Curriculum

Orthopaedic Residency Curriculum

Dignity Health St. Joseph’s Medical Center Orthopaedic Residency five-year program offers a robust and comprehensive training experience with opportunities to rotate to several affiliated institutions, including Alpine Orthopaedics, San Joaquin General Hospital, Plastics Surgery Center of Stockton, UC Davis Hospital, Shriners Hospitals for Children - Northern California, and Children’s Hospital Oakland. The core curriculum for orthopaedic residents comprises a series of learning modules. The modules focus on basic and advanced topics outlined in the American Board of Orthopaedic Surgery (ABOS) examination content outline, ABOS certification requirements, leadership and healthcare systems fundamentals, and essential clinical skills.

Clinical Base Year (CBY)

The categorical positions begin with an integrated internship at Saint Joseph Medical Center. The internship is designed to offer the intern a foundation in medical and surgical specialties, and an introduction to orthopaedic surgery. The curriculum of the year is divided into four-week block rotations.

Clinical Base Year (CBY) rotation schedule

Orthopaedic year 1 (PGY-1) rotation schedule

The PGY-1 residents on the orthopedics surgery service will evaluate and manage patients presenting with musculoskeletal complaints; including, but not limited to, the following: traumatic injuries to the extremities (fractures, dislocations, amputations, sprains, contusions, lacerations, puncture wounds, and bite wounds), joint swelling/pain (infections or inflammatory etiologies), extremity pain resulting from overuse.

Rotation – Length

Anesthesiology – 3 weeks
Emergency Medicine – 4 weeks
General Orthopaedics – 20 weeks
General Surgery – 4 weeks
Hand – 4 weeks
General Surgery - Intensive Care Unit – 3 weeks
General Surgery - Physical Medicine and Rehabilitation – 4 weeks
Plastics (Plastic Surgery Center of Stockton) – 3 weeks

Orthopaedic Surgery Year 2 (PGY-2)

The resident will participate in performing the primary and secondary trauma surveys and necessary interventions of all patients evaluated by the Surgical Service and ED Trauma Team. The resident will participate in the care of patients requiring operative interventions at the discretion of the Supervising Surgical Attending. The resident will also assume the primary responsibility for ongoing inpatient care, including the surgical, telemetry, and ICU levels of care, at the direction of the Supervising Surgical Attending.

Orthopaedic Surgery year 2 (PGY-2) rotation schedule

Rotation – Length

Adult Reconstruction – 7 weeks
General Orthopaedics – 4 weeks
Hand – 7 weeks
Musculoskeletal Oncology (US Davis) – 8 weeks
Pediatric Orthopaedics (US Davis) – 8 weeks
Sports Medicine – 7 weeks
Trauma (San Joaquin General Hospital) – 8 weeks

Orthopaedic Surgery Year 3 (PGY-3)

The orthopaedic spine rotation will enable residents to obtain adequate clinical and surgical skills in all areas of orthopaedic surgery for medical practices. Residents will participate in patient care in in-patient and out-patient settings, as well as in the operating room. The residents will be under close faculty supervision.

In the operating room, the junior resident is responsible for assisting the attending orthopaedic surgeon. The resident will perform appropriate portions of the surgical procedure as directed by the attending orthopaedic surgeon and under the direct supervision of the attending orthopaedic surgeon.

Orthopaedic Surgery Year 3 (PGY-3) rotation schedule

Rotation – Length

Foot & Ankle – 8 weeks
General Orthopaedics – 8 weeks
Pediatric Orthopaedics (Children’s Hospital Oakland) – 8 weeks
Pediatric Orthopaedics (Shriners Hospital/Sacramento) – 8 weeks
Spine – 8 weeks
Trauma – 8 weeks

Orthopaedic Surgery Year 4 (PGY-4)

Provide a sports service program dedicated to the superior care of the sports injury patient, combining patient care and an appropriate associated teaching program. Our primary goal is superior care of patients with sports injuries and total commitment to returning people to useful life. Residents will participate in in-patient and out-patient settings, as well as in the operating room. The residents will be under close faculty supervision. The rotation is multi-disciplinary, including plastic surgery, as well as multi-professional, including physician assistant and occupational therapists.

Orthopaedic Surgery Year 4 (PGY-4) rotation schedule

Rotation (Length)

Elective – 8 weeks
General Orthopaedics – 8 weeks
Hand – 8 weeks
Shoulder & Elbow – 8 weeks
Spine – 8 week
Trauma – 8 weeks

Orthopaedic Surgery Year 5 (PGY-5)

Residents will participate in patient care in in-patient and out-patient settings, as well as in the operating room. The residents will be under close faculty supervision. Residents will grow their knowledge in treatment of patients with degenerative musculoskeletal conditions.

Orthopaedic Surgery Year 5 (PGY-5) rotation schedule

Rotation (Length)

Elective – 8 weeks
Foot & Ankle – 8 weeks
General Orthopaedics – 8 weeks
Hip/Knee Reconstruction – 8 weeks
Trauma – 8 weeks

SJMC Orthopaedic Academic Activities

Every Tuesday is dedicated to the core curriculum educational activities (0800-1300)

Third Wednesday of the month 0700 Orthopaedic Grand Rounds
Last Thursday of the month (quarterly) 1800 Journal Club
Third Wednesday of the month 1200 Ortho/Spine M&M
Second Thursday of the month Tumor Board/Oncology Multidisciplinary 1200
Daily Rounds 0700 – Orthopaedic Conference Room
Third and Fourth Friday of the month 0800 Surgical Skills

Resident Presentations

Residents are required to provide a case presentation at didactics are part of their educational experience. The resident will present an interactive clinical case providing literature-based presentation regarding the approach and management of the specific disease process and how to apply it to the patient.

Educational Activities

The core curriculum for Orthopaedic residents includes the following educational activities:

1. Resident Preparation
The residents should prepare for lecture follow-up discussions and problem-based learning discussions. Senior residents attending interactive case discussion (ICD) must prepare for the discussion using the assigned chapter. All attending residents are expected to participate in an in-depth discussion of the topic during the module. Also, residents are expected to prepare for simulation sessions as directed by instructors.

2. Lectures and Follow-up Discussions
The didactic core lectures will be held on an 8-week rotating schedule basis covering the major subspecialties (Trauma/Hand/Spine/Shoulder & Elbow/Foot & Ankle/ Adult Reconstruction/ General). Additional lectures will be included in the quarterly didactic rotation to cover Anesthesia/ MSK Radiology/ Rehabilitation/ Soft Tissue Management. The follow-up discussion session involves questions on the topics covered in these lectures. This provides another assessment of knowledge and an opportunity for discussion and questions.

3. Problem-Based Learning Discussions (PBLD)
Problem-Based Learning Discussions focus on a clinical topic or problem. The PBLD sessions are based entirely on the assigned reading.

4. Self-Directed Learning Projects (SDLP)
Involves individual and small group self-directed projects related to education and research. The primary goal of this activity is to foster the development of the residents as adult self-directed life-long learners.

5. Medical Ethics and Professionalism
The goal of these lectures is to introduce the residents to important and fundamental concepts in education, business, law, and communication, which impact the delivery of effective health care. These lectures focus on healthcare management, organizational structure, clinical instruction, ethics, healthcare economics, risk management, professionalism, research, educational skills, physician leadership, and excellence in patient care.

6. Simulation Scenarios
The goal of these sessions is to facilitate the acquisition of fundamental knowledge, basic psychomotor and technical skills for the practice of general orthopaedic surgery.

7. Surgical Skills Lab
A dedicated 13-module surgical skills curriculum has been developed to cover fundamental skills and operative techniques across the breadth of orthopaedic & spine surgery. As junior residents, the focus will be on acquisition of technical skills and mastery of basic instrumentation for safe orthopaedic practice. As senior residents, the focus will be on advanced specialty-specific orthopaedic techniques and facilitating the teaching competencies to junior residents.

8. Anatomy/Cadaver Lab
Anatomy labs will be offered on an 8-module rotating basis. Each module will be led by a designated faculty member with subspecialty expertise. Wet lab facilities are available at our primary site for anatomy prosecutions and simulation models. Additional cadaveric dissection opportunities will be made available through our partnership with the Touro University Department of Anatomy.

9. Problem-Based Simulation Scenarios
These sessions will be scheduled during the Grand Rounds/Didactics session.

10. Interactive Case Discussions (ICD)
Interactive Case discussion (ICD) involves a case-based clinical discussion of one or more topics. Preparation material (usually a small book chapter) is distributed to faculty and residents prior to the scheduled session. Residents are expected to prepare and participate in the discussion.

11. Journal Clubs
Journal Club is held every four weeks. The main goals are to discuss up to date literatures and provide the opportunity to understand how research conclusions assist in developing evidence-based medicine and best practices guidelines.