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MSK Rotation Overview
Updated July 2026
Rotation Lead: Dr. Jacqueline Stoller
Introduction
The MSK rotation is one month in duration, separated into two weeks of MSK and two weeks of Orthopedics.
The MSK portion is a two-week outpatient rotation that takes place during the first two weeks of each block. It is comprised of five components:
Sports Medicine Clinic (Dr. Stoller/Dr. Zeldin/Dr. Fine)
Rheumatology Clinic (Dr. Dostrovsky)
Pain Clinic (Dr. Karmy)
Physiotherapy (at Dr. Stoller’s clinic)
Joint Injection Clinic (Dr. Zeldin)
The Orthopedics portion is a two-week mainly hospital-based rotation that takes place during the last two weeks of each block. It is comprised of four components:
Orthopedics Clinic (various orthopedic surgeons)
On Call Orthopedics Clinic and Operating Room (on call doctor of the day)
Minor Fracture Clinic (Dr. Sayal)
Plastics Clinic (Dr. Somogyi)
Rotation Goals
Develop an approach to the investigation and management of common MSK and orthopedic conditions seen in Family Medicine.
Practice and improve on MSK/ortho physical exam skills.
Obtain an introduction to common joint injections.
Exposure to Rheumatology and Pain Clinics and know when to refer patients to these specialities.
Evaluation
Dr. Stoller will complete an ITER for each resident on POWER at the end of the rotation, in collaboration with feedback provided by other staff that worked with the resident during the rotation.
MSK Competencies
On this rotation, residents should work towards the following competencies:
Utilize the competencies of a family physician when addressing musculoskeletal issues.
Conduct a screening musculoskeletal history to identify: a) the presenting complaint, b) any emergent signs and symptoms, and c) occupational MSK exposure.
Understand the significance of red and yellow flag identification in the history for appropriate triage and management.
Perform an appropriately thorough and focused musculoskeletal physical examination.
Construct an appropriately thorough differential diagnosis for musculoskeletal conditions that is congruent with the data generated by the history and physical.
Select appropriate diagnostic investigations (i.e. radiography, ultrasound, MRI), if required, to support or refute differential diagnosis.
Interpret diagnostic investigations for common conditions for prognosis and management.
Recognize the typical and atypical presentation of common diagnoses as well as possible emergent life-threatening and/or limb-threatening disease.
Demonstrate an evidence-based approach for appropriate care of common conditions, including non-pharmacological and pharmacological management, rehabilitation and discussion of management options.
Demonstrate understanding of the indications, contraindications and side effect profile of medications.
Describe the prescribing guidelines for opioid medications in non-cancer pain management.
Determine appropriate return to activity, return to work, and return to sport planning using evidence-based medicine in collaboration with the patient.
Understand the psychosocial impact that pain and disability have on patient outcome and care.
Demonstrate an effective approach to the assessment of conditions benefiting from joint injection.
Describe the indications and contraindications for common joint and bursa injections including shoulder, elbow, and knee.
Perform a joint injection in the shoulder or knee with supervision.
Understand the role of physiotherapy in the rehabilitation protocol for patients with MSK conditions.
Ortho Competencies
On this rotation, residents should work towards the following competencies
Obtain focused musculoskeletal histories for patients with common injuries: ankle sprains, knee ligament injuries (ACL/MCL), meniscal tears, shoulder dislocations/rotator cuff injuries, hand/wrist injuries (Colles’ fracture, scaphoid fracture), and hip fractures in older adults.
Perform systematic physical examinations for spine (low back pain, radiculopathy), upper limb, and lower limb conditions.
Recognize and describe typical presentations of osteoarthritis, tendinopathies (tennis elbow, Achilles), and overuse injuries.
Identify “red flag” findings in back pain, septic arthritis, and neurovascular compromise.
Interpret plain X-rays of common fractures (wrist, ankle, shoulder, hip, knee).
Understand when advanced imaging (MRI, CT, ultrasound) is indicated.
Recognize fracture patterns that require urgent orthopedic referral (open fractures, displaced hip fractures, intra-articular injuries).
Observe or participate in joint injections and aspirations where appropriate.
Formulate management plans for fractures (immobilization, referral, follow-up) and soft tissue injuries.
Counsel patients on conservative care: RICE, physiotherapy, analgesia, activity modification.
Recognize when surgical intervention is necessary (e.g., displaced fractures, rotator cuff tears, ACL injuries in active patients).
Collaborate with physiotherapists, occupational therapists, and orthopedic surgeons.
Reflect on the family physician’s role in initial management, follow-up, and rehabilitation of orthopedic patients.
Contact information
Please see below for contact information for the various clinics.
Dr. Jacqueline Stoller
Athlete's Care: 801 York Mills Road, Suite 103a
Phone: (416) 479-8377
drjstoller@gmail.com
Dr. David Zeldin
Athlete's Care: 5095 Yonge St (Empress Walk)
Phone: (416) 479-8685
Monday afternoon hours: 1:30 – 5 pm
Thursday joint injection clinic hours: 2-5 pm
dazeldin@gmail.com
Paid parking underneath clinic. North York Centre subway station directly under clinic.
Dr. Nathaniel Dostrovsky/Dr. Wayne Potashner
4430 Bathurst Street, Suite 209
Phone: (416) 631-6090
nathaniel.dostrovsky@nygh.on.ca
Parking lot behind the building off Cocksfield Ave. Use second entrance without a gate to access building.
Dr. Perelman/Dr. Wansbrough
Orthopedic Rehabilitation Institute
865 York Mills Rd, Suite 20
Phone: (647) 349-7880
Dr. Grigory Karmy
North York Clinic
5927 Bathurst Street, Suite 204
Email: grigmed66@gmail.com
Dr. Claire Fine
Unify Health
25 Industrial Street, Unit 207, M4G 1Z2
Fridays from 9:00am – 2:30pm
Dr. Jonathan Lockwood
Cleveland Clinic Midtown
150 Eglinton Avenue East
Start time 8:15am
Email: jontylockwood@gmail.com
Please see below for contact information for the various ortho clinics.
NYGH Chief of Orthopedics
Dr. Frank Mastrogiacomo
Email: Frank.Mastrogiacomo@nygh.on.ca
Ortho, Plastics, and Fracture Clinic
Orthopaedic and Plastics Centre (Gulshan & Pyarali G. Nanji)
1st Floor, West Lobby, North York General Hospital
Phone: 416-756-6970
Sample MSK Rotation
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