Veteran's Affairs Medical Center
The Veteran's Affairs Medical Center Level III trauma program has 207 beds and conducts close to 7,000 outpatient visits per year. The strength of this rotation is the diverse patient population requiring challenging reconstructive surgery. The chief resident oversees two junior residents and works closely with ancillary personnel to replicate the experience of a private orthopaedic practitioner. The VA rotation also features subspecialty clinics with faculty supervision in hand, knee reconstruction, shoulder, spine, and sports medicine. Special features include exposure to amputation surgery and problems associated with the rehabilitation of amputee patients. The orthopaedic service at the VAMC is fully integrated with the medical student educational program within the Department of Orthopaedic Surgery at WUSM.
The VAMC serves a diverse patient population in need of challenging reconstructive surgery. The theme of the rotations at this institution is resident automy. Surgical experience includes extensive exposure to primary and revision elective knee and hip surgery, arthroscopic and open reconstructive shoulder surgery, hand and upper extremity surgery, musculoskeletal oncology, and knee arthroscopy.
The Chief Resident assigned to the VA oversees a Junior Resident and Physician Assistant and works closely with ancillary personnel to replicate the experience of a busy private Orthopaedic practitioner. The residents are guided by both full and part-time faculty who are fellowship-trained in their respective subspecialties.
The essence of the educational experience is elective adult reconstructive surgery and treatment of low- and moderate-energy trauma. Residents have considerable autonomy to determine the treatment course and perform most surgical procedures with input and guidance from the faculty. The VA rotation features subspecialty clinics and operating room sessions with faculty supervision in specific domains including but not limited to hand and upper extremity, shoulder, reconstruction, knee and hip reconstruction, spine, and sports medicine. Operating room volume is considerable and includes over 150 hip and knee arthroplasties annually. The resident participates in an extensive academic conference program sponsored by the Department of Orthopaedic Surgery as well as an Indication Conference and lower extremity anatomy prosection series unique to this rotation.
Residents acquire maturity most readily when and if they are required to manage patients from presentation to postoperative rehabilitation. This is the essence of the VA experience. The service is structured on the premise that the chief resident is the primary surgeon. The Chief Resident is permitted to perform surgical procedures under minimal faculty intervention depending upon the complexity of the case. The clinic is intentionally structured to permit residents to see al pre-operative and post-operative patients in order to most closely duplicate the experience of private practice.
The rotation is assigned to one PGY-3 and one PGY-5 Resident.
Goals for the PGY-5 level trainee include:
- Accumulate surgical and decision-making experience in complex adult reconstruction
- Acquire skill orchestrating the clinical activities of a junior resident and P.A. while providing care to a large HMO population exhibiting considerable co-morbidity
Goals for the PGY-3 level trainee include:
- Acquire self-assurance in evaluating, planning for and conducting adult reconstructive surgical procedures, arthroscopy and basic fracture surgery.