Clinical Responsibilities
Objectives: By the end of the fellowship, the SCIM fellow should be proficient in the diagnosis and management of acute and chronic SCI/D, management of an SCI/D team, overseeing the rehabilitation process including the ability to write appropriate prescriptions for therapy and equipment, understanding the basic pathophysiology of traumatic and non-traumatic spinal cord injuries and disorders or syndromes affecting the spinal cord, and be able to identify preventive strategies and manage secondary complications relating to SCI/D.
Inpatient responsibilities
The fellow is assigned to a preceptor (inpatient physician/faculty member) who guides him/her through inpatient responsibilities. The fellow will begin his/her training under the guidance of the faculty member for each rotation and by the end of the fellowship will be given much greater responsibility for patients assigned to him/her, including management of the SCI/D team and direction of team conferences. Examples of specific activities include:
- Pre-admission screening with the admission coordinator, when applicable
- Evaluation, diagnosis and management of patients admitted to his/her service.
- Prescribing appropriate therapeutic treatment and equipment
- Conducting interdisciplinary rounds and team conferences
- Patient and family education
- Education of residents and medical students
- Consults
- Care Coordination
Outpatient Responsibilities
The SCIM fellow will be responsible for attending certain clinics each week as well as those that involve an inpatient under the fellow’s care. Each fellow is assigned to a preceptor (outpatient physician/faculty member) who guides him/her through the outpatient responsibilities. Responsibilities will be progressive as discussed above. This includes the following clinics:
- SCID Wellness/Annual Evaluations
- SCI/D Clinic
- Wound clinic
- Plastic surgery clinic
- ALS clinic
- Functional extremity clinic
- SCI/D Urology clinic
- Urodynamic and urological procedures clinic
- Advanced seating clinic
- Upper extremity/hand clinic
- Sexuality clinic
- Psychology clinic
- Chiropractic and acupuncture clinic
- SCI/D Telehealth Clinics
- NCS/EMG clinic
- SCI/D Pain clinic
- Spina Bifida Clinics
Didactics
Objectives: By the end of the fellowship the SCIM fellow should have an understanding of pathophysiology of acute and chronic SCI and various syndromes and have the ability to evaluate and diagnose all related conditions and complications. The fellow should be familiar with current medical management, research trends, and significant relevant literature relating to acute and chronic spinal cord injury /disorders.
- The fellow will be expected to be familiar with relevant literature relating to spinal cord injury and spinal cord dysfunction by the end of the fellowship.
- The fellow will attend lectures presented by SCI/D Service faculty, staff, and lecturers from other departments.
- The fellow will coordinate and participate in a bimonthly journal club providing guidance to the 2nd and 4th year residents during their SCI/D rotations.
- The fellow will participate in weekly one-to-one sessions with the assigned faculty member for chapter review or discussing didactic topics.
- The fellow will have the opportunity to attend in-services sponsored by other Services (e.g., Physical Medicine and Rehabilitation monthly In-services, Stanford grand rounds and virtual conferences).
- The fellow will be responsible for presenting two formal lectures to the SCI/D Service staff and at least four brief presentations during the course of the fellowship.
- The fellow will be expected to attend one relevant conference such as the American Spinal Injury Association (ASIA) Conference and/or the Academy of Spinal Cord Injury Professionals (ASCIP) Conference.
Rounds
Participation in rounds provides the fellow with training from an interdepartmental approach to patient care. The fellow interacts and collaborates with colleagues and faculty during these sessions. This includes:
- Monday Noon SCI/D Case Conferences that are attended by Neuro-Radiology/ SCI/D staff
- Tuesday morning Interdisciplinary Team conference
- Wednesday morning Plastics/Bedside Rounds with the Plastic Surgery attending physician and residents
- Thursday morning Psycho/Social Rounds
- Friday Morbidity & Mortality Conference held the third Friday of the month.
