The mission of the Boston University Orthopaedic Residency & Fellowship Programs is to graduate knowledgeable orthopaedic surgeons who possess the critical analysis skills needed for lifelong learning in order to make the best treatment decisions for their patients and to be able to enact those plans in whatever clinical setting they desire. We serve the Boston area including the most vulnerable of our community, as Boston Medical Center is the largest indigent care center in the city. To accomplish this we have a mentorship based model where decision-making for individual patients in a shared decision making model is stressed as the most important element. The model also allows for the routine teaching of problem-based philosophy of care including the technical details of surgery. Residents & fellows are taught evidence based care and critical analysis consistently through experiences in clinic, lectures, critical analysis journal clubs, and the completion of research projects.