Rotations In Orthopaedic Surgery - PGY IV and PGY V

PGY-IV

Currently the PGY 4 year at UC Irvine is divided into four 3-month rotations: Long Beach Veterans Administration, Long Beach Memorial Medical Center (Trauma and Elective) and UCI Joint Service.

As a PGY-IV resident the longitudinal development of the resident's evaluation and management of adult and pediatric orthopaedic problems continues. There is emphasis on patient evaluation for elective procedures, identification of surgical and non-surgical treatment options, preoperative planning, and acquisition of more advanced technical skills. Residents continue to gain more responsibility and independence as they take both primary and back up call.

The three months spent at Long Beach Veterans Administration is to prepare the residents for their transition to practice and instill a sense of confidence in their abilities to care for patients. They lead the foot and ankle service with patient evaluation, surgical scheduling and operative care. They are the assistant to the chief resident who is working mainly on the total joints service.

Long Beach Memorial Medical Center is a 6-month rotation split between elective cases and trauma. For the three months on trauma, you continue to hone your operative skills and increase your operative experience under the supervision of three orthopaedic traumatologists and an upper extremity trauma specialist. For the elective service, we work with a number of part time private practice physicians who take great pride in teaching residents. Both rotations are very operative heavy with one on one teaching mentorship by the attendings. All call is from home for 2 nights per week.

While on the total joints service at UCI, you will be responsible for all aspects of patient care from the initial consult evaluation to the post op visits. The resident on the total joints service is also rresponsible for coordinating all joint replacement education responsibilities during this time period as well, which includes monthly journal clubs, weekly journal readings, and weekly didactic lectures.

 

PGY-V

The PGY-V year the resident assumes the mantle of chief resident on the respective services, the resident spends 6 months at UC Irvine Medical Center and 6 months at the Long Beach Veterans Administration. The PGY-V year requires the assumption of responsibility for primary decision making to patient evaluation and management. The assumption of responsibility for care of the full spectrum of trauma and elective orthopaedic cases, under the direction of faculty, is expected. The supervision and teaching of junior residents, interns, and medical students is also required. Administrative duties are assumed. Although major decision-making responsibilities have been assumed, staff directly supervises all surgical procedures and patient management.

As a chief resident, we do a six-month rotation at UC Irvine and six months at the VA. The chief residents act as attendings during the year in that they manage the orthopaedic services, orchestrate the OR cases and help run resident clinic. All clinics and OR cases are supervised, but the chief resident is usually able to make appropriate decisions in managing patients and attendings are there for guidance and help in refining operative indications as well as techniques and postoperative management. This year is also a great year to help educate junior residents and help them progress early on during their residency as well. The chiefs are very comfortable in taking the juniors through cases that come through the ED during the night/day.

The VA is a unique experience as it is run like one’s own private practice. You have your own clinic, sign up your own patients for surgery, perform the surgery and follow them post op for six months. You also learn to manage patients non-surgically as well. There is always an attending available at clinic and the OR, but this is an opportunity for you to act as if you are on your own (with constant backup).

Call is from home and is one weekend a month during the VA rotation. During the UCI rotation, weekday call is splint between the two chiefs and they also take one weekend call a month.

Link to PGY-I
Link to PGY-II and PGY- III

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