The Dartmouth Orthopedics linician/Researcher Training Program (DOC/RTP) annually provides two orthopaedic residents (one after their PGY2 and one after their PGY3) a research year during which they take courses and receive a Master's degree from The Dartmouth Institute for Health Policy and Clinical Practice (TDI). The objective is for these residents to grow into the orthopaedic research leaders of the future, possessing sound research practices and techniques to perform their own and evaluate the research of others. The educational program, designed by Dr. John E. Wennberg, offers an unparalleled curriculum in the evaluative clinical sciences. Along with Dr. Wennberg-voted the most influential health policy researcher of the past 25 years by Health Affairs-TDI provides a host of national science education leaders, 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, who is now past director of TDI and is currently CEO and President of Dartmouth-Hitchcock Medical Center. The commitment from the Department of Orthopaedics, TDI, Geisel School of Medicine at Dartmouth, and Dartmouth-Hitchcock has been so positive that the program is being copied and emulated by others at Dartmouth and around the country. In our first 10 years of funding, Master's degrees in the evaluative clinical sciences will have been awarded to 19 Orthopaedic residents and to one junior faculty member. Each of these outstanding individuals, from medical schools such as Yale, Harvard, Georgetown, University of Washington, Dartmouth 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 orthopaedic 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 continued to increase. More importantly, the quality of resident work has improved through deeper understanding of biostatistics, epidemiology, and medical decision-making, as well as hands-on work using control charts and large databases. The study of the science of medicine has been developed as a critical component of their clinical success.

Public Health Relevance

Our NRSA grant will continue to support the training of future orthopaedic clinician/researchers who will assume leadership positions to initiate health care improvement and transform our nation's health care system from the inside out. This is particularly critical now, when our nation's health care system is in a chaotic state and in desperate need of leaders who can apply themselves to reforming a currently dysfunctional system.

National Institute of Health (NIH)
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
Internal Medicine/Medicine
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United States
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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