The Interventional Orthopedics of Washington Fellowship
A one-year, non-accredited clinical and non-clinical fellowship in image-guided regenerative orthopedics and functional medicine, built around the spine, the major joints, hormonal and metabolic health, and advanced orthobiologics.
Overview
The Interventional Orthopedics of Washington (IOW) Fellowship is a one-year, non-accredited immersive clinical and non-clinical program for physicians who want to master image-guided, non-surgical treatment of spine and joint conditions using regenerative orthobiologics, including platelet-rich plasma, bone marrow concentrate, and lipoaspirate, alongside a functional medicine approach to the hormonal and metabolic factors that affect musculoskeletal health. Fellows train at IOW's clinic in Bellevue, Washington, a dedicated interventional orthopedics and functional medicine practice that draws patients from across the Pacific Northwest for advanced, non-surgical orthopedic and whole-person care.
Training centers on the diagnosis and treatment of complex spinal and joint pathology using autologous biologics, precise image guidance, and a percutaneous approach that helps patients avoid surgery, alongside functional medicine evaluation of nutrition, hormonal balance, and metabolic health as they relate to musculoskeletal recovery. Fellows work daily alongside faculty who practice interventional orthopedics and functional and regenerative medicine full time.
Accreditation and Scope
This is a non-accredited fellowship designed and administered by Interventional Orthopedics of Washington. It is not accredited by the Accreditation Council for Graduate Medical Education (ACGME) or any other residency or fellowship accrediting body, and it does not confer board certification. Interventional orthopedics and functional medicine are not recognized subspecialties of the American Board of Medical Specialties. This program is intended as post-residency, practice-based clinical training for physicians who are already board-eligible or board-certified in their primary specialty.
Why This Fellowship
Interventional orthopedics is advancing quickly, and the connection between musculoskeletal health and hormonal, metabolic, and nutritional status is often left out of procedural training altogether. This fellowship is built for physicians who want to develop the ability to independently evaluate, plan, and perform advanced image-guided procedures across the spine and every major joint, while also learning to assess and address the functional medicine factors that influence healing and long-term outcomes.
Fellows perform procedures with autologous platelet-rich plasma (PRP), bone marrow concentrate (BMC), and lipoaspirate, work to develop command of ultrasound and fluoroscopic guidance, and build clinical judgment for managing complex cases from first evaluation through outcome. Fellows also learn to incorporate functional medicine assessment, including nutrition, hormonal, and metabolic evaluation, into a musculoskeletal care plan. This fellowship is designed for physicians who already have a working foundation in orthopedics and musculoskeletal medicine and are ready to build advanced procedural and functional medicine skill on top of that foundation.
Why IOW
IOW is a dedicated interventional orthopedics and functional medicine clinic, not a general practice with a procedures line added on. Physicians here treat spine and joint conditions through image-guided, non-surgical approaches and integrate functional medicine evaluation into patient care, which gives fellows exposure across both disciplines in the same practice.
The procedural scope spans spinal injections across the cervical, thoracic, and lumbar spine, treatment of every major joint, tendon and ligament work, and peripheral nerve procedures, performed with precision imaging and autologous orthobiologics including PRP, bone marrow concentrate, and lipoaspirate. Alongside this, fellows participate in functional medicine intake and follow-up visits, including review of hormonal and metabolic lab panels and development of nutrition and lifestyle plans. Fellows train in a focused environment built around regenerative orthopedics, advanced biologics, and functional medicine.
Fellowship Structure
Fellowship time is split between clinical training and non-clinical work. The balance is flexible rather than fixed to a set ratio, and shifts over the year based on practice needs, patient volume, and each fellow's strengths and interests.
Clinical Training
Hands-on training in image-guided interventional orthopedic procedures across the cervical, thoracic, and lumbar spine, all major joints, and peripheral structures, combined with supervised functional medicine patient evaluation and management. Training emphasizes progressive procedural autonomy under direct faculty supervision within a full-scope interventional orthopedics and functional medicine practice.
Non-Clinical Work
Non-clinical work includes a supervised research project with the goal of peer-reviewed publication, along with practice-building and promotional work such as video recordings, presentations to referring providers, and written content for the practice and for patient education.
Opportunities also include clinical outcomes studies, procedural technique analyses, and protocol development within the orthobiologics and functional medicine space.
Clinical Training Experience
Fellows participate directly in patient evaluation, diagnostic imaging review, procedural planning, and the execution of advanced interventional orthopedic procedures, as well as functional medicine intake, lab interpretation, and treatment planning. Training emphasizes technical precision, ultrasound and fluoroscopic guidance, and the evidence-based use of autologous orthobiologics, together with a functional medicine approach to the hormonal and metabolic factors that affect recovery.
Fellows gain repeated, supervised experience across the full spine and every major joint, and in functional medicine patient management, building the clinical breadth that defines an independent interventional orthopedics and functional medicine practice.
Faculty and Mentorship
Fellows are mentored directly by Dr. Otoño Silva, MD, founder of IOW, a board-certified physical medicine and rehabilitation (PM&R) physician who completed fellowship training in interventional orthopedics at the Centeno-Schultz Clinic. Dr. Silva's functional medicine practice is based on independent training and clinical experience rather than a board certification, since functional medicine is not a certifying board recognized by the American Board of Medical Specialties. The fellowship maintains a low fellow-to-faculty ratio so that every fellow receives individualized instruction, close procedural mentorship, and direct involvement in clinical decision-making at the attending level.
Dr. Otoño Silva, MD
Founder of IOW. Board-certified PM&R physician who also practices interventional orthopedics and functional medicine. Functional medicine is not a board-certified specialty.
Career Outcomes
Graduates gain experience relevant to regenerative orthopedic medicine and functional medicine. Alumni may join or establish interventional orthopedics clinics, bring orthobiologics and functional medicine into PM&R or sports medicine practices, or build independent practices centered on image-guided, non-surgical care and functional medicine. Outcomes vary by individual background, effort, and local practice environment.
IOW does not guarantee employment, a specific salary or income level, hospital privileges, payer or insurance panel participation, or the ability to independently perform any procedure or offer any service described in this program after the fellowship ends. Board certification, state licensure, credentialing, and the scope of procedures a physician may lawfully perform are determined by state medical boards, hospital credentialing bodies, and payers, and remain the responsibility of the individual physician both during and after the fellowship.
Benefits
Fellows are employed by Interventional Orthopedics of Washington for the duration of the one-year fellowship. The position includes an annual salary of $75,000, a five-day-per-week clinical and non-clinical schedule with designated administrative days for research and program-related work, professional development support, and direct mentorship within an interventional orthopedics and functional medicine practice. This compensation applies to the fellowship term only and is not a representation of expected income before, during, or after independent practice.
Who We're Looking For
This fellowship is best suited for a physician who already has a working foundation in orthopedics and musculoskeletal medicine, including some prior experience with non-surgical orthopedic care and injection, procedural, or image-guided technique. It is designed to build advanced skill on that foundation, not to introduce these skills from a starting point of no prior exposure.
- Comfortable and effective working with people, including patients, referring providers, and staff
- Willing and able to be flexible with non-clinical, practice-building work, including video recordings, presentations to referring providers, and written content
- Self-sufficient and motivated to learn independently, since this is a small, high-volume practice rather than a large program with structured didactics
- Interested in long-term employment with IOW beyond the fellowship year; while completion of the fellowship does not guarantee an ongoing position, the program is designed with that goal in mind
Eligibility
Applicants must be board-eligible or board-certified physicians who have completed a United States based residency and are eligible to train and practice medicine in Washington State. The fellowship is designed primarily for graduates of PM&R residency programs.
Applicants must already be familiar with orthopedics and musculoskeletal medicine, with at least some existing expertise in non-surgical orthopedic care and injection, procedural, or image-guided technique. This fellowship builds on that foundation and is not structured to teach these skills from a starting point of no prior exposure.
Highly qualified physicians from other backgrounds may be considered case by case, including sports medicine trained family medicine physicians, anesthesiology physicians with interventional pain training, and orthopedic surgeons seeking non-surgical fellowship training.
Application Timeline
Applications are accepted on a rolling basis.
- Applications Open
- Rolling
- Interviews
- Conducted during the review process by Zoom, with in-person interviews for finalists
- Final Decision
- Timing varies with program capacity and applicant review
- Start Dates
- The fellowship may accept up to two fellows per year, with staggered start dates
How to Apply
To apply or ask questions, contact Dr. Otoño Silva directly at [email protected] or call (425) 326-1665. Please submit:
- A signed letter from your Program Director verifying completion of prerequisite training
- A current curriculum vitae (CV)
- An academic writing sample that demonstrates research or clinical writing ability
- A letter of recommendation from an outpatient musculoskeletal attending physician
Location
Interventional Orthopedics of Washington, Bellevue, WA, located near Seattle Children's Hospital, Bellevue. IOW is an independent practice and is not affiliated with or endorsed by Seattle Children's Hospital.
Bellevue sits at the center of the greater Seattle metro area, with access to world-class outdoor recreation, a thriving medical and biotech community, and an exceptional Pacific Northwest quality of life.
Apply for the IOW Fellowship
To apply or ask questions, contact Dr. Otoño Silva directly at [email protected] or call (425) 326-1665.
This page describes a physician training program. It is not medical advice and does not describe specific treatments, outcomes, or guarantees for any patient. Individual clinical outcomes vary and are not represented or guaranteed by this page.
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