Adult Reconstruction Fellowship

Fellowship overview

Our goal is to provide the adult reconstruction fellow with the clinical knowledge and surgical skills to manage all aspects of a modern, complex adult reconstruction practice. We focus on evidence-based decision making derived from the literature in our field. Our fellow will obtain in-depth exposure to primary total hip and total knee arthroplasty, along with exposure to unicompartmental knee arthroplasty and revision hip and knee arthroplasty. There will be the opportunity for the fellow to gain surgical skills in the direct anterior approach and the mini-posterior approach for minimally invasive techniques for hip replacement. Additionally, there will be exposure to emerging technologies for total knee arthroplasty including patient-specific instrumentation, navigation, and robotics. 

The fellow will have the opportunity to develop surgical skills and exposure to open hip preservation including periacetabular osteotomy, proximal femoral osteotomy and open surgical dislocation. If a fellow is interested in exposure to hip arthroscopy, that can be considered and potential accommodations made if desired. 

~ Dr. Thomas Huff, Adult Reconstruction Fellowship Director

Experience OHSU Graduate Medical Education, the wonders of Oregon, and something bigger.

Adult Reconstruction Fellowship details

Fellowship duration: 1 year (August 1 to July 31)

Stipend: $74,482/year plus benefits

Application Deadline: November 1

Fellowship Director:  Thomas Huff, M.D.

Arthroplasty Faculty:  Kathryn Schabel, M.D. and Ryland Kagan, M.D.

The Department of Orthopaedics and Rehabilitation at Oregon Health & Science University seeks applicants for a 12-month clinical fellowship. Candidates should have completed the equivalent of five years of orthopaedic training in the United States or Canada. To qualify, candidates much be eligible for employment in the United States and must have a US social security number.  The candidate must also have passed all 3 steps of the USMLE exams. 

Interview dates for the 2022-2023 fellowship are:

  • Thursday, January 14, 2021
  • Friday, January 15, 2021

Please apply through Fellowship Match.

Dr. David Putnam

David Putnam, M.D.

David was born and raised in Santa Cruz, CA. He completed his undergraduate education at the University of California, San Diego where he studied Human Biology. He then went on to medical school at Oregon Health and Science University where he stayed on for his orthopedic surgery residency and now Adult Reconstruction Fellowship. David is thrilled to continue his training at OHSU and looks forward to expanding his experience in primary and revision hip and knee arthroplasty. In his free time, David enjoys spending time with his family, kiteboarding, mountain biking, snowboarding and exploring the amazing outdoors that the Pacific Northwest has to offer.

As an extension of the faculty, fellows are responsible for participating in patient care, including operative care, inpatient care, call and clinics. Fellows are also responsible for resident education, and are required to participate in weekly basic scientific and clinical conferences, as well as clinical or basic research. The goal of the fellowship is to produce a well-rounded adult reconstruction surgeon who can provide a valuable contribution to the medical community. The main priorities are: 1) surgery and patient care; 2) research and education.

Operative care

OHSU Orthopaedics performs approximately 1000 arthroplasty cases per year. A recent year included 414 primary TKA, 425 primary THA, 146 TKA revisions, 129 THA revisions, 16 periacetabular osteotomies, 17 conversions of previous surgery to THA and 23 unicompartmental knee arthroplasty cases. Operative involvement will increase with maturity with a clear goal that the fellow is capable of operating independently and able to manage a complex adult reconstruction practice and case load by the end of the fellowship. 

Inpatient care

The adult reconstruction service is run by three full-time attending orthopaedic adult reconstruction surgeons, with the fellow functioning as a junior consultant. The fellow is responsible for supervision of two orthopaedic residents assigned to the adult reconstruction service (PGY-3 and PGY-5).  The fellow and residents are responsible for ensuring adequate communication with the attending physician(s). While the primary responsibility for inpatient work rounds is carried by the residents, fellows are responsible for knowledge of and involvement with patient care on an ongoing basis.

Call

General orthopaedic call is required at the attending level, with an in-house junior resident as first call and a senior or chief resident as second call.  The fellow is expected to take one or two weeknight calls per month. Faculty members will be assigned as back-up for each call. There are additional opportunities for general orthopaedic call at local partner community hospitals within the region for additional pay. 

Clinic

The fellow is expected to be at all clinic sessions with the attending physician(s) as dictated by the trainee schedule. The fellows will become proficient in the diagnosis of all degenerative hip and knee conditions, as well as modes of failure of primary and revision arthroplasties. This learning environment provides the opportunity to develop clinical judgment that will ultimately lead to the ability to function independently as the primary surgeon.

Conferences

The fellow is expected to attend and participate in the following weekly scheduled conferences at OHSU:

  • Grand Rounds/M&M -- Presentation of service M&M summary will be done by the PGY-1 or PGY-4. Presentation of individual cases will either be by the senior resident or the fellow, depending on faculty assignment.
  • Joints conference -- Fellows and residents will present operative elective cases for the upcoming week. Fellows are responsible for presenting or guiding the residents in presenting concise patient histories, including relevant radiographs.

The fellow is permitted to attend one approved course or national meeting during the fellowship year, with a $1500 travel stipend provided by the department. To ensure adequate coverage of the service, fellows to should plan to attend different meetings. Additional meetings may be approved on a case-by-case basis if the fellow has original research to present.

Protected time for study and research is assured. The fellow is expected to complete one clinical or basic science project for potential publication. The fellow is also expected to participate in the Arthroplasty Curriculum with the residents and give one lecture during the year to the residents. Additionally, the fellow is expected to assist the residents to select literature for review at two arthroplasty-themed journal clubs during the year.

The fellow is expected to participate in at least one original research project, supervised by an attending surgeon, and one review article, book chapter or similar. Opportunities for both in-house and external grant funding exist for collaboration in valid clinical or basic science research projects. An epidemiologist and statistical consultant are available for research project design and analysis. In addition, two full-time research assistants support the adult reconstruction service. Fellows are encouraged to begin their research project early, in order to prepare abstracts for submission by March or early April. The goal is to have a peer-review publication submitted by the end of the fellowship year.

Timeline for milestones is as follows:

  • Review of research opportunities complete by Sept. 1
  • Presentation of written research proposal with critique by faculty by Dec. 1
  • Submission of first draft of the paper to faculty advisor(s) by March 1

Authorship: Fellows will be given first authorship on papers if they complete a nearly final draft prior to the conclusion of the fellowship. However, if the attending physician has to substantially complete the paper, or a major rewrite is needed, the fellows will forgo the privilege of first authorship.

Presentation: Costs for travel and registration to any North American meeting at which the fellows are presenting original research will be covered by the fellowship.  Abstract authorship and presentation will be handled as for paper authorship.

Adult reconstruction faculty

Dr. Thomas Huff

Dr. Thomas Huff received his M.D. from the University of Iowa and completed his residency at Case Western Reserve University. He did fellowship training in New York and Europe, and specializes in hip and knee replacement, adult reconstruction and revision joint replacements.

Dr. Kathryn Schabel

Dr. Kathryn Schabel received her M.D. from the Medical College of Wisconsin and did both her residency and fellowship in Adult Reconstruction at the University of Utah. Dr. Schabel specializes in hip and knee replacement, adult reconstruction surgery and revision joint replacements.

Dr. Ryland Kagan

Dr. Ryland Kagan received his M.D. from Albany Medical College. He completed his residency at OHSU and a fellowship in Joint Reconstruction and Hip Preservation at the University of Utah. Dr. Kagan specializes in hip and knee replacement, adult reconstruction, and hip preservation.