Episode 19: RUSM and Sports Medicine

Milena Garcia: Well welcome back everybody. Thanks for joining us again. This week we have Dr Irvin Sulapas. Thank you for joining us, Dr. Sulapas. Let's have you introduce yourself.

Irvin Sulapas: Alright, thanks for having me. I'm. My name is Dr. Irvin Sulapas. I am a Ross graduate class of 2010. A little bit of background on me. I'm from Houston, Texas. I currently practice at Houston. So I'm back home. I did my undergraduate at University of Texas in Austin major to Biomedical Engineering,  and then went to Ross right after college. So more of the traditional route to go to med school did most of my rotations up in New York and enjoy my third year, but the vast majority of my fourth year at Ross actually spent in Texas, because I wanted to residency and practice back in the state I grew up in. So I matched into Family Medicine at Texas Tech in Lubbock, which was my number one choice. And  I was also chief resident during my third year and then I decided to stay another year and do a sports medicine fellowship right after fellowship. I'm still currently at my first job after training. I am an assistant professor at Baylor College of Medicine in Houston, Texas. SoI haven't left Texas since fourth year med school.

RUSM and Sports Medicine

Milena Garcia: And why sports medicine. When did that interest start?

Irvin Sulapas: I didn't know sports medicine was a thing going in. I always wanted to do some primary care and I still do. But a couple of months into my intern year as a family medicine resident I met the sports medicine fellows and I thought they were like, the coolest people.You know, Texas Tech athletic apparel is Under Armour. So they had the Under Armour polos,  normal khakis shoes. They always had to go travel with the team, say, “Hey, I gotta go cover this football game or cover this soccer game,” they had this nice badge that said all access pass to all sports for the year. You guys are so cool and talk sports every day. This is the thing I liked about it. I'm going to try for this. So I decided to prepare for us to get into a sports medicine fellowship. They let me tag along to cover high school games because I don't have the all access badge to go to the other collegiate game. I did some research in the field, tried to submit some abstracts or posters sports medicine, volunteered as medical staff or the local Iron Man, that's in Lubbock and just to show my interest in sports medicine. One of my mentors in residency was sports medicine trained too. He helped me, kind of guide me on to be a competitive applicant 

Milena Garcia: And like you , we may have some prospective students that may not have known that sports medicine is a fellowship, so can you please talk a little bit more about that. What is a sports medicine fellowship?

Irvin Sulapas: After medical school, you apply for residency and then you match it to that residency field, whether it's internal medicine, ob-gyn, surgery, family, whatever. And that's three to five years, depending on what specialty you choose.

A fellowship is basically subspecialized into that field. So how do you become a cardiologist? You do internal medicine first and then go to cardiology. How do you become a cardiothoracic surgeon?  You go do surgery first, so it's basically like another specialty, like, you know,

Milena Garcia: Checks

Irvin Sulapas: Yeah, or a neonatologist-- you know wouldn't go through pediatrics. Sports medicine, you can do from family. You can do it from other specialties as well, just family medicine is the most common route. About 80% of sports medicine doctors are family medicine trained. I'm talking about medical sports medicine. There is another type of sports medicine and orthopedic realm. And that's the one that people probably know more of. And that's the one the orthopedic sports medicine doctors are the ones who repair shoulders, torn ACLs from athletes. So it's more into the surgical sense. In the sports medicine that I practice is, you know, I do a lot of what we call musculoskeletal medicine, right? Not every injury needs to be operated on you know. If you broke a toe, you're not gonna get surgery before I can take care of that. You know, if you break a toe, that doesn't need surgery, I can put a cast on. It's fine. So basically I'm the nonoperative kind of musculoskeletal care.

But sports medicine isn't all muscles and bones. A good example is managing concussions. Concussion is a big topic in our sports medicine realm. Knowing how to recognize it, diagnose and treat it accordingly so they can get back to the game safely. Lately the bigger, even bigger, topic is return to play to the sport after being or after having a concussion, so that that's a big topic right now, when people were come in for a concussion and  writing all those protocols on how to keep the game going with all the weeks with the college football. The pro sports, all those protocols that are written were done by the sports medicine guys.

Sports Medicine: A Day in the Life

Milena Garcia: Interesting. And what is a normal day like in your life?

Irvin Sulapas: Yes. So as a sports medicine doctor, Monday through Friday I have clinic time. I am a family medicine doctor. Well, I kind of have a hybrid practice of same general primary care patients with checkups, coughs, colds, whatever. And then any muscle, skeletal injury or any sports injury, they'll come see me in clinic as well. I like practicing both. It's because it kind of melds with each other. I'll see an Ironman triathlete who just sprained his ankle or whatever but also wanted to get a general checkup. Like a family care doctor, all my sports athletes are pretty healthy, so you know they’re barely on any medicines, you know, impeccable bloodwork

 So, you know, so I treat the healthy population, but I also treat people who want to be healthy, you know? A sedentary person who wants to train for their first  5K, they will come to see me for advice on how to do that and safely, without injury. So injury prevention is big to people with conditions like hypertension or diabetes, you know. So I would see them and then give them an exercise prescription like this: These are the exercises you can do to help bring your blood sugars down, or this is what you should do to bring your heart rate or your blood pressure down. So that's where my family medicine comes into sports and saying it's not it's not just pro athletes. I take care of everyday people who just want to be healthier.

Milena Garcia: I love the expression exercise prescription. That's great. The first time I’ve heard that. What games or teams have you covered?

Irvin Sulapas: Yeah so sports medicine isn't just about seeing patients in clinic, the best part of the specialty is to go to games for free, on the sideline. Wearing their team swag, so to speak, with the polos, and the khakis and cheese. So the teams I cover, I cover a couple high schools in Houston and that's the majority of where my patients come from, from the schools, but it's not just the HIGH SCHOOL ATHLETE. Since I'm a family doctor, you know, I also take care of the coaches, the English teacher, the principal, you know, things like that. So I'm really more into  the community of the school. Which is great. I love that sense of community. College wise I take care of Texas Southern University here in Houston and professionally, with Major League Rugby I cover the Houston Sabrecats and Major League Soccer I help out with the Houston Dynamo.

 Internationally,  I'm on the pool for USA Rugby and I see a couple of Olympians who kind of live in the Houston area, mostly from the track and field. So my game coverage can range from middle school field hockey all the way to marathons.

Milena Garcia: Yeah, remember from a previous conversation. You mentioned you cover and you run marathons. 

Irvin Sulapas: Thanks for bringing that up. That's actually my favorite event to cover. I am on medical staff for the Houston marathon. It's a huge marathon here. A lot of people run, at least around like 20,000 people run it. So the way I see it, it's 20,000 potential patients to see, should they get injured. It's always held, well, not this upcoming year because of COVID but it's always held like on MLK weekend in Houston, it's cold, but not too cold and Houston is pretty flat. So it's what they call a fast course, people like to hit their PR, or personal records and see if they can qualify for Boston, you know, and in the running world, the Boston Marathon is the pinnacle of the field. So if you can make time. So a lot of pros come down for it. And a lot of people who aren't pros who feel like they're fast enough and they'll try to qualify and it's great, it's great seeing them. Some people get injured. And then they finish and get injured or hurt themselves, and I'll see them in the medical area and they just say “Everything hurts.” They have a big smile on their face because they qualify for Boston or this  is their first marathon. You know, so it's very gratifying to see those patients both succeed and in pain at the same time.

Milena Garcia: I'm not a runner. So I will never understand. You mentioned this is your favorite event to cover, but do you have a favorite sport to cover?

Irvin Sulapas: I like covering all sports, you know, watching games. As you know, the part I enjoyed the most in my specialty. But I guess the fair one to cover would probably be basketball because I couldn't sit for an entire  And I don't have to Render the court or something em injury, you know, with football, especially college football you know there's timeouts.

 There's TV timeouts. There's refs reviewing thing. So, you know, these games can last longer than anything.  With soccer and rugby, you know, it's 90 minutes or 90 minutes for soccer, 80 minutes rugby with a couple of minutes past that. But I know that I'm out of there around an hour and a half. Football, you can say two and a half to three hours depending on the game flow.

Milena Garcia: Do you personally do any sports or any healthy activities you prefer to do?

Irvin Sulapas: Yeah, so I gotta fight, talk the talk, I got to walk the walk, right? So as a sports med doctor, I tried to stay active. I lift weights, just for strength training. I also like to run. We didn't mention about the Houston marathon, I can't run the Houston marathon, because I'm also a medical staff. So what I actually do is I run the half marathon every year. And then right after I finish the half marathon, I go straight into the medical and take care of patients.

Milena Garcia: With your medal.

Irvin Sulapas: With my medal, with my stethoscope and then people always look to me like, who's this crazy guy who just ran 30 miles and started to see patients. I did to prove a point that anyone can run a half. It takes a little bit more training to do a full, but I think anyone can do a half marathon. 

Milena Garcia: What are some of the common injuries you see in your everyday life?

Irvin Sulapas: Sure. So most of the common injuries that I see are the big joints, you know, ankle sprains, knee injurie, shoulder injuries from throwing or working out. So, you know kind of the big joints of the body. During football season, concussions. Lately, though interestingly enough, in this work from home kind of era, I've been seeing a lot of ergonomic issues. People with neck and back pain from sitting too long. Or they don't have their work from home office setup like they had in that in their actual office. The monitor height may be off. You're using a dining room chair, instead of an office chair with adjustable height and the dining room chair that has just a stiff, stiff back. At work you may be used to a big computer with a big keyboard and now they give you a laptop with a smaller keyboard and may or may not use a mouse. So I've been seeing a lot of like, you know, carpal tunnel elbow stuff, neck pain, back pain. It's pretty amusing, like I've been seeing a lot more of that since the pandemic.

Milena Garcia: Well, in your introduction you also talked about your academic role. Can you talk a little bit more about that?

Irvin Sulapas: Yes, so my official title is Assistant Professor at Baylor College of Medicine. So I don't see patients, Monday through Friday morning and evening, so I split my time between seeing patients and teaching.

 I also am a faculty advisor for the med school. And what that is is that I mentor a group of first year medical students and I am their faculty mentor/advisor till they graduate. So that's why I feel comfortable talking about medical student education because I pretty much know the curriculum, know when you should take step, what to study for, what board scores are needed for what specialty, any networking, I can do with your specialty mentor. If you want to consider a different specialty or a specific specialty guidance. looking over their CV, personal statements, interviewing tips for for residency. So really, I'm kind of like a college counselor.

 I also teach two of the physical exam courses at Baylor too, and that's the course that every med school has where you learn. It's what we call like the doctorate course. You learn how to use the stethoscope and listen to the heart and the lungs and the abdomen. And what I like about that physical exam course is that the way I was taught at Ross is the same way that the students here are being taught as well. I feel like that's when it's seamless, when I do the teaching, but too, it just tells me, Hey, you know, Ross actually prepared me to practice out in the real world and teach in the real world.

Milena Garcia: It looks like it's been working out so far. You are so accomplished. It's great. How did you end up at Ross to begin with?

Irvin Sulapas: Good question. I decided to apply to med school during my senior year of college and I did apply to US med schools, had a few interviews, got whitelisted by those schools and then I heard about Ross. You know, I always was interested in some sort of primary care family, obviously I went into family medicine. So I figured why not just apply and see if I can get in and got the acceptance letter and decided to just go for it. Let's, try it out and see if I can do this and, yseah, and that's pretty much it. And then I just went through it. And by no means s I breezed through it. I did more work for that degree but it got me to where I am today.

Milena Garcia: And we're super proud of you. Thanks for representing us and being so accomplished, as I mentioned. What kind of advice do you have for any pre med or med students that may be considering sports medicine?

Irvin Sulapas: That's a good question. When I said personally, for me, I didn't know that was even a specialty until I graduated med school. But now, since you guys know that that specialty exists, I would say know your anatomy. Know your muscles, know where they attached it to the bones. A lot of the things I see it's having a good basis of your anatomy and also trying to stay active health wise. You don't need to be a doctor to tell people that you should exercise too for good overall health. But just having that kind of purpose and background is like, Hey, I'm here to promote general health, You know, make you healthy and then I feel like that's a good basis of being a good sports medicine doctor.

Milena Garcia: Doctor Sulapas. Thank you again for your time. I often talk to pre med students who come in with this idea of how glamorous, the life of a doctor is and the majority of the time, not necessarily true. Certainly seems to be in your case, sir. Thank you so much for sharing your experience. You sound like you're living the life and you enjoy what you do.

Irvin Sulapas: I sure do. I always joke around with med students and prospective students in my residents and they asked “Why did you go to sports med ?” I was like, well, I can't afford these tickets. So I'm gonna see if I can let me be your team doctor, I can be on the sideline. And I may see the next Olympics. Breakdancing, yeah breakdancing, curling, whatever, I'm gonna try to make my way to the Olympics. As a doctor, not an actor.

Milena Garcia: Oh no, I will see you on that dance floor. Thank you again for taking your time everybody out there. We will see you next week. Thanks for joining us.

Irvin Sulapas: Thank you.