Goals and Objectives of Each Major Rotation
The educational goals of our program focus on the logical progression of knowledge, experience, and responsibility for each resident. Each rotation at each institution is designed to provide opportunities for increasing clinical and surgical responsibilities for the resident depending on the level of training and progression of his or her clinical and surgical skills as demonstrated by evaluation by faculty members, oral examinations, and the annual OITE.
The orthopaedic residency program currently includes PGY-1 through PGY-5. At the PGY-1 level we have four surgical internships and four transitional internships. We have worked with the Graduate Medical Education Department of the University of Tennessee and those of the institutions involved to develop a plan for a uniform PGY-1 according to ACGME guidelines. This uniform PGY-1 will allow residents to develop knowledge, attitudes, and skills in a variety of medical disciplines, while more adequately preparing them for their intensive orthopaedic studies. Medical specialties included in the rotations are multi-system trauma, plastic surgery, vascular surgery, general surgery, neurological surgery, emergency medicine, musculoskeletal imaging, and orthopaedic surgery. This program meets the criteria outlined in the Program Requirements for Residency Education in Orthopaedic Surgery, Section 2-B.
PGY-2 through PGY-5
Specialty rotations during PGY2 through PGY-5 are graduated from level C (least resident responsibility) to level A (most resident responsibility) to foster progression of knowledge and skills and allow increasing levels of responsibility in these areas. Areas of emphasis in each rotation are approximately 50% clinical and 50% surgical. This allows residents to experience continuity of care for most patients, from initial examination and evaluation through surgical or non-surgical treatment and postoperative rehabilitation (if appropriate) until final result.
Description of Rotation by PGY-Level
A typical PGY-2 rotation schedule includes 3 months of Orthopaedic Trauma, 3 months of Trauma Surgery, and 6 weeks each of Sport C, Total Joints C, Oncology, and General Orthopaedics B. Orthopaedic Trauma and Trauma Surgery rotations are scheduled in one-month blocks to accommodate the University of Tennessee Department of Surgery; these one-month blocks may not be consecutive and a resident may not complete all three months of either in a single quarter. These rotations provide basic-level instruction in surgical skills and care of orthopaedic trauma patients under the supervision of faculty and senior residents. Instruction includes general health evaluation and preoperative preparation of trauma patients, surgical indications and contraindications, anesthesia, pre-surgical and post-surgical consultations, and follow-up care after surgery.
The Orthopaedic Trauma rotation is based at the Regional Medical Center Level 1 Trauma Center and the emphasis is the role of the orthopaedic care in the treatment of multi-trauma patients. Faculty and senior residents supervise and assist residents as they develop skills in determining proper triage procedures, necessity of consultations, selection of appropriate procedures, and indications for and timing of orthopaedic procedures as part of the multi-trauma team.
General Orthopaedics B is a 6-week rotation during which residents work with faculty members in the outpatient area to develop skills in history taking and physical examination, diagnosis of a variety of adult orthopaedic conditions, and formulation of surgical and non-surgical treatment plans. Surgical skills are developed in a variety of orthopaedic procedures as the resident assists faculty and senior residents. Continuation of care is ensured as the resident follows patients through surgical or non-surgical treatment and rehabilitation.
Sport Medicine C is a 6-week rotation during which the resident works with faculty members who have interest and training in the subspecialty. Instruction in the outpatient area focuses on development of skills in specialized diagnostic tests and maneuvers, formulation of treatment plans (surgical and non-surgical), and rehabilitation after surgery. Surgical approaches and procedures, including arthroscopic procedures, are introduced as the resident serves as first assistant.
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