TRAINING PROGRAM AND CURRICULUM


The residency training program in Orthopaedic Surgery at the University of Western Ontario offers training in all subspecialty areas of orthopaedics.  Orthopaedic care is organized into Clinical Teaching Units (CTUs) in Arthroplasty, Trauma, Reconstructive Surgery, Sports Medicine, Hand and Upper Limb Surgery, Paediatric Orthopaedic Surgery, Spine Surgery, and Foot and Ankle (Foot and Ankle is included as a component of the Sports Medicine and Trauma CTUs). Experience in Orthopaedic Oncology occurs in conjunction with the Sarcoma Unit at Mount Sinai Hospital in Toronto.


The residents rotate through each of these subspecialty disciplines.  The residents will complete six months for most subspecialty disciplines.  Large clinical volumes ensure that there is optimum hands-on experience for the residents during their training.

Resident progress is monitored with twice yearly interviews by the Program Director and annual interviews with the Chief of Orthopaedic Surgery.  In addition, discussion of the In-Training Evaluation Reports with the supervising physician is carried out in the middle and at the end of each rotation.


Core surgical training occurs during PGY-1 and PGY-2 years of residency.  During the core training, residents complete rotations in Orthopaedic Surgery, Emergency Medicine (consisting of ER - ER/Ortho Hybrid), Anaesthesia, Ambulatory General Internal Medicine, Radiology, Traumatology, Plastic Surgery, Vascular Surgery, Critical Care, Rheumatology, Physical Medicine & Rehabilitation, and Community Orthopaedic Surgery. During the first two years of training, approximately one-half the time is spent on an orthopaedic service.

 

The final three years of training are exclusively devoted to Orthopaedic Surgery.  The academic year is divided into 13 four-week blocks.  A typical residency schedule is described below.


PGY-1:

The first postgraduate year consists of the following rotations:

- 6 Blocks Orthopaedic Surgery (three 2 Block rotations)

- 1 Block Anaesthesia

- 1 Block Plastic Surgery

- 1 Block Ambulatory General Internal Medicine

- 1 Block Traumatology

- 1 Block Radiology

- 1 Block Emergency Medicine

- 1 Block Emergency Medicine/Ortho Hybrid


PGY-2:

The second postgraduate year consists of the following rotations:

- 5 Blocks Orthopaedic Surgery (2 & 3 Block rotations)

- 2 Blocks Vascular Surgery

- 2 Blocks Critical Care Trauma Centre

- 2 Blocks Community Orthopaedic Surgery

- 1 Block Rheumatology

- 1 Block Physical Medicine & Rehabilitation


PGY-3 to 5:

The residency program is run on a Clinical Teaching Unit basis with residents assigned to specific teaching units with rotation-specific objectives for junior and senior rotations.  There is also a two-block elective, and one block of Musculoskeletal Oncology.


During the final year of training, one block is devoted to Academic Enrichment and Knowledge Consolidation.


TEACHING


The Orthopaedic Program at the University of Western Ontario has evolved as a structured program in which every member of the department is expected to participate in teaching. All trainees should view this as a major responsibility and share this commitment to teaching.


This teaching obligation is especially true with regard to the medical students. Many students now spend considerable time in either elective or selective rotations in Orthopaedic Surgery. These rotations are in high demand, not only because of the nature of our specialty but also because of the rewarding experience as expressed by previous students. Some of these students are seriously considering Orthopaedic Surgery as their future. Therefore, encouragement and participation is required.


Compulsory attendance is demanded for all trainees (residents and students) at all formal didactic teaching sessions. This includes Orthopaedic Surgery Grand Rounds from 07:15 to 08:15 and the Orthopaedic Resident Seminar Teaching from 08:30 to 11:30 every Wednesday morning.  The notices for these sessions are updated in the Weekly Events section and in the UWO Orthopaedics Full Calendar on this site.  All trainees are to be released from service commitments by their staff for these teaching times and attendance is mandatory.


SEMINARS


Daily seminars in all subspecialty areas are a key component of our training program.  City-Wide Grand Rounds occur on Wednesdays at 07:15, and are followed by the Academic Half-Days that include seminars, lectures, surgical simulation, and anatomy instruction.  Journal Club is held once monthly usually at one of the attending physician's home.


TRAINING SITES


Victoria Hospital

This is the site of the Paediatric, Trauma, Foot and Ankle, Spine, Critical Care, Vascular Surgery, and Plastic Surgery Clinical Teaching Units.


St. Joseph's Health Care London

This is the site of the Hand and Upper Limb Centre, and Rheumatology Clinical Teaching Units.


University Hospital

This is the site of the Arthroplasty/Adult Reconstruction, Sport Medicine, and Foot and Ankle Clinical Teaching Units.


Fowler Kennedy Sport Medicine Clinic

This is the site of the Sport Medicine Clinical Teaching Unit.


Mount Sinai Hospital, Toronto, Ontario

This is the site for Orthopaedic Oncology.


RESEARCH


In the PGY-3 year, three blocks are allotted for research.  This may be basic or clinical and is at the discretion of the trainee with the advice and guidance of the research committee.  A review of available research opportunities is given at the beginning of each academic year.  Residents may select from these options or pursue study of their own design.  Each resident is expected to carry out one clinical or basic science project annually to be presented at the Annual Residents' Research Day conference held in the fall of each year.  As well, this material will also be submitted by every resident to the Annual Canadian Orthopaedic Residents' Association Meeting.  Residents who wish to pursue a more in-depth research focus have the opportunity to participate in Masters level programs they desire.


Residents should discuss in each academic year, their proposed subject of research with Dr. David Sanders, Director of Research, who will correlate the projects with the appropriate consultant. The Postgraduate Medical Education Office has a "Resident/Fellow Travel Reimbursement Fund" to support trainee travel to present their research at meetings.  The deadline for submissions is April 30 and October 31.  You may also access the Schulich website for further information at:


http://www.schulich.uwo.ca/medicine/postgraduate/travelaward


SERVICE


Residents and students will be assigned to a specific orthopaedic team based on well-designed educational objectives. Ultimate authority for the activities of each team rests with the responsible consultant. It is expected that the senior resident in each hospital or on each team, will assume considerable responsibility acting, in fact, as a junior attending staff member. Junior attending staff member residents will be delegated responsibilities commensurate with their level of training. In order for the team approach to be successful, however, no member should assume any responsibility for any activity which they are not familiar with. We feel that the strength of our program owes much to this philosophy.


On-call rosters are prepared monthly by each training unit. On-call responsibilities will meet PAIRO guidelines. While we acknowledge that being "on-call" is of a high service-oriented nature, nevertheless, it provides an excellent teaching and learning experience.


IN-TRAINING EVALUATIONS


Our program has been constructed so that adequate exposure will be provided in all major areas of Orthopaedics, sufficient to prepare the final year resident for the Royal College Fellowship Examination. Assessment of each individual resident's performance is done during and at the end of each three-month rotation. As well, each resident is interviewed by the Program Director twice yearly to discuss their progress. It is expected that each resident will write and pass the OITE Examination each November. The PGY-2 residents will be obliged to write the Royal College Principles of Surgery Examination in May.

The notices for the upcoming orthopaedic weekly activities are displayed on the UWO Orthopaedics Full Calendar. Attendance of residents and students is at the discretion of the Chiefs of Service or appropriate Faculty members, except for the compulsory didactic sessions discussed above.


In addition to resident evaluations, consultant evaluations are performed after each rotation by the resident staff and a composite evaluation is done for each consultant at the end of the year by all residents.


HOLIDAYS


All hospitals in our training program are prepared to share in allotting one week of holiday time for each resident during each three-month rotation. Statutory holidays will be distributed equitably. A five-day holiday period will be arranged over the Christmas period. All holidays must be arranged through the appointed senior resident and coordinated with the Chief of Service at each hospital and the individual consultant. As a general principle - holidays should not be taken in association with conventions and meetings or the Christmas season, as this causes difficulties in arranging coverage for the services.


APPEAL MECHANISM


Postgraduate medical trainees registered with the Faculty of Medicine, Postgraduate Medical Education Office whose performance has been judged unsatisfactory by their teachers have the right to appeal. The grounds of an appeal may include medical, compassionate or extenuating circumstances, bias, inaccuracy or unfairness.

The full Appeal Mechanism Policy is available through the UWO Postgraduate Medical Education Office.

 

RESIDENT HANDBOOK


The Schulich Resident/Fellow Handbook can be accessed by clicking on this link:

http://www.schulich.uwo.ca/medicine/postgraduate/Documents/Residents/Resident_Handbook.pdf