Musculoskeletal Oncology Fellowship

Developing Tomorrow’s Leading Specialists

At Vanderbilt, our ACGME-accredited and MSTS recognized oncology program guides you toward becoming a physician armed with the surgical confidence and clinical acumen to deliver the highest level of thoughtful and evidence-guided care. 

As our fellow, you can expect to work alongside regionally, nationally and internationally recognized faculty and surgeons every day. We’re one of the busiest orthopaedic oncology groups in the country, which means you’ll manage a high surgical volume and highly complex cases. You’ll also learn to make informed diagnoses through multi-disciplinary clinical analysis, will get access to innovative research opportunities and most importantly, will learn to become a compassionate leader.

What We Do Here Every Year

Program Overview

Positions: 1 fellow
Duration: 1 year, August 1st through July 31st
Stipend: PGY6 level
Location: Vanderbilt University Medical Center

Our staff works closely in conjunction with experts in medical oncology, surgical oncology, radiology, pathology, radiation oncology and plastic surgery to treat adults and children with conditions of the extremities, pelvis, chest wall, retroperitoneum, and spine. 

Some areas of special interest include the diagnosis and treatment of:

  • Bone and soft tissue sarcomas
  • Benign bone and soft tissue tumors
  • Pathologic fractures
  • Metastatic bone disease
  • Primary and Revision Total Joint Replacement

As part of our fellowship program, you’ll work closely with faculty and staff at the Vanderbilt Department of Orthopaedic Surgery and the Monroe Carell Jr. Children’s Hospital at Vanderbilt. You will also: 

  • Complete at least one publishable research project
  • Coordinate our weekly Sarcoma Tumor Board Conference, presenting cases and best practices and learning to advocate for patients among a group of esteemed peers
  • Participate in orthopaedic oncology clinical research team, leading students and residents 
  • Organize quarterly orthopaedic oncology journal club discussing key topics related to practice and career
  • Log cases/duty hours
  • Prepare daily written pre-operative plans for surgical cases

Clinical Program

Your time in clinic will provide experience in:

  • Analyzing radiographic imaging, pathology slides and tissue analysis to make a differential diagnosis
  • Delivering hard news in an empathetic and kind manner
  • Identifying ways these conditions present
  • Making a robust assessment of each patient 
  • Respecting the personal impact these conditions have on patients and their families
  • Understanding how a patient’s story can illuminate a diagnosis

The make-up of clinical cases you will participate in as a fellow is:

  • 1/3: Sarcoma (2/3 soft tissue, 1/3 bone)
  • 1/3: Benign tumors (2/3 soft tissue, 1/3 bone)
  • 1/3: Metastatic disease/arthroplasty/infection

Surgical Experience

In the operating room, you’ll work directly with an attending surgeon, leading or assisting on a wide variety of cases to gain firsthand technical experience. One of our most common observations is that we’ve never seen the same case twice.

As a fellow of this high-volume program, you’ll experience a significant number of complex cases. This exposure helps you build expertise in:

  • Anatomy
  • Creativity in consideration of post-resection reconstruction options
  • Humility
  • Understanding of tumor biology

Research Program

Our program offers around one- half dedicated weekly time to focus on your research interests. Our evidence-based treatment decisions are based on careful review of the literature. 

We encourage you to translate clinical questions you face into scientific studies and to take part in ongoing faculty-led projects, including clinical and pre-clinical studies. 

Currently, our division is also leading two prospective clinical trials, several retrospective cohort analyses, has established collaboration with colleagues in biomedical engineering with regards to machine learning in the diagnosis of musculoskeletal tumors, and participates in a multicenter clinical research consortium.

Leadership Training

A critical part of your education revolves around the concepts of leadership – as a teacher, coordinator and advocate. You will:

  • Give formal educational lectures to residents
  • Learn to mentor and guide residents as they develop their own surgical and clinical skill sets
  • Learn to share profound diagnoses that impact one’s life and livelihood in a way that patients and families can understand 

Conferences and Weekly Schedule

Fellows complete a rigorous schedule of clinical care, conferences, research and surgery.

Conferences

Weekly Wednesday Sarcoma Tumor Board Conference 
(7 a.m.)

Fellows and faculty review 100 percent of sarcoma tumor cases for the week. Fellows coordinate the conference meetings. 

Daily Schedule

Monday

  • AM: Children’s surgery
  • PM: Adult surgery

Tuesday

  • All day: Clinic

Wednesday

  • All day: Adult Surgery

Thursday

  • All day: Adult Surgery

Friday

  • AM: Adult Surgery or Clinic
  • PM: Admin/Research

Application Process

We participate in the ACGME Fellowship Match process. For more information about our fellowship program, contact Takia Richardson, Fellowship Program Manager at takia.k.richardson@vumc.org or contact Josh Lawrenz MD, Fellowship Director at joshua.lawrenz@vumc.org.

 

Fellow Benefits 

At Vanderbilt, we want you to enjoy a well-rounded fellowship experience. Benefits of our program include:

  • Attendance at two conferences: MSTS in the fall, AAOS in the spring
  • Office with computer and workspace
  • Readily available orthopedic anatomy cadaver lab on medical campus
  • Participation in an industry Tumor Fellows Course

Division Research 

Our recent research publications include:

  • Goldin AN, Johnson SR, Hajdu KS, Kowalski BL, Volkmar AJ, Moran CP, Rekulapelli A, Lawrenz JM, Halpern JL, Schwartz HS, Holt GE. Surgical Fixation Method in Lower Extremity Intercalary Allograft Reconstruction After Oncologic Resection: A Comparison of Plates and Nails. J Am Acad Orthop Surg. 2023 Jun 12. DOI: 10.5435/JAAOS-D-23-00025. Epub ahead of print. PMID: 37311442.
  • Lawrenz JM, Johnson SR, Zhu K, McKeon M, Moran CP, Vega JF, Hajdu KS, Norris IV JP, Luo LY, Shinohara ET, Cates JMM, Rubin BP, Reith JD, Halpern JL, Mesko NW, Schwartz HS, Nystrom LM, Holt GE. Adjuvant Radiation after Resection of Atypical Lipomatous Tumors of the Extremity Reduces Local Recurrence but Increases Complications: A Multicenter Evaluation. Sarcoma. 2022 Aug 22;2022:2091677. DOI: 10.1155/2022/2091677. PMID: 36046749.    
  • Lawrenz JM, Johnson SR, Hajdu KS, Chi A, Bendfeldt GA, Kang H, Halpern JL, Holt GE, Schwartz HS. Is the Number of National Database Research Studies in Musculoskeletal Sarcoma Increasing, and Are These Studies Reliable? Clinical Orthopaedics and Related Research. 2022 June 21. PMID: 35767810. 
  • Lawrenz JM, Krout JC, Moran CP, Ready AK, Schafer EA, Higgins RT, Halpern JL, Schwartz HS, Holt GE. Telemedicine in Orthopaedic Oncology During the COVID-19 Pandemic: An Assessment of Patient Satisfaction, Reimbursement and Physical Exam Competency. Orthopedics. Sept-Oct 2021;44(5):274-279. PMID: 34590949. 
  • Wilson RJ, Freeman TH Jr, Halpern JL, Schwartz HS, Holt GE. Surgical Outcomes After Limb-Sparing Resection and Reconstruction for Pelvic Sarcoma: A Systematic Review. JBJS Rev. 2018 Apr;6(4):e10. PMID: 29688908
  • Nguyen JQM, McWade M, Thomas G, Beddard BT, Herington JL, Paria BC, Schwartz HS, Halpern JL, Holt GE, Mahadevan-Jansen A. Development of a modular fluorescence overlay tissue imaging system for wide-field intraoperative surgical guidance. J Med Imaging (Bellingham). 2018 Apr;5(2):021220. PMID: 29531968
  • Mesko NW, Wilson RJ, Lawrenz JM, Mathieu JL, Ghiam MK, Mathis SL, Halpern JL, Schwartz HS, Holt GE. Pre-operative evaluation prior to soft tissue sarcoma excision – Why can’t we get it right? Eur J Surg Oncol. 2018 Feb;44(2):243-250. PMID: 29269109
  • Colazo JM, Prasad K, Miller A, Sharif K, Aweeda M, Fassler C, Singh R, Schwartz, Lawrenz JM, Holt GE, Topf MC. 3D Specimen Scanning and Mapping in Musculoskeletal Oncology: A Feasibility Study. Ann Surg Oncol. 2023 Dec 22. PMID: 38133863.
  • Quirion JC, Johnson SR, Kowalski BL, Halpern JL, Schwartz HS, Holt GE, Prieto-Granada C, Singh R, Cates JMM, Rubin BP, Mesko NW, Nystrom LM, Lawrenz JM. Surgical Margins in Musculoskeletal Sarcome JBJS Rev 2024 Mar 6;12(3) PMID: 38446910.
  • Hajdu KS, Chenard SW, Judice AD, Quirion JS, Mika AP, Giblert WB Jr, Hefley W, Johnson DJ, Wright PW, Kang H, Halpern JL, Schwartz HS, Holt GE, Lawrenz JM. Prophylactic Antibiotic Choice and Deep Infection in Lower Extremity Endoprosthetic Reconstruction: Comparison of Cefazolin, Cefazolin-Vancomycin, and Alternative Regiments. J AM Acad Orthop Surg. 2024 July 2. PMID: 38968697.

Our recent research presentations at the Musculoskeletal Tumor Society (MSTS) Meetings include: 

2024 Meeting

  • Chenard SW, Rekulapelli A, Merfelder RB, Holt GE, Schawartz HS, Halpern JL, Kang H, Borinstein SC, Singh R, Lawrenz JM. What are the accuracy and clinical implications of intraoperative marrow margins in long bone Ewing sarcoma resection? Musculoskeletal Tumor Sociey (MSTS) Annual Meeting 2024, Chicago, IL. Podium Presentation 
  • Lawrenz JM, Chenard SW, Kang H, Lazarides aL, Joyce DM, Alexander JH, Vigauss JD, Collier CC, Mesko NW, Mystrom LM. Cemented vs, Uncemented Hip Arthroplasty for Proximal Femoral Metastatic Bone Disease: A Multicenter Analysis of 264 Cases. Musculoskeletal Tumor Soceity (MSTS) Annual Meeting 2024, Chicago, IL. Podium Presentation
  • Chenard SW, Hajdu KS, Gilbert WB, Mika AP, Hefley WF, Kang H, Halpern JL, Schwartz HS, Holt GE, Lawrenz JM. Do Endoprostheses Performed for Tumor, Arthroplasty, or Post-Trauma indication Have the Same Fate? Musculoskeletal Tumor Society (MSTS) Annual Meeting 2024, Chicago, IL. Podium Presentation
  • Johnson DJ, Chenard SW, Kang H, Quirion J, Hajdu KS, Schwartz HS, Halpern JL, Holt GE, Lawrenz JM. Is Stem to Canal Ratio Assocaited with Stem-Related Complication in Lower Extremity Oncologic Endoprosthesis Reconstruction? Musculoskeletal Tumor Society (MSTS) Annual Meeting 2024, Chicago, IL. Podium Presentation

2023 Meeting

  • Colazo JM, Prasad K, Miller A, Sharif K, Mcpeak S, Singh R, Lewis Jr. JS, Lawrenz JM, Holt GE, Topf MC. Making Negative Margin Musculoskeletal Tumor Surgery a Virtual Reality Using 3D Specimen Scanning. Musculoskeletal Tumor Society (MSTS) Annual Meeting, 2023, Banff, Alberta, Canada. Podium Presentation 

2022 Meeting

  • Lawrenz JM, Can C, Johnson SR, Hajdu KS, Shechtel JL, Chadwick N, Luo LY, Kang H, Smith DS, Schwartz HS, Holt GE. Predicting Diagnosis in Myxoid Soft Tissue Tumors: Performance of Radiomics vs. Radiologists. Musculoskeletal Tumor Society (MSTS) Annual Meeting 2022. Podium Presentation.

2021 Meeting

  • Goldin AN, Volkmar A, Johnson SR, Moran CP, Kowalski BL, Hajdu KS, Lawrenz JM, Halpern JL, Schwartz HS, Holt GE. Surgical Fixation of Allografts: Plate vs. Nail. Musculoskeletal Tumor Society (MSTS) Annual Meeting 2021. Podium Presentation. 
  • Lawrenz JM, Chi A, Bendfeldt GA, Halpern JL, Holt GE, Schwartz HS. Challenges and Patterns of Registry Research in Sarcoma. Musculoskeletal Tumor Society (MSTS) Annual Meeting 2021. Podium Presentation. Awarded “Young Investigator Award, 1st place”.
  • Lawrenz JM, Can C, Johnson SR, Moran CP, Hajdu KS, Shechtel JL, Luo LY, Kang H, Schwartz HS, Dawant B, Holt GE. Radiomics and Machine Learning Predict Diagnosis in Musculoskeletal Myxoid Soft Tissue Tumors. Musculoskeletal Tumor Society (MSTS) Annual Meeting 2021. Poster Presentation. Awarded a “Best Poster Prize”. 
  • Lawrenz JM, Johnson SR, Zhu K, McKeon M, Moran CP, Vega JF, Mesko NW, Halpern JL, Schwartz HS, Nystrom LM, Holt GE. Adjuvant Radiation after Resection of Atypical Lipomatous Tumors is associated with Improved Local Control but Increased Complications: A Multicenter Evaluation. Musculoskeletal Tumor Society (MSTS) Annual Meeting 2021. Podium Presentation.

Our Current and Past Fellows

 

 

Rajul Gupta, MD
Hometown : Bhopal, India
Undergrad : Barkatullah University
Medical School : Gandhi Medical College
Residency : 
 

Past Fellows 

Our past musculoskeletal oncology fellows, their current positions, and their fellowship year: 

  • Daniel Johnson, Intermountain Health in Longmont, CO, 2024
  • Julia Quirion,  Billings Clinic, Billings, MT, 2023
  • Anthony Judice, Rochester Regional Health, Rochester, NY, 2022
  • Amanda Goldin, UC-Irvine, Orange, CA, 2021
  • Joshua Lawrenz, Vanderbilt University, Nashville, TN, 2020
  • James Norris, Spartanburg Regional Healthcare System, Spartanburg, SC, 2018
  • Robert Wilson, Baptist MD Anderson Cancer Center, Jacksonville, FL, 2017
  • Geoff Siegel, University of Michigan, Ann Arbor, MI, 2016
  • Krishna Reddy, University of Cincinnati, Cincinnati, OH, 2015
  • Nathan Mesko, Cleveland Clinic, Cleveland, OH, 2014
  • Nicole Behnke, Orthopedic & Fracture Specialists, Portland, OR, 2013
  • Kelly Homlar, Medical College of Georgia, Augusta, GA, 2012
  • Jennifer Halpern, Vanderbilt University, Nashville, TN, 2007