Thomas Jefferson University

Structure

Residency Photo 2013-14

PGY - 1

The PGY-1 year is primarily spent at Thomas Jefferson University Hospital (TJUH). It is a transitional year designed to teach the basics of care and evaluation of the surgical patient. Intern year includes three 8-week Orthopaedic Surgery rotations and six 4-week rotations coordinated with the Departments of Surgery, Emergency Medicine, and Non-Operative Orthopaedics.  

During the 24 weeks on Orthopaedics, 16 weeks are spent at TJUH and eight weeks at Bryn Mawr Hospital. At TJUH, PGY-1s learn how to care for patients on the Ortho Trauma and Spine services. This includes managing floor patients, seeing consults, performing procedures, and scrubbing operative cases. Eight weeks at Bryn Mawr Hospital further expose the PGY-1 to basic fracture care and orthopaedic patient management. PGY-1's spend time evaluating and treating fractures in the Emergency Room, managing in-patients, and participating in surgeries.

Interns spend an additional four weeks on outpatient non-operative sports medicine. This familiarizes PGY-1s with patient evaluation and work-up in the outpatient setting, and provides exposure to a wide range of non-operative treatment modalities.

Four-weeks rotations on Vascular Surgery, Plastic Surgery, General Surgery Trauma, and in the Surgical ICU, provide the PGY-1 further instruction in the management of complex surgical patients, with skill sets directly applicable to orthopaedics. Four weeks of Emergency Medicine allow additional experience seeing and triaging consults and formulating treatment and disposition plans.

PGY-1 Rotation Schedule
Ortho Spine (TJUH) – 8 weeks
Ortho Trauma (TJUH) – 8 weeks
Bryn Mawr Hospital General Ortho – 8 weeks
Rehabilitation/Non-op Sports Medicine – 4 weeks
Emergency Medicine – 4 weeks
Plastic Surgery – 4 weeks
Vascular Surgery – 4 weeks
Trauma Surgery – 4 weeks
Surgical ICU – 4 weeks
Ortho Flex Coverage Block (TJUH and/or BMH) – Final 4 weeks of Year


Call Schedule

  • Orthopaedics (BMH, 8 weeks) - In-house 12 hour call Friday PM and Sunday AM
  • Orthopaedic Trauma and Spine (TJUH, 16 weeks) – Alternating Weekends AM
  • General Surgery (Plastics, Vascular, Trauma, SICU) - schedule provided by Department of Surgery

Vacation

  • Two weeks during Rehabilitation / Non-op Sports Medicine (Step 3 recommended)
  • One week during a General Surgery rotation (most often Vascular)
  • 10 days off at the end of June

PGY - 2

The PGY-2 year provides residents graduated responsibility and progressive exposure to the orthopaedic sub-specialties. It consists of seven 7-8 week rotations including general and specialty pediatric ortho, joint arthroplasty, spine surgery, foot and ankle surgery, and a dedicated night float rotation.

PGY-2 Rotation Schedule
(each 7-8 weeks)
Shriners Pediatrics (Shriner’s Hospital)
St. Christopher’s Pediatrics (St. Christopher’s Hospital)
Spine Surgery (TJUH)
Joint Arthroplasty 1 (TJUH)
Joint Arthroplasty 2 (TJUH)
Night Float (TJUH)Foot and Ankle (Bryn Mawr Hospital) 
file

On sub-specialty rotations, residents split their time between the operating room and clinic, learning the physical examination, work-up, decision making, pre-operative planning, surgical treatment, and aftercare of a broad range of orthopaedic conditions. As the night float resident, PGY-2s are in-house Sunday-Thursday nights at TJUH, an inner-city Level 1 trauma center and regional spinal cord injury center, with a PGY-5 on back-up call. 

Call Schedule

  • Spine, Joints 1 and 2 (TJUH, 21 weeks) – Every other weekend Saturday 24hr call OR weekly Sunday 12hr day call
  • Shriners and St. Chris (14 weeks) – home call, schedule provided by sites
  • Foot and Ankle (Bryn Mawr Hospital, 7 weeks) – Call Sunday and Tuesday nights

Vacation

  • Four weeks

PGY - 3

The PGY-3 year is focused on increasing residents’ responsibilities and developing subspecialty specific orthopaedic skills. This year will prepare trainees for the responsibility and independence expected of a senior resident. While PGY-1 and PGY-2 residents spend much of their time on inpatient services, the PGY-3 year is more outpatient-predominant subspecialties. This includes immersive preceptor-style rotations in Foot and Ankle, Shoulder and Elbow, Hand, and Sports. Each rotation includes sub-specialty specific didactics in addition to the residency-wide didactics.

PGY-3 Rotation Schedule
(each 7-8 weeks except Dupont)
DuPont Pediatrics (A.I. Dupont Pediatric Hospital) - 14 weeks
Shoulder and Elbow
Sports
Foot and Ankle
Hand (Rothman)
Research
file

PGY-3s also spend 14 weeks at Alfred I. DuPont Hospital for Children in Wilmington, DE. This renowned children's hospital provides house staff a firm understanding of pediatric orthopaedics. Resident responsibilities include operating, clinics hours, and seeing inpatient and emergency room consults at this level 1 pediatric trauma center. PGY-3s work closely with rotating residents from other programs, including Mt. Sinai in NY, Seton Hall in North Jersey, Rowan in South Jersey, and Georgetown in Washington DC. Finally, PGY-3s enjoy a protected research rotation.

Call Schedule

  • Hand, Shoulder and Elbow, Foot and Ankle, Sports, Research (36 weeks) – in-house call two weekends per month, either TJUH Friday night 12-hour call or Bryn Mawr Saturday 24-hour call
  • DuPont Pediatrics (14 weeks) – in-house call divided between residents from multiple programs, average three weeknights and 1 weekend per month

Vacation

  • Four weeks

PGY- 4

The PGY-4, as a senior resident, assumes increased independence and responsibility. On most rotations, PGY-4s act as service chiefs, overseeing a team of junior residents. This is the case during two rotations of general orthopedics at Bryn Mawr Hospital, with four operative days per week comprising a mixture of joint arthroplasty, spine, sports, hand surgery, and community trauma.

PGY-4 Rotation Schedule
(each block 7-8 weeks)
Bryn Mawr 1
Bryn Mawr 2
Ortho Oncology
Sports
Hand (Philadelphia Hand to Shoulder Center)
Trauma
Vacation Coverage
file

During an orthopaedic trauma rotation at TJUH, the PGY-4 spends most of the day in the operating room, gaining experience treating high-acuity, complex trauma. In addition, the PGY4 oversees the intern on trauma, triaging consults and assisting with procedures. An orthopaedic oncology rotation at TJUH includes robust experience in the workup and treatment of primary and metastatic bone and soft tissue lesions. As part of its NCI-designated Cancer Center, Jefferson has one of the nation’s few designated sarcoma centers. As a member of the orthopedic oncology team, residents work with sub-specialized counterparts in medical and radiation oncology, musculoskeletal radiology, and pathology to treat patients.

Other PGY-4 rotations include Hand Surgery with the Philadelphia Hand to Shoulder Center, with exposure to microsurgery and replant, Sports Medicine, and a Vacation Cross-Coverage rotation covering operative days for co-residents on their scheduled vacations.

Call Schedule

  • Bryn Mawr - 1 weeknight in-house call per week
  • Hand - 1 weekday home call per week, 1 Saturday home call per month

Vacation

Four weeks.


PGY- 5

PGY-5 year is designed to fine tune decision making, surgical, and leadership skills to equip residents with the tools needed to be successful practicing orthopaedic surgeons. The year includes rotations in trauma at a busy level 2 trauma center, spine surgery, joint arthroplasty, shoulder and elbow, sports, and an elective rotation. In addition, each PGY-5 has administrative duties and takes back-up call at TJUH. At the end of the PGY-5 year, the orthopaedic resident is expected to demonstrate the clinical skills and orthopaedic knowledge appropriate for a graduating chief resident.

PGY-5 Year Rotation
(each 7-8 weeks)
Spine (Chairman Rotation)
Joints
Combo Joints/Spine
Trauma (Jefferson Northeast)
Sports
Shoulder and Elbow
Elective
file

Call Schedule

  • Home backup call at TJUH on weeknights and weekends, split evenly within the class

Vacation

  • Four weeks