Length: 1 year
Number of positions: 1
Type of Fellowship: Clinical Fellowship
Fellowship Directors: Dr. Monika Volesky and Dr. Ruth Chaytor
Hospital Affiliation: Sir Mortimer B. Davis - Jewish General Hospital- McGill University

Objectives: The main mission of the McGill Orthopaedic Foot and Ankle Fellowship is to provide the trainee with the knowledge, clinical and surgical skills in all areas of foot and ankle surgery necessary to practice at the highest possible level of competence by the completion of the training program. This fellowship offers an outstanding diversity of experience in all areas of adult foot and ankle surgery, including sports medicine, trauma, and reconstruction of the foot and ankle.

Program Description: Program is one year in length, from July 1 through June 30, under the supervision of 2 fellowship-trained Orthopaedic Foot and Ankle surgeons: Dr. Monika Volesky and Dr. Ruth Chaytor, at the Jewish General Hospital.

The purpose of this clinical fellowship is to expose the fellow to all aspects of the diagnosis and treatment of a wide spectrum of pathology of the Foot and Ankle. This would include disorders of the forefoot, midfoot, hindfoot, and of the ankle, such as arthritis, fractures, ligamentous and tendinous injuries, and complex acquired, congenital or neurological deformities. Emphasis is placed on gaining advanced knowledge of the anatomy and pathophysiology of each condition, as well as understanding systemic diseases such as rheumatoid arthritis and diabetes/charcot as they relate to the foot and ankle.

In addition, through participation in clinic, the fellow should gain advanced skills in the history taking of patients with foot/ankle problems, physical examination techniques, and interpretation of radiographs, including CT scans and MRIs. Other skills to be mastered include treating patients with appropriate non-operative measures, such as properly prescribing orthotics and prosthetics. In the operating suites, the fellow should develop advanced surgical skills for repair of hallux valgus and rheumatoid foot deformities, trauma with fracture or dislocations, and major reconstructive procedures in the adult consisting of fusions or osteotomies, particularly for posterior tibial tendon dysfunction and arthritis at all levels of the foot and ankle. Additionally, ankle replacement will be addressed, as will anterior and posterior ankle arthroscopy.

Participation in all customary academic activities of the department and completion of at least one publishable research project are expected. Research activity is mostly clinical, however basic science or biomechanical opportunities are available. Teaching skills will be promoted, and the fellow will be expected to give presentations during the Divisional Grand Rounds, as well as participating in the weekly Foot and Ankle teaching rounds with the residents at the Jewish General Hospital.

Expanded Educational Objectives: By the end of this fellowship, the Fellow will have acquired the following skills:

Cognitive:

• Understand the biomechanics of the foot and ankle and how this is related to the overall gait mechanics of the lower extremity
• Experience in management of acute trauma of the lower extremity, in particular of the foot and ankle
• Experience in the assessment and management of various foot pathologies
• Understand the natural development of the foot and be able to differentiate between normal variations in foot mechanics and those that are pathologic
• Experience in the evaluation of the neuropathic (diabetic) foot and understand the stages of managing various problems related to this disease
• Understand the deformities in the forefoot and the importance and application of both conservative and surgical modes of treatment
• Understand the disease processes which benefit from surgical management and become comfortable with the principles and various techniques of surgery
• Experience in the interpretation of the radiographs and other investigations pertinent of the foot and ankle.

Attitudinal:

• Experience in approaching and attending to patients with various foot pathology in both adolescents and adults
• Learn the skills required to be a successful sub-specialist in foot and ankle surgery and contributing member of a team of physicians, nurses and paramedical personnel providing care of the foot and ankle
• Learn the skills required to be a successful provider of foot and ankle expertise and advice to various health professionals

Technical:

• Acquire surgical skills for handling and repair of both soft tissues and bone
• Acquire skills required in correcting simple and complex foot and ankle deformities
• Acquire athroscopic skills necessary in the assessment and treatment of foot and ankle pathology
• Acquire expertise on orthotics, prosthetics and other devices that iad in the conservative and surgical management of foot and ankle pathology.

Job Description:

Clinical

• Attend the orthopaedic foot and ankle clinics and private offices, and become competent and autonomous in the evaluation of various foot and ankle pathologies
• Assist in the pre-operative, intra-operative and post-operative care of the supervisors' patients
• Assist in the evaluation of in-patient, out-patient and Emergency Department consults referred to the supervisors
• Assist in the didactic teaching responsibilities of the Division of Orthopaedics at the Jewish General Hospital
• *** It is clearly understood that none of the above responsibilities will interfere with the Orthopaedic Residency Training Programme of McGill University but will, rather, complement and supplement the teaching of residents on rotation.

Research

• Completion of at least one publishable/presentable research project is expected. Research activity is mostly clinical, however basic science or biomechanical opportunities are available.

http://www.medicine.mcgill.ca/postgrad/fellowship_programs.htm#ortho