The Orthopedic Surgical Program at Union Memorial Hospital in Baltimore is an extremely well-rounded community based orthopedic surgical training program. Based at Union Memorial Hospital, a 301-bed community teaching hospital, orthopedic surgical residents gain broad exposure to various important facets of orthopedic surgical training. With a combined inpatient and outpatient orthopedic surgical volume of over 6,000 cases per year, residents gain broad exposure to orthopedic subspecialty areas including joint replacement surgery, spine surgery, arthroscopic surgery and sports medicine, foot and ankle surgery, and hand surgery as well as adult reconstruction and extremity trauma.

Through affiliation with the other major teaching hospitals in the City of Baltimore, residents also gain valuable and necessary experience in the areas of pediatric orthopedic surgery and orthopedic oncology through rotations at Johns Hopkins Hospital as well as valuable experience in the evaluation and management of multi system trauma and the multiply injured orthopedic patient through there rotation at the Maryland Institute for Emergency Medical Services at the University of Maryland Hospital. The combination of the in house experience attained at Union Memorial with the outside rotations provide an extremely well rounded clinical training experience.

Outpatient experience is broad and diverse as well. In addition to a three time per week resident clinic in which house staff patients are evaluated, treated and followed, residents also spend extensive time in the outpatient setting working in a preceptorship environment with attendings of various subspecialties thereby gaining valuable experience in the pre-operative evaluation of patients as well as management of there post-operative recovery.

Didactic activity is equally broad and diverse. While rotating at Union Memorial Hospital residents participate in didactic activities on a daily basis. Various subspecialty conferences are held on a weekly basis and are combined with clinical conferences for case presentation and review as well as morbidity and mortality conference. Basic science lectures occur on a regular basis. In addition, topics in ethics are included in the didactic curriculum.

Research opportunities focus on clinical research as well as biomechanical research opportunities attained through interaction with the extensive facilities of the orthopedic biomechanical laboratory at Union Memorial Hospital.

The training experience at Union Memorial Hospital is unique due to the extremely well rounded clinical experience gained by orthopedic surgical residents. Residents work extremely closely with faculty and the department enjoys a unique one to one full-time faculty to resident ratio. The Ofrthopedic Surgical Residency at Union Memorial Hospital participates in the resident matching program and accepts two residents per year into a six year training program. Applicants are screened by faculty members for academic credentials, interest, aptitude and participation in orthopedic surgical initiatives while in medical school training and emphasis is given to evidence of strong personal character, community involvement, leadership as well as interest in research. Applicants are then screened using these criteria to provide a pool who are offered personal interviews. Interviews are conducted by faculty members and at the completion of the interview process faculty meet to review the applicants interviewed and to develop a rank list to be submitted to the National Matching Service for selection of residents.

The PGY-1 residents of the orthopedic program at Union Memorial Hospital receive six months of general surgical training which is closely coordinated with the Chief of General Surgery. These rotations include vascular surgery, general surgical rotations which include exposure to pediatric surgical cases. The PGY-I year is structured to attempt to allow PGY-I residents to develop the knowledge, attitude and skills necessary to assess the patient with medial and/or surgical problems as well as to formulate principles for planning treatment and initiation of treatment. Throughout the PGY-I year, residents are involved in the care of patients with surgical and medial emergencies , multiple system trauma, soft tissue problems including burns and peripheral vascular diseases. The PGY-1 residents also gain experience in management ot the critically ill surgical and medical patient through their ICU rotation. They develop an understanding of surgical anesthesia through a one month anesthesia rotation. PGY-1 residents are also intimately involved in the pre, intra and post-operative care of surgical patients.

Rotations incorporated in the PGY-1 year include Emergency Medicine, Medical/Cardiac Intensive Care and Anesthesia. In addition, residents spend rotation time on the orthopedic surgical service and the hand surgical service. The remaining rotations are general surgical in nature and include general as well as vascular surgery and exposure to plastic surgical and burn care as well. PGY-1 residents are under the direct supervision of the Chief of the Department of Orthopedic Surgery and Resident Program Director. Competency based evaluations are obtained from attendings on each rotation and overall rotation structure, curriculum and goals and objectives are discussed with the Chief of General Surgery on annual basis.

The PGY-II year is the point at which residents become immersed in orthopedic surgery and its various subspecialties. The PGY-II year consists of two months rotations on each of the following services, spine, adult reconstruction, sports, foot and ankle, and the chief residents general orthopedic service. Goals for the PGY-II year include the attainment of basic knowledge in the areas of orthopedic disease stage, management of ambulatory orthopedic trauma, basics of anatomy, physiology, biomechanics of the musculoskeletal system. In addition basic understanding of surgical approaches to the musculoskeletal system are learned. Management of the pre-operative, intra-operative and post-operative management of the orthopedic surgical patient is also emphasized in the PGY-II year. Residents are also introduced to basics of specific subspecialty areas including spine, sports medicine, and foot and ankle surgery.

The PGY-III year includes rotations on the chief resident's general orthopedic service as well as the spine surgery service. In addition, the resident's spend three months on the hand surgery rotation where they receive broad exposure to the evaluation and management of a broad spectrum of disorders of the hand and upper extremity including congenital abnormalities, trauma and various disease states. In addition, the residents spend two months on research initiating and developing a clinical or laboratory research project. Goals of the PGY-III year include enhancement of knowledge in the evaluation and management of various orthopedic disorders and disease states, understanding and developing broad knowledge in the area of management of hand and upper extremity disorders and initiating of research project with emphasis on planning and implementing a research project using sound scientific methodology.

The PGY-IV year includes the second two-month research block for each resident. During this second research rotation residents are anticipated to complete or near completion of a research project developed during the PGY-III year. They will complete testing and data collection and gain experience in statistical analysis, preparation of manuscripts and data analysis. In addition, residents will spend additional time on the foot and ankle and sports medicine services at Union Memorial Hospital where they will gain additional experience in the evaluation, management and treatment of disorders of a sports related nature as well as disorders of the foot and ankle. In addition, the residents will spend a six-month block of time at Johns Hopkins Hospital, which will be equally divided between rotations on the orthopedic oncology service and the pediatric orthopedic service. On the orthopedic oncology service residents will gain valuable experience in the diagnosis and management of benign and malignant primary and secondary tumors affecting the musculoskeletal system. They will also gain experience in the radiologic assessment of such lesions as well as the pathologic analysis of such conditions. On the pediatric orthopedic service residents will gain experience in the evaluation and management of pediatric orthopedic disorders. This will include evaluation and management of pediatric orthopedic trauma, as well as experience in evaluation and management of a broad spectrum of pediatric disorders including congenital and acquired disorders, neuromuscular disorders of the spine and musculoskeletal system.

The PGY-V year will include rotations on foot and ankle, sports medicine and spine at Union Memorial Hospital. On each of these three two month rotations residents will gain more detailed experience in the management of disorders in each of these subspecialty areas. Included in these rotations are extensive outpatient experience in the pre and post-operative management of patients with disorders within the subspecialty areas. They will also gain valuable insight into rehabilitation following surgical and non-surgical treatment within these areas. A second three-month pediatric rotation at Johns Hopkins is also included in the PGY-V year. During this rotation the residents gain more in-depth experience and knowledge in the management of the spectrum traumatic, congenital and acquired disorders affecting the pediatric orthopedic patient. The residents also gain more significant surgical experience as well as experience in post-operative rehabilitation of pediatric orthopedic patients. The final three-month rotation during the PGY-V year includes experience at the Maryland Institute of Emergency Medical Services (Shock Trauma Unit). Here residents gain valuable experiences in the management of level I orthopedic trauma and the multiply injured patient. Residents learn principles of evaluation of the multiply injured patient, prioritization of surgical management as well as post-operative management and rehabilitation techniques.

The PGY-VI Chief Resident year allows each chief resident to function in a more autonomous yet supervised role as the administrative chief resident. During this six-month rotation the chief resident conducts his/her own clinics, maintains admitting privileges and has assigned block operating room time. The chief residents gain valuable insight into continuity of care issues, planning of surgical and non-surgical treatment and management of the post-operative patient. The remaining six months is equally divided between elective time in which chief residents may chose additional services at Union Memorial or affiliating hospitals where they would like to spend additional time to develop skills of a greatest interest. In addition, the chief residents will spend three months on the adult reconstructive service learning advanced techniques in areas of joint replacement, revision joint surgery, management of infected joint replacements, nonunions and infected nonunions.

Back to Graduate Medical Education Residency Programs