Orthopaedic Surgery Residency
The Orthopaedic Surgical Program at MedStar Union Memorial Hospital in Baltimore is an extremely well rounded community based orthopaedic surgical training program. Based at MedStar Union Memorial Hospital, a 350 bed community teaching hospital, orthopaedic surgical residents gain broad exposure to various important facets of orthopaedic surgical training. With a combined inpatient and outpatient orthopaedic surgical volume of over 6,000 cases per year, residents gain broad exposure to orthopaedic 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 orthopaedic surgery and orthopaedic 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 orthopaedic patient through there rotation at the Maryland Institute for Emergency Medical Services at the University of Maryland Hospital.
Outpatient experience is broad and diverse as well. In addition to a two-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 MedStar 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 orthopaedic biomechanical laboratory at MedStar Union Memorial Hospital.
The PGY-1 residents of the orthopaedic program at MedStar Union Memorial Hospital receive six months of general surgical training which is closely coordinated with the Chief of General Surgery. 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 of the critically ill surgical and medical patient through their ICU rotation. Rotations incorporated in the PGY-1 year include Emergency Medicine, Medical/Cardiac Intensive Care and Anesthesia. In addition, residents spend rotation time on the orthopaedic 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 Orthopaedic 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 orthopaedic surgery and its various subspecialties. The PGY-II year consists of two rotations on each of the following services, joint/spine and the chief residents general orthopaedic service. Goals for the PGY-II year include the attainment of basic knowledge in the areas of orthopaedic disease stage, management of ambulatory orthopaedic 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 orthopaedic 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 hand surgery and sports orthopaedic surgery. The PGY III year also includes six months at Johns Hopkins Hospital doing rotations on orthopaedic oncology and pediatric orthopaedic surgery. Goals of the PGY-III year include enhancement of knowledge in the evaluation and management of various orthopaedic disorders and disease states, understanding and developing broad knowledge in the area of management of hand and upper extremity disorders. On the orthopaedic 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 orthopaedic service residents will gain experience in the evaluation and management of pediatric orthopaedic disorders. This will include evaluation and management of pediatric orthopaedic 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-IV year includes the six month research block for each resident. Where they are anticipated to complete 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 doing electives and on the shoulder & elbow service. Residents can choose to spend extra time at MedStar Union during their elective time or rotate with another attending. Past rotations have been done at Franklin Square Hospital, Washington Hospital Center and St. Joseph's. While on the shoulder & elbow service, residents will gain knowledge in the management of upper extremity disorders.
The PGY-V year will include rotations on foot and ankle and spine at MedStar Union Memorial Hospital. On each of these 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 orthopaedic patient. The residents also gain more significant surgical experience as well as experience in post-operative rehabilitation of pediatric orthopaedic 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 orthopaedic 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 the adult reconstructive service and sports medicine.
The training experience at MedStar Union Memorial Hospital is unique due to the full and extremely well rounded clinical experience gained by orthopaedic surgical residents. Residents work extremely closely with faculty and the department enjoys a unique one to one full-time faculty to resident ratio.
The Orthopaedic Surgical Residency at MedStar 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 orthopaedic 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.
