Orthopedics

Overview:

The orthopedics rotation is a preceptorial rotation. The rotation occurs at Memorial Hospital , in the orthopedist's office, and in other locations included in the orthopedist's usual practice. The teaching of orthopedics in the program includes this rotation as well as experiences in the Family Medicine Center, the noon conference series, and on other rotations (See other curricula.).

Goals:

1) At the completion of this rotation, the resident will have an understanding of the practice of orthopedics in a community setting which will facilitate appropriate referral practices in the future.

2) At the completion of this rotation, the resident will have knowledge and skills in the areas of orthopedics pertinent to the practice of family medicine.

Objectives:

At the completion of this rotation, the resident will have demonstrated to the satisfaction of the orthopedics preceptor:

--medical knowledge in orthopedics pertinent to the practice of family medicine, including the appropriate evaluation and treatment of (MK): osteoarthritis, muscle strains and tears, ligament sprains and tears, common fractures, tendon injuries, compartment syndrome, avascular necrosis, osteochondritis dissecans, slipped capitofemoral epiphysis, Osgood-Schlatter's disease, lower limb alignment abnormalities in children, low back pain, and joint pain.

--the ability to perform an appropriate history and physical examination on the orthopedics patient and to present these findings to another physician in an appropriate manner (PC).

--the ability to interpret appropriate data related to the orthopedics patient and arrive at reasonable diagnostic and management decisions, weighing alternatives, benefits, and risks of diagnostic and therapeutic options, and co-managing patients appropriately with other specialists (PC).

--the ability to make appropriate decisions to assure high-quality care in a cost-effective manner ( SBP ).

--communication and interpersonal skills which facilitate positive and therapeutic relationships (ICS).

--the ability to work cooperatively with other health professionals as part of a health care team (ICS).

--compassion, respect, and integrity; responsiveness to the needs of patients and society that supercedes self-interest; accountability to patients, society, and the profession; a commitment to excellence and on-going professional development (P).

--a commitment to ethical principles pertaining to the provision or withholding of clinical care, confidentiality of patient information, informed consent, and business practices (P).

--sensitivity and responsiveness to a patient's culture, age, gender, and disabilities (P).

There are no specific procedural requirements for this rotation. However, there is a separate Procedures Curriculum and residents may gain experience meeting these requirements during this rotation. Procedures typically performed by residents with the orthopedist on this rotation include (PC): interpretation of musculoskeletal radiographs, surgical assist, joint examination, casting and splinting, reduction of fractures and dislocations, and joint aspiration and injection.

Implementation:

This is a preceptorial rotation, so the resident is assigned to a particular orthopedist or orthopedics group. The resident will accompany the orthopedist during his/her professional activities in Memorial Hospital , in the orthopedist's office, and in other locations involved in the preceptor's usual practice. In the course of seeing patients, the orthopedist will provide experiential learning, role-modeling, and one-on-one teaching to the resident. At the discretion of the preceptor, the resident may be assigned to research specific topics in orthopedics.

The resident is responsible for contacting the orthopedist prior to the start of the rotation to arrange a schedule for the rotation. The resident must continue to meet usual residency obligations to his/her Family Medicine Center population including attending scheduled clinics, caring for continuity patients admitted to Memorial Hospital, and rounding in the nursing home. The resident is expected to attend noon conferences and abide by duty hour restrictions in keeping with usual program policies. Upon completion of the rotation, the resident must complete and return the evaluation form provided by the program.

Evaluation:

The orthopedics preceptor will complete an evaluation form at the end of the rotation assessing the resident's success in meeting the rotation objectives as outlined in this curriculum.