Orthopaedic Surgery Lab Coats

Resident Life at the Medical College of Wisconsin

Beyond conferences and operating room experiences, residents in our program develop special relationships, friendships and mentorships. At MCW, residents and faculty work in a collegial environment which foster important experiences beyond just orthopaedic surgery education.
Resident Life

Program Overview

The orthopaedic surgery education at the Medical College of Wisconsin has a long and successful tradition. Our goal is to provide a well-monitored academic environment for achieving excellence in the diagnostic, cognitive, therapeutic, and technical skills essential in the treatment of congenital, acquired, traumatic, infectious, and degenerative diseases and conditions affecting the musculoskeletal system. The orthopaedic program places a strong emphasis on mentoring. The resident will be exposed to the entire spectrum of orthopaedic specialties, and participate in the practice of both general and sub-specialized orthopaedics in both academic and private practice settings. Graded responsibility is present throughout the training years providing residents with opportunities for decision-making, clinical care, and surgical experience. These broad experiences prepare our residents for outstanding careers in either academics or private practice orthopaedics. Specialty services at Froedtert Hospital include Spine, Hand and Upper Extremity, Sports Medicine, Orthopaedic Oncology, Adult Reconstruction, Foot and Ankle, and Orthopaedic Trauma. Specialty services at Children’s Wisconsin include Congenital Foot and Hand Deformities, Hip Dysplasia, Spina Bifida, Cerebral Palsy, Scoliosis, Pediatric Orthopaedic Trauma, and Sports Medicine.
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Year 1
PGY-I residents spend one-month rotations on general trauma surgery, vascular surgery, orthopaedic medicine consult, plastic surgery, radiology, surgical intensive care unit, orthopaedic bioskills, orthopaedic hand & upper extremity, general orthopaedics at the VA medical center, pediatric orthopaedics, and two months of the adult orthopaedic/trauma surgery.
Year 2
PGY-II residents spend 10 weeks each on the pediatric orthopaedic service, hand and upper extremity service, adult reconstruction service and 20 weeks (2 separate 10-week rotations) on the orthopaedic trauma service.
Year 3
PGY-III residents spend 10 weeks each on the oncology service, foot and ankle service, spine service, sports medicine service, and the VA medical center.
Year 4

PGY-IV residents spend 10 weeks each on the orthopaedic trauma service, pediatric orthopaedic service, hand and upper extremity service, adult reconstruction service, and at the VA medical center.

Year 5
PGY-V residents spend 10 weeks each on the orthopaedic trauma service, the pediatric orthopaedic service, the VA medical center, sports medicine service, and an elective rotation at a local private hospital of their choice.

Conferences

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Core Curriculum

The resident’s core conferences are held on Monday, Wednesday, and Fridays. The program’s core conference schedule is regularly scheduled didactic sessions that review established and evolving biomedical, clinical, and epidemiological information, and the application of this knowledge to patient care. Conferences are organized by specialty, with each section having 18 conferences per year. Specialty divisions repeat the subject matter every two years such that each resident will review each topic at least twice during their residency. All resident, including PGY1 residents on non-orthopaedic rotations, attend all conferences. Conferences are formatted to provide core orthopaedic knowledge and promote the evaluation of medical literature and research. With their iPads, residents have unlimited access to the MCW library database, as well as electronic subscriptions to major orthopaedic journals for literature which support this endeavor. The core curriculum runs September through June of each academic year.

Anatomy

All resident, including PGY1 residents on non-orthopaedic rotations attend two hours of Anatomy instruction per week during the months of July and August. Pro-sections are prepared by assigned residents with a faculty member. Faculty, together with a senior resident and a junior resident, are selected to present based on the region of the body being discussed. Presentations include the relevant local anatomy and surgical exposures.

Basic Science

The Orthopaedic Basic Science Conference didactic series occurs every Wednesday for an hour during the months of September through June. The two-year lecture series covers all basic science topics in the current editions of the AAOS Orthopaedic Basic Science: Foundations of Clinical Practice and the AAOS Orthopaedic Knowledge Update.

Basic science is also integrated into other aspects of the resident’s experience through the inclusion of relevant basic science material in other didactic sessions including: Core Specialty Conferences, Grand Rounds and M&M Conferences.

During clinical rotations and daily clinical patient care activities, relevant basic science material is integrated as it applies to the diagnosis, treatment, and management of clinical orthopaedic disorders. For example, residents experience and learn topics pertaining to orthopaedic infections in the treatment of a patient with a postoperative infection. Residents learn principles of bone regeneration during intra-operative discussions regarding fracture fixation.

Grand Rounds

Grand Rounds is an hour conference held on Wednesdays. Faculty members, visiting professors, fellows, PGY-5 residents, and PGY-4 residents present topics of their choice. The conference is primarily a didactic session designed to represent cutting-edge knowledge and regularly includes treatment indications, clinical outcomes, complications and evidence-based guidelines. All residents PGY1-PGY5 attend this conference as well as faculty and fellows. Grand Rounds runs September through June each academic year.

Journal Club

Journal club is organized by a small group of residents and faculty and held at the end of each rotation. Articles from core and specialty orthopaedic journals are selected by the faculty. Residents are then assigned these papers and are expected to present to the group. The discussions examine the scientific methods of the studies and their clinical relevance. Each paper is critically reviewed followed by a group discussion. The goal of journal club is to promote evidence-based medicine, remain up–to-date, demonstrate continuing medical education, and learn critical appraisal skills.

Morbidity and Mortality

Morbidity & Mortality Conference is held at regular intervals through out the academic year as part of the core curriculum. Residents on each service compile lists of cases performed and complications. Dr. JC Neilson, the department patient safety officer, reviews the reported complications and chooses cases for discussion. The residents present the cases in a manor similar to Orthopaedic Surgery Oral Boards, with 2 reviewers asking the resident questions. The residents are expected to prepare ahead of time and have reviewed the literature as applied to their case. As appropriate, evidence based medicine principles are used to improve medical knowledge and patient care. Residents discuss physician and system errors, patient safety issues, and methods of improvement. All residents PGY1-PGY5 attend this conference as well as faculty. The review at M&M includes the residents performing an evaluation of the system, as well as a critical self-evaluation, to identify errors that produced the outcomes. The role of different specialists and other health care professionals in overall patient management are identified. The resident identifies breakdowns in the system, any role that they played in it, and ways to prevent future errors. M&M runs September through June each academic year.

Experiences Beyond Education

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AAOS Annual Meeting

Each year the department sponsors the chief resident’s trip to the American Academy of Orthopaedic Surgeons Annual Meeting.

AO Fracture Course

Each year the department sponsors the PGY 2 residents’ attendance to the AO Basic Fracture Course.

Camp Schwab

We welcome our new PGY1 residents to the Department of Orthopaedic Surgery with a two day orientation. The first day starts off with a continental breakfast with the chair, Dr. King, and the PGY2 residents. Residents receive their i-pads, lab coats, pagers, books, and are fitted for lead and loupes.

The PGY1 residents continue with training sessions including introduction to sterile technique and the operating room, application of casts and splints, basic suturing and knot tying, behavior expectations and code of conduct, CPT and case log coding, and clinic operations and expectations. There is also 4 hours of instruction for the PGY5’s.

Topics include CPT coding, being an effective teacher and leader, and how to evaluate junior residents or medical students.

Graduation Week 
Graduation is a time of celebration. Our PGY5 graduates are recognized for their academic accomplishments at the end of the year with a week of celebratory events, followed by a traditional formal dinner. Events for the week include:
  • Jeopardy: Orthopaedic Jeopardy is a long-standing graduation tradition for the Department of Orthopaedic Surgery. Every year the faculty and residents separate into three teams who compete in orthopaedic related jeopardy questions. Drs. Schwab and Schmeling host the game and the residents on the Trauma team are the judges. It is also tradition for the PGY2 on the trauma service to dress up as “Vanna”, the game scorekeeper.

  • Annual John S. Gould Lectureship & Scientific Day: The John S. Gould Lectureship is the Department’s annual scientific program associated with graduation. Each year a nationally recognized orthopaedic surgeon is invited as visiting professor and gives a Grand Rounds lecture. Graduating residents, graduating fellows, other residents and graduate students present their research. Residents also give case presentations to the visiting professor. Residents compete for a $500.00 award for the best paper submitted as a manuscript to the Lectureship organizing committee.

  • Graduation Dinner and Ceremony

  • Annual Golf Outing: The annual graduation golf outing is a long-standing tradition for the day after graduation. Faculty, residents, family, and alumni play an 18 hole round of golf. There are multiple prizes provided for different contests throughout the day.

  • Skits & Picnic: A time to roast the graduates, faculty, and staff. The celebration is hosted completely by the PGY4 residents and their families. It is the highlight of the year with faculty, residents, family, hospital and clinic staff all in attendance.
Milwaukee Orthopaedic Society

A local society of orthopaedic surgeons, which meets four times per year to hear an invited speaker. Residents are invited to attend as sponsored guests. One meeting per year is dedicated to the graduating residents for presentation of a case report.

Nicaragua Mission

As part of MCW’s orthopaedic surgical training program, fifth year residents have the opportunity to participate in an international externship with Milwaukee Orthopaedics Overseas (MOO).

Wisconsin Orthopaedic Society

A state society of orthopaedic surgeons, including residents from the two academic residency programs in Wisconsin (MCW and UW). All MCW residents, PGY2-PGY5, are excused from clinical duties to attend the meeting. The purpose of the Wisconsin Orthopaedic Society is to enhance the commitment of the practicing orthopaedic surgeons in Wisconsin to stay abreast of current information and advancements in the dynamic practice of modern orthopaedic surgery. This is encouraged by members and by selected guest speakers and annual meetings.

Participation in this annual program affords Orthopaedic physicians, residents, interns, medical students and allied health care personnel the opportunity to:

  • Update their knowledge and skills and professional performance and relationships that a physician uses to provide services for patients, public, or the profession.
  • Discuss clinical information in an educational setting where common concerns can be expressed and relevant experiences shared.
  • Describe both established procedures and recent advances in orthopaedic diagnosis and treatment.

Resident Resources

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Library Guide
The MCW Library Resource for includes databases, journals, books and library tools for Orthopaedic Surgery.

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