The Dartmouth Orthopedics Clinician/Researcher Training Program (DOC/RTP) annually provides two orthopedic residents (one after the PGY 2 and one after the PGY 3) a research year during which they earn a Master's degree from The Dartmouth Institute for Health Policy and Clinical Practice (TDI), formerly the Center for the Evaluative Clinical Sciences. The objective is for these residents to grow into the orthopedic research leaders of the future, possessing sound research practices and techniques to perform their own research and to evaluate the research of others. The singular curriculum, designed by Dr. John E. Wennberg (voted the most influential health policy researcher of the past 25 years by Health Affairs), combines epidemiology and biostatistics, decision analysis using Bayesian theory, quality improvement in ambulatory and hospital-based practice settings, economics of health care, health policy, sociology of health care systems, and use of large data bases, all taught by some of our nation's leading experts in these fields, 7 of the faculty being members of the National Academy of Science. The infrastructure to support the many research opportunities for our NRSA residents has been coordinated by Dr. Weinstein, recently appointed as TDI Director and successor to Dr. Wennberg. The success of the DOC/RTP has been so unmistakable that the program is being copied and emulated by others at Dartmouth and around the country. In our first 5 years of funding, Master's degrees in health policy and clinical practice will have been awarded to 10 orthopedic residents. Each of these outstanding individuals, from medical schools such as Yale, Dartmouth, University of Washington and Northwestern, came to Dartmouth not only because of the outstanding Orthopedics program but also because of the opportunity afforded by the NRSA and the chance to learn about the delivery and science of health care. All orthopedic graduates from TDI's program have continued their academic careers either in subspecialty fellowships or through medical center/medical school association. Research projects and publications have increased exponentially. More importantly, the quality of resident work has improved and the study of the science of medicine has been developed as a critical component of their clinical success.

National Institute of Health (NIH)
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Institutional National Research Service Award (T32)
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Arthritis and Musculoskeletal and Skin Diseases Special Grants Review Committee (AMS)
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Panagis, James S
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Dartmouth College
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Pearson, Adam; Blood, Emily; Lurie, Jon et al. (2011) Predominant leg pain is associated with better surgical outcomes in degenerative spondylolisthesis and spinal stenosis: results from the Spine Patient Outcomes Research Trial (SPORT). Spine (Phila Pa 1976) 36:219-29
Pearson, Adam M; Tosteson, Anna N A; Koval, Kenneth J et al. (2010) Is surgery for displaced, midshaft clavicle fractures in adults cost-effective? Results based on a multicenter randomized, controlled trial. J Orthop Trauma 24:426-33
Pearson, Adam; Blood, Emily; Lurie, Jon et al. (2010) Degenerative spondylolisthesis versus spinal stenosis: does a slip matter? Comparison of baseline characteristics and outcomes (SPORT). Spine (Phila Pa 1976) 35:298-305
Pearson, Adam M; Lurie, Jon D; Blood, Emily A et al. (2008) Spine patient outcomes research trial: radiographic predictors of clinical outcomes after operative or nonoperative treatment of degenerative spondylolisthesis. Spine (Phila Pa 1976) 33:2759-66
Pearson, Adam M; Blood, Emily A; Frymoyer, John W et al. (2008) SPORT lumbar intervertebral disk herniation and back pain: does treatment, location, or morphology matter? Spine (Phila Pa 1976) 33:428-35
Weinstein, James N; Lurie, Jon D; Olson, Patrick R et al. (2006) United States' trends and regional variations in lumbar spine surgery: 1992-2003. Spine (Phila Pa 1976) 31:2707-14