PGY-1 Rotations

General Orthopaedic Rotation

The 6 months a resident spends on the General Orthopaedic Surgery rotation is one of the more intense learning experience during residency. Direct care of surgical patients is the cornerstone of developing a resident's skills as an internal medicine physician. Residents will begin to gain skills in identifying key history and exam needed to evaluate adults presenting with conditions involving the musculoskeletal systems. The resident will become familiar with common diagnostic imaging procedures when evaluating and managing patients with orthopaedic conditions: plain radiographs, body MRI, CT scan, radionuclide bone scans. During this rotation, residents will begin to make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment.

Emergency Medicine Rotation

During this rotation, Orthopaedic Surgery residents rotate in the Broward Health Medical Center Emergency Department. Our Emergency Department is a Level 1 Trauma Center and exposes residents to large volume and exposure to emergency situations in all levels of acuity. The residents gain an exciting hands-on opportunity to care for adults and pediatric patients.  They learn how to provide acute care services to patients in the Emergency Department and develop an understanding of the criteria for hospitalization versus outpatient therapy of patients with non-life threatening diseases. As a safety net hospital, residents are exposed to a fast paced environment with a variety of medical conditions, levels of acuity, opportunity to be involved in procedures, as well as contributing to patient and family care needs. Residents are supervised on this rotation by Board-certified Emergency Medicine physicians.

Trauma Surgery Rotation

Residents spend two months rotating with the Trauma Surgery team at Broward Health Medical Center. Residents participate in the Trauma Team, responding to trauma cases that present to the Level 1 Trauma center at BHMC. During this time, the residents gain skills in evaluation of pre-operative surgical trauma patients, management of hospitalized postoperative patients, and the surgical care of the injured patient. Residents develop mastery of basic suturing technique, including multi-layer wound closure and complex wound management as well as mastery of basic surgical instrument skills (tools for exposure, hemostasis, retraction, tissue handling, and closure) including aseptic technique and atraumatic soft-tissue handling.

Plastic Surgery Rotation

Residents spend one month rotating on the Plastic Surgery team at BHMC as a first year resident.

Anesthesia Rotation

Orthopaedic surgery residents spend one month rotating in the operating room with Board-certified Anesthesiologists. During this rotation, the residents gain knowledge of the pharmacology of various anesthetic agents and adjuncts to anesthesia and the evaluation and care of a patient undergoing anesthesia. The resident will participate in the pre-, intra-, and post-operative care of the patient undergoing an anesthetic. Residents learn a basic understanding of the physiologic changes associated with the induction, maintenance, and emergence of anesthesia.

Neurosurgery Rotation

Residents spend one month rotating the neurosurgery team. This will allow you to gain operative and clinical experience to evaluate and manage surgical issues with the brain and spine. This also tends to be a highly operative rotation. You will learn valuable lessons regarding care for brain injury patients, microsurgical technique and neurosurgical spine surgery perspectives.

Rotations

PGY-2 through PGY-5 rotations are three months in length.

Orthopaedic Trauma Rotation

Residents spend varying blocks of time on the Orthopaedic Trauma Service during their PGY-2 through PGY-5 years. During the Orthopaedic Trauma Rotation, residents are active participants on the Orthopaedic Trauma service. The Orthopaedic trauma service is separate from the General Trauma service but often works in tandem with the Surgical Trauma Team to care for patients with multiple traumatic injuries. Residents develop the ability to perform closed reduction and manipulations of fractures and dislocations including appropriate casting, splinting, and immobilization. Residents also develop an understanding of common surgical approaches for fracture care. Examples include lateral approach to the ankle, lateral approach to the femur, deltopectoral approach to the shoulder, volar approach to the forearm. Residents gain the ability to perform the approach and find the starting point for femoral and tibial nails. The residents receive comprehensive training in evaluation and treatment of acute trauma of the spine, pelvis, and lower and upper extremities, as well as limb salvage and chronic sequelae of fractures such as non-unions, mal-unions, infection, and post traumatic arthritis. In each successive year, the resident will hone their skills in caring for some of the most severely injured orthopaedic patients.

Pediatrics

Orthopaedic surgery residents spend two - three months blocks in their 2nd and 4th years rotating at the Nicklaus Children's Hospital in Miami. The residents are supervised by a large group of Board-certified Pediatric Orthopaedic Surgeons. Residents learn to identify key history and exam needed to evaluate children presenting with musculoskeletal conditions. Residents identify the role and general scope of practice of pediatric orthopedists; recognize situations where children benefit from the skills of specialists training in care of children; and work effectively with these professionals in the care of children with orthopedic conditions. During this second rotation in Pediatrics, the residents learn to develop and present treatment plans for pediatric orthopaedic conditions, implement treatment plans, both operative and non-operative, with the appropriate supervision of clinical faculty, and perform more complicated pediatric orthopaedic procedures with faculty supervision.

General Orthopaedic Rotation

The General Orthopaedic Surgery rotation continues to build on the intense learning experience of the PGY-1 year. Direct care of surgical patients is the cornerstone of developing a resident's skills as an internal medicine physician. Residents will continue to increase their skills in identifying key history and exam needed to evaluate adults presenting with conditions involving the musculoskeletal systems. The resident will become familiar with more complex diagnostic imaging procedures when evaluating and managing patients with orthopaedic conditions. During these rotations, residents will begin to make more complex informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment. During this rotation, the resident must demonstrate competence in the surgical management of a broad variety of orthopedic diseases. The senior resident must also effectively oversee the appropriate care of patients by the junior residents.

Sports Medicine

Residents on the Sports Medicine Rotation develop the patient care and clinical skills to facilitate adequate evaluation of common shoulder, elbow, knee, and ankle problems seen in the athletic patient population. This includes physical examination of the knee, shoulder, elbow and ankle that facilitate identification of typical findings of sports medicine problems of these joints. Residents have the opportunity to demonstrate surgical skills that include portal placement for and complete diagnostic arthroscopy of the knee and shoulder, arthroscopic partial meniscectomy, harvest of the central-third patella tendon and hamstring tendons for ACL and PCL reconstruction, arthroscopic acromioplasty and deltopectoral approach to the shoulder for anterior stabilization, and open debridement of the medial and/or lateral epicondyle of the elbow. In addition, residents will also have the opportunity to perform other common sports medicine surgical procedures including primary repair and reconstruction of collateral ligament injuries; patellar stabilization procedures; shoulder stabilization, rotator cuff and labral repair, and acromioplasty; UCL reconstruction; distal biceps tendon repair; Achilles tendon repair and ankle stabilization. The residents have a VirtaMed Arthos™ simulator to help enhance their arthroscopy skills.

Foot & Ankle Rotation

Residents spend three months on the Foot and Ankle rotation with Board-certified Orthopaedic surgeons who specialize in the care of foot and ankle problems. Residents develop knowledge and comprehension of common surgical approaches, non-operative and operative treatment options for common foot problems such as bunions, neuromas, hammertoes, plantar fasciitis, Achilles tendinopathies, ankle and foot fractures, tarsal tunnel syndrome, ankle instability, arthritis, and pes planus. Residents will also gain experience with performing surgical procedures including. reconstruction for posterior tibial tendon dysfunction, arthrodesis techniques for complex hindfoot deformities, operative and nonoperative treatment of rheumatologic conditions, acute reconstruction for complex fractures including pilon fractures, calcaneus fractures and complex midfoot fracture/dislocations, and diagnosis and treatment for diabetic foot conditions. The care and treatment of patients with complex neuromuscular disorders is covered on this service, including adults with cavovarus foot deformities and adult patients with deformities after neuromuscular conditions of childhood.

Musculoskeletal Oncology

Residents spend three months rotating with a Board-certified Orthopaedic surgeons who specializes in musculoskeletal oncology, including bone and soft tissue tumors. The resident will learn the appropriate laboratory workup and diagnostic tests best suited for patients with musculoskeletal tumor and tumor-like conditions. This includes the appropriate disease staging studies for those patients with primary bone and soft tissue malignancies, as well as when is it better to be evaluated by a CT scan, an MRI, a bone scan, or PET scan. Residents will develop an understanding of the principles associated with selecting the appropriate type of biopsy and surgical approach and the surgical management of the musculoskeletal tumor patients. The resident is responsible for active participation in the pre, intra, and post-op care of these patients with ample opportunities to participate in basic science and clinical research.

Adult Reconstruction Rotation

During the Adult Reconstruction rotation residents learn to evaluate hip and knee problems in adult patients. Residents participate in the team caring for patients with hip and knee pain pre and post operatively. This rotation offers a broad exposure to both the primary and revision surgery of the hip and knee. The residents are actively involved in the operative and perioperative care of these patients. The residents are expected to participate in the preoperative planning of these frequently complex cases. Additionally, there is ample opportunity for long-term follow-up of adult reconstructive cases in busy follow-up clinics.

Spine Rotation

The resident spends three months on the Orthopaedic Spine service. During this rotation, the residents learn to evaluate, document, and present a patient with spine problems specifying the working diagnosis, studies to confirm or change the diagnosis, treatment alternatives and expected outcomes. Residents perform and assist in essential surgical procedures: posterior cervical, thoracic and lumbar exposure and arthrodesis, anterior cervical approach and arthrodesis, discectomy. They learn to manage patients with spinal cord injuries, degenerative cervical and lumbar pathology as well as complex spinal deformity, tumors and infections.

Hand Rotation

The resident receives intensive education in hand and microvascular surgery. The attending faculty offer excellent and varied teaching throughout the rotation. The goal of the hand rotation is to provide comprehensive training in all aspects of upper extremity. Residents will acquire significant experience in microsurgery, casting and splinting techniques, and basic operative skills.