Specific Rotation Objectives

General Orthopaedics | Hand Surgery | Foot & Ankle Surgery | Arthroplasty Surgery | Pediatric Orthopaedic Surgery | Orthopaedic Trauma Surgery | Spine Surgery | Orthopaedic Sports Medicine | Orthopaedic Oncology

GOALS: To provide state-of-the art, high-quality oncology care, education, and research in an environment that promotes and nurtures the best academic, clinical, ethical, and moral growth for its trainees and students

OBJECTIVES: At the end of this rotation residents will be able to:

1. Identify the anatomy of the musculoskeletal system.
2. Demonstrate the techniques for history and physicals for general orthopaedic patients.
3. Discuss the non-operative management of general orthopaedics.
4. Discuss the operative management of general orthopaedic patients.
5. Manage complications in general orthopaedics.
6. Competently evaluate and manage orthopaedic consults including the multiply injured orthopaedic patient and to communicate a care plan to the attending physician on call.
7. To be thoroughly competent in the neuromusculoskeletal examination.
8. If a resident has operated with a physician he is expected to follow the patient in the hospital and be involved in his perioperative care. The resident is expected to review all postoperative films ordered.
9. Develop a comprehensive understanding of the multiply injured patient with the ability to formulate specific care plans.
10. Refine and develop complete surgical skills required to manage adult orthopaedic injuries including periatricular foot and ankle, knee, shoulder, elbow, hip, wrist and pelvis: including pelvic ring injuries and simple acetabular fractures. In addition the resident is expected to have mastered management of long bone injuries with the ability to co-instruct junior residents under the supervision of the attending.
11. Cogently evaluate the new patients in clinic and formulate differential diagnoses, preoperatively plan the operative cases, manage post operative care for arthroplasty cases, post-traumatic reconstructive deformities, general orthopaedic cases, and be able to discuss this with his/her attending.
12. Develop and demonstrate ethical behavior acceptable for membership in the American Academy of Orthopaedic Surgeons. He will demonstrate responsiveness to the needs of the patients and society that supersedes self interest and a commitment to excellence and ongoing professional development.

GOALS: To provide state-of-the art, high-quality hand surgery care, education, and research in an environment that promotes and nurtures the best academic, clinical, ethical, and moral growth for its trainees and students

OBJECTIVES (First Rotation): At the end of this rotation residents will be able to:

1. Explain the functional anatomy of the upper extremity.
2. Demonstrate the clinical techniques and physical examination of the upper extremity.
3. Diagnose traumatic, functional, OVU, sport, and oncology problems of the upper extremity.
4. Demonstrate the basic techniques for operative management of upper extremity problems, indications for surgery, complications and contraindications.
5. Demonstrate integrity, respect, compassion and empathy for patients and their families.

OBJECTIVES (Second Rotation): At the end of this rotation residents will be able to:

1. Demonstrate an investigatory and analytic approach to clinical situations.
2. Accurately perform carpal tunnel surgery, trigger finger release, tendon repair.
3. Conduct advanced hand surgery operations, arthroplasty, tendon transfers, wrist arthroscopy and fusions.
4. Senior resident must demonstrate the ability to delegate duties and responsibilities to junior residents and participate in the teaching of junior residents.
5. Refine interpersonal skills with hospital support professionals in order that these skills will always be with the resident as he/she advances into orthopaedic practice.

GOALS: To provide state-of-the art, high-quality foot & ankle surgery care, education, and research in an environment that promotes and nurtures the best academic, clinical, ethical, and moral growth for its trainees and students

OBJECTIVES: At the end of this rotation residents will be able to:

1. Recognize the importance of clear and accurate instructions for patients and their families.
2. Outline the functional anatomy of the lower extremity, foot and ankle.
3. Demonstrate the clinical techniques and perform a physical examination of the lower extremity.
4. Diagnose traumatic, functional, OVU, sport, and oncology problems of the lower extremity.
5. Outline the basic techniques for operative management of lower extremity problems, indications for surgery, complications and contraindications.
6. Perform end-to-end microvascular leak proof anastomosis of vessels less than one millimeter.
7. Perform bunion surgery, hammer toe, tendon repairs, etc.
8. Perform ankle arthroscopy, fusions, and ankle arthroplasty.

GOALS: To provide state-of-the art, high-quality arthroplasty care, education, and research in an environment that promotes and nurtures the best academic, clinical, ethical, and moral growth for its trainees and students. The joint reconstruction rotation involves basic and complex reconstruction of adult hip and knee. The senior level resident is exposed to a large volume and wide spectrum of adult hip and knee disease. They are also provided with the unique exposure to biological reconstruction, including osteotomy and osteocartilaginous transplantation.

OBJECTIVES (First Rotation): At the end of this rotation residents will be able to:

1. Demonstrate an understanding of the importance of history in deriving a differential diagnosis.
2. Describe the functional anatomy of the knee, hip shoulder and elbow.
3. Demonstrate the clinical techniques, physical examination of the hip, knee, shoulder and elbow.
4. Diagnose joint arthritis and functional loss.
5. Outline the indications and the contraindications for total joint surgery for the hip, knee, shoulder and elbow.
6. Perform the basic operative techniques for primary total joint surgery.

OBJECTIVES (Second Rotation): At the end of this rotation residents will be able to:

1. Demonstrate the techniques for revision total joint surgery, minimal invasive surgical techniques, computer navigation techniques and limb salvage surgery.
2. Demonstrate knowledge about established and evolving biomedical, clinical, and cognate (e.g. epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.
3. Understand the indications for surgical treatment for adult hip and knee disease.
4. Understand material science and prosthetic joint replacement.
5. Understand design-engineering principles underlying osteotomy and cartilage transplantation.
6. Recognize the patterns of prosthesis failure.
7. Become technically proficient in the performance of basic hip and knee reconstructive procedures.

GOALS: To provide state-of-the art, high-quality pediatric surgical care, education, and research in an environment that promotes and nurtures the best academic, clinical, ethical, and moral growth for its trainees and students

OBJECTIVES (First Rotation): At the end of this rotation residents will be able to:

1. Understand the special elements of examination of the pediatric orthopaedic patient, including working with families, the non-verbal child, the child with developmental disabilities, infants and adolescents.
2. Understand normal and abnormal growth and development, including bone growth, muscular growth, growth rate, developmental milestones, and timing.
3. Evaluate and manage pediatric fractures and the implications of involvement of the growth plate.
4. Evaluate and manage torsional problems involving lower extremity (intoeing) and angular deformities (physiologic bowing, Blounts).
5. Evaluate and manage skeletal dysplasias.
6. Understand the characteristics, pathogenesis, diagnostic features, and management of constitutional diseases with bone pathology (rickets, mucopolysaccah, Ca/Phosphorous disorders), metabolic diseases ( osetomalacia, renal osteodystrophy, etc), connective tissues disorders (Ehlers Danlos, Marfan’s, etc), and short stature.
7. Understand the etiology, embryology, classification, diagnosis, and treatment of genetic disorders.
8. Understand the etiology, diagnosis, and treatment of hematologic disorders (Gaucher’s hemoglobinopathies, hemophilia) and benign bone tumors or tumor-like conditions.
9. Understand the characteristics, pathogenesis, diagnostic features, and management of muscular dystrophies (Duchenne, Becker, etc), inflammatory myopathies (polio, SMA, HMSNs), myelodysplasia, spondyloarthropathies and spinal deformities (scoliosis, kyphosis, spondylosis, and spondylolisthesis.)
10. Understand underlying processes involved in hip abnormalities (CDH, synovitis, LCPD, SCFE), leg length discrepancies, lower limb abnormalities (congenital deficiencies, clubfoot, polydactyly, congenital pseudoarthrosis of tibia, etc.), and upper limb deficiencies and malformations.
11. Interpret and synthesize patient history, clinical exam, and diagnostic tests into a differential diagnosis for the conditions listed above.
12. Interpret laboratory, radiologic, and other diagnostic tests for the conditions listed above.
13. Plan appropriate surgery based upon the diagnosis and clinical findings.
14. Perform or assist in surgical procedures required to address the conditions listed above (i.e. scoliosis surgery, limb length problems , fracture care, neuromuscular disease, cerebral palsy, myelomeningocele, developmental deformities, DDH, Legg Calve Perthes disease, slipped capital femoral epiphysis, and congenital anomalies.

OBJECTIVES (Second Rotation): At the end of this rotation residents will be able to:

1. Understand the characteristics, pathogenesis, diagnostic features, and management of complex neuromuscular disorders.
2. Recognize and treat, in conjunction with a multidisciplinary team, cerebral palsy, spina bifida, other neuromuscular diseases, and complex spinal deformities.
3. Understand, recognize, and non-operatively and operatively manage complex upper limb, leg length, hip, and lower limb deformities and disorders.
4. Understand the clinical manifestations, treatment, and long-term prognosis of complex gait disorders.
5. Understand the clinical manifestations, treatment, and long-term prognosis of complex fractures.
6. Understand, recognize, and manage complex skeletal dysplasias.
7. Understand the etiology, diagnosis and treatment of complex hematologic disorders.
8. Interpret and synthesize patient history, clinical exam, and diagnostic tests into a differential diagnosis for the conditions listed above.
9. Know the indications for an interpretation of various laboratory, radiologic, and other diagnostic tests for the conditions listed above.
10. Plan appropriate outpatient management for common disorders (clubfoot, toe walking).
11. Plan appropriate surgical procedures based upon the diagnosis and clinical findings.
12. Perform or assist in surgical procedures required to address the conditions listed above (i.e. scoliosis surgery, limb length problems , fracture care, neuromuscular disease, cerebral palsy, myelomeningocele, developmental deformities, DDH, Legg Calve Perthes disease, slipped capital femoral epiphysis, and congenital anomalies.

GOALS: To provide state-of-the art, high-quality trauma surgery care, education, and research in an environment that promotes and nurtures the best academic, clinical, ethical, and moral growth for its trainees and students

OBJECTIVES (First Rotation): At the end of this rotation residents will be able to:

1. Assimilate information gathered from the history and physical exam.
2. Describe the functional anatomy of the upper and lower extremity and pelvis.
3. Discuss the clinical techniques and physical examination and evaluation of a trauma patient upper/lower extremity and pelvis examination.
4. Evaluate and recessitate the multiple trauma patient.
5. Describe the diagnostic studies including radiologic and blood tests on the multiple trauma patient.
6. Outline the non-operative and the operative management of a multiple trauma patient.
7. Demonstrate the post-operative management of the multiple trauma patients.
8. Perform open reduction and internal fixation techniques and intrameduallary rodding for non-complex bone trauma.
9. Operate and manage a mechanical ventilator.
10. Perform wound management techniques and methods.

OBJECTIVES (Second and Third Rotations): At the end of these rotations, residents will be able to:

1. Identify indications for surgery on the multiply injured patients.
2. Demonstrate the operative management of complex fractures of upper, lower extremity and pelvis.
3. Explain the operative complications in multiple trauma patients.
4. Perform surgeries on complex bone fractures, pelvic and acetabular reconstructions, tibia plateau fractures and arthroplasty for fractures.
5. Become certified and competent in ATLS.
6. Understand the pathophysiologic effect of blunt and penetrating trauma.
7. Understand the pathophysiology, diagnosis, treatment and prognosis of disorders of the various organs and organ system.
8. Effectively manage the surgical care of patients with multisystem injuries.
9. Actively participate in the evaluation, resuscitation, operative care and ICU care of trauma patients.
10. Formulate rehabilitation plans for trauma patients.
11. Learn and perform basic surgical procedures and assist with complicated general surgical cases.

GOALS: To provide state-of-the art, high-quality spine surgery care, education, and research in an environment that promotes and nurtures the best academic, clinical, ethical, and moral growth for its trainees and students.

OBJECTIVES (First Rotation): At the end of this rotation residents will be able to:

1. Name the anatomy of the upper and lower spine.
2. Demonstrate the techniques for a physical examination of the spine.
3. Diagnose spinal cord injury patients, herniated disc patients, arthritic spine patients.
4. Define the non-operative management of upper and lower spinal conditions.
5. Define the operative management for upper & lower spinal surgery.
6. Demonstrate the surgical techniques in discectomy and laminectomy.
7. Broaden knowledge of orthopaedic spine pathology as it relates to patient evaluation of musculoskeletal complaints/symptoms.
8. Expose residents to varied practices of orthopaedic spine subspecialists.
9. Develop practical skills in taking histories and examining patients with musculoskeletal complaints as they relate to spine pathology.
10. Expose residents to spinal surgery to gain proficiencies in operative technique, as well as gain understanding of surgical anatomy.
11. Gain experience in reviewing plain radiographs, bone scans, CT scans, myelograms, and MRI’s for evaluation of spine pathology.

OBJECTIVES (Second Rotation): At the end of this rotation residents will be able to:

1. Demonstrate the complex spinal implementation, spinal fusion, and revision spinal surgery.
2. Work in teams with junior residents and attending physicians. When supervising junior residents, senior residents should be able to observe students, demonstrate skills and give constructive feedback.

GOALS: To provide state-of-the art, high-quality sports medicine care, education, and research in an environment that promotes and nurtures the best academic, clinical, ethical, and moral growth for its trainees and students.

OBJECTIVES (First Rotation): At the end of this rotation residents will be able to:

1. Perform a basic sports medicine specific history and physical.
2. Understand the utility of and interpretation of imaging studies for sports medicine.
3. Diagnose and distinguish ACL, PCL, MCL and posterolateral corner injuries.
4. Diagnose and prepare treatment plans for tendonitis and patellofemoral problems.
5. Diagnose shoulder instabilities and rotator cuff pathologies.
6. Diagnose and treat elbow and shoulder problems in the throwing athlete.
7. Diagnose of overuse running injuries and implementing effective treatment plans.
8. Understand an MRI of the knee and shoulder.
9. Demonstrate the ability to recognize secondary signs of ACL tears on MRI.
10. Identify the functional anatomy of knees, shoulders, hips, foot and ankle as related to sports injury.
11. Discuss the clinical techniques and physical examination of the sports related injuries.
12. Explain the non-operative management of sports related injuries.
13. Explain the operative management including arthroscopic surgery, open surgical techniques and other minimal invasive surgical techniques of sports related injuries.
14. Perform the basic techniques in arthroscopy.

OBJECTIVES (Second Rotation): At the end of this rotation residents will be able to:

1. Demonstrate complex arthroscopy with knee reconstruction, shoulder reconstruction, and cartilage repair.
2. Provide thorough and complete written or electronic documentation of patient care (e.g. progress or procedure notes, history and physical exams, consultant notes, discharge summaries), which are legible, timely and use appropriate medical terminology.
3. Master diagnostic arthroscopy skills for the knee and shoulder.
4. Garner some experience in ankle and elbow arthroscopy.
5. Demonstrate proficiency in evaluation of meniscal tears and performance of partial meniscectomies.
6. Develop the skills necessary for meniscal repair and understand the appropriate indications.
7. Develop skills for graft harvest and preparation of ACL reconstruction – to include patellar tendon autografts, hamstrings autografts and various allografts.
8. Able to perform notchplasties and drill tunnels for ACL reconstruction.
9. Become adept at arthroscopic subacromial decompression and arthroscopic evaluation of rotator cuff pathology.
10. Develop experience in open rotator cuff repairs and open Bankhart repairs.
11. Develop understanding and develop skills in capsular plication and arthroscopic repairs of rotator cuff, Bankhart lesions and SLAP Lesions.
12. Perform and understand the mechanics of repair to injuries such as Achilles, patellar and distal biceps tendon ruptures.

GOALS: To provide state-of-the art, high-quality oncology care, education, and research in an environment that promotes and nurtures the best academic, clinical, ethical, and moral growth for its trainees and students

OBJECTIVES (First Rotation): At the end of this rotation residents will be able to:

1. Describe the functional anatomy of the upper and lower extremities and spine.
2. Identify the clinical techniques for physical examination of the patient with metastatic disease of primary bone and soft tissue tumors.
3. Diagnose patients with metastatic disease and bone and soft tissue tumors.
4. Outline the operative and non-operative management of patients with metastatic disease and primary bone and soft tissue tumors.
5. Perform the basic operative techniques for biopsies, prophylactic internal fixation for impending pathological fractures.
6. Describe and identify pathologic lesions of the musculoskeletal system, including bone, soft tissue, and cartilage tumors.
7. Formulate a reasonable plan of care for orthopaedic oncology patients, to include appropriate biopsy plans, referral patterns, and treatment options, taking into consideration of age, special needs, and specific characteristics of the pathologic lesion.
8. The resident should be knowledgeable regarding proper biopsy and surgical principles in the treatment of bone and soft tissue tumors.

OBJECTIVES (Second Rotation): At the end of this rotation residents will be able to:

1. Demonstrate complex bone reconstruction for periarticular pathological fractures, ace tabular reconstruction, and limb salvage surgery for both bone and soft tissue sarcomas.
2. Regularly utilize drug information and drug-drug interaction programs.
3. Perform under supervision orthopaedic oncology reconstructive techniques, pre-operative planning and appropriate use of imaging modalities.