OUTLINE
FOR DESCRIPTION OF ROTATION
ROTATION: Orthopedics/Sports
Medicine
PRECEPTOR: Steven
J. Merkow, M.D. (Rotation Coordinator for the Orthopedics Group)
Timothy
K. Schultz, Michael Tjarksen, et al
DURATION: One Month (PG-II) You may elect to complete an additional half month in the second year
or include the half months in the third year with this group or other
designated preceptors
1. GOALS/OBJECTIVES:
·
Become familiar
with common office orthopedic problems, their diagnosis, and their treatment.
·
Develop practical
experience with treatment of common fractures and with splint and cast
application.
·
Learn the family
physicians’ role in orthopedic problems, knowing when consultation is necessary
and how to effectively communicate orthopedic findings.
·
Become familiar
with common orthopedic surgical procedures so that families can be counseled
effectively.
·
Become familiar
with sports related injuries, their treatment and rehabilitation.
2. EXPECTATIONS: Document all experiences listed on the Ortho
Documentation Sheet, found in your Ortho Articles folder.
·
Orientation – Review rotation description carefully and
meet with Dr. Merkow or designee on the first day of rotation or before to
discuss ground rules. Based on attending
input select patients you will see ahead of attendings and be prepared to
articulate your impression and plan after your exam. Practice your regional exam and review it
with the attending. Remind attendings
that you would like to actively participate in injections and casting. Try to attend clinic 5 to 6 half days per
week. Let one of the three attendings
know if you will not be able to attend.
·
Sports Medicine Clinic with Dr. Merkow – Try to attend
each Monday afternoon clinic with him.
·
Spine Clinic (Thursday afternoon) – Work with Dr.
Tjarksen to develop a focused history and exam.
·
Casting - Some of
your time in office must be devoted to working with the cast technician
(Cindy). Negotiate with her in advance so that you are doing 5 casts/week. She
will work directly with you to provide hands on teaching.
·
Discussion of
fracture care with attendings - Each week pick one patient who had a common
fracture that you had casted with the casting tech. Identify the attending physician and plan to
meet with the Orthopedist to discuss for 10 minutes the fracture care of that
patient. Let attendings know while you are seeing patients with them so that
this discussion can be held between patients or at the end of a clinic. Record
on your documentation sheet the interaction. Let Dr. Merkow know if you are
having any difficulty accomplishing this goal.
·
Call – Residents are encouraged
but not required to schedule one weekend of call during their rotation. This
optional experience allows residents to have greater exposure to the evaluation
and management of orthopedic trauma and emergencies.
·
Inpatient
surgeries - Participate/observe in at least 3 surgeries so that you understand
common operations (e.g., hip fracture, Joint replacement for osteoarthritis,
internal reduction of extremity fractures, arthroscopy).
3. PREPARATION/TEXTS:
·
Essentials of Musculoskeletal Care, Robert K. Snider, MD,
1997,
·
Physical Examination of the Spine and Extremities, Hoppenfeld,
·
Primary Care Sports
Medicine Text (kept in staffing room,
several, for primary care orthopedics & sports medicine (see staffing room
but do not remove)
4.
TYPICAL DAY/WEEK:
·
Preceptor Office – 5 to 6 half days per week with periodic
selected inpatient admissions as noted above. Attend each Monday afternoon
Sports Medicine Clinic with Dr. Merkow and Thursday afternoon Spine Clinic with
Dr. Tjarksen.
·
You should still be
able to participate with most of the important residency functions, such as
Monday-Thursday morning rounds, Tuesday morning All-staff conference, and Wednesday Resident Educational Conferences.
5. WORK-UPS/WRITE-UPS:
Variable depending on Orthopedist
you are working with. Some will ask you
to do office charting and others may ask you to perform and dictate H & P's
if you are involved with the hospital admission.
6. PROCEDURES:
·
Splint and cast
applications (5 per week with casting tech)
·
Steroid injections
into soft tissue.
7. AVAILABLE
EDUCATIONAL EXPERIENCES/CONFERENCES: Educational Conferences as noted in section
4.
8. IMPACT
OF OFFICE SCHEDULE/NOON CONFERENCES/FAMILY PRACTICE MORNING ROUNDS: You should
still be able to be involved in all residency related functions.
9. CALL AND SHARED CALL: See expectations. You will continue to be
involved in Family Practice Center call as normally scheduled.
10. WEEKEND REQUIREMENTS: You
should be scheduled for one weekend per month with an orthopedist for
additional casting and acute trauma experience.
This could be combined with call for the Family Practice Center.
11. VACATION/TIME OFF: May take one week
vacation but be certain to inform Dr. Merkow of this in advance (at the
beginning of the rotation).
Revised: 6/1/05 –
PHG:lmc