|
Resident rotations, on-call schedules, and duty hours are structured to be in full compliance with the institutional policies and ACGME requirements regarding limits on resident work hours.
PGY-1
The PGY-1 year is spent at Carolinas Medical Center and is coordinated by the Department of Orthopaedic Surgery. The PGY-1 year is divided into 12 one month rotations on a variety of surgical and primary care services. The goal of the PGY-1 year is to provide the basics of learning how to take care of patients. Intern year is spent rotating through:
Orthopaedics - 3 months
Each of the three months is spent on the orthopaedic trauma service. These three months are devoted to learning the basics of care for patients with orthopaedic injuries. Under the supervision of senior residents, interns are expected to develop the basic clinical skills and judgment to allow an easy transition into the PGY-2 year. Call is five to seven times per month, including two weekends.
Trauma Surgery - 2 months
These months are spent on the Trauma Service supervised by attending traumatologists from the Division of Trauma and Critical Care in the Department of General Surgery. You will be an integral part of the team that delivers care to the seriously injured from the minute they hit the ER until they are discharged. Generally very busy. By the end of the three months, you will be master of the chest tube and the femoral stick. You will also see a good amount of "virgin" orthopaedics.
Trauma Surgery Intensive Care Unit- 1 month
One month is spent in the Trauma Intensive Care Unit. You will work closely with the Trauma and Critical Care attendings managing the most seriously injured patients. You will become comfortable with managing patients on ventilators and in placing and using intravascular monitors. Call is between every 3rd to 4th night.
Emergency Medicine - 1 month
Roughly 21-22 twelve hour shifts per month in the emergency department. A way to learn how the ER works and familiarize oneself with the ER faculty and the facility.
Plastic Surgery - 1 month
You will work with a plastic surgery fellow as the only two residents on the service. You will round on the plastics patients in the hospital, then cover a variety of cases staffed by the CMC Plastic Surgery department. Good exposure to various coverage procedures that are important in orthopaedic patients, as well as good surgical technique for the soft tissues.
Internal Medicine - 1 month
Remember medical school. This is to remind yourself how glad you are to be doing orthopaedics. Physically refreshing.
Pediatric Surgery - 1 month
You will work with four pediatric surgeons and learn valuable lessons about basic surgical care of children.
Neurosurgery - 1 month
Spend a month with the largest neurosurgery group in the area. Not especially demanding, but some valuable lessons about the neurologic system and care of the head-injured patient can be learned.
General Surgery- 1 month
Spend the month seeing ED consults, learning how to manage abdominal pain. This too is reaffirming your career choice.
PGY-2
The PGY-2 year, the first year of clinical orthopaedics is divided up into 6 two month rotations. The residents spend time in the office setting with attending supervision, as well as in the inpatient setting.
PGY-3
The PGY-3 year is set up similarly to the PGY-2, but the resident finishes rotating through all the subspecialties of orthopaedics. By the end of the PGY 3 year you will have rotated through all of the subspecialties in orthopaedics, thus providing some real world experience to assist in making decisions about possible fellowship training. The residents rotate through 6 two month blocks including,
PGY-4
The PGY-4 year is spent rotating back through the subspecialties as an upper level resident, with increased independence and responsibility. The 6 two month rotations include:
-
Pediatrics
-
Hand
-
Sports
-
Foot/Ankle
-
Spine
-
Adult Reconstruction
PGY-5
The PGY-5 year is spent as the chief of the services, and you are responsible for the service. Duties include the supervision and teaching of junior residents and medical students, and preparation of the weekly clinical conferences. Chief residents also spend four months as the acting administrative chief. During this time they are responsible for scheduling the clinical conferences, vacations and the monthly call schedules. The rotations include:
-
Trauma Chief - 4 month block, congruent with Administrative Chief
-
Adult Reconstruction- two separate 2 month blocks
-
Tumor - 2 month block
-
Sports - 2 month block
Clinics
As a PGY 2-5, you generally will be assigned to the clinic experience of your specific rotation (joints, hand, etc.) The clinics are designed to allow some continuity of care. At least one attending will be in clinic with you for teaching and consultation purposes. The clinics are busy, but manageable. In addition, the system is organized so that if you work up a patient that needs an operative procedure, you will almost certainly do that procedure with the attending.
CALL:
One junior resident (PGY 2-3) and one senior resident (PGY 4+5) are on call each night. The junior resident is "in house" and is responsible for all of the orthopaedic patients in the hospital, all consults, and the emergency department. In general, call is very busy and all-nighters are common. The senior resident takes call from home, and is available to come in for complicated patients and when you are really busy. The senior resident is "in-house" with PGY2 residents during their first two months of call to assist in the transition to orthopaedic residency. If the junior resident needs to take a patient to the OR, the senior resident is available to come in to help with the case or to cover the floor and ER.
The chief resident makes call schedules in four month blocks, with specific requests for call dates usually honored. Frequency works out to every six nights. View sample call schedule.
OPERATIVE EXPERIENCE:
Enormous. Unlike many programs where residents stand in line and compete for cases, at CMC the surgical experience comes early and often. On the trauma service, cases are assigned by the chief resident and trauma attendings based on experience. A table of the operative cases as done by the residents as primary surgeon and first assistant is provided. All operative cases are staffed by an attending. View resident case load example.
MEETINGS:
Residents are allowed to attend one instructional meeting per year (one week). In addition, residents may attend any meeting within reason (generally defined as the contiguous 48 states) at which they will be presenting a paper. Travel, room and board, and a daily food stipend are provided. Instructional meetings are as follows:
PGY-1: Orthotics and Prosthetics Course in Chicago (often also attend Southeastern Fracture Consortium meeting)
PGY-2: Orthopaedic Trauma Association Residents Fracture Course
PGY-3: Pediatric Review Course, Montreal
PGY-4: American Academy of Orthopaedic Surgeons Annual Meeting
PGY-5: Residents' Board Review Course
Research Fellow: Orthopaedic Research Society meeting, and/or AAOS annual meeting
|
