Office Orthopedics

Office Orthopedics:

Goals:

The goals of this rotation are to provide the residents with an outpatient experience in orthopedics which will provide them with the knowledge and skills needed to provide care and appropriate referral for primary care patients with musculoskeletal disorders.

Objectives:

Patient Care

1. Obtain an orderly history on patients suspected of having bone and joint diseases.

2. Perform a systemic physical examination on patients with a variety of presenting complaints pertinent to bones, joints, and soft tissues with particular emphasis on examination of the spine, shoulder and knee. Demonstrate the ability to perform a complete joint examination.

3. Learn how to perform aspiration of the knee joint.

4. Diagnose and properly manage osteoarthritis, rheumatoid arthritis, shoulder pain, knee pain, neck pain, low back pain, foot and ankle pain, carpal tunnel syndrome, anserine and trochanteric bursitis, stenosing tenosynovitis, ganglion cysts, epicondylitis, and minor sports-related injuries.

Medical Knowledge

1. Learn the indications for diagnostic procedures such as x-rays for fractures and MRI and CT scans of the joints.

2. Become aware of the use of various treatment modalities (pharmacologic, exercise, immobilization, physical therapy) for common outpatient orthopedic conditions seen by primary care physicians including: tendonitis, bursitis, degenerative joint disease, acute and chronic back pain, rotator cuff injuries.

3. Learn the problems for which referral to an orthopedic surgeon may be necessary.

4. Discuss legal issues in caring for individuals involved in trauma and injury.

Teaching Methods used during this rotation:

This will include out-patient management discussions, individual instruction in procedures, review of diagnostic studies, including radiology. Principal ancillary education materials used will include ,texts, and articles from the literature.

Learning Venues:

Residents rotate through outpatient orthopedics via a 1 week rotation under the direction of an orthopedic surgeon. The practice site for this rotation is at private orthopedists offices. A listing is available in the Program office.

Methods used to evaluate the resident and the rotation:

1. The ABIM global assessment form of all six competencies will be completed by the attending and reviewed with the resident.

2. A written examination, developed by the program director and subspecialty director is given to the resident at the end of rotation and will be evaluated by the department.

3. Evaluation of attending teaching skills and other attributes

4. Rotation assessment by the resident

Outcomes Assessment:

Primary care orthopedics subsection on the in-training examination and ABIM certifying examination will be monitored with an expectation of 50 %ile performance by all residents. In addition resident evaluation of their experience, annual program evaluation by residents, and periodic surveys of program graduates will be monitored.