The Hospitals of the Program
Primary Institution
Boston Medical Center
Boston Medical Center is a private, not-for-profit,academic medical center with a capacity of 547 licensed beds. The facility provides an impressive spectrum of pediatric and adult care services - from primary and family medicine to advanced specialty care. The hospital receives 420,000 patient visits annually; our emergency department alone, with its twenty-four hour Level I trauma center, capably met the demands of 84,000 visits last year. Boston Medical Center is a founder of Boston HealthNet; a partnership of the medical center, Boston University School of Medicine and thirteen community health centers in neighborhoods throughout Boston. The center employs a diverse work force of nearly 4,500 physicians, medical residents, nurses, allied health professionals, and a broad variety of service and support personnel, all working together to provide the highest quality, patient-focused care.
Although partnered with Boston University School of Medicine, Boston Medical Center independently received more than thirty million dollars in sponsored research funding for a variety of research activities in 1998 and currently oversees 472 research and service projects. BMC operates thirty-eight residency-training programs with more than 620 resident positions.
Orthopaedic residents get the majority of their trauma experience at the medical center, which sees more than 2,000 trauma admissions each year. The medical center serves as a tertiary referral center for complex trauma and spine problems for a three state area. Approximately 30% of the procedures are performed on patients referred for orthopaedic management. Four rotations at the medical center focus the resident experience on trauma, pediatrics/hand, spine, and reconstruction/sports. The center has two sites and three sets of operating suites, including a new outpatient facility with “smart rooms”. The bulk of the educational schedule occurs at the main medical center, and the largest proportion of residents are at the medical center.
The rotations are set up so that each resident spends a significant amount of time with one attending, allowing a close interaction over months. This one on one teaching in the clinic and the operating room creates a concentrated learning experience in each major orthopaedic area.
For more information on Boston Medical Center click here.
Affliated Institutions
The Lahey Clinic
Orthopaedic surgery residents at the Lahey Clinic receive individual teaching from the attending staff daily. Residents participate in preoperative evaluation of patients in the outpatient clinic, emergency room, and during preoperative case conferences. During their rotation each resident spends four hours per week with attending surgeons in the outpatient clinic. Exposure in the clinic includes diagnosis and nonoperative treatment as well as surgical planning. A weekly preoperative case conference is held, reviewing complex problems and their potential solutions. Attending orthopaedic surgeons present patients who have not had definitive treatment in an open forum with residents and other attending surgeons.
The Lahey clinic provides a tremendous volume of cases for the residents to scrub on. Residents are given opportunities to perform surgery commensurate with their level of training and surgical skills. Reconstructive surgery, hand surgery, sports medicine, and foot and ankle surgery are all well represented. A new rotation at the outpatient surgery center has increased the number of procedures that residents have to choose from.
All residents participate in acute postoperative patient care. An inpatient physician assistant helps to improve logistical issues and paperwork.
For more information on the Lahey Clinic click here.
Shriners Hospital for Children
The Shriners Hospital for Children in Springfield, Massachusetts provides for each resident an educational experience in pediatric orthopaedics. A wide spectrum of orthopaedic disorders and deformities in children is evaluated and treated from a referral base which includes New England, New York state, Puerto Rico, the U.S. Virgin Islands, the Dominican Republic, and Cyprus.
Out-patients (14,000 per annum) are seen in weekly specialty clinics: hip, foot, scoliosis, shoulder, genetics, rheumatology, hand, neuromuscular, knee, growth discrepancy, myelodysplasia, lower limb deficiency, upper limb deficiency, metabolic, and general orthopaedics. In-patients are seen on daily teaching rounds and their cases are discussed in daily conferences.
Residents participate in the initial evaluation, definitive treatment plan, and follow-up of all patients. This begins with the clinic assessment and preoperative planning and continues through the operating room and then the postop and rehabilitation course. Residents have primary responsibility for the peri-operative care of in-patients. Surgery is carried out by residents under direct supervision by attending faculty. The independent activities of individual residents are increased according to demonstrated abilities and skills.
Conferences include patient management and core curriculum conferences on Mondays, a case presentation conference on Tuesdays, hand conference on Wednesdays, morbidity and mortality conference once a month on Thursdays, and ward rounds every day. Once a month patients are presented to visiting lecturers immediately preceding didactic sessions.
For more information on Shriners Hospital for Children, please click here.
Boston Veterans Administration Medical Center
The Boston VA Medical Center is a tertiary care institution dealing exclusively with the medical and surgical needs of the veteran population. This facility deals almost exclusively with reconstruction in adults. Approximately 90 percent are males, with residual war wounds. The focus is on hip and knee arthroplasty and the treatment of fractures. In addition, care is provided by nonsurgical means for conditions such as osteomyelitis and other chronic infectious diseases.
In addition to performing supervised surgery, the more senior residents can supervise junior residents in performing the simpler types of orthopaedic surgery. Similarly, on rounds and in caring for patients in the ward and clinic settings, the more senior residents supervise the junior residents. More autonomy is available for the residents at the VA than other hospitals in the system.
