The Training Program
PGY-I – Consists of a rotational internship. It grants exposure to services helpful in preparing for orthopedic surgery. Rotations include two-to three-month blocks in general surgical trauma, emergency room, anesthesia and medicine, as well as orthopedic surgical services.
PGY-II – Residents are actively involved in the orthopedic trauma service and the hand service.
PGY-III – Provides residents with experience in sports medicine, spine, hand surgery and general orthopedics.
PGY-IV – Residents spend three months as the chief resident on the pediatric orthopedic service. The resident also learns the intricacies of foot and ankle as well as adult reconstructive surgery.
PGY-V – The resident is the chief resident on the general orthopedic service for a six-month block. 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. The off-service chief resident has administrative responsibility as well as clinical responsibilities. The administra-tive chief has an opportunity for elective rotations in various areas including foot and ankle, orthopedic tumor surgery and any areas of interest to the individual resident.
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, are protected time, and are 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 2 year rotating curriculum of orthopaedic essentials, such as pedicatric orthopaedics and basic science, interspersed with case conferences and morbidity and mortality presentations. Lectures are given by attendings as well as residents to keep the resident actively involved in learning and teaching orthopaedics.
Adult Orthopedics/Trauma, Including Multisystem Trauma
Diagnosis and management of adult orthopedic problems is particularly emphasized on the general orthopedic service rotation with Dr. Haidukewych, Dr. Burgess, Dr. Munro, Dr. Kupiszewski and Dr. Langford. The trauma experience is quite extensive since we are a Level I system and one of the busiest in the nation. The exposure to the surgery of the spine, as well as disk surgery, spinal trauma and deformities is obtained both during the pediatric rotation where a great deal of scoliosis and congenital spine problems are managed and also during a dedicated rotation with the spine surgeons.
Led by Dr. David Dore and Dr. Haidukewych 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. The reconstructive experience is augmented with Dr. Haidukewych's complex joint reconstruction expertise focusing on complicated revisions and infection management.
Pediatric Orthopedics, Including Pediatric Trauma
Pediatric orthopedics has traditionally been a strong aspect of the residency going back to the original founding of the program in 1957. Led by Charles Price, MD as well as a very competent traditional faculty of five fellowship trained pediatric orthopedic surgeons it is based at Arnold Palmer Hospital for Children and Women.
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 orthopedist. Dr. Choung is a recent addition to our community faculty and this rotation is well received by our residents. His practice is quite extensive in that there are only two fellowship trained orthopedists in the metro Orlando area.Foot and ankle surgery of children is also learned during the seven month rotation with the pediatric orthopedic service as well as, to a limited extent on the several rotations of the general orthopedic service.
Hand Surgery Hand
Surgery is very effectively the responsibility of Dr. Wadih Macksoud and his associates. Dr. Macksoud has also proven to be an excellent teacher and lecturer and the rotation is one of the favorites of the residents. During this time they also have an opportunity to practice their microsurgical skills in an in vitro model usually done in our laboratory on Friday afternoons.
Diagnosis and management of metastatic disease is included in the general orthopedic service rotation and during a musculoskeletal tumor rotation at the Moffitt Cancer Center in Tampa. While there they work with Doug Letson, M.D., and David Cheong, M.D., both fellowship trained in this specialty. Lectures in musculoskeletal pathology and treatment are given throughout the year by these individuals and in addition the residents attend a musculoskeletal conference off campus yearly directed by Dr. Letson. At ORMC the general orthopedic service will attend with these individuals as well as Craig Jones, M.D. who is a community faculty member fellowship trained in this discipline.
The exposure to the surgery of the spine, including disk surgery, spinal trauma and deformities is obtained both during the pediatric rotation where a great deal of scoliosis and congenital spine problems are managed and also during the dedicated rotation with the adult orthopedic spine surgeons. The resident experience includes clinic time in the spine surgeons' offices where the assessment and management are defined by the resident and attending.The resident experience in adult spine trauma is now included in the spine rotation. Two well trained spine trauma surgeons have joined our clinical faculty to teach this aspect. They are Dr. Nizam Razack neurosurgeon and Dr. Jason Conaughty Orthopedic spine surgeon.
Skill and experience in the diagnosis and management of athletic injuries is gained during an excellent rotation with our sports medicine faculty including Randy Schwartzberg, M.D., Kevin Nowicki M.D., and Bryan Reuss, M.D., all of whom are fellowship trained. As part of this rotation the resident attends high school sport events. As with all specialties extensive lectures are also part of the rotations. The residents receive training in arthroscopy not only on this rotation but also on the general orthopedic rotation.
These statistics represent recent graduates' and residents' operative experience.
Most graduating residents have been involved with 2,000 -3,000 cases. In more than 98 percent of these cases, the residents are either the primary surgeon or the first assistant.
|Approximate Cases ||Number of Cases |
|Adult reconstruction including (total hip, total knee, total shoulder and arthroplasties) ||400 |
|Sports Medicine including arthroscopy and open reconstructions ||600 |
|Trauma including foot and ankle ||600 |
|Hand and Upper Extremity ||500 |
|Spine ||100 |
|Foot and Ankle Reconstruction ||70 |
|Pediatrics ||200 |
|Tumor* ||20 |
|Total Cases ||2,470 |