Clinical Training

Intern Skills 2016

PGY-I

The PGY-I year includes 1 month of intern skills, 3 months of general surgery, 6 months of orthopaedic surgery, and rotations in anesthesia at both University of Michigan Health Center as well as the St. Joseph Mercy Health System.

PGY-II

At the beginning of the PGY-II year, the residents are in orthopaedic surgery full time. The University subspecialty-based rotations include trauma, adult reconstruction (total joints), pediatric orthopaedics, foot and ankle, and spine as well as at the Veteran’s Administration Hospital. Additionally, residents rotate during each PGY year to St. Joseph Mercy Hospital, our affiliate, where they work with community based orthopaedic surgeons.

PGY-III

PGY-III rotations include hand and upper extremity, trauma, pediatric orthopaedics, and sports medicine. Residents also have a dedicated 6 week research block during this year. The goal of resident research is to provide residents with the opportunity to develop a greater understanding of the scientific literature and participate in the advancement of orthopaedic science. Resident papers are often published in notable journals, such as the Journal of Bone and Joint Surgery, American Journal of Sports Medicine, Journal of Orthopaedic Trauma, and Journal of Pediatric Orthopaedics.

PGY-IV

PGY-IV rotations include tumor, adult reconstruction (total joints), pediatric orthopaedics, sports medicine, and spine.

PGY-V

PGY-V rotations include hand and upper extremity, trauma, adult reconstruction (total joints), pediatric orthopaedics, and sports medicine as well as seeing patients at the Veteran’s Administration Hospital.

Rotations

The residents rotate on ten different services spending six weeks to two months on each service at a time. In general, each service consists of a chief, a mid-level resident and a junior resident. Most of the services have mid-level providers (either a Physician’s Assistant or Nurse Practitioner) who assist in clinic, with H&P’s, and occasionally in the OR.

When rotating on a University Hospital service and at the VA, the residents are responsible for their staff’s clinic and OR. The chief resident on each service assigns resident coverage according to educational value and equitable exposure to operative and clinical experience.

Joint Reconstruction

The Joint Reconstruction service has five attendings, Drs. David Blaha, Brian Hallstrom, Joe Maratt, Aidin Eslam-Pour and Andrew Urquhart. The Joint Reconstruction service (SJO) consists of an HO I, II, IV and V along with several physician extenders. This service performs complex adult reconstructive cases including total hip and knee arthroplasty.

Spine

The Spine service (SMO) currently has 2 attendings, Dr. Rakesh Patel and Dr. Ilyas Aleem. The Spine service consists of an HO II and HO IV along with a physician assistant. Graduating residents will have completed 4 months on the adult spine service.

Foot and Ankle

The Foot and Ankle service has three attendings, Drs. James Holmes, Paul Talusan and David Walton. The Foot and Ankle service consists of an HO II, HO IV and a physician assistant. Graduating residents will have completed four months on the Foot and Ankle Service.

Hand

The Hand Service (SHO) at the University has three attendings, Drs. Jeff Lawton, Kagen Ozer and John Lien. The service consists of an HO III, HO V and a physician’s assistant. Hand call is divided between this service and plastic surgery. This service is done for 2 months as an HO III and HO V. The Hand service takes care of everything from simple hand cases, such as trigger fingers and carpel tunnel to complex cases such as digital replants. Additionally residents will perform simple wrist cases such as scaphoid fractures to complex wrist cases, such as wrist instability. Furthermore, a resident’s operative experience will include simple elbow cases, such as non-displaced radial head fractures, to complex elbow reconstructions including total elbow arthroplasty. This service also takes care of congenital hand disorders and obstetric brachial plexus palsies.

Tumor

The Tumor service has two attendings, Drs. Sybil Biermann and Geoff Siegel. Residents rotate on the oncology service for two months as a HO IV, working with a Physician’s Assistant, as well as a clinical nurse practitioner. The Tumor service manages benign and malignant primary bone and soft tissue tumors, as well as bone metastasis. This service does large limb salvage procedures using implants and/or allograft.

Trauma

The Trauma service currently has three attendings, Drs. James Goulet, Aaron Perdue and Mark Hake. The service consists of an HO I, II, HO III, HO V, and several physicians’ extenders. The trauma services manages acute trauma such as tibia and femur fractures, as well as complex pelvic and acetabular fractures. In addition, other elective reconstructive procedures are done, such as periacetabular osteotomies and adult limb lengthening. The PGY II is assigned to cover the ER and emergency consults during the daytime hours, with a night float system providing night call coverage that is the PGY III’s responsibility.

Pediatric Orthopaedics

The Pediatric orthopaedic service has six attendings, Drs. Matthew Abbott, Michelle Caird, Clifford Craig, Frances Farley, Robert Hensinger and Ying Li. The service consists of a HO II, HO III, HO IV and HO V. There are also two Nurse Practitioners and a part time Physician’s Assistant who help with clinic as well as inpatient responsibilities. On this service, you will take care of the entire spectrum of pediatric orthopaedics, including scoliosis (idiopathic, congenital, neuromuscular), developmental dysplasia of the hip, clubfeet, trauma and adolescent sports medicine.

Sports Medicine

The Sports Medicine service has six attendings, Drs. Asheesh Bedi, James Carpenter, John Grant, Bruce Miller, Edward Wojtys and Mike Freehill. The service consists of an HO V and HO III, as well as several Physician Assistants. In addition, Drs. Tariq Awan, Jeff Housner, and David Alvarez, fellowship trained in non-operative sports medicine, participate in the care of UM and EMU athletes and the USA Hockey program. Residents spend eight months on the Sports service. The Sports service takes care of patients with knee ligament injuries (ACL or PCL tears), shoulder instability and arthritis, ankle and elbow injuries. The clinic is located off-site in the newly expanded Domino’s Farms and is known as MedSport. It is connected with the physical therapy facilities there. The service provides care for the sports teams for the University of Michigan and Eastern Michigan University as well as the USA Junior National Hockey team.

VAMC

The orthopaedic service at the Ann Arbor VA is directed by Dr. Josh Miller, with the assistance of emeritus faculty, Dr. Dean Louis. Other UM orthopaedic faculty are available for special cases and clinics as needed. Residents rotate at the VA for 2 months as an HO V and HO II.

A&R (Anatomy and Research)

Prior to graduation, you are required to complete a publishable quality research project, which can be either a clinical or basic science project. As an HO III, there are 6 weeks in which you may work on clinical or bench research, or work on anatomy project may be completed. This is not enough time to complete a major project, but it is expected that most of the setup work would have been done prior to and the completion of the manuscript after these 6 months.