Orthopaedic Oncology Fellowship Information
Download Orthopaedic Oncology Fellowship Program Descriptions: Clinical versus Observational (.pdf)
Download Fellowship Application (.pdf)
The University of Florida is a unique facility in that in one campus there is a major university, a dental school, a medical school, and a veterinary school, thereby bringing together many diverse areas of knowledge and creating a particularly good environment for training future academicians. The medical school is supported by two major hospitals, Shands at the University of Florida and the Gainesville Veterans Affairs Medical Center, with a cumulative total bed number of over 1,200 beds. The musculoskeletal oncology service operates predominantly out of Shands Hospital which has 30 operating rooms and a full surgical intensive care unit available. Annually, the orthopaedic oncology service sees an average of 625 new patients w ith an average of 212 admissions to the orthopaedic oncology service. From these patients, the fellow is trained in the clinical management of patients with musculoskeletal tumors from presentation through work-up, biopsy, treatment planning, and follow up. The fellow is active in the outpatient clinic where annually 2500 patients are seen by the orthopaedic oncology service.
A multi-disciplinary approach to musculoskeletal tumors is carried out at the University of Florida with combined cooperation between the medical oncology, radiation oncology, pediatric oncology, musculoskeletal radiology, pathology, and the orthopaedic oncology services. Weekly meetings between these services are carried out for the coordination and management of patients. The fellow is a major participant in these meetings and in the planning of the care of the patients. The Department of Radiation Oncology is well equipped and very experienced in the management of musculoskeletal tumors as well as the medical and pediatric oncologists with their active services and bone marrow transplant unit.
During the non-clinical portion of the fellowship, the participant has the use of a full biomechanics and a motion analysis lab with one PhD bioengineer available for consultation and co-participation in projects in the biomechanics of limb reconstruction following sarcoma resection. There are ongoing projects in these areas available for the fellow’s participation.
A major emphasis is placed on the correlation of clinical and radiographic musculoskeletal pathology with that of gross and histologic pathology. To facilitate this, the Enneking-Anspach Research Center is available for the fellow to study the more than 12,000 past cases on record in the Study Center as well as all ongoing cases on the clinical service. The Department of Orthopaedics has an extensive computer system with database management for the record keeping of the cases in the study center as well as those on the clinical service. The fellow may use these facilities for study as well as clinical research.
Each year, the fellow is a participant in one of the two one-week courses on musculoskeletal pathology taught by the faculty of the orthopaedic oncology service for residents throughout the United States. The fellow is active as an instructor as well as a participant in this course.
The Orthopaedic Oncology service manages patients with both benign and malignant bone and soft tissue tumors. The goal of the Oncology Fellowship is to assist in the development of the skills and knowledge necessary for managing these patients and to encourage the fellow to develop the skills necessary for a career in academic orthopaedic oncology. The fellowship is a combined clinical and non-clinical rotation.
During the clinical rotation, the fellow is involved in all aspects of evaluation, surgical treatment, and care of patients referred to the orthopaedic oncology service. During the non-clinical rotation, the fellow has the opportunity to review case files archived in the Enneking-Anspach Research Center and also to prepare new cases to be added to the study center. Opportunities exist for both clinical and basic science research and each fellow is expected to complete a research project during the year that is suitable for publication. The orthopaedic department has a full and active biomechanics laboratory and there are opportunities for the fellow to participate in other basic science research in cooperation with the pediatric and medical oncologists as well as the general surgical oncologists who have an active lab in the study of the nutritional aspects of cancer.
The Enneking-Anspach Research Center houses more than 12,000 past cases managed by the orthopaedic oncology service. The fellow is expected to study these cases to ascertain that exposure to all of the different types of musculoskeletal tumors is accomplished within a one-year period. During the year, the fellow is also responsible for reviewing and presenting an average of 250 outside consults that are difficult cases sent for interpretation and advice from throughout the world.
Conferences in which the fellow is involved include a bimonthly pathology conference with the review of histology and radiology of musculoskeletal tumors. The fellow is responsible for review of all of these cases prior to the conference. Every week there is an orthopaedic oncology sign-out conference where all cases from the previous week are reviewed with participation of the radiologists, pathologists, and the faculty of the orthopaedic oncology service to correlate the radiographic picture with the pathologic picture and the margins obtained at the surgical procedure.
Every week there is also a sarcoma conference in which the fellow is responsible for presentation of all new patients who have presented to the orthopaedic oncology service during the week for a combined management planning. This conference is attended by the pediatric and adult oncologists, radiation oncologists, musculoskeletal radiologists, and pathologists. Twice weekly the fellow presents the next day's cases at a preoperative conference attended by the musculoskeletal radiologists, pathologists, and orthopaedic oncologists where differential diagnoses and surgical plans are discussed. The fellow is also a participant in a one-week retreat type course, which is taught biannually by the orthopaedic oncology service. During this course, the fellow is active as instructor in the interpretation of the radiographic and histologic picture of musculoskeletal pathology.
Educational Objectives for the Fellowship
To teach the fellow the basic skills necessary for the management of patients with musculoskeletal tumors.
To teach the fellow the anatomy and surgical skills necessary for a variety of limb salvage and other oncologic surgical procedures.
To expose the fellow to and train in basic bone banking techniques and the use of allografts in skeletal reconstruction as well as the correlative pathology and immunology of allografts.
Allow the fellow time to study musculoskeletal pathology of both current cases and the more than 12,000 cases in the Enneking-Anspach Research Center in order to correlate the clinical and radiographic picture with the gross and histologic pathology seen in the musculoskeletal system.
The fellow is to have a minimum of one clinical or basic science research project completed during the year of training that is suitable for publication.
To train the fellow in all aspects of orthopaedic oncology to be suitable for a career in academic orthopaedics and research.
