Professional Development

Senior Service Residents

Senior residents serve as professional role models and instructors for junior residents and students in all phases of clinical activity. They are, likewise, directly responsible for the supervision and evaluation of the residents and students assigned to their clinical service. The senior resident on each service is expected to resolve problems on their clinical service with the assistance of the service attendings and/or Division Director. The senior resident years are designed to prepare residents for independent clinical practice.

Teaching Responsibilities

All physicians have a responsibility to teach other physicians. This is an ongoing responsibility. Residents are expected to teach junior residents, medical students, nurses, and other allied health professionals. They are also encouraged to begin to take responsibility for the education of their colleagues by conducting conferences, rounds and informal teaching sessions.

Extramural Medical Education

In order to maintain high quality medical care, physicians must be engaged in continuous medical education. The Residency Program Director must help residents develop mature, self-directed learning habits and an ability to evaluate their own educational strengths and needs. No matter what the resident's personal and professional goals may be, setting aside time for study and professional development, is a priority. The development of a commitment to ongoing education during the residency is essential to maintaining successful high quality practice after graduation.

Continuing Medical Education

Resident Coverage

The resident carrying the ER Consult Beeper, will be responsible for providing the initial evaluation of all Orthopaedic consultations during the day (7:00 am – 6:00pm), i.e. the same coverage responsibility as first call during the evening.

The daily call pager resident coverage should be discussed weekly between the available junior residents.

The Orthopaedic Nurse Practitioner will respond to many routine calls during the day helping to facilitate flow of operative cases.

Surgical Assistants will be utilized for scheduled cases in the main OR on Monday, Tuesday, Wednesday and Friday.

Each Resident (Junior and Senior) MUST attend at least one half day of scheduled outpatient visits every week with an attending on the service, and SHOULD average at least two half days of outpatient visits per week.

The use of beepers during scheduled cases detracts from the care of the patient most in need of our full attention, the patient on the table. Therefore, the operating team should turn off or hand off their beepers while scrubbed on a case. It is the responsibility of the residents and attendings scrubbed in on surgery to promptly attend to their calls and clinical business prior to and following the scheduled surgical procedure.

Lines of Communication

Uniformity in the lines of communication between junior residents, senior residents and supervising attending physicians is preferred with the understanding that flexibility is required in varying educational environments. We believe that junior residents gain from presenting their clinical evaluation and initial formulation of plans to their resident/faculty supervisors. Likewise, senior residents gain experience and confidence by presenting their management plans to a supervising faculty member. Senior level residents must also be aware of all patient care activities on their clinical service and hence, must be an integral part of any reporting system.

Similarly, senior residents need autonomy in decision making, yet all parties need to be aware that the attending physician carries ultimate responsibility for patient care. Therefore, by recommending appropriate lines of communication between junior residents, senior residents and attendings, it is possible to maximize the educational experience from each case, as well as provide for safe and effective patient care. The following suggestions for reporting have been recommended by residents and faculty as a group with these goals in mind:

Junior residents will report all clinical evaluations, laboratory results and initial management plans to their senior resident on service.

The senior resident on service will discuss these findings and plans with the junior resident and acquaint themselves with the specifics of the case. This senior level resident is expected to critique and build on the presentation. After consultation, the senior resident may then encourage the junior resident to report directly to the supervising attending physician or the senior resident may choose to present the case directly to the supervising attending physician. In general, the presentation of simple and straightforward cases should be made by junior residents, while complex cases should be the responsibility of the senior level resident.