Orthopaedic Traumatology Fellowship
The SSM Health/Saint Louis University School of Medicine Orthopaedic Traumatology Fellowship Program offers a diverse experience incorporating five full-time SLU traumatologists — all with designated areas of interest and expertise.
Program Overview
The one-year orthopaedic traumatology fellowship is accredited by the Orthopaedic Trauma Association. Fellows train alongside the SSM Health St Louis University Hospital trauma service, which includes a chief resident, senior and junior residents, and SLU medical students, as well as a trauma nurse practitioner and clinical trauma nurse.
Fellows will benefit from a substantial operative caseload; the trauma service treats 35-45 patients each day and runs two to three orthopaedic trauma operating rooms daily. While fellows can select the cases that align with their interests and future goals, they are expected to take full advantage of the high volume of available operative opportunities.
The following statistics are from the 2020-2021 academic year:
Program Volume
- 2,907 ER orthopaedic trauma admissions
- 1,802 total operative procedures performed by trauma service
- 650-800 averages cases per fellow
Surgical Case Numbers
- Pelvic and acetabular surgery: 176
- Humerus and elbow: 87
- Tibial plateau: 72
- Leg and ankle: 349
- Fott and toes: 46
- Femoral shaft fractures: 104
- Proximal femur and peritrochanteric fractures: 72
- Nonunions: 37
- Ring fixators: 20
- Spanning ex-fix: 59
- Open fractures: 79
- Daily Cases: service as primary operating surgeon under the assistance and supervision of faculty.
- Subspecialized, Complex or Reconstruction Cases: role as assistant surgeon, or primary surgeon depending on skill level.
- Routine Trauma Cases: occasional staffing of routine trauma case (e.g., washout, ankle fracture, femoral nail, etc.); not in lieu of primary trauma case of interest
- Teaching Opportunities: basic tenets of trauma care, evolution and management of patients, operative principles of long bone fracture fixation
Fellows take call approximately five to seven times per month, depending on the trauma staff schedule. Faculty is always available to answer questions or address problems.
- Month One: no call
- Month Two: supervised call
- Beginning Month Three:
- Monitored supervision
- Independent night call as attending on trauma service
- Full operative privileges
Fellowship training includes numerous basic science research opportunities.
- Key Areas: fracture biomechanics and orthobiologics
- Fully Staffed Labs: biomechanics and cellular biology labs run by Ph.D. experts, master's students and doctoral candidates
- Collaborative Environment: facilities dedicated to collaborative orthopaedic research projects
Previous fellows have obtained a wide variety of positions, including academic traumatologists running trauma services at:
- Naval Medical Center in San Diego, California
- State University New York in Buffalo, New York
- Louisiana State University in New Orleans, Louisiana
- University of Colorado in Denver, Colorado
- University of Missouri- Springfield in Springfield, Missouri
Other graduates are heading Level 1 and Level 2 trauma services for large orthopaedic groups practicing in community-based institutions nationwide.
Program Highlights
- Level 1 trauma center treating largest number of trauma patients in Missouri
- Average 650-800 cases per year
- Select cases that benefit interests and goals
- Collaborative research opportunities in fracture biomechanics and orthobiologics
- Options for additional training:
- Active pediatric trauma
- Microvascular hand service
- Adult reconstruction
Current Fellow
Terry Bujnak, D.O.
Residency: Case Western Reserve University/University Hospitals in Cleveland, Ohio
Medical school: Des Moines University College of Osteopathic Medicine
Apply
The fellowship program has one available position per year.
It participates in the SF Match in coordination with the Orthopaedic Trauma Association (OTA).
About the SSM Health/Saint Louis University School of Medicine Graduate Medical Education Program
SSM Health proudly sponsors the Graduate Medical Education Program at Saint Louis University School of Medicine. This university-based training program offers a world-class academic environment that fosters clinical excellence, research innovation and compassionate care. All program participants are employed by SSM Health, ensuring a cohesive and supportive experience within a nationally recognized health system.
Trauma Service at SSM Health Saint Louis University Hospital
The trauma service at SSM Health Saint Louis Hospital has a chief resident, senior and junior residents, and varying numbers of medical students from SLU. Additionally, a trauma nurse practitioner and clinical trauma nurse help manage the service.
An American College of Surgeons designated Level 1 trauma center for Missouri and Illinois, the hospital also sees the largest number of patients of any trauma center in Missouri.
Fellowship Overview
SLU’s orthopaedic traumatology fellowship is accredited by the Orthopaedic Trauma Association and participates in the orthopaedic trauma SF match for the selection of candidates.
An optional active pediatric trauma, microvascular hand service and adult reconstruction experience is also available if the fellow has an interest but not required.
Role of the Fellow
Fellows assume a crucial role in the management of patients at SSM Health Saint Louis University Hospital and help coordinate the trauma service in conjunction with the chief residents on the service. Daily census ranges between 35 and 45 patients with two-to-three orthopaedic trauma operating rooms every day so the number of cases to choose from is substantial.
There is no assigned fellow service. Fellows can select the cases that they feel will benefit their interests and future goals. This is a surgical fellowship and fellows are expected to take full advantage of all the operative opportunities afforded. One fellow is selected per year so cases are not divided amongst multiple fellows.
During the day, the fellow is scrubbed as the operating surgeon with the faculty scrubbed as the first assistant and providing direct supervision. For more subspecialized, complex trauma or reconstruction cases, the attending will be the primary surgeon with the fellow as the first assistant (or primary surgeon depending on the skill level).
Fellows are free to pick the most appropriate case throughout the day and is not tied to a particular staff surgeon. If necessary or available, fellows may be asked to staff a routine trauma case if additional rooms become available during the day (e.g., washout, ankle fracture, femoral nail, etc.) but not in lieu of a primary trauma case of interest to the fellow.
Our trauma fellows are expected to be able to actively teach residents basic tenets of trauma care, the evaluation and management of trauma patients and operative principles of long bone fracture fixation.
Current Fellow
Terry Bujnak, D.O.
Medical school: Des Moines University College of Osteopathic Medicine
Residency: Case Western Reserve University/university hospitals in Cleveland, Ohio
Fellowship Statistics
- Total number of emergency room orthopaedic trauma admissions for the combined institutions for the 2020-2021 academic year: 2,907 admissions.
- Total operative procedures performed by the orthopaedic trauma service during 2020-2021: 1,802 procedures.
The most recent case numbers for 2020-2021 are as follows:
- Pelvic and Acetabular surgery: 176 cases
- Humerus and Elbow: 87 cases
- Tibial plateau: 72 cases
- Leg and Ankle: 349 cases
- Foot and Toes: 46 cases
- Femoral shaft fractures: 104
- Proximal femur and peritrochanteric fractures: 72
- Nonunions: 37
- Ring fixators:: 20
- Spanning ex-fix: 59, Open fractures: 79
Average fellow case logs range from 650-800 cases per year
In addition to the large numbers of acute polytrauma and monotrauma patients treated, a large volume of post-traumatic reconstruction surgery is performed including Ilizarov reconstruction for nonunions, malunions, post-traumatic osteomyelitis, leg length discrepancy, and hip related osteotomies.
Call Responsibilities
There is no call for the first month, supervised call for the second month and then the call is under monitored supervision beginning the third month of the fellowship.
After the second month, the fellow will take independent night call as an attending on the trauma service with full operative privileges. There is always a backup faculty member on call if the fellow has questions or problems and fellows can call the faculty in at any time deemed necessary. Call averages approximately five to seven times per month depending on trauma staff schedules.
Research Opportunities
In addition to the vast clinical experience offered in the course of this fellowship, there are many basic science research opportunities in the areas of fracture biomechanics and orthobiologics. Our biomechanics and cellular biology labs are staffed by full-time Ph.D.s and their master’s and doctoral candidates. The labs are dedicated to collaborative orthopaedic research projects.
Career Opportunities
Our previous fellows have obtained a wide variety of positions, including academic traumatologists running trauma services at the Naval Medical Center in San Diego, State University New York in Buffalo, Louisiana State University in New Orleans, University of Colorado in Denver and University of Missouri- Springfield.
Other previous fellows are heading Level One or Two trauma services for large orthopaedic groups practicing in community-based institutions nationwide.