Orthopaedic Surgery Residency

Saint Louis University’s orthopaedics residency is a six-year, fully accredited training program consisting of five years of clinical instruction and one year of research that provides training in all areas of adult and pediatric orthopaedics.

Orthopaedic Residency Program Overview

There are 30 residents in the program, five at each PGY year and five in the research year, which is positioned between the PGY-1 and PGY-2 years. The PGY-1 year is an orthopaedic year which meets all current Accreditation Council for Graduate Medical Education (ACGME) and The American Board of Orthopaedic Surgery (ABOS) requirements, providing an excellent background in general surgery and the surgery subspecialties.

The research year is an organized program in research education supported through the Saint Louis University School of Medicine in conjunction with the University’s Department of Biomedical Engineering. The year is dedicated mainly to research but is structured to maintain the residents’ newly acquired clinical skills.

The research year is required between the first and second years of the orthopaedic residency. This year is committed to having the resident read research correctly. At minimum, each resident must complete a publishable basic science and a clinical project during this year. One day per week is spent doing clinical activity to help maintain and enhance your clinical knowledge while improving your academic skills.

Research Strengths

  • There have been 38 publications with resident authors in the last six years.
  • Thirty-two resident presentations at national meetings the last two years.
  • Ninety-six resident presentations from July 2007 to June 2013.
  • Continued improvement of OITE scores over time.
  • Presentations, publications and OITE scores are frequently used in deciding fellowship acceptances.

The PGY-2 through PGY-5 years are spent solely within the Department of Orthopaedic Surgery with residents rotating through all the major subspecialties. As the years in training increase, so does the level of resident responsibility, culminating in a PGY-5 or Chief Resident year. Upon successful completion of the program, residents are eligible for board certification through the American Board of Orthopaedic Surgery.

Resident Rotations

Adult Reconstruction – General Orthopaedics

One PGY-5 and one PGY-3 resident rotate through the Adult Reconstructive Service. The residents work in close association with the two full-time faculty in a preceptorship-like environment located mainly at SSM Health St. Mary’s Hospital, performing both primary and complex revision arthroplasty.

Foot and Ankle Service

One PGY-5 and one PGY-2 resident rotate through the Foot and Ankle Service. The residents work in close association with the one full-time faculty and one adjunct faculty in a preceptorship-like environment located mainly at SSM Health St. Mary’s Hospital.

Hand and Upper Extremity

The hand and upper extremity rotation takes place at SSM Health Saint Louis University HospitalSSM Health Cardinal Glennon Children's Hospital and Des Peres Hospital. This rotation provides residents with a broad exposure to congenital disorders of the upper extremity, upper extremity trauma, industrial and occupational medicine involving the upper extremity, endoscopy and microvascular reconstruction and reimplantation.

Residents are actively involved in both the outpatient setting and the surgical management of these disorders. There are two 10-week rotations on the hand and upper extremity service. One rotation at the PGY-3 level occurs mainly at SSM Health Saint Louis University Hospital and SSM Health Cardinal Glennon Children's Hospital and one at the PGY-5 level is mainly at Des Peres Hospital.

Musculoskeletal Oncology

During this PGY-4 rotation residents are exposed to a wide variety of benign and malignant musculoskeletal tumors. They are also exposed to and participate in limb salvage techniques.

Pediatric Orthopaedic Surgery

For pediatric orthopaedic surgery, residents rotate at SSM Health Cardinal Glennon Children's Hospital. During this 10-week rotation, residents are exposed to a broad variety of inpatient and outpatient pediatric orthopaedic conditions including congenital and developmental abnormalities, pediatric trauma and metabolic, endocrine, infectious and neuromuscular diseases. Residents rotate through pediatric orthopaedic surgery at the PGY-1, PGY-2, PGY-3 and the PGY-5 levels.

Spine

The Department of Orthopaedic Surgery spine section manages all varieties of diseases, disorders and trauma involving the cervical, thoracic, lumbar and sacral spine. This 10-week rotation is based at SSM Health Saint Louis University Hospital. Residents rotate at the PGY-1, PGY-3 and PGY-4 levels and the orthopaedic surgery resident is an active participant in all spine service cases.

Sports Medicine and Shoulder Surgery

The sports medicine and shoulder surgery rotations take place at SSM Health Saint Louis University HospitalSSM Health Cardinal Glennon Children's Hospital and SSM Health St. Mary’s Hospital and its associated outpatient surgical center. This rotation provides PGY-4 and PGY-5 residents with a broad exposure to sports related injuries, including arthroscopy, shoulder trauma, arthroplasty and multiligament knee injuries.

Extensive one-on-one training is provided in both the inpatient and outpatient settings, as well as with SLU athletics. Exposure to the care of the professional athlete working with the St. Louis Cardinals baseball team is also available through rotation with the adjunct faculty of the motion orthopaedics group. In addition, shoulder experience is available at the PGY-5 level at St. Anthony’s Medical Center during the research block.

Trauma

This 10-week rotation is based at SSM Health Saint Louis University Hospital, an American College of Surgeons verified Level I Trauma Center and a tertiary/quaternary care referral center for the region.

During this rotation, residents are involved with the management of the full variety of musculoskeletal trauma, including industrial injuries, geriatric fractures, penetrating trauma and complex multiple injuries. In addition, residents obtain a broad exposure to an inpatient and outpatient elective adult trauma (i.e., malunion, nonunion) and foot and ankle reconstruction orthopaedic practice. Residents rotate through trauma at the PGY-1, PGY-2 and PGY-5 levels.

Funded Educational Meetings

Residents are funded to attend one regional and one national meeting for each research project accepted for a poster or podium presentation. In addition:

  • Residents at the R2 level of training are funded to attend an AO/ASIF Residents Basic Fracture course.
  • Residents at the R3 level do not attend any scheduled meetings/courses.
  • Residents at the R4 level are funded to attend the Annual AAOS meeting and the MD Anderson Musculoskeletal Pathology Course.
  • Residents at the R5 level are funded to attend the Smith & Nephew Surgical Approaches for Internal Fixation course, and the AO/ASIF Advanced Fracture Course.
  • Residents at the R6 level are funded to attend an ABOS review course of their choice.

Conferences

Residents participate in a variety of formal and informal conferences through their involvement with the Department of Orthopaedic Surgery.

Adult Fracture Conference is conducted and presented by the orthopaedic surgery chief resident rotating through adult trauma. It is supervised by at least one orthopaedic attending and is considered a mandatory conference for all residents in the program.

Orthopaedic Surgery Basic Science/M and M Conference is a mandatory weekly conference in which presentations are required of both faculty and residents.

Orthopaedic Surgery Grand Rounds occur on a weekly basis. They are mandatory for all residents in training and also mandatory for all active faculty. Didactic presentations are prepared by both faculty and residents.

Pediatric Orthopaedic Surgery Conference/Grand Rounds are conducted quarterly and a didactic presentation is prepared by either a resident or faculty. This conference is mandatory for all residents and all active staff at SSM Health Cardinal Glennon Children's Hospital.

Additional subspecialty conferences are conducted on a weekly basis and residents rotating on that service actively participate in those conferences. These include weekly the Hand and Upper Extremity Conference, weekly Spine Conference, weekly Pediatric Fracture Conference, weekly Friday morning Pediatric Orthopaedic Conference.

Anatomy and Surgical Technique Laboratory

Each week selected residents participate in human anatomy and surgical approaches to the musculoskeletal system and the surgical skills laboratory.

Overseas Rotation in Malawi

Each year, one resident from the R5 year is supported to experience a five week overseas elective in the medically underserved nation of Malawi, financially supported by the Richard J. Kemme, M.D. Endowed Professorship in Orthopaedic Surgery.

Dr. Kemme is a graduate from the SLU Medical School (’56) and the SLU Orthopaedic Residency Program (’61) and is nationally recognized for his volunteer work in Malawi through Orthopaedics Overseas. During the first week of the elective, the resident is accompanied by one of a full-time orthopaedic faculty member and helps run a fracture course for local orthopaedic assistants that is sponsored by the AO Foundation.

General Description
The resident will participate in both outpatient and inpatient evaluation of patients on the service under the direction of Dr. Nyengo Mkandawire, a fully-trained Malawian orthopaedic surgeon who serves as the head of the department of surgery and the deputy undergraduate dean of the Malawi College of Medicine. The resident will be an active participant in the surgical management of specific orthopaedic conditions and procedures deemed appropriate by the attending orthopaedic staff, as well as in all the weekly conferences and in the Malawi Orthopaedic Association Annual General Meeting and Scientific Conference.
Specific Description

 

Approximately half of the clinical time will be spent on the wards participating in teaching rounds. Topics covered will include all areas of orthopaedics, including how to take an appropriate history, conduct a physical exam on an orthopaedic patient, application of relevant clinical anatomy, interpretation of radiographs, general management principles of specific conditions and fractures as well as the timing and role of operative intervention. The remainder of the clinical time will be spent visiting the district hospitals and assisting the local orthopaedic clinical officers in the management of their patients on the ward and in the clinic.

The weekly schedule is generally as follows:

  • Monday: Assisting Professor Mkandawire in the OR.
  • Tuesday: Ward rounds in the morning, OR with Mr. Ngulube in the afternoon.
  • Wednesday: Site visits to the district hospitals.
  • Thursday: Ward rounds in the morning, clinic in the afternoon.
  • Friday: Assisting with add-on cases in the OR, teaching conference in the afternoon.
Goals  
The overall goals for the resident at this level are to master an orthopaedic history and physical exam and to be able to apply the appropriate imaging and laboratory studies to establish a diagnosis in an underserved setting. The resident is expected to have a sound knowledge of general orthopaedics, trauma care and joint reconstruction. The resident is expected to have a sound knowledge of the overall treatment principles that apply to patients with general orthopaedic maladies.
Selection Process
The participating resident is identified from those applying for the elective during the first three years of residency. The resident must be in excellent academic standing. In the case of multiple qualified applicants, the resident with the earliest application date will be given preference. However, selection is at the discretion the program director, associate program director and assistant program director.

Facilities

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Application Process

The Saint Louis University Department of Orthopaedic Surgery participates in and will only accept application through the AAMC Electronic Residency Application Service (ERAS). Contact your medical school for the student work station kit. Our program offers five PGY-1 categorical slots.