PASSOR Fellowship Guidelines

For many years there has been a proliferation of musculoskeletal fellowships throughout the country. There has been a wide disparity of fellowship qualifications and requirements. The PASSOR Board of Governors became concerned because there were graduating residents who were signing onto fellowships and were not getting the training they were expecting.

These guidelines serve to designate fellowships as "PASSOR Recognized" which indicates that they meet the minimum standards set out by the PASSOR Board of Governors to have a fellowship. In addition, these guidelines further designate the fellowship’s area of focus as "Spine,"  "Sports Medicine," or “General Musculoskeletal Medicine.” Fellowships may have more than one designation.

Fellowships without the "PASSOR Recognition" may be fine fellowships from a learning and exposure standpoint. In these instances the lack of this designation only means that the fellowship is lacking in one or more areas considered important by the PASSOR Board.

Fellowship Director

(one designated proctor must meet the minimum criteria)

Must be:

• Board certified in physical medicine and rehabilitation
• In practice for at least five consecutive years following residency. A clinical fellowship following residency will be considered one of the five years of practice.
• A PASSOR Fellow Member
   

Must fulfill at least three of the following five:

• Have three publications on relevant topics such as spine, sports, musculoskeletal or pain medicine in peer reviewed journals. (a peer reviewed journal may best be described as having a formal editorial board such as PM&R, Archives of Physical Medicine and Rehabilitation, Spine, Clinical Journal of Sport Medicine, etc. Publications in peer reviewed journals include review articles or presentation of original research, abstracts will not be considered)
• Published in four book chapters
• Five presentations at national medical conferences on relevant topics (e.g., the presentation of the management of a clinical topic or original research, poster and platform scientific presentations will be considered)
• Be affiliated (at least an assistant clinical professor) with an ACGME-accredited physical medicine and rehabilitation residency program
• Must have served on a committee of a national medical organization

Maintenance of Recognition

• “PASSOR Recognized” fellowship programs will be graded on their academic and research productivity. Each program is required to score three points over each three year period beginning July 1, 2003. For those applying for designation following July 1, 2003, the three year period will begin the year the fellowship is designated as “PASSOR Recognized”.

Points are awarded as follows:

• Original paper published in peer reviewed journal – 1.5 pts.
• Book chapter – 1 pt.
• Scientific presentation at national meeting (poster/platform) – 1 pt.
• Invited presentation at national meeting – 1 pt. maximum per meeting
• Grand rounds, invited presentation at a local or regional meeting or AAPM&R online case presentation – 0.5 pts. maximum per regional meeting

For all categories, author/presenter must include designated fellowship director and/or fellow(s).

Patient Population

• >75% of the patient population must be musculoskeletal in nature
• Must see a minimum average of 12 patients per day

Practice Focus

The Practice focus should be spine, sports medicine, general musculoskeletal medicine, or any combination thereof.

• The practice focus should be described in the PASSOR Fellowship/Elective Directory by descriptors known as designations. Designations will be as follows: spine, sports medicine, or general musculoskeletal medicine. In order to have a designation, a practice must dedicate at least 33% of its time to that area.
• A practice must have at least one designation but may have more than one. In order to have a sports medicine designation, the practice must be the designated team physicians for one or more organized sports teams or associations. (verification of professional or college team physician status must be sent to the Academy national office.)

Teaching

• The fellowship director or designated proctor must be in the same office as the fellow at
  least 50% of the time.
• There must be at least one formal monthly journal club and the fellow must be required to present at a journal club at least once every other month.
• The fellow should have >25 hours per week designated to direct patient care.
• The fellow must have designated teaching responsibilities on an intermittent or continual basis. This may be fulfilled by weekly teaching responsibilities for residents or medical students, lecturing at educational courses, or other similar activities.
• There must be at least one research project structured within the fellowship. This project may be a chapter, educational video, article submitted to a peer reviewed journal on a relevant topic, or other similar project approved by the fellowship director.
• The fellow is encouraged to keep a log of activities as evidence of their competency. (e.g., number of injections, number of EMGs, organized sports team or associations’ coverage, etc.)

Fellowships that do not satisfy all minimal criteria

• If a fellowship does not satisfy all criteria listed above, then it will not be PASSOR Recognized. It will still be listed in the PASSOR Fellowship/Elective Directory in a separate section. All fellowship directors listed in the PASSOR Fellowship/Elective Directory will be notified each year of the requirements to be PASSOR Recognized.

"PASSOR Recognized" Fellowship Monitoring

• Prior to the beginning of the academic year, the fellowship director will be asked to fill out a questionnaire describing his or her fellowship. In addition, the exiting fellow (if one exists) will be asked to complete a questionnaire. In order to maintain recognized status, all fellows must turn in fellowship questionnaire prior to determined deadline.
• The fellow questionnaire will include parameters of satisfaction. The fellowship should receive an overall rating of fair or above from the fellow and pass all other minimal requirements in order to be PASSOR Recognized. If the fellowship receives a fellow rating of poor and this rating appears to be for nonarbitrary reasons, then the PASSOR Medical Education Committee may, at its discretion, give the fellowship a warning. If the fellowship receives a fellow rating of poor in one of the two subsequent years, the PASSOR Medical Education Committee may, at their discretion, remove the PASSOR Recognized designation from the fellowship listing in the PASSOR Fellowship/Elective Directory.
• If a fellow has a specific documented grievance, and the grievance is of an egregious nature, then the PASSOR Medical Education Committee may, at their discretion, remove the PASSOR Recognized designation from the fellowship listing in the PASSOR Fellowship/Elective Directory.
• A fellowship that has been warned or had the PASSOR Recognized designation removed from their listing in the PASSOR Fellowship/Elective Directory may, at their discretion, reapply the following year with the submission of an appropriate plan of correction.
• The PASSOR Medical Education Committee will expeditiously review this information and decide whether or not a fellowship should be designated as PASSOR Recognized in the PASSOR Fellowship/Elective Directory. If based upon the above criteria, a fellowship is not designated as PASSOR Recognized in the PASSOR Fellowship/Elective Directory then the fellowship director has the one time right of appeal to the PASSOR Board of Governors Executive Committee who will make the final decision.

PASSOR Recognized Fellowship Grievances

• PASSOR recognition and maintenance of recognition will continue to be based upon a fellowship’s achievement of previously stated and documented criteria, based upon the PASSOR Fellowship Guidelines. Failure to meet these requirements will result in loss of PASSOR recognized status. Factors unrelated to these specific criteria will NOT affect PASSOR recognition.
• The PASSOR Medical Education Committee does NOT assume any formal role or responsibility in solving grievances between fellows and fellowship directors.
• PASSOR Medical Education Committee members and members of the PASSOR Board of Governors are available however, to assist, advise, and mediate when formally requested by PASSOR leadership.

PASSOR Fellowship Guidelines – 2008

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