledge of managing private practice
Interact with private practice ancillary staff (PA’s, ARNP’s, RN’s)
Disadvantages
Minimizes teaching exposure
Lacks access to basic science, mechanical testing, and cadaveric research projects

26. Fellowship Program Weekly Schedule Template Daily schedule
Monday, Wednesday-Friday
Manage SRMC ACOS service
Back up daily by core trauma faculty
Some Fridays covered by surgeons outside core group. Fellow will round, do cases, or have free academic time.
Tuesday
Grand rounds (when applicable)
MSJMC cases with P. Gregory, M.D.
SRMC trauma clinic
Call responsibility
Wednesday – on-call SRMC
Thursday – on-call SRMC (2 out of 3, off prior to weekend) call
Fri-Sun – once every 3rd weekend

27. Fellowship Program Conferences Monday AM
Weekly fracture conference
Thursday (1st each month) – SRMC trauma program peer review conference
Thursday evening
Quarterly city-wide orthopaedic trauma fellow grand rounds

28. Outside Conferences OTA Annual Meeting (Oct.)
Stryker Pelvic Dissection Course (Nov.)
Synthes Surgical Exposures Course (Jan.)
AAOS Annual Meeting (March)
OTA Fellows Conference (April)

29. Fellowship Program Hospital Staff Status Business Arrangement
Credentialed with full orthopaedic surgery privileges at MSJMC and SRMC
Business Arrangement
One-year contract as employee physician
Health insurance (pending changes due Obamacare)
Malpractice coverage

30. OTSNC Trauma Fellowship
Thank You