A TEAM EFFORT

Sports Medicine Fellowship Program
keeps physicians and area athletes at the top of their game
e

By Tessa Bowen

It’s a rainy spring afternoon at Peccole Park. The smells of freshly cut grass, broken-in leather and popcorn mean baseball season is in full swing. In the bottom of the first inning, the Nevada Wolf Pack is up to bat. Watching from the dugout, Christopher Amundsen, M.D., isn’t part of the lineup or the coaching staff. He’s there to ensure the Pack don’t strikeout – from injuries.


Over at Lake Tahoe’s Squaw Valley Ski Resort, thousands of skiers and riders are riding the mountain in bluebird conditions. Inside the Truckee-Tahoe Medical Group at the base of the bustling Village at Squaw Valley, Shane Hawthorne, M.D., is treating a steady stream of unexpected accidents – from concussions, strains and sprains to a wailing child suffering from a case of cafeteria chair-crushed fingers.


Dr. Amundsen and Dr. Hawthorne have practiced sports medicine for the past year as 2018-19 University of Nevada, Reno School of Medicine Sports Medicine fellows. For the two physicians, each a graduate of UNR Med’s Family Medicine Residency program, the sports medicine fellowship program was their top choice of fellowship programs.

““Going into the athletic training room with an established dynamic when they didn’t know who I was, yet establishing trust and credibility as a physician. It wasn’t an easy proposition, but I was able to develop relationships with the athletic trainers and athletes and gained their trust in my judgement – even if it wasn’t popular and would lead to an interaction with coaches that they didn’t want to hear.””

Christopher Amundsen, M.D. 2018-19
sports medicine fellow

With more applicants than available fellowships, competition is fierce. According to the National Resident Matching Program, 386 sports medicine fellowship hopefuls applied for 298 positions in 2019.

Opportunities for cross-training

UNR Med’s sports medicine fellowship program offers fellows unique experiences as varied as the field itself, beyond baseball and skiing to scuba diving, rodeo, trail running and youth sports.


“The breadth of training opportunities is second to none,” said Amundsen.


The 4,000 patients they see and treat annually are also diverse. “It’s rewarding working with elementary school students, collegiate athletes and the 65-year-old running the Tahoe Rim Trail, because they’re motivated to get better,” said Hawthorne. “It’s satisfying to help them get back to their sport, but can be difficult when they can’t compete after an injury. It takes empathy and careful redirection of their motivation.”


For Hawthorne, another draw to UNR Med was the opportunity to be a team physician for an NCAA Division I university and work unimpeded with athletes, trainers and coaches.


UNR Med Sports Medicine Fellows cover the majority of Nevada Athletics events, assisting daily with training room injuries and illness evaluations. “There is more Division I coverage and training room experience than most fellowship programs, a definite highlight of our program that sets UNR Med apart from others throughout the nation,” said Tony Islas, M.D., sports medicine fellowship director.


“Our Wolf Pack athletes have amazing access to immediate, quality care every day right here on campus, which is something not all university athletic programs are as privileged to have access to,” said Doug Knuth, director of athletics. “The UNR Med Sports Medicine Program and fellows are a large part of Wolf Pack athletics successes.”

Put me in, Coach

During serious spine or head injuries, sometimes the very equipment designed to protect athletes can hinder medical teams. Incorrect removal of a football helmet or shoulder pads may lead to unwanted motion of the cervical spine. In that moment, the focus isn’t on the score, it’s on the clock. From injury to diagnosis to treatment of a suspected cervical spine or head injury, every minute counts when considering the future of the injured athlete.


“The most dramatic moment of my fellowship happened during a Wolf Pack football game,” said Amundsen, “The athlete went up to catch the football, got knocked around in the air and landed on his head. We stabilized him on the field and then transported him to the hospital for evaluation. It is never comfortable to take care of an athlete in that setting, but we train for those situations, and everything flowed smoothly.”


A $17 billion market in the U.S., the youth sports market rivals the size of the $15 billion NFL market, according to WinterGreen Research. In the U.S., about 3.5 million youth sports injuries occur each year, accounting for almost one-third of all annual childhood injuries, according to the Centers for Disease Control and Prevention (CDC).


“Having access to UNR Med doctors and fellows not only gives us extra hands on the football sidelines, but different expertise and backgrounds,” said Ashleigh Rahming, sports medicine director and athletic trainer at Reno High School. “Our Reno High Sports Medicine students have the priceless experience of working alongside the fellows, which exposes them to all of the opportunities in the sports medicine field.”

“Working side-by-side and learning from pioneers developing studies and standards that are adopted by the NCAA for nationwide athletic screening has been a unique opportunity at UNR Med.”

Shane Hawthorne, M.D.
2018-19 sports medicine fellow

Field training in the literal sense

For sports medicine fellows, going to the “office” spans the Reno/ Tahoe region – from modern clinics to medical tents, from the sidelines to dirt roads.


“This will be the 12th year the UNR Med Sports Medicine Fellowship has partnered with us to provide medical support,” said George Ruiz, race director for the Tahoe Rim Trail Endurance Runs. “The partnership with UNR Med’s Dr. Islas and his staff, along with our medical director Dr. Andy Pasternak, allows our event to provide the highest level of medical care in a backcountry setting of any premier event in the country.”


This summer, a former UNR Med Sports Medicine Fellow will return to run the 100-mile race. “We have fellows coming full circle,” Ruiz said. “We cherish our partnership with the UNR Med Sports Medicine Fellowship and the relationships it forges.”


Amundsen will mark his fourth year helping with the Tahoe Rim Trail events this summer, first as part of his UNR Med residency and now his fellowship. “These endurance athletes are a different breed with such different mentalities, approaches to training, exercise and life in general that is hard for us non-endurance, ‘mainstream’ athletes to grasp. When they come into the medical tent, you know something is wrong, but even then, we have a hard time convincing them that a particular injury or illness is enough to keep them from finishing the remaining 25-plus miles in their race.”


Amundsen and Hawthorne will soon cross the finish line of their own fellowships. Amundsen is relocating to Branson, Missouri, where he signed a contract to work in primary care sports medicine for Mercy Clinics beginning September 2019. Hawthorne will return to his native Utah to practice ski medicine in the Park City area.


“Seeing our fellows work with a variety of patients and teams across the nation after getting their dream jobs as a result of graduating from our program and passing their board certifications is the ultimate measure of success,” Islas said.

SPORTS MEDICINE
FELLOWSHIP PROGRAM STATS

Established: 2007
Founding director
: Carol Scott, M.D.
Accreditation
: Accreditation Council
for Graduate Medical Educati
on

Affiliations:
  • UNR Med Department of
  • Family and Community
  • Medicine and Nevada Athletics

    Optional wilderness medicineelective is the oldest U.S. program of its kind Six-week ski clinic rotation is the longest in the nation

Mark L. Stovak, M.D.,FAAFP, FACSM, CAQ Sports Medicine

POSITIONS:

UNR Med professor and sports medicine fellowship assistant director


FELLOWSHIP TRAINED:

  • Sports Medicine
  • SPECIAL INTEREST:
  • Athletes and NCAA sports


AUTHOR:

Nationwide sports fellowship curricula forultrasound, standards of excellence and competence


MEMBER:

AMSSM Board of Directors

UNR Med Class of 1995

Arthur A. Islas, M.D.,MPH, FAWM, CAQ Sports Medicine

POSITIONS:

UNR Med professor, sports medicine fellowship director and wilderness medicine fellowship director; Great Basin National Park medical director


FELLOWSHIP TRAINED:

  • Sports Medicine


SPECIAL INTEREST:

Wilderness Medicine


CO-AUTHOR:

Guidelines on spine immobilization,wound care and lightning in austere environments