PGY-1 (Intern year)
Interns rotate through surgical subspecialties, which include orthopedic surgery – 6 months. This is broken down into one month of the introduction to history and physical examination under the tutelage of Dr. Hawkins; two months on the Foot and Ankle Service; and finally three months on the ED/Orthopedic Trauma Service. The other six months consists of one-month rotations each on: plastic surgery, neurosurgery, trauma surgery, vascular surgery, radiology/rehabilitation, and surgical ICU. Over the course of the year simulation exercises, casting labs, anatomic dissections, and surgical simulation on saw bones and cadavers are performed.
While assigned to the orthopaedic service, the resident will see patients in the emergency department, clinics, and on the hospital floors. When assigned to other services, the resident will be under the supervision of the appropriate faculty and will have no assigned duties in the orthopaedic department.
PGY-2 (1st year in orthopaedics)
The PGY-2 consists of formal instructions and training in Orthopaedics. Three months of the PGY-2 year will be spent on the orthopedic trauma service including the Emergency Room. The resident is responsible for all orthopedic patients entering the emergency department. The resident is to be immediately available in the hospital at all times and has appropriate backup with attendings as well as a chief resident in house during the day and two upper level residents and an attending physician immediately available while on call. As part of this rotation, the resident will manage inpatients that are not considered trauma patients. This is overseen by both a senior resident and attending. Responsibilities include admission workup via the ER, preoperative evaluation, and participation in the operative procedures, postoperative care, and discharge planning.
Three months are on the hand service, which is primarily an outpatient-based rotation spent under the supervision of the orthopedic hand surgeons. However, the resident is responsible for following the inpatients when appropriate. Three months is spent on the sports medicine service. This rotates among the eight orthopedic sports medicine surgeons and again is primarily outpatient based, however there is also exposure to some inpatient surgery such as revision ACL, TKA, reverse and total shoulder surgery, etc. Three months is on the pediatric orthopedic service. This rotation incorporates both inpatient and outpatient surgeries including spinal surgery for all the children under the age of 16. The final three months during the PGY-2 year is spent on the ER/orthopaedic trauma surgery service. This service is primarily inpatient and has a large inpatient census. Here the residents work with senior residents in addition to the attendings unlike the other three mentioned rotations, which are typically more of the apprenticeship model.
PGY-3 (2nd year in orthopaedics)
The rotations at the PGY-3 level will be every three months. The PGY-3 resident will be assigned to both inpatient and outpatient services. The rotations include tumor, spine, and arthroplasty experience. The final three months are spent with a research block. Clinical assignments will vary according to the service. Call will be no more than every fourth night and will include in-house call as well as some home call. While on the tumor service or spine service you will work one on one with the attendings. While on the arthroplasty service, there will be a PGY-5 and at times a fellow. However, this service has four full-time arthroplasty surgeons and a very high case volume. The research block allows for the resident to both help with ongoing prospective studies by enrolling patients and data collecting, and having the time to work/develop his/her own project.
PGY-4 (3rd year in orthopaedics)
Residents at this level will bear increased responsibility for the care of patients assigned to them. This includes increased level of participation in operative procedures, in postoperative and rehabilitative management, and increased independence in the outpatient department. One three-month rotation will be at the Shriners Hospitals for Children, Greenville Hospital. All educational and clinical responsibilities will be under the direction of the faculty and staff of the Shriners Hospitals for Children. The resident on this rotation will be relieved of all clinical and educational responsibilities at Greenville Memorial Hospital including all educational conferences. One three-month rotation will be on sports medicine. The majority of this rotation is at the outpatient surgery centers with eight fellowship-trained sports medicine orthopaedic surgeons. All types of arthroscopy and ligament reconstruction is taught. Both private and hospital sports clinics allow for learning the exam, diagnosis and non-operative treatment of sports related injuries. One three-month rotation is on the Orthopaedic Trauma Teaching Service. The resident will assist the PGY-5 resident in the evaluation and management of all orthopaedic trauma patients under the direct supervision of the three fellowship-trained orthopaedic traumatologists. The resident will assume an increasingly responsible role in the management of these patients in both the inpatient and outpatient settings, with emphasis on continuity of care. Every effort is made to ensure that the residents see the trauma patients in follow-up either in the private office or the hospital clinic over the four month period. The resident also has a responsibility to teach and direct the PGY-1 and PGY-2 residents on the trauma service. The last three-month rotation is on the hand service. The hand service has two full time fellowship trained hand surgeons, again in a one-on-one learning experience. While on the hand service, the resident will interface with the private hand surgeons as well, giving the residents exposure to the private practice settings.
PGY-5 (4th year in orthopaedics)
Residents at this level will be expected to assume responsibility for all patients on the Orthopaedic Trauma Teaching Service (a three-month block) and any others assigned to their care. A three month rotation on pediatric orthopaedic surgery is under the direction of two fellowship trained pediatric orthopaedic surgeons at Greenville Memorial Hospital. The rotation prepares the resident for most of the general pediatric orthopaedic problems encountered in practice and provides a balance between the experience at the Shriners Hospital. The resident assigned to the Elective Service for four months will participate in both inpatient and outpatient surgery with a private practice group that provides the sports medicine coverage for Clemson University. This rotation focuses on sports medicine with time dedicated to caring for Clemson under the supervision of six fellowship trained surgeons at Blue Ridge Bone and Joint. This rotation gives the resident the opportunity to polish his/her skills both inside and outside the operating room. It also allows for the resident to focus on any special areas of interest. As chief on the Elective Service the resident will have the responsibility of making resident assignments to all electively scheduled operative cases. The resident is responsible for presenting orthopaedic complication (M&M) conference monthly. The resident is also responsible for all administrative functions during this period, some of which include the call schedule, vacation requests, and clinic staffing. The other four months is spent on the Orthopaedic Trauma Teaching Service. The resident is responsible for the evaluation, treatment, rehabilitation, and general care of all patients assigned to the Orthopaedic Trauma Teaching Service. This resident is expected to be knowledgeable about patients under his/her care. The organization and presentation of the patients at case surgical review conference, held weekly, is the responsibility of this resident. The last three-month rotation is on the arthroplasty service just as described at the PGY-3 year, but the responsibilities and surgical skills are refined further with this rotation.
All basic science topics and general orthopaedic subjects are covered in our regular conference schedule. Each sub-specialty area is covered during the specific rotation as well as in the general conferences. Regular general and specialty journal clubs are held.
Subjects of general interest: ethics, economics, legal issues, research design, etc are covered in a core curriculum series. Multiple educational seminars with invited guest professors are held each year.
The educational contributions provided by a core of fellowship-trained faculty include basic sciences, emergency services, foot and ankle surgery, hand surgery, spine surgery, joint arthroplasty surgery, sports medicine, adult reconstruction, orthopaedic trauma surgery, pediatric orthopaedics, and orthopaedic oncology.