Residents are immersed in orthopaedic surgery during the intern year with a comprehensive program utilizing bioskills, simulation, didactic, group sessions, and early operative experience. In years 2-5, the residents rotate through all orthopaedic specialties with junior and senior rotations. Emphasis is placed on engaging residents to become quality educators and leaders, in addition to technically skilled and compassionate surgeons.
The main training facility is Allegheny General Hospital (AGH), a non-profit, Level 1 Trauma Center that is one of the largest tertiary care centers in the region. AGH's surgical facilities include:
The Orthopaedic internship is coordinated by the Orthopaedic Department. Each resident will spend 6 months on Orthopaedic surgery and 6 months on non-orthopaedic services. All interns participate in a didactic training program with the goal of introducing the new residents to the field of orthopaedic surgery. Learning sessions take place weekly throughout the year where interns discuss various orthopaedic pathologies, are introduced to standard operating room procedures and surgical tools, are taught casting and splinting techniques, and participate in surgical simulation. Day-long simulation testing takes place several times throughout the year to ensure each intern is adequately prepared for the transition to the PGY2 year.
The intern will hold the call pager for all ED consults, floor consults, and floor calls. Goals for the rotation include becoming proficient in evaluation of orthopaedic consults, learning about the various orthopaedic pathologies, formulation of a differential diagnosis, and skill in communication, evaluation, and management of orthopaedic patients. There is an assigned back-up resident available to assist at all times.
On this rotation, time will be spent with an adult reconstruction surgeon in both the operating room and clinic setting. Goals of the rotation are to develop a foundation in the evaluation, diagnosis, and management of orthopaedic patients in the field of adult reconstruction.
The ED rotation is made up of 17-20 shifts over the month including both day and night shifts. Goals for the rotation include exposure to various pathologies across the spectrum of medicine, management of acute patients, and ability to initially assess and manage patients from a medical standpoint.
Goals for the service include evaluation and management of soft tissue injuries as well as knowledge of available reconstruction options utilizing grafts and flaps. In addition, residents will also be involved in the management of patients with hand trauma.
Primary goals for the service are to become proficient in the assessment of patients with vascular insufficiency, evaluation of acute vascular injury, and coordinated care with the orthopaedic surgery service.
Interns will work with faculty from the musculoskeletal radiology service reviewing imaging including radiographs, CT, and MRI studies. There is a curriculum with required readings and modules.
This ICU month exposes interns to the care of critically ill patients secondary to a traumatic event. The service generally consists of 3-4 residents from various departments, providing exposure to inter-disciplinary coordinated care. Goals of this service involve the management of patients who are critically ill, many having sustained injuries to multiple organ systems. This rotation allows orthopaedic interns an opportunity to manage the patient not from an orthopaedic standpoint, but from an overall view to allow greater integration with other health care teams.
This rotation provides the interns with the experience of managing total care of traumatically injured patients outside of the ICU. Responsibilities include general patient care and management as well as responding to all Level 1 and Level 2 traumas with the General Surgery Trauma team. Interns will be exposed to a variety of injury mechanisms including blunt and penetrating trauma, and will become proficient in the triage, evaluation, and management of trauma patients.
The administrative chief resident is responsible for developing the call schedule. This schedule is typically created 2 months in advance.
In-house, overnight weekday call is covered by the PGY2 night float resident. PGY2 residents will each rotate through this dedicated night float rotation 5 weeks at a time for two rotations. The rotation consists of 5 night shifts (Sunday through Thursday) over the course of the week. Friday and Saturday night call is covered by a different PGY2 or PGY3 resident.
During this rotation, the resident is free from all other clinical responsibilities. The resident is still involved in the lecture series and PGY2 simulation training sessions.
Each weeknight, a PGY4 or PGY5 resident will be available as the back-up senior call resident. This call is taken from home. The call resident is available to answer any questions from in-house residents, evaluate difficult patients, and present to the hospital for any emergent overnight surgical cases.
A team of junior and senior residents cover all call, rounding, and surgical responsibilities each weekend. Two to three junior residents are present and have assignments as the in-house call resident or surgical junior resident. Friday night in-house call is shared between PGY2 and PGY3 residents. Saturday in-house call is covered by PGY2 residents while Sunday is covered by PGY3 residents.
Two senior residents are present every weekend as backup call residents. The senior residents participate in all surgical cases that take place over the weekend and are always available to answer any questions from in-house residents or assist in the evaluation of complex patients.
Each resident typically works 1-2 weekends per month. The weekend call is structured to allow residents to become directly involved in emergent and weekend surgical cases early on in the training years. Each PGY2 and PGY3 participates in surgeries during their call weekends, with graduated responsibility as they progress.
Residents meet at 6am daily for Fracture Conference followed by Morning Conference. At the beginning of each academic year, conferences are based on our Summer Anatomy Series. This is a comprehensive, 2-month lecture series aimed at reviewing physical exam, radiographic evaluation, anatomy, and basic operative skills. Each week focuses on a different anatomic segment of human anatomy. Anatomic dissections are performed and presented on cadaveric specimens in our Center for Surgical Arts. Weekly teaching labs occur throughout the summer when surgical skills are taught both on cadaveric models and sawbones. There is a bioskills curriculum thorough out the year.
Following the completion of the Anatomy Series, the Morning Conference Schedule returns from September through June. Daily fracture conference is typically followed by a 30-45 minute didactic lecture within Orthopaedic Subspecialties as listed above. These lectures are either Attending physician led, or presented by a resident with an Attending present.
Alvin H. Crawford, MD
Professor Emeritus Pediatric and Orthopaedics, University of Cincinnati Professor, Pediatric Orthopaedic Surgery, Cincinnati Children’s Hospital Medical Center Cincinnati, Ohio
Brock A. Lindsey, MD, FAOA
Director, Musculoskeletal Oncology and Adult Reconstruction Director, Musculoskeletal Research Laboratory Medical Director, Allied Health Solutions West Virginia University Morgan Town, WV
Samir Mehta, M.D.
Chief, Division of Orthopaedic Trauma Associate Professor of Orthopaedic Surgery University of Pennsylvania Philadelphia, PA
Hans-Christoph Pape
Professor and Chairman, Department of Orthopedic Trauma Surgery University of Zurich, Zurich, Switzerland
Scott David Weiner, MD
Chair, Department of Orthopaedic Surgery Summa Healt System, Akron, OH
