Rotation schedule

PGY-1

Pediatric orthopedics (2 months)

  • Nemours Children’s Hospital – Orlando, FL
    • Seven faculty members
    • Focus on pediatric orthopedic trauma, congenital orthopedic pathology, developmental orthopedic pathology
    • Responsible for floor management and clinic primarily with one dedicated OR day but able to scrub additional trauma cases
    • Preoperative conference (Tuesday), Education (Thursday), Postoperative/Fracture conference (Friday)
    • Monthly journal club
    • Call with orthopedic PA performing reductions, casting, splinting
    • Multiple opportunities for research with various attendings
    • No weekend call

General orthopedics (2 months)

  • As an intern, residents will spend 2 weeks with Dr Mahmood (Hand and Upper Extremity), Dr. Henry (Shoulder and Elbow), Dr. Gupta (Hand and Upper Extremity), Dr. Farr (Joints/Sports)
  • Exposure to the breadth of orthopedics
  • Develop physical exam, diagnosis, and management, in addition to operative technical skills

Orthopedic trauma (2 months)

  • Ocala Regional Medical Center
    • Responsible for all consults from 6:30am – 7:00pm
    • Responsible for work-up of new consults, as well as inpatient management of patients of the orthopedic trauma service
    • Experience in fracture management ranging from isolated orthopedic injuries to polytrauma
    • Two half days of clinic per week to develop skills in outpatient management of orthopedic trauma patients
    • Will gain valuable hands-on technical experience in the ED and operating room

Neurosurgery (1 month)

  • High-volume spine/cranial surgery
  • Experience in both elective spinal deformity cases, neurosurgical trauma, neuro-oncology
  • Primarily operative experience

Plastic surgery (1 month)

  • Private practice
  • Develop soft tissue handling skills and suturing technique
  • Primarily operative experience
  • Will take call for facial trauma 1-2 weekends of the month

Musculoskeletal radiology (1 month)

  • One on one with MSK radiology attendings
  • Develop skills in reading and interpreting radiographs, CT scans, and MRIs

General surgery trauma (1 month)

  • High volume level 2 trauma center
  • Management of polytrauma patients who have orthopedic, neurologic, and visceral injuries
  • Participate in trauma alerts with the trauma attending and emergency department trauma team
  • Develop skills in inpatient management of trauma patients
  • Will take call 2 weekends of the month

Anesthesia (1 month)

  • Learn the role of anesthesia and pain management in orthopedic patients
  • Develop knowledge and skills including intubation, line placement, general/regional anesthesia including nerve blocks

Vascular surgery (1 month)

  • Experience in elective and trauma
  • Exposure to vessel bypass, angiograms, vascular repair
  • Will take vascular call with the attending

PGY-2

Sports (4 months)

  • Rotate with Dr. Farr, Dr. Rogers, and Dr. Sahajpal
  • One on one with attending
  • Balance between clinic and operative experience
  • Exposure to common sports-related injuries involving shoulder arthroscopy, rotator cuff/labrum repair, knee arthroscopy, meniscectomy, ACL reconstruction, etc.

General orthopedics (4 months)

  • Continues to build on the general orthopedics rotation from the intern year
  • One-month preceptorship with Dr. Mahmood, Dr. Gupta, Dr. Henry, and Dr. Farr encompassing hand & upper extremity, shoulder & elbow, sports, and total joint replacement
  • Develop skills in both inpatient and outpatient management of orthopedic patients
  • Further hone technical skills in the operating room

Orthopedic trauma (2 months)

  • Graduated autonomy
  • Will continue to see consults and develop fracture management skills
  • High volume femoral nails, tibial nails, periarticular fractures, tibial plateaus, open fractures
  • Two half days of clinic per week as well to observe postoperative care of simple and complex orthopedic injuries

Pediatric orthopedics (2 months)

  • Nemours Children’s Hospital
    • Primarily operative experience with preceptorship model
    • Balance of operative and clinical experience
    • Develop physical examination, diagnosis and management of pediatric patients
    • Exposure to scoliosis, sports, lower extremity deformity, and congenital pediatric orthopedic pathology.
    • Will take primary call approximately 10 days a month including 2 weekends a month

PGY3

Foot and ankle (4 months)

  • Two-month preceptorship with Dr. Goldstein and Dr. Toussaint
  • Experience the breadth of foot and ankle reconstruction as well as foot and ankle trauma
  • Develop physical exam skills, diagnosis, radiographic interpretation, and management of foot and ankle pathology
  • Combination of outpatient clinical and operative experience to hone pre-operative, intra-operative, post-operative skills and management

Spine (4 months)

  • One-month preceptorship with Dr. Reddy, Dr. Main, Dr. Munroe, and Dr. Lowell
  • High volume elective adult spinal deformity operative experience as well as exposure to spinal trauma
  • Mix of neurosurgical and orthopedic spine training
  • Combination of outpatient clinical and operative experience to hone pre-operative, intra-operative, post-operative skills and management

Hand and upper extremity (4 months)

  • One-month preceptorships with Dr. Bachoura, Dr. Harding, Dr. Gupta, and Dr. Mahmood
  • Continue to further develop exam skills, diagnosis, management, and operative skills of common hand and upper extremity injuries
  • Combination of outpatient clinical and operative experience to hone pre-operative, intra-operative, post-operative skills and management

PGY4

Trauma (4 months)

  • Chief of trauma service
  • Majority operative days with 1-2 days of clinic with Dr. McFadden and Dr. Siebuhr
  • Expectation to run orthopedic trauma service and operate independently as well as teach and lead the junior resident through cases

Adult joint reconstruction (4 months)

  • Preceptorships with Dr. Van de Leur, Dr. Farr, Dr. Rogers, and Dr. Locker
  • Build experience with pre-operative and post-operative planning, primary arthroplasty, as well as complex revision arthroplasty
  • Diverse operative experience with use of robotic and navigation technologies in addition to traditional arthroplasty experience

Orthopedic oncology (4 months)

  • Preceptorship with Dr. Temple in Miami, FL
  • Diverse exposure to various benign and malignant orthopedic tumors
  • Experience with limb salvage, endoprostheses, and reconstruction

PGY5

Hand (4 months)

  • One-month preceptorships with Dr. Mahmood, Dr. Gupta, Dr. Henry, and Dr. Harding
  • Expectation to be able to indicate surgery, operate independently, and improve surgical skills

General (4 months)

  • Two-month preceptorships with Dr. Farr, Dr. Locker
  • Continue to develop independent operative ability within the breadth of general orthopedics ranging from adult reconstruction, arthroscopy, carpal tunnel, etc.

Advanced clinical experience (2 months)

  • Two months of elective experience based on the resident’s specialty interest
  • Continue to master surgical skills in whatever specialty of resident’s choice

Pediatric orthopedics (2 months)

  • Nemours Children’s’ Hospital
    • Chief of pediatric service
    • Preceptorship model with specialty-specific focus (i.e., will work with sports attending if interested in sports or with foot and ankle attending if interested in foot and ankle, etc.)
    • Senior call and expectation to operate autonomously as well teach the junior resident

Curriculum

Call

Call is structured to provide orthopedic exposure from the first year and develop residents’ skills, diagnosis, and confidence in the management of acute orthopedic injuries and pathology. Residents will take call starting from their first month and will have a senior resident to assist them before transitioning to solo call. The resident(s) on the orthopedic trauma service will be responsible for consults from 6:30am to 7:00pm. The late call resident is responsible for consults that come in between 7:00pm and 6:30am the next morning. Consults will be presented during morning conference and orthopedic management of these injuries/pathology will be discussed by the residents and faculty.

Didactics

There is morning conference from 6:30am to 7:30am Monday through Thursday. The curriculum is structured with specialty specific focus every week, with additional emphasis on basic science and anatomy. The goal of the morning didactics is to cover the breadth of orthopedic topics, especially ones that are tested on the Orthopedic In Training Examination (OITE), as well as to improve pre-operative, intra-operative, and post-operative planning and management of orthopedic injuries.

Morbidity and Mortality conference

Morbidity and Mortality conference will occur every other month on a Wednesday. Two to three cases will be presented at each conference. Residents will submit their cases for compilation and will then be assigned to present their case. Case presentations will encompass background of the case, the perioperative complications in question, and will be followed by an evidence-based literature discussion amongst the faculty and residents.

Journal club

Journal club will occur every 2-3 months, and will be specialty specific. Articles will cover fundamental and current literature to enhance residents’ understanding of the orthopedic science. It will also allow residents to develop skills of critically appraising scientific papers as well as build a habit of keeping up with current evidence. Four to five articles will be presented by designated residents and a resident and faculty discussion will follow. This generally takes place at a local restaurant.