Boarding a plane this week back to her native Thailand, physical medicine and rehabilitation physician Piyaporn “Taya” Pramuksun, MD, was bringing back with her a wealth of knowledge and experience from her year-long fellowship at Atlantic Sports Health.

Set amidst the COVID-19 pandemic, it wasn’t the fellowship she expected when she landed in New Jersey in January 2020 – but the unique circumstances made an indelible impact and revealed new perspectives in practicing sports rehabilitation.

“I think the thing I most liked about being here is the atmosphere of how people learn,” Pramuksun said of her fellowship experience. “People here are very educationally-oriented. I think the most important thing is not the skill but the atmosphere.”

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In her home country, Pramuksun practices physical medicine and rehabilitation at Bhumibol Adulyadej Hospital, where she is also head of its Sport Rehabilitation clinic. She has been team physician for a Thai football club, as well as a general practitioner in the Royal Thai Air Force hospital, as well as a World Para Swimming classifier.

It was in 2019 when the possibility of advancing her skills in America emerged, after one of her colleagues in Thailand attended a conference featuring Robert Monaco, MD, as a speaker. Monaco, a physician with Atlantic Sports Health Associates, is board-certified in family medicine, sports medicine and musculoskeletal ultrasound, and the former director of sports medicine at Rutgers University for many years.   He is a recognized national leader in the field of musculoskeletal ultrasound and interventional ortho-biologics and very active in teaching and research. Following that conference, Monaco was invited to and since has directed three ultrasound courses in Thailand.

“All of my colleagues loved him, so they encouraged me to come here,” she recounted.

Following an observational visit with Monaco that year, Pramuksun applied to spend a one-year fellowship with Dr. Monaco at Atlantic Sports Health. The fellowship began January 19 of last year, their time split between Atlantic Sports Health Associates’ offices in Morristown and Bridgewater.

For Monaco, Pramuksun was the first international fellow he had taken on, and he was impressed with her acumen in the field, particularly in the use of ultrasound.

She really fit right into our program, and we were able to do more high-level academic work and teaching,” Monaco said. “This was by far the best experience I’ve had in my many years of teaching.”

When the presence of the COVID-19 virus arose throughout New Jersey, Pramuksun’s experience took an unexpected turn, as many did. But while numerous fellowships and similar medical education programs took hiatuses or were outright cancelled in the face of the pandemic, Monaco and the sports health program worked to ensure that she and other fellows were able to continue their experiences, albeit with some changes.

“COVID hit my country first, so I thought it was interesting to see how the U.S. and Atlantic Health System, in particular, adapted to the situation,” Pramuksun said. “Within a week, you changed so much to virtual, and that was amazing,” she noted, adding that the adoption of virtual solutions was much slower in her home country.

As the practice adopted virtual visits and safety precautions limiting how many people could be in the room with a patient, the teaching dynamic between her and Monaco shifted from more hands-on to more didactic – reviewing cases, discussing options and strategizing treatment. In addition, they began adapting to virtual teaching, and both worked together on multiple virtual national and international presentations and workshops. They also put together a virtual ultrasound journal club series that educates more than 15 fellowships on a weekly basis. Pramuksun also proctored other physicians and taught an attending physician the basics in ultrasound.

“I think this experience was extremely rewarding,” Monaco said. “Taya had such a great background and was so motivated, that we were able to do so much more at high academic level nationally and internationally.”

Monaco said that he and the sports health program has also benefited from Pramuksun’s presence, which brought new perspectives on treatment. One example is the use of shockwave therapy – in which ultrasound is used to guide soundwaves from specialized equipment, that are used to stimulate muscle tissue or break up calcification in tendons.   These techniques have been used far more in Asia than in the U.S. Through Pramuksun’s influence, it’s now a technique that Monaco has adopted more frequently in his practice, making him one of the relatively few physicians in NJ to offer the therapy.

“It was just a fantastic experience to work with someone at an advanced level who has passion to learn and to commit to a year away from home Monaco said. “I just learned so much  about my approaches to medicine and especially my teaching skills, particularly using newer virtual techniques since the pandemic.

Monaco said that as a result of the positive experience, he will be looking to further develop the already strong ties he has to the main medical teaching school in Thailand and hopefully work with future international fellows.  He noted plans for combined research and educational projects moving forward

“I look forward to expanding our relationships and seeing Dr. Pramuksun work in advancing Thailand’s sports and rehabilitation medicine,” he said.

“This is a wonderful example of how leadership support for education helps showcase Atlantic Health System internationally,” added Damion A. Martins, MD, medical director of Sports Medicine and Executive Health for Atlantic Health System, and program director of its sports medicine fellowship. “I am very proud of the work from our Sports Health team to make this happen.”

Atlantic Sports Health Associates is part of Atlantic Medical Group. To learn more about the practice, click here.

To learn more about Sports Medicine at Atlantic Health System, click here.