University reopens orthopaedic training program after 17 years

For nearly two decades, the University of South Florida’s (USF) College of Medicine lacked one crucial component: orthopaedics. The void was created in 1990 when, as the result of a political dispute, 13 of the 17 orthopaedic surgery faculty members left USF and formed the Florida Orthopaedic Institute (FOI), which established its own resident training program.

While issues between the USF administration and the former orthopaedic faculty members remained unresolved, the university was without an orthopaedic surgery department or orthopaedic surgery residency program. That all changed this past summer, when the university, FOI, Tampa General Hospital, and several other healthcare organizations in the community came together to reestablish orthopaedics at USF—and make the program better than ever.

Laying the groundwork—and getting SMART
One of the first catalysts in bringing orthopaedics back to the university was the USF Bulls football team’s decision to work with team physicians provided by USF Health. Because orthopaedics and sports medicine are so heavily intertwined, the agreement started the process of rebuilding an orthopaedic core at the school.

A second impetus was a state grant to establish the Sports Medicine and Athletic Related Trauma (SMART) Institute at USF. The grant enabled USF to establish a comprehensive sports safety program using a multidisciplinary approach. The next step was to recruit staff members with clinical expertise.

A top priority: orthopaedics
The selection of Stephen Klasko, MD, MBA, as vice president for USF Health and dean of the USF College of Medicine also contributed to the resurgence of orthopaedics at USF. Dr. Klasko established a blueprint for making the College of Medicine a “nationally and internationally known clinical and educational powerhouse.” One of his top priorities was to rebuild the orthopaedic department.

“The university recruited internally and externally to send the signal that we’re in the game, especially from a sports medicine perspective,” says Dr. Klasko.

One of the first faculty members the university recruited was USF Bulls team physician David Leffers, MD. Other orthopaedists, including Charles Nofsinger, MD, the former team physician for Tulane University in New Orleans, and Robert A. Pedowitz, MD, PhD, who serves as professor and chair of USF’s new department of orthopaedics and sports medicine, also joined the faculty.

Forging key partnerships
Dr. Pedowitz has been heavily involved in reestablishing the program. He helped solidify a partnership between USF, FOI, and Tampa General during a meeting with two founding members of FOI—Roy Sanders, MD, and Thomas Bernasek, MD—and Tampa General’s chief executive officer and president, Mr. Ron Hytoff.

“The most pivotal part of the process was when the board of Tampa General Hospital and the board of USF recognized that—from an institutional perspective—working together was a win-win situation, and they applied their influence to get it done,” says Dr. Pedowitz. “That occurred during negotiations that took place over the course of weeks. We compressed a process that could have taken years into a short timeframe.”

According to Dr. Pedowitz, much of the credit for the reestablishment of orthopaedics at USF should also go to G. Douglas Letson, MD, orthopaedic surgery residency director and professor in the department of orthopaedics and sports medicine.

“Dr. Letson has been very engaged in USF and has been committed to rebuilding this program for many, many years. He helped create the foundation for this resurgence. We worked together on the curriculum and the design of the program. He’s also been instrumental in building community relationships and partnerships,” says Dr. Pedowitz.

Robert J. Belsole, MD, the former acting dean of USF, was another early driving force.

“Dr. Belsole was a very important institutional leader who saw the opportunity for the reestablishment of the program,” says Dr. Pedowitz. “He also happens to be the head of our practice group. His leadership was important because he has a sense of the resources of our multispecialty group, as well as the history within the community.”

Creating a revolutionary program
The new orthopaedic residency program, which began with six residents and now has eight, will eventually train 20 residents each year. The department of orthopaedics and sports medicine has 16 full-time faculty members; 40 community orthopaedic surgeons have clinical appointments at USF.

According to Dr. Letson, the program is partnering with many high-quality institutions.

“The USF orthopaedic residency program offers exceptional training opportunities at a variety of superb institutions such as the world renowned Moffitt Cancer Center, University Community Hospital, Shriners Hospitals for Children, James A. Haley Veterans’ Hospital, All Children’s Hospital, Lakeland Regional Medical Center/Watson Clinic, and Tampa General Hospital.”

Dr. Pedowitz says that USF plans to expand the program.

“We are currently adding another foot and ankle surgeon and another hand surgeon to the faculty,” he says. “We will be adding more faculty as part of our growth plan over the next few years. We also intend to add three PhD research faculty members within the next 3 to 5 years.”

According to Dr. Pedowitz, residents who participate in the program will benefit from its collaboration with athletic trainers.

“We are very excited to have the USF Athletic Training Education Program (ATEP) within the department of orthopaedics and sports medicine,” he says. “It is one of a few programs nationwide within a college of medicine, and the first to be anchored within an orthopaedic department. This is an extraordinary educational opportunity to connect student athletic trainers with the professionals they will work with during the rest of their careers. Our program also strengthens a key element of our sports medicine outreach efforts within the SMART Institute.”

Dr. Pedowitz explains that the department’s structure will benefit USF as well as the orthopaedic residents it trains.

“Having ATEP within the department helps us because we can then look at those students as part of our own stream of potential employees,” he says. “When we get to equilibrium with that program, we’ll have 60 undergraduates who are in the department of orthopaedics and sports medicine. There’s no example like that in any other orthopaedic department in the country.”

According to Dr. Pedowitz, the revitalized program has attracted many applicants since it began operations this summer.

“It’s exciting to me how quickly the residency program has gained attention,” he says. “We only got approved in June, and right now we have the first two years filled. We’ve already received more than 400 applications for the residency program for next year. The excitement and confidence that people are showing in the educational program is really remarkable.”

Jennie McKee is a staff writer for AAOS Now. She can be reached at mckee@aaos.org