The intent of this five-year training program is to develop fully competent orthopaedic surgeons. At the end of the program, all residents should successfully complete the qualifying and certifying examinations of the American Board of Orthopaedic Surgery (ABOS) and function as independent practitioners of orthopaedic surgery at the highest level of performance expected of a board certified specialist.
Orthopaedic residents are provided a sufficient number and variety of simple and complex cases for the achievement of adequate operative skills, surgical balance, and experience. Residents will participate in the preoperative, intraoperative and postoperative care of their patients. This will be accomplished by participation in clinics, operating room, and postoperative follow-up on the wards and clinics.
The PGY-1 intern year consists of thirteen 4-week blocks, and includes six blocks of structured education on non-orthopaedic surgery rotations:
- Surgical Intensive Care
- General Trauma Surgery
- Emergency Medicine
- Musculoskeletal Radiology
- Vascular Surgery
These rotations are designed to foster proficiency in basic surgical skills, the perioperative care of surgical patients, musculoskeletal image interpretation, medical management of patients, and airway management skills.
The remaining rotation blocks focus on orthopaedic surgery and are also designed to foster proficiency in basic surgical skills, as well as the general care of orthopaedic patients, both as inpatients and in the outpatient clinics, the management of orthopaedic patients in the emergency department, and the cultivation of an orthopaedic knowledge base.
PGY-2 though PGY-5 rotations range from one to four months in length and continue to expand residents’ skills in orthopaedic specialties.
Residents are required to attend conferences held during their specialty rotations, as part of an active involvement in scholarly activities.
Orthopaedic Surgery Grand Rounds
These conferences are presentations to faculty and residents on a variety of topics relevant to orthopaedic education. Subspecialty lectures focus on Foot/Ankle, Spine, Sports, Joints and Trauma. Occasional talks are given by visiting professors, in their area of expertise. There is also a monthly Pediatric Orthopaedic Grand Rounds conference held by Valley Children’s Hospital.
Orthopaedic Journal Club
During all five years, residents participate in Journal Club, with an emphasis on critical appraisal skills. Residents are asked to review articles using a worksheet that walks them through the research methodology.
Orthopaedic Surgery Radiology/Trauma Grand Rounds
A weekly conference with resident presentations on types of fractures, focusing on use of x-ray films and practical departmental cases.
Conferences include Adult Reconstruction, Foot/Ankle, and Hand subspecialties.
Basic Surgical Skills Lab
Residents learn skills used in the initial management of injured patients, including splinting, casting, application of traction devices, and other types of immobilization; and basic operative skills, including soft tissue management, suturing, bone management, arthroscopy, fluoroscopy, and use of basic orthopaedic equipment.
The Anatomy Lab is held at CSU Fresno under the supervision of faculty. Residents study and dissect anatomic specimens over the course of nine weeks. The Lab Agenda includes:
- Humerus & Elbow
- Wrist & Hand
- Femur & Knee
- Distal Tibia, Foot & Ankle
Faculty members moderate these conferences and assist residents with presentations on a series of orthopaedic-related topics, including a Q&A component.
During each year of residency, residents participate in a quality improvement project. With the aid of a faculty advisor, residents will:
- Choose a patient care practice that they would like to change/improve
- Complete a SWOT analysis (Strengths of current situation, Weaknesses of current situation, Opportunities for improvement, and Threats to improvement), including a literature review
- Complete a fishbone planning diagram to determine possible steps to get from the current state to the desired state
- Develop an action plan for the improvement project
- Present the outcomes to the department during in an Orthopaedic Grand Round Conference
Over the course of the program, residents must demonstrate scholarly activity through the completion of a hypothesis-driven research project. Residents must make a significant contribution to the project.
Residents are also required to present a Systems-Based Practice Academic Presentation.