Rotations In Orthopaedic Surgery - PGY IV and PGY V

PGY-IV

The PGY-IV year resident spends six months at Children's Hospital of Orange County (CHOC) which specializes in children. The second six months is done at Mission Hospital. The longitudinal development of the resident's evaluation and management of adult and pediatric orthopaedic problems continues. After 6 months at CHOC in the PGY-IV year, the resident should have the foundation to treat all pediatric problems he/she is likely to encounter in practice. There is emphasis on patient evaluation for elective procedures, identification of surgical and non-surgical options, preoperative planning, and acquisition of more advanced technical skills.

Currently the PGY 4 year at UC Irvine is divided into two 6 month rotations: Children’s Hospital Orange County and Mission Hospital. Mission Hospital is a bustling private, level 2 trauma center in South Orange County. Surgical cases at Mission are diverse; including joint replacement, sports, pediatrics, hand, foot and ankle and trauma. Cases are done one-on-one with the attending and generally speaking there are more cases happening than residents to cover them. There are two 4th year and two 3rd year residents rotating there at any one time. Mission affords residents an opportunity to truly expand their surgical skills while being exposed to a wide variety of attendings and their surgical techniques and management plans. In addition, residents have an opportunity to work one-on-one with attendings in their clinics and are involved one half day a week at a free clinic in Orange County seeing the orthopaedic patients. This rotation is a continuation of the experience seen as a third year resident, but as a fourth year, you are performing surgery on the more complex cases you were assisting on as a third year. You also begin to fine tune your ability to plan for the cases, choose your instrumentation and post operative care of the patients.

Children’s Hospital Orange County (CHOC) is a tertiary care center in Orange County just east of UC Irvine. CHOC has great exposure to a wide assortment of pediatric cases for the two 4th year residents and one DO resident rotating. Surgical cases include trauma, syndactyly, spine, cerebral palsy, spina bifida, dysplasias, tumor and more. In addition to great one-one-one exposure in the OR we have the opportunity to see patients in the attendings’ private clinics and fine tune the pediatric history and physical exam. At CHOC we take call from home about 1 in 3 nights. Call nights there are generally busier in the summer with reductions, etc than in the winter, but definitely tolerable.

ROTATION KEY
MISS: Mission Hospital
CHOC: Children's Hospital of Orange County

PGY-V

The PGY-V year resident spends 6 months at UC Irvine Medical Center and 6 months at the Long Beach Veterans Administration. The PGY-V year requires the assumption of responsibility for primary decision making and patient evaluation and management. The assumption of responsibility for care of the full spectrum of trauma and elective orthopaedic cases, under the direction of faculty, is expected. The supervision and teaching of junior residents, interns, and medical students is also required. Administrative duties are assumed. Although major decision-making responsibilities have been assumed, staff directly supervises all surgical procedures and questions of patient management.

As a chief resident, we do a six month rotation at UC Irvine and six months at the VA. The chief residents act as attendings during the year in that they manage the orthopaedic services, orchestrate the OR cases and help run resident clinic. All clinics and OR cases are supervised, but the chief resident is usually able to make appropriate decisions in managing patients and attendings are there for guidance and help in polishing operative indications as well as techniques and post operative management etc…

There are not any cases chief residents do not feel comfortable tackling during this year (except for complicated spine cases probably), and this year is used to fine tune one’s skills. This year is also a great year to help educate junior residents and help them progress quickly early on during their residency as well. The chiefs are very comfortable in walking the juniors through cases that come through the ED during the night/day.

The VA is a unique experience as it is run like one’s own private practice. You have your own clinic, sign up your own patients for surgery, perform the surgery and follow them post op for six months. You also learn to manage patients non-surgically as well. There is always an attending available at clinic and the OR, but this is an opportunity for you to act as if you are on your own (with constant backup).

Call is from home and is one weekend a month during the VA rotation. During the UCI rotation, weekday call is splint among the two chiefs and they also take one weekend a month.

ROTATION KEY
UCIMC: University of California, Irvine Medical Center
LBVA: Long Beach Veterans Administration Hospital
* Denotes Administrative Chief

Link to PGY-I
Link to PGY-II and PGY- III

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