Rotations In Orthopaedic Surgery - PGY II and PGY III

PGY-II

The PGY-II year consists of a nine-month rotation at UC Irvine MC and a three-month rotation at the Long Beach VA Medical Center. The goal of the PGY-II resident is to acquire diagnostic and clinical skills through participation in supervised outpatient clinics and through consultation in the Emergency Room. He/she is to learn total appraisal of the trauma victim, emergency room treatment of the trauma victim, the closed manipulation and reduction of fractures, and the care of a full spectrum of musculoskeletal injuries. They also learn to administer care for pre- and postoperative surgical patients. In the operating room, the PGY-II should acquire familiarity and use of all orthopaedic instrumentation and develop basic orthopaedic operative skills under the supervision of senior residents and faculty. Experience with operative care of fractures and other musculoskeletal conditions are instituted. A working knowledge of surgical approach is required. Specific skills include application of all standard casts, splints and traction setups and basic internal fixation techniques.

The PGY 2 year is an intensive introduction to the fundamental principles of managing orthopaedic pathology, disorders and trauma. Nine months are spent at UC Irvine Medical Center and three months at the VA Hospital in Long Beach. During this time residents learn the basics of orthopaedic surgery by treating patients on the general orthopaedic services. The “R2” gets their first real introduction to the basics of orthopaedic surgical technique by spending a great deal of time in the operating room. At the end of the year, residents are fluent in the basic AO principles of fracture management, understand the biomechanics of joint reconstruction, and are able to diagnose and manage orthopaedic emergencies and trauma. Exposure to all of the subspecialties provides a foundation for the remaining years of residency and helps shape a future career path in orthopaedics.

There are no fellows at UC Irvine or any of the other affiliate hospitals and rarely there are two residents scrubbed into the same case. This means that as an R2, you are the primary surgeon with the attending walking you through the case (as long as you are well prepared and read for the case). At night, usually the senior residents will take the junior through the trauma case with attending supervision as well.

Also, as an R2, you become very proficient in managing consults in the ED and performing reductions. There is resident clinic each week and you get exposure to non-surgical management of patients, you learn indication to operate as well as post surgical management of patients. This is an intense year but with a steep learning curve, you will become some of the best residents in the country by the end of the year.

PGY-III

The PGY-III year generally consists of one three-month rotation at the UC Irvine Medical Center, one three-month rotation of Anatomy and Basic Science Research, and six months of adult reconstruction and pediatric orthopaedics at Mission Hospital. During this year, the resident is to continue to develop clinical and diagnostic skills in both the Emergency Room and outpatient arena with more autonomy being allowed in the outpatient setting. Surgical skills continue to develop. Depending on the training facility at which the resident is located, and at the discretion of the attending physician, major participation of the resident in orthopaedic re-constructive surgery such as joint replacement surgery and spinal surgery is initiated.

The third year currently involves a three month research rotation, a three month rotation at UC IrvineMC and a six month rotation at Mission Hospital (private community hospital).

There are many different research opportunities available with current UC Irvine faculty, although ample facilities and willing faculty members allow research in any area of orthopaedics. Many of the research projects performed have won top awards within the field of orthopaedics and we boast some of the top biomechanics and neuroscience labs within the country. Current areas include neuroscience, biomechanics of the shoulder, elbow, knee, spine, foot and ankle, orthopaedic oncology, and muscle and bone basic science.

The UC Irvine Medical Center rotation is a continuation of the nine months spent at UC Irvine Medical Center during the second year. It is currently a general orthopaedic rotation with emphasis placed on evaluation and care of the orthopaedic trauma patient. Similar to the second year, however, every type of orthopaedic patient is encountered, from outpatient sports and foot & ankle patients, to complicated reconstruction, spine and oncology patients. In hospital call is approximately one out of every four nights.

The Mission Hospital rotation where general orthopaedics is emphasized as well as trauma patients. The difference lies in the private, community-hospital setting. Community trauma (hip fractures, etc…) is more commonplace. (differing from the high-energy, multi-extremity trauma at UC Irvine Medical Center which is still encountered but only about half of what is seen at UC Irvine). In hospital call is also one out of every four nights at Mission; however, most of these nights are not spent awake. It is an opportunity to see the community practice side of orthopaedics as well as different operative techniques as well as patient management. It is a great rotation to prepare one for moving to the next step of leading an orthopaedic service.

You should be comfortable doing performing surgery on all types hip fractures (cephelomedullary, sliding hip screws, percutaneous pinning as well as hemiarthroplasty), ankle fractures/arthrodesis, wrist fractures, total knee (including unicompartmental knees) and total hip arthroplasties, knee arthroscopy and management of all orthopaedic consults. You will be exposed to acetabulum/pelvic fractures, shoulder arthroscopy (rotator cuff and labral repairs) as well as hemiarthroplasty, complex plateau and elbow fractures etc and have performed the approaches to these surgeries and formulates plans on how to fix these fractures. By the end of one’s third year, there are not many cases you have not scrubbed on and do not feel comfortable with.

ROTATION KEY
MISS: Mission Hospital
ANAT: Anatomy, Lab, LBVA Foot Service
UCIMC: University of California, Irvine Medical Center
LBVA: Long Beach Veterans Administration Hospital
CHOC: Children's Hospital of Orange County
GS: General Surgery
VAC: Vacation

Link to PGY-I
Link to PGY-IV and PGY- V

Back to the Residency Program

Dr. Neil Jones joins the Department of the UC Irvine Center for Hand & Upper Extremity Surgery.

Dr. Stuart Green has been featured in the June 2008 Orthopedics Today magazine about his book "Dear Doctor Franklin; Emails to a Founding Father about Science, Medicine and Technology".

Dr. Steven Ross is President of the American Orthopaedic Foot and Ankle Society (AOFAS) in 2007-2008.

Dr. Ranjan Gupta selected as the Sterling Bunnell Traveling Fellow by the American Society for Surgery of the Hand for 2008.

Dr. Nitin Bhatia selected for the AOA-Japanese Orthopaedic Association Exchange Traveling Fellowship for 2008.

Dr. Ranjan Gupta chosen by Orange County Medical Association as a "Physicians of Excellence" and listed in the January, 2008 Orange Coast Magazine.

Dr. Martin Tynan is completing an Orthopaedic Trauma Fellowship and will be returning to UCIMC April, 2008