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OGME 2


​Goals & Objectives for PGY 2 / OGME 2

  • ​​Effectively able to evaluate the polytrauma patient or suspected polytrauma patient on presentation to the trauma resuscitation unit. Effectively detect abnormalities on physical examination and develop a plan for further investigation of diagnosis.
  • Effectively demonstrate that he/she can competently:
    • Obtain a comprehensive history
    • Perform any relevant physical examination including a through secondary survey
    • Identify appropriate radiographic imaging studies
    • Formulate a differential diagnosis and make an accurate final diagnosis
  • Define secondary conditions that require attention from a diagnostic standpoint in the context of primary diagnoses (i.e. compartment syndrome potential in the patient with tibia fx and traumatic brain injury)
  • Outline the natural history of the specific condition with and without surgical treatment
  • Describe appropriate non-operative treatment options (if they exist)
  • Describe possible operative treatment options (if they exist)
  • Describe possible complications of non-op and operative treatment
  • Establish treatment priorities in the multiply injured patient including the timing of treatment of open fractures, stabilization of long bone fractures and stabilization of intra-articular fractures
  • Be able to perform simple invasive procedures including:
  • Joint aspirations and arthrocentesis to assess communication of the joint with open wounds
  • Hematoma block
  • Closed reduction of distal radius fracture, shoulder dislocation, elbow dislocation, hand and wrist injuries, hip and knee dislocations, foot and ankle injuries
  • Insertion of distal femoral and proximal tibial traction pins
  • Application of a pelvic binder
  • Demonstrate understanding of anatomy and surgical plan for:
    • Debridement of open wounds and open fractures
    • Debridement of traumatic arthrotomies
    • Fasciotomies for compartment syndrome of the arm, forearm, leg and thigh
    • Intermedullary nail fixation of simple femoral and tibial fractures
    • Plate fixation of humeral and forearm fractures
  • Demonstrate knowledge of the indication for surgical procedures such as ORIF of lower and upper extremity fractures
  • Demonstrate an understanding of the relevant surgical anatomy of the lower extremity
  • Demonstrate an understanding of simple invasive procedures for patients such as injection/ aspiration, abscess drainage, closed reduction of simple fractures
  • Demonstrate an understanding of the classic and contemporary literature pertaining to lower extremity reconstruction through self-guided study and participation in conferences and journal club.
  • Understand, recognize, and manage simple fractures in children.
  • Understand the etiology, diagnosis, and treatment of musculoskeletal infections in children.
  • Understand osseous growth, timing of ossification centers, physeal growth, endochondral ossification and intramembranous ossification.
  • Understand, recognize, and manage simple torsional abnormalities in the growing child.
  • Be proficient in the application and removal of upper and lower extremity casts.
  • Develop H&P skills to identify the typical findings of sports medicine injuries:
    • KNEE
    • ACL tears
    • PCL tears
    • MCL tears
    • LCL/PL corner injuries
    • Meniscal tears
    • Osteochondral injuries
    • IT band syndrome
    • P-F disorders
    • Extensor mechanism injuries
    • Pes bursitis
    • SHOULDER
    • Glenohumeralinstablity
    • Labral/SLAP tears
    • Bicep tendon injuries/instability
    • RC tendinitis/impingment
    • RC tears
    • AC joint injuries
    • Glenohumeral arthritis
    • Internal impingment
  • Develop H&P skills to identify the typical findings of sports medicine injuries:
    • ELBOW
    • Ulna collateral ligament tears
    • Posterolateralrotatoryinstablity
    • Flexor/Pronator tendinitis/epicondylitis
    • Lateral epicondylitis
    • Distal bicep tendon injuries
    • Tricep tendon injuries
    • Osteochondral injuries
    • Elbow arthritis
  • Procedural Responsibilities:
    • Able to perform single invasive procedures including
    • Knee joint aspiration/injection
    • GH joint aspiration/injection
    • SA space injection
    • Pes anserine bursa injection
    • Leg compartment pressure monitoring
  • Demonstrate competence in the OR to:
    • Position patients for knee, shoulder, elbow, ankle/foot procedures
    • Prep and drape of the operative field
    • Have a pre-op plan and be able to perform a diagnostic arthroscopy of the knee, shoulder, and ankle with the ability to make the correct diagnosis of associated pathology
    • Perform basic surgical exposures of open procedures
    • Close the surgical wound
    • Apply the post-op dressing
The resident will:
  • Obtain a comprehensive history
  • Perform a thorough physical examination.
  • Formulate a differential diagnosis and make an accurate final diagnosis.
  • Discuss the theology and natural history of the specific condition.
  • Describe non-operative treatment options.
  • Describe operative treatment options.
  • Discuss complications of operative and non operative treatment.
  • Discuss the prognosis of operative and non operative treatment.
  • Demonstrate competency in primary joint arthroplasty techniques.
  • Outline a rehabilitation program.
  • Demonstrate competency with surgical approaches to the hip and knee.
  • Effectively supervise post operative care and manage postoperative operations.
  • Demonstrates knowledge of preoperative templating techniques.
  • Demonstrates knowledge of diagnosis and treatment of complications related to reconstructive procedures of the hip and knee.
  • Demonstrates development of case presentation skills.
  • Reads and understands material developed in the OKU Specialty Series on Hip and Knee Reconstruction.
  • Satisfactorily completes the OKU Self Assessment Examination for Hip and Knee Reconstruction.
  • Completes the reference syllabus for hip and knee reconstruction.

OGME 2 Spine Goals and Objectives:

Effectively evaluate the following conditions via a thorough H&P:

  • Cervical
  • Degenerative spondylosis
  • Radiculopathy/Disk herniation
  • Myelopathy
  • Rheumatoid arthritis
  • Thoracolumbar
  • Degenerative spondylosis
  • Spinal stenosis
  • Disk herniation/radiculopathy
  • Scoliosis
  • Spondylolisthesis
  • Systemic
  • Spinal osteomyelitis
  • Metastatic spine tumor
  • osteoporosis
  • Fractures and dislocations

Effectively demonstrate that he/she can competently:

  • Obtain a comprehensive history
  • Perform any relevant condition-specific physical examination including specific provocative maneuvers and tests (eg., Hoffman's sign, femoral stretch test, etc.)
  • Formulate a differential diagnosis
  • Identify appropriate radiographic imaging studies and discuss the pros and cons of each study
  • Perform basic radiographic interpretation of spinal radiographs, CT and MRI studies
  • Outline the etiology, or possible etiologies of the specific condition
  • Outline the natural history of the specific condition with and without surgical treatment
  • Describe appropriate non-operative treatment options (if they exist)
  • Describe appropriate operative treatment options (if they exist)
  • Describe possible complications of non-operative and operative treatment
  • Outline the rehabilitation program involved in non-operative and operative treatment

Demonstrate competence in the operating room to:

  • Position patients for anterior and posterior procedures
  • Application of Gardner Wells tongs/Mayfield Pin head holder or headrest
  • Prep and drape of the operative field
  • Close the surgical wound
  • Apply post-operative dressing

Be able to perform simple invasive procedures including:

  • Perform initial surgical dissection of the posterior approach to cervical or lumbar spine
  • Iliac crest bone graft harvest
  • Insertion of lumbar pedicle screws excluding scoliosis

Evaluate and communicate the status of postoperative patients:

  • Neurologic status
  • Wound status
  • Wound drainage
  • Laboratory studies
  • Demonstrate familiarity and understanding of reading materials describing the systemic and specific conditions listed
  • Demonstrate an understanding of the role of other health care providers and ancillary services in the care of patients with spinal pathology
  • Accurately locate, appraise and assimilate evidence from scientific studies relating to the patient's orthopaedic and neurologic condition. This requires knowledge of the pertinent recent literature as may be obtained in:
  • American JBJS
  • Spine
  • Journal of Spinal Disorders and Techniques
  • Journal of the AAOS
  • Journal of neurosurgery/spine
  • Neurosurgery

OGME 2 Hand/Upper Extremity Goal and Objectives:

  • Able to perform a thorough and accurate history and physical examination for a patient seen for Hand/Upper Extremity complaints. This includes the history of the chief complaint, history of injury, and the mechanism of injury, past medical and surgical history, as well as social history.
  • The physical examination should include an exam for the identification of peripheral nerve compression at the carpal, cubital, and radial tunnels, common tendinitis/tendonopathies (DeQuervain's tendinitis, ECU tendinitis, or A-1 pulley stenosis) as well as the presence of arthritis (CMC arthritis, PIP, DIP, or MCP arthritis).
  • Effectively able to evaluate the following conditions via a thorough history and physical examination and to perform most or all of their corrective surgical procedures:
  • Arthritis of the thumb-carpometacarpal joint, animal bites, carpal tunnel syndrome, DeQuervain's tenosynovitis, extensor tendon injuries and amputations, fractures of the metacarpals, infections of the flexor tendon sheath, ganglion of the wrist and hand, human bites, mallet finger, sprains and dislocations of the CMP, MCP, and PIP joints, static carpal instability, trigger finger and cubital tunnel syndrome.
  • Competent in developing initial management plan for patients with hand-related injuries and/or other complaints.
  • Demonstrates knowledge and application of knowledge of nonoperative treatment, which includes anti-inflammatories, hand therapy, applications of heat and cold as well as basics of splinting.
  • Able to perform simple invasive procedures for patients with hand-related complaints such as injections of trigger-finger, carpal tunnel, and base of thumb arthritis at the CMC joint.
  • Demonstrates the ability to perform commonly-encountered surgical procedures in hand surgical procedures in hand surgery such as carpal tunnel release, trigger finger release, release of first dorsal compartment for DeQuervain's tenosynovitis and excision of dorsal/volar carpal ganglion.
  • Possesses an understanding of the scientific basis of the diagnosis and treatment of commonly-encountered hand conditions.
  • Demonstrates knowledge of the indications for basic surgical procedures in hand surgery such as carpal tunnel release, trigger finger release, release of the first dorsal compartment, and excision of dorsal and volar ganglion.
  • Demonstrates knowledge of nonoperative treatment, hand therapy, application of heat and cold as well as the basics of splinting.
  • Demonstrates familiarity and understanding of reading materials described in diagnosis and treatment of carpal tunnel, trigger finger, tendinopathies, and thumb base arthritis.
  • Has successfully completed and mastered the concepts outlined in the OKU Subspecialty Series: Hand Surgery.
  • Has successfully completed the OKU Subspecialty Series Self Assessment Examination: Hand Surgery.
  • Has successfully read and understand the principles and concepts outlined in the Hand/Upper Extremity Reading Reference List.
  • The PGY-2/PGY-3 resident will see patients with Attendings in the Hand/Upper Extremity Clinic. Duties will include pre and postoperative evaluation of patients, preoperative work-up of patients, follow-up evaluation of operative patients and management of nonoperative hand and upper extremity problems.
  • PGY-2/PGY-3 Resident's responsibilities include floor rounds twice daily on patients admitted through the Hand and Upper Extremity Service. The activities of the PGY-2/PGY-3 resident are supervised by the Chief Resident and/or the Attending Orthopaedic Surgeon.
  • In the operating room, the PGY2/PGY-3 Resident is responsible for assisting the attending orthopaedic surgeon. The resident will perform appropriate portions of the surgical procedure as directed by the attending orthopaedic surgeon and under the direct supervision of the attending orthopaedic surgeon.