Curriculum for training in orthobiologics

There are currently a number of educational offerings in orthobiologics, but there is no comprehensive, standardized approach to education and training in the field. This curriculum (available online curricula.aapmr.org) provides a framework to identify the necessary knowledge, skills, and attitudes pertaining to orthobiologic treatments of orthopedic and musculoskeletal conditions. It can be used as a guide for institutions and residency programs to develop training or for individual practitioners looking to assess and augment their own knowledge and skills pertaining to orthobiologic treatments. The primary target audience of this document is physiatrists, with core competencies aligning with physical medicine and rehabilitation (PM&R) postgraduate year-2 through year-4 training, and specialized competencies aligning with fellowship and more advanced training. This template, however, can be easily modified to fit the training needs of physicians from other specialties who are considering practicing in orthobiologics. This curriculum is not intended to be a comprehensive overview of all nonsurgical treatments for orthopedic and musculoskeletal conditions. Instead, it focuses on treatments that meet the definition of an orthobiologic, with greater emphasis placed on such treatments that align with current U.S. Food and Drug Administration guidelines. As the regulatory landscape evolves over time, it is anticipated that this curriculum will require updating. It should also be noted that this document does not advocate for any specific treatment modality. Rather, the goal is to outline important knowledge, skills, and attitudes that physicians practicing orthobiologics should be familiar with. Not all physicians practicing in orthobiologics will perform all the listed procedures; nevertheless, to provide the most accurate information and effective care to patients, those practicing in orthobiologics need to be familiar with the existence of and evidence base (or lack thereof) for all relevant orthobiologic treatments. The Curriculum Workgroup recognizes that other interventions, such as percutaneous tenotomy and shockwave technologies, contain mechanisms of action that overlap with orthobiologics and are potential alternative treatment options. However, because these treatments do not meet the definition of an orthobiologic, they are considered beyond the scope of this document. Similarly, surgical applications of orthobiologics are beyond the scope of this curriculum. This document was developed in accordance with the American Academy of Physical Medicine and Rehabilitation's (AAPM&R) process for curricula in specialized topics. These curricula are designed to define the full spectrum of training needs in a specific clinical area from residency through practice. AAPM&R's approach is to develop curricula from an aspirational and educational perspective, not a regulatory one. For that reason, it is not prescriptive in how it is applied; rather, this document provides a broad and comprehensive framework from which any program or practitioner can identify gaps in training and adapt the curriculum to their diverse needs. Core and specialized competencies are further stratified into basic, intermediate, and advanced categories, as well as by knowledge, skill, and/or attitude. This taxonomy serves as a guideline for identifying educational needs and designing programs and resources to meet those needs. The Curriculum for Training in Orthobiologics was written by the AAPM&R Orthobiologics Curriculum Workgroup, overseen by the AAPM&R Orthobiologics Workgroup and Medical Education Committee. As the field of orthobiologics continues to grow, it is important to ensure that practitioners are equipped with the tools needed to be successful. This curriculum outlines the current competencies that are essential to ensure that residents, those in fellowship training, and practicing physicians have the foundation required to effectively optimize patient care. Because the field continues to evolve, this curriculum is expected to be a living document and will be updated accordingly. Dr Cianca is a member of the AAPM&R Board of Governors. Dr Gruner reports consulting fees from PACES, State of Maryland, Rubicon Founders, Apex Medical; Board and founder with equity of Limber. Dr Sussman reports the following Trice Medical, Medical Advisory Board; Lipogems LLC, Consultant. Apex Biologics, Consultant Interventional Orthobiologic Foundation, Board Member. You can access this curriculum and the other curricula in this series at curricula.aapmr.org.