Orthopedic Residency Training

The Training Program


PGY-I
– Grants exposure to services helpful in preparing foundation for a well rounded orthopaedic surgeon. Rotations outside of orthopedics include one month blocks in general surgical trauma, plastic surgery, infectious diseases, burns/icu, vascular surgery and neurosurgery. For the orthopedic services four months are on our general orthopedic green and gold services. These teams consists primarily of orthopedic trauma along with adult joint reconstruction, sports and foot & ankle components. Each intern also spends one month during the first half of the year on the orthopedic trauma night float service alongside a third year teaching resident, followed by another month of night float in the winter/spring.

PGY-II – Consists of three months on the general orthopedic green team focusing on trauma, foot and ankle and joint reconstruction. An additional three months is spent on the general orthopedic gold team focusing on trauma, joint reconstruction and sports. Residents spend five months together with a fourth year resident on the hand surgery service (2 months) and pediatric surgery service (3 months). The remaining month is spent on the orthopedic trauma night float service.

PGY-III – Residents are involved in three month rotations in Sports and Spine. Two months are dedicated to Foot and Ankle. Two months on the Trauma team which are primarily operative in working alongside our Trauma Fellow. One month is allocated towards research, and one month is spent as the teaching resident on night float with an intern.

PGY-IV – Residents spend three months each as the chief resident on the pediatric and hand orthopaedic services working with a second year resident. This year also consists of a three month rotation dedicated to adult joint reconstruction. Further exposure to Orthopedic Oncology is obtained by spending one month at Shands Hospital at the University of Florida in Gainesville. A unique mentorship also occurs this year working one-on-one with two of our faculty members focusing on Hip & Knee Reconstruction as well as Shoulder and Elbow. One month is also allocated towards research.

PGY-V – During the chief resident year it is expected that the knowledge gained over the previous four years will be applied in clinical decision making as well as the applied operative technique with staff supervision. Three months are spent as the general orthopedic gold service chief and three months as the general orthopedic green chief. The remaining six months consists of three months as administrative chief and three months of elective rotations in various areas of interest to the individual resident.

Didactics
There is a dedicated hour of conference every day except for Friday in which there is a two hour grand rounds. Our conferences are very important to us and are protected time and uninterrupted by other services or responsibilities for their entirety. Conferences are well balanced to cover the essential learning objectives that are required for success on board style exams such as OITE and licensure examination. Our academic calendar is a two year rotating curriculum of orthopaedic essentials, interspersed with case conferences and morbidity and mortality presentations, as well as guest lecturers. Lectures are given by attendings as well as residents to keep the resident actively involved in learning and teaching orthopaedics.

Orthopaedic Rotations:


General Orthopedics Green & Gold Teams

Adult orthopaedics/Trauma, including multisystem trauma. Diagnosis and management of adult orthopaedic problems is particularly emphasized on the general orthopaedic service rotation. The trauma experience is quite extensive since we are a Level I system and one of the busiest in the Southeast.

- Gold: Drs Haidukewych, Koval, and Kupiszewski; In addition to the trauma aspect this team offers exposure to high volume elective joint replacement including knee, hip and shoulder arthroplasties. Dr. Haidukewych also has an extensive revision hip and knee arthroplasty practice. Furthermore, gold team is our residents first exposure to Sports style surgery through Dr. Kupiszewski with multi-ligamentous knee reconstructions, as well as various shoulder and knee arthroscopies.

- Green: Drs Langford and Munro; In addition to the trauma aspect this team offers expsure to many foot and ankle procedures and limb deformity correction through Dr. Langford’s practice. Furthermore, both surgeons routinely perform anterior total hip arthroplasties as well as total knee replacements.


Adult Reconstruction

Led by George Haidukewych, MD the joint reconstructive service offers a comprehensive experience for the resident in both clinical and surgical joint reconstruction. Residents are exposed to a variety of joint disorders, which include but are not limited to total joint procedures, degenerative osteoarthritis, rheumatoid arthritis, posttraumatic arthritis, osteonecrosis, dysplasia, and hemophilic/sickle cell arthroses.

Pediatric orthopaedics, including pediatric trauma

Pediatric orthopaedics has traditionally been a strong aspect of the residency going back to the original founding of the program in 1957. Led by Jose Herrera-Soto, MD as well as a very competent traditional faculty of four fellowship trained pediatric orthopaedic surgeons it is based at the nationally recognized Arnold Palmer Hospital for Children, which is the only Level One Pediatric Trauma Center in Central Florida.

Foot and Ankle
Office, surgical and non-surgical experience is gained by a dedicated rotation with Steven Choung, M.D., who is a foot and ankle fellowship trained orthopaedist. Dr. Choung’s practice is quite extensive in that there are only two fellowship trained Foot and Ankle orthopaedists in the metro Orlando area. Foot and ankle surgery of children is also learned during the rotation with the pediatric orthopaedic service as well as the rotations of the general orthopaedic service.

Hand surgery

The Hand surgery rotation is led by Brett Lewellyn, MD. This is one of the busier services at Orlando Health. Residents receive a high operative volume, well balanced training with regards to trauma and elective procedures over the entire upper extremity. All of our hand attendings are trained in microvascular surgery and a large coverage area spanning North and Central Florida.

Musculoskeletal Oncology

Diagnosis and management of orthopedic oncologic disease is included in the general orthopaedic service rotation and during a musculoskeletal tumor rotation at UF Health in Gainesville. While in Gainesville the residents work with Mark Scarborough, M.D., and Parker Gibbs, M.D., and Andre Spiguel, M.D. all fellowship trained in this specialty. Lectures in musculoskeletal pathology and treatment are given throughout the year by these individuals and in addition the residents in the PGY4 year attend a musculoskeletal conference off campus yearly directed by Dr. Scarborough. While in Gainesville housing is provided for the fourth year resident during this rotation.

Spine

The exposure to surgery of the spine, spinal trauma and deformities is initiated as an intern with Neurosurgery. It is expanded upon during both during the pediatric rotation, where a great deal of scoliosis and congenital spine problems are managed, and during the dedicated adult spine rotation with Drs. Flynn and Stewart during third year.

Sports
Led by Daryl Osbahr, MD the Sports rotation focuses on diagnosis and management of athletic injuries. As part of this rotation the resident attends various sporting events including coverage of high school athletic and Orlando City Major League Soccer team. The residents receive training in arthroscopy not only on this rotation but also on the general orthopaedic rotation.

Approximate Case Volume


Adult reconstruction including (total hip, total knee, total shoulder and arthroplasties) - 400
Sports Medicine - 600
Trauma - 600
Hand and Upper Extremity -500
Spine - 100
Foot and Ankle Reconstruction - 70
Pediatrics - 200
Tumor* - 20

Total Cases - 2,470