Curriculum

Orthopedic Surgery Residency Program

MMC Orthopaedic Surgery Residency Program

Our program is designed to address the growth and development of each resident with progressive responsibility delegated as accumulated knowledge and skills warrant. The small size of the program permits a more individualized approach to resident needs.

The teaching staff is attuned to the needs for appropriate supervision at all levels of the residency and work closely with the program director in ongoing evaluation of residents.

Resident Schedule

PGY-1

The first year of training is structured to provide the resident a broad exposure to general surgical principles and medical management, which are essential to building a good foundation for orthopaedic surgery. With this preliminary year incorporated into the orthopaedic residency, the program director can structure an ideal experience tailored to each resident. There is enough flexibility in this year to accommodate individual resident needs.

Monmouth Medical Center is a rotational site for Rutgers Robert Wood Johnson General Surgery Residency Program. Medical students from Rutgers University Robert Wood Johnson School of Medicine have clinical rotations in the surgery department as well. The surgical department staff is comprised of Board-certified faculty in multiple subspecialties including general, plastics, vascular, cardiothoracic, colorectal, pediatric and neurosurgery.

The six months assigned to General Surgery include exposure to vascular, pediatric, urologic, plastic, neurosurgical and otolaryngologic surgery. The resident is also assigned to the Surgical ICU and works as a member of the trauma surgery service at Jersey Shore University Medical Center for two months during their off-service rotations. Each resident is assigned to the orthopaedic service for six months. The program director in orthopaedic surgery works with their counterparts in surgery and medicine to assure that our resident is fully incorporated into all patient care activities and relevant conferences during each rotation, including the on-call schedules of departments and sections to which they are assigned. Timely evaluations are submitted to the program director. While on the orthopedic service as an intern, eaçh resident begins scrubbing into orthopedic cases and beginning to develop their surgical skills immediately.

The program is designed to provide increasing responsibility for patient care, teaching and research. The responsibilities are delineated as per year in training with flexibility and recognition of specific needs and abilities of each resident. A description by year is as follows:

PGY-1

6 months on-service of General Orthopaedic Surgery

6 months off-service:

  1. General Surgery (MMC)
  2. General Surgery (MMC)
  3. Surgical Intensive Care Unit / Trauma (JSUMC)
  4. Surgical Intensive Care Unit / Trauma (JSUMC)
  5. Musculoskeletal Radiology (MMC)
  6. Pain management / Anesthesia (MMC)

PGY-2

This second year introduces a resident into the management of orthopaedic patients. The interviewing and physical examination skills, general patient management and competence with acute medical emergencies gained in the rotations during intern year provide each resident with an excellent clinical foundation. The essentials of a proper orthopaedic evaluation are now added. The PGY-5 resident closely supervises the PGY-2 in developing this competence.

Residents are encouraged to seek appropriate consultations from other services where needed in the pre-operative evaluation of orthopaedic patients and management of significant illnesses through surgery and post-operatively. The resident continues to build their skill in the operating room with progressive responsibility as demonstrated confidence warrants. Collateral experience with ambulatory orthopaedic patients is obtained through increased responsibility at the resident orthopedic clinic. Supervision by more senior residents and attendings is present in all clinic assignments and daily rounds on the orthopaedic floor are made by PGY-2 residents with the chief resident, intern and students.

PGY-2

  1. Adult Reconstruction/ Community Trauma (MMC)
  2. Adult Reconstruction/ Community Trauma (MMC)
  3. Adult Reconstruction/ Community Trauma (MMC)
  4. Sports Medicine/ Foot-Ankle (MMC)
  5. Sports Medicine/ Foot-Ankle (MMC)
  6. Sports Medicine/ Foot-Ankle (MMC)
  7. Spine (MMC)
  8. Spine (MMC)
  9. Spine (MMC)
  10. Hand (MMC)
  11. Hand (MMC)
  12. Hand (MMC)

PGY-3

The PGY-3 resident gains further experience in appropriate investigational studies needed to assess emergency orthopaedic situations, management of acute orthopaedic problems, and how to triage patients for admission. In all this, the resident is always supervised by a member of the teaching staff in a consultative role and becomes intimately involved with the trauma team in the management of patients with multiple injuries. Under the direct supervision of the attending physician, it is their responsibility to manage the orthopaedic patients and consults located on other floors within the hospital including intensive care units, pediatrics and infectious wards.

Surgical judgment and skills are further developed through an increasingly responsible role in patient management. Their role in the operating room evolves from assistant to surgeon, as appropriate, and is increasingly involved in procedures that are more complex.

During this year, the PGY-3 resident gains access to the local affiliated surgery centers and begins further exposure to outpatient surgery. The resident is encouraged to attend the private office practice of selected members of the teaching staff.

An orthopedic trauma and musculoskeletal oncology rotation has been established in collaboration with the orthopedic residency at University Hospital (UH) in Newark, NJ. The rotation is for six months during the third year (4 months of trauma, 2 of oncology), where the resident is primarily responsible for the initial evaluation and management of all trauma cases admitted through the hospital. The faculty consists of full-time attendings who are all fellowship trained in traumatology or musculoskeletal oncology. The operative experience includes clinics such as rehabilitation and orthotics, along with journal review and didactic lectures.

PGY-3

    1. Orthopedic Trauma (JSUMC)
    2. Orthopedic Trauma (JSUMC)
    3. Orthopedic Trauma (UH)
    4. Orthopedic Trauma (UH)
    5. Musculoskeletal oncology (UH)
    6. Musculoskeletal oncology (UH)
    7. Shoulder and Elbow (MMC)
    8. Shoulder and Elbow (MMC)
    9. Shoulder and Elbow (MMC)
    10. Spine (MMC)
    11. Spine (MMC)
    12. Spine (MMC)

PGY-4

The cognitive knowledge and surgical skills developed during the first three years of residency are required for advancement to the PGY-4 year. These experiences should produce a mature resident ready for augmented responsibilities in patient care, surgery, teaching and supervision. The PGY-4 resident is away on a pediatric orthopedic rotation at the Children's Hospital of Philadelphia (CHOP) for a five month period during this year. CHOP provides the resident with a plethora of complex cases in a large urban referral center, along with laboratory bench time, which is an important ingredient in proper resident development.

Responsibilities as a supervisory and teaching member of the team significantly increase, as does involvement in outpatient programs and surgery. The PGY-4 resident is increasingly involved as operator in surgical procedures with teaching staff assisting and supervising as is appropriate. It is at this point when residents begin to tailor their rotations and case selection at Monmouth Medical Center towards their individual fellowship interests.

PGY-4

  1. Pediatric Orthopedics (CHOP)
  2. Pediatric Orthopedics (CHOP)
  3. Pediatric Orthopedics (CHOP)
  4. Pediatric Orthopedics (CHOP)
  5. Pediatric Orthopedics (CHOP)
  6. Orthopedic Trauma (JSUMC)
  7. Orthopedic Trauma (JSUMC)
  8. Sports / Shoulder & Elbow (MMC)
  9. Sports / Shoulder & Elbow (MMC)
  10. Sports / Shoulder & Elbow (MMC)
  11. Hand / Foot and Ankle (MMC)
  12. Hand / Foot and Ankle (MMC)

PGY-5

The Chief Resident has major supervisory responsibility over all aspects of the program, including resident assignments to surgical cases, conference scheduling and the administrative details of the residency. Some tasks are delegated to more junior residents, making workflow management an important aspect of the chief resident learning experience as well. The Chief Resident has a significant role in resident evaluations. In surgery, the Chief Resident performs most of the major reconstructive cases and sophisticated hand, spine, and trauma cases under supervision.

The Chief Resident becomes preceptor to the PGY-1 resident assigned to orthopaedics. They are responsible for third-year medical students rotating to orthopaedics while at Monmouth Medical Center, and for fourth-year students taking electives at MMC. They do, as well as all other residents, work under the direction and supervision of the attending physician.

PGY-5

  1. Sports / Shoulder & Elbow (MMC)
  2. Sports / Shoulder & Elbow (MMC)
  3. Sports / Shoulder & Elbow (MMC)
  4. Hand / Foot and Ankle (MMC)
  5. Hand / Foot and Ankle (MMC)
  6. Hand / Foot and Ankle (MMC)
  7. Orthopedic Trauma (JSUMC)
  8. Orthopedic Trauma (JSUMC)
  9. Adult Reconstruction / Spine (MMC)
  10. Adult Reconstruction / Spine (MMC)
  11. Adult Reconstruction / Spine (MMC)
  12. Adult Reconstruction / Spine (MMC)