Residency Program

PGY-1 year

The PGY-1 year at Long Island Jewish Medical Center is in the Department of Surgery. Residents matching in Orthopaedic Surgery begin their training in General Surgery followed by four years in Orthopaedic Surgery. Therefore, Long Island Jewish Medical Center is now a five year program. In conjunction with the Department of Surgery we have designed a plan which will prepare our residents for specialty education in Orthopaedic Surgery. Residents participate in clinical and didactic activities, allowing them to develop the knowledge, attitudes and skills needed to assess, plan and treat adult and pediatric patients with surgical and/or medical problems. This training includes experiences in the following areas: general surgery, (which includes experiences in plastic surgery and hand surgery,) cardio-thoracic, vascular disease, multi-system trauma, medical and surgical intensive care and anesthesiology. Residents develop an understanding of intra-operative complications associated with anesthesia. Residents will have experience in the following areas, totaling twelve months of education:
 

• Pediatric Surgery, 1-2 months

• General Surgery, 4-5 months

• Cardiothoracic, 1-2 months

• Vascular Surgery, 1-2 months

• Trauma, 1 month

• Surgical Intensive Care, 1 month

• Medical Intensive Care, 1 month

• Anesthesiology, 1 month

• Orthopaedics, 1 month

 
The Orthopaedic Attendings participate in the PGY-1 review and evaluation sessions in the Department of Surgery. Problems with residents are dealt with collaboratively between the two departments.

PGY-2 Year

During the PGY-2 year, the residents divide their time between the trauma services at North Shore University Hospital and the adult service at Long Island Jewish Medical Center. At both institutions, these junior residents immediately care for patients and learn to take responsibility in a supervised environment. They are observed and assisted by senior and chief residents and the attendings on the service. At North Shore University Hospital, they are exposed to multiple trauma and fractures, including some sports medicine. At Long Island Jewish Medical Center, they learn to care for patients undergoing total joint replacement, spine surgery, sports medicine, foot surgery and hand surgery. During this period they are exposed to common adult fractures such as those to the hip, forearm and other low impact injuries. During their on-call time, they also see and treat many common children's fractures and injuries of the hand. Two months of the PGY-2 year are dedicated to hand surgery, where the residents work with Dr. Lewis Lane and Dr. Peter Stein, following patients from the private office through surgery and the post operative period. Emphasis is placed on anatomy, examination, diagnosis and the basic principles of hand surgery.

PGY-3 Year

The PGY-3 year provides the Orthopaedic Residents with their first formal exposure to Pediatric Orthopaedic Surgery for four months of the year. They join the Chief Residents on a busy service which is run in close cooperation with the staff pediatric attendings and some voluntary attending participation. The residents spend virtually all their time either seeing patients in an ambulatory setting, on the floor or in the operating room. As in any busy pediatric orthopaedic service, a large number of patients are seen in the ambulatory area. The weekly clinic provides excellent patient material, exposing residents to a wide variety of pediatric orthopaedic problems. In this setting, the residents see patients initially without an attending and they re-examine the patient and discusses examination techniques and decisions on management protocols. The residents are usually present at the attendings' private office hours where they have an opportunity of increasing their clinical exposure, honing their decision making skills and management techniques of young patients and their parents.

A formal, pre-operative conference is held on every patient who is booked for surgery. At this conference, detailed pre-operative planning is undertaken, hospital stay is defined and post-operative care is outlined. All this is shared with the patient and family prior to discussion of alternatives and potential risk. The residents learn the techniques of managing the small patient in a frightening situation and also how to maintain proper ethical standards and medical legal correctness by open and full communication. Pre-operative planning is an essential component of all work-ups.

Residents spend three months on the adult service. During this rotation, they are involved in the adult orthopaedic clinic, where patients are seen with the responsible attending. They are involved in pre-operative planning and subsequently assist at surgery, take care of the patients in-house and follow these patients at the clinic upon discharge. Much of the surgical involvement of the residents during this rotation is on patients who are seen in the attending physicians' private offices. Radiographic films are studied and the plan of care is developed.

Four months on the trauma service rounds out the PGY-3 year. This rotation takes place at North Shore University Hospital, a level 1 trauma center with 731 beds and a staff of approximately 2,700 specialist and sub-specialist physicians.

PGY-4 Year

During the PGY-4 year, the residents spend four months on the adult orthopaedic service at Long Island Jewish Medical Center and four months on the trauma service at North Shore University Hospital. As senior residents, they take a much more active role in the planning and supervisory aspects of patient care and personally perform increasingly difficult operative procedures with supervision. At this level the residents act as team physicians for high schools and other teams in the neighborhood, which augments their training in sports medicine.

Orthopaedic oncology training is received at this level. A two-month rotation takes place at the Memorial Sloan Kettering Cancer Center under the direction of Dr. John Healey. Residents are involved in both in-patient and out-patient services.

PGY-5 Year

As Chief Resident, the resident spends the year divided equally among Pediatric Orthopaedic Surgery at Steven and Alexandra Cohen Children's Medical Center of New York, adult orthopaedic surgery at Long Island Jewish Medical Center and trauma at North Shore University Hospital. At this point, the resident has reached a level of maturity and takes on a leadership role. He/she takes an active role in the planning of patient care and in performing surgery.

As part of this final year, the Chief Resident learns administrative techniques and is responsible for the supervision and scheduling of junior residents and the other responsibilities required of a leadership role. In addition the Chief Resident refines academic pursuits in Orthopaedics with the completion of research projects, clinical publications and academic meeting participation.