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 The Orthopaedic Surgery Residency ProgramMark E. Baratz, M.D., Program Director Length of program: 5 years Two residency positions are available at each of the four program levels. Residents rotate through the following areas during that time:
Residents rotate through the various offices for outpatient training. Clinical ServicesFractures and TraumaAs a Regional Resource (Level I) Trauma Center accredited by the Pennsylvania Trauma Systems Foundation, Allegheny General Hospital has one of the state's busiest emergency departments. The Orthopaedic Trauma Service treats a variety of orthopaedic injuries but specifically includes care of multiply traumatized, severely injured patients. The Trauma Service also places particular emphasis on its extensive reconstruction program, which focuses on malunions, non-unions and osteomyelitis. Residents in the Orthopaedic Trauma Service rotation receive experience and training particularly in the area of blunt trauma. Their hands-on experience is reinforced by a dedicated clinical research program and access to the hospital's Trauma Registry, which dates back to 1981 and contains information on thousands of patient cases. Other areas of support to residents include clerical staff, computers and a library dedicated to orthopaedic trauma and research in the department's private offices. In addition, faculty members coordinate the Motor Skills Laboratory, which takes place every week during July and August. Trauma Service faculty members are regularly involved in the diagnosis, evaluation and treatment of fracture and trauma patients. Faculty members staff the Orthopaedic Trauma Service 24-hour call, which is separate from the General Orthopaedic Service call duty. Upper-Extremity Surgery Surgeons at Allegheny General Hospital treat a variety of ailments of the upper extremities - from replantation of a limb to carpal tunnel release. The Upper-Extremity Surgery Service of the Department of Orthopaedic Surgery is dedicated exclusively to arm, shoulder and hand problems and also includes a referral center for replantation of the severed or critically wounded arm. During rotation in this service, residents are involved in the treatment of acute upper-extremity injuries as well as the reconstruction of congenital, arthritic and post-traumatic injuries. This experience is supplemented by an adult outpatient experience. Residents are given the opportunity to develop microsurgical skills in the hospital's Microsurgical Laboratory. Sports Medicine Through the Sports Medicine Service in the Department of Orthopaedic Surgery, residents gain experience in the care of athletes from a major university sports program, high school sports teams, as well as a professional baseball team. They also have the opportunity to become involved in general training room activities. Residents follow athletes through a comprehensive approach to sports med-icine injuries, from diagnosis to treatment to rehabilitation. The Allegheny General Hospital/Duquesne University Sports Medicine Institute was completed in fall 1994 on the campus of Duquesne University. The Sports Medicine Institute is a comprehensive center with full rehabilitation and X-ray capabilities. It is a unique combination of the clinical excellence of Allegheny General Hospital and the academic faculty of Duquesne University. In addition, it houses a sophisticated gait laboratory, a state of the art metabolic laboratory and a cadaveric anatomy laboratory to assist in both clinical teaching and basic science research efforts. Residents are required to participate in clinical and research activities at the Sports Medicine Institute during their rotation on the Sports Medicine Service to learn the day-to-day management skills of a team physician. They also aid in coverage of mass events, the Great Race, high school, university and professional athletes. Sports medicine physicians provide the following for patient-athletes:
Joint Reconstruction and Replacement Resident training in joint reconstruction is guided by faculty members who are regularly involved in caring for patients through this area of orthopaedic medicine. Residents are expected to participate in a weekly joint reconstruction conference that requires critical analysis of case material for case presentation. Clinical and pathological correlations are emphasized. The purview of joint reconstruction includes juvenile, adult and geriatric arthritic conditions and encompasses experiences in congenital, metabolic and post-traumatic disorders. Residents become familiar with various surgical techniques, including arthroscopy, osteotomy, surface replacement arthroplasty, total joint arthroplasty and revision joint arthroplasty. The diverse training background of the faculty helps to enrich the inpatient and outpatient clinical experience. Outpatient joint reconstruction care is a weekly feature of the rotation. Residents also work closely with the hospital's divisions of Rheumatology and General Internal Medicine. Pediatric Orthopaedics Residents participate in the Pediatric Orthopaedic Service and work with specially trained pediatric orthopaedic surgeons to help children reach maximum functioning for walking, sitting and daily activities. This training includes treatments for conditions such as bone tumors, cerebral palsy, club foot, dislocated hips, slipped femoral epiphysis, muscular dystrophy, Perthes disease, scoliosis, skeletal dysplasia and spina bifida. Residents become familiar with modern technological advancements - the use of stainless steel rods, screws and fasteners fitted specifically for children to correct most scoliotic and other spinal deformities, and casting, nails, titanium plates and screws for fractures and congenital deformities of the musculo-skeletal system. Rehabilitation Residents become involved in the pre-prosthetic and prosthetic processes and participate in multidisciplinary team discussions at the monthly Amputation Clinic. Here, an orthopaedic surgeon, physiatrists, residents, a prosthetist and physical and occupational therapists review each patient's case and treatment progress. Residents receive instruction on bracing, retraining and gait retraining in multiple-fracture patients as well as the proper use of orthopaedic modalities in continuing care. Residents also have the opportunity to visit a rehabilitation facility and review postorthopaedic surgery patient cases. Orthopaedic Spine The Orthopaedic Spine Service evaluates and treats an array of clinical problems involving both adult and pediatric spinal pathology. Several hundred procedures are performed annually to treat fractures, deformities, degenerative conditions and tumors. These procedures include both anterior and posterior approaches to the cervical, thoracic and lumbar spine. Monthly conferences are conducted to discuss surgical indications and topics of particular interest. In addition, there is a monthly scoliosis conference that reviews the surgical management of spinal deformities. For residents interested in pursuing an academic career, independent research activities may be pursued during PGY-4. Many of the Department of Orthopaedic Surgery's clinical services are involved in research projects specific to their areas. Microsurgical Laboratory Course As part of its curriculum, the Department of Orthopaedic Surgery offers residents a two-day workshop to provide an opportunity to master precise, hand-eye coordination needed during microsurgery. The course gives residents an opportunity to receive:
Residents have access to information in the hospital's Trauma Registry, which was created in 1981 for the purpose of collecting data on all trauma admissions. This data collection effort has resulted in an extensive clinical, epidemiologic and demographic database that is used for research, administrative and planning purposes. More than 29,000 cases are part of the registry. Educational ProgramThe Orthopaedic Surgery Residency Program offers a PGY-1 component to its educational program. This year allows residents to acquire many of the skills necessary to effectively complete the Orthopaedic Surgery Residency Program.Clinical Rotations
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