Adult Clinical and Research Fellowships in Limb Lengthening and Reconstruction

We have one clinical and one research fellowship position available for our Adult Fellowship in Limb Lengthening and Reconstruction at the Rubin Institute for Advanced Orthopedics at Sinai Hospital of Baltimore. These positions will be from August 2022 - July 2023.

Duration: 12 months (minimum of 6 months with maximum of 2 years)

Deadline: Rolling

Clinical Fellow Stipend: Approximately $63,500/year plus benefits (salary commensurate with Sinai Hospital’s PGY-7 scale)

Research Fellow Stipend: Approximately $40,000/year plus benefits 

Goals and Characteristics:

Our physicians treat a wide range of clinical problems including limb length discrepancy (LLD), fracture malunions/nonunions, osteomyelitis, joint infections, angular deformities, and congenital deficiencies. The physicians see approximately 50 new patients and 120 follow-up patients per week.

This fellowship focuses on adult LLD, malunions, nonunions, segmental bone defects, osteomyelitis, rotational muscle flaps, and joint infections. Fellows will learn to determine current LLD, evaluate limb alignment, and analyze single and multiapical deformities. The Adult Clinical Fellow will rotate with Dr. Janet Conway and Dr. Michael Assayag for eight months and with our pediatric orthopedists for a total of four months.

At the end of the fellowship, the Fellow should be able to competently perform limb lengthening and reconstruction surgical procedures and understand the technical aspects, indications, risks, results, prognosis, and limitations of these procedures. Per week, the adult orthopedic surgeons perform 20 to 25 surgical cases. Clinical fellows will apply external fixation and insert femoral and tibial intramedullary nails. They will also perform Gigli saw osteotomies, fixator-assisted nailing or plating, and bone transport. Fellows will treat hypertrophic, atrophic, and infected nonunions and learn to resect necrotic bone to treat osteomyelitis. Fellows will also gain exposure to the correction of foot deformities.

Clinical fellows are required to collect data and produce at least one scientific paper that will be submitted to a peer-reviewed journal. Ample support is available for assistance in publication, including a medical editor, illustrator, graphic artist, photographer, and research coordinator. A modern gait laboratory is onsite for research and clinical applications. The clinical and research fellows will attend orthopedic grand rounds, research meetings, in-service training lectures, and the annual Baltimore Limb Deformity Course; they will also help prepare for and attend weekly preoperative indications conferences.

The program is based on techniques derived from the science of distraction osteogenesis. Methodologies used are not limited to any specific device or apparatus but encompass the full gamut of orthopedic fixation materials including plates, intramedullary rods, telescopic rods, and monolateral and circular fixators.

For international physicians applying for a clinical position, this fellowship requires USMLE, Canadian LMCC provided the candidate is a graduate from an LCME-accredited medical school, or ECFMG certification. Because of the relatively new nature of the techniques and methodologies involved, no guidelines have been published by the ACGME so this fellowship is not currently accredited. However, the guidelines are modeled after existing guidelines of similar orthopaedic subspecialty programs.