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OGME 4 & 5


​​​Goals & Objectives for PGY 4 & 5 / OGME 4 & ​5

The resident will demonstrate mastery of all OGME-3 level goals and objectives
  • Demonstrate understanding of the​ anatomy and surgical plan for:
    • ORIF of complex proximal humeral fractures
    • ORIF of complex peri-articular elbow fractures
    • ORIF of intra-articular distal radius fractures
    • ORIF of complex hand injuries
    • ORIF of simple acetabulum fractures
    • ORIF of simple pelvic ring injuries
    • ORIF of intra-articular fractures about the knee
    • ORIF of talus and calcaneal fractures
    • ORIF of complex midfoot and forefoot injuries
  • Demonstrate an ability of defining a musculoskelatal operative emergency, develop an appropriate pre-op plan and begin the appropriate procedure
  • Demonstrate an understanding of the process of diagnosis and treatment of complex post traumatic disorders including:
    • Osteomyelitis
    • Non-union
    • Failure of fixation
    • Heterotopic ossification
    • Post-traumatic arthritis
  • Demonstrate an advanced understanding of pathology surgical anatomy and operative exposures
  • Assume a leadership role in planning patient care (including assignment of cases in the OR) and teaching conference

OGME 4 – Pediatrics Goals and Objectives

  • Understand, recognize, and manage complex skeletal dysplasia.
  • Understand the etiology, diagnosis and treatment of complex hematologic disorders.
  • Understand the characteristics, pathogenesis, diagnostic features, and management of complex neuromuscular disorders.
  • Recognize and treat, in conjunction with a multidisciplinary team , cerebral palsy, myelomeningocele, muscular dystrophy, and juvenile rheumatoid arthritis.
  • Understand the clinical manifestations, treatment, and long-term prognosis of complex gait disorder and fractures.
  • Understand the etiology, diagnosis and treatment of pediatric sports medicine conditions
  • Progressively have more responsibility for the care of increasingly complex patients under the supervision of the attending physician, for teaching residents, and for ongoing follow-up and communication with patients and their families.
  • Understand the etiology, diagnosis and treatment of complex spinal deformities.

OGME 5 Pediatrics Goals and Objectives

  • Understand, recognize, and non-operatively and operatively manage complex bone cysts, bone defects and malignant tumors that occur in the growing child.
  • Understand, recognize, and non-operatively and operatively manage complex upper limb and lower limb deformities and disorders
  • Plan appropriate surgery based upon the diagnosis and clinical findings.
  • Understand the clinical manifestations, treatment, and long-term prognosis of complex gait disorders, scoliosis surgery, limb length problems, tumors, fracture care, neuromuscular disease, cerebral palsy, myelomeningocele, developmental deformities, DDH, Legg Perthes disease and congenital anamolies.

OGME 4 & 5 Sports Medicine Reconstruction Goals and Objectives

  • Demonstrate mastery of all OGME-2&3 Goals and Objectives
  • Demonstrate understanding of the anatomy and surgical plans for complex cases ie:
    • PCL reconstruction
    • PL corner repair/reconstruction
    • Combined Ligament reconstruction
    • Meniscal allograft
    • Hip arthroscopy
  • Treatment refinement in advanced patient care in the clinic, OR, ER, and on the wards, in the evaluation and treatment of sports related injuries
  • Review appropriate imaging studies to produce an appropriate diagnosis and/or differential diagnosis and treatment plan.
  • Develop refined H&P skills with particular emphasis on subtle and complex conditions of the shoulder, elbow, knee, and ankle/foot
  • Demonstrate understanding of appropriate indications for non surgical vs. surgical treatment and appropriate rehabilitation for complex injuries and conditions
  • Review and understand post operative rehabilitation protocols of patients following common sports medicine surgical procedures.
  • Effectively and responsibly evaluate patients in various post operative intervals and modify rehab protocols as necessary.

OGME 4 & 5 – Adult Reconstruction Goals and Objectives

Reading List:

  • Chapmans Orthopaedic Surgery (Third Edition)
  • Chapters
  • 104 Osteo Otomies about the hip
  • 105 Primary THA
  • 106 Failed hip arthroplasty
  • 107 Osteo Otomies about the knee for osteo arthritis
  • 108 Primary TKA
  • 109 Revision knee arthroplasty and arthrodesis
  • OKU 9
  • Chapters 33 Hip & pelvic reconstruction arthroplasty
  • 37 Knee reconstruction and replacement
  • 2007 Hip & Knee self assessment exam

The resident will:

  • Demonstrate mastery of all PGY-3 level goals and objectives.
  • Demonstrate competency in primary and revision total joint arthroplasty techniques.
  • Outline prognosis of non operative and operative treatment of the following specific conditions:
    • Post traumatic arthrosis of the knee
    • Post traumatic arthrosis of the hip
    • Acetabular dysplasia
    • Femoral acetabular impringement
    • Painful TJA
    • Loose TJA
    • Unstable TJA
    • Infected TJA
  • Demonstrates knowledge of revision surgical approaches and procedures.
  • Demonstrates knowledge of diagnosis and treatment of hip pain symptomatic total hip replacements.
  • Reads and understands material developed in the OKU Specialty Series on Hip and Knee Arthroplasty Reconstruction
  • Satisfactorily completes the OKU Self Assessment Examination for Hip and Knee Reconstruction.
  • Completes the reference syllabus for hip and knee reconstruction.
  • Assume a leadership roll in planning patient care and teaching conferences.
  • The Chief Resident will assist the PGY-3 resident in inpatient rounds and will report and coordinate with the PGY-3 resident to the attending orthopaedic resident.
  • The Chief Resident's responsibilities in the operating room include assisting the attending orthopaedic surgeon in all aspects of operative care.
  • The actual performance of all or part of the operative procedure will be accomplished either under direct supervision or semi-independently in those situations deemed appropriate by the attending orthopaedic surgeon.

Reading List:

  • Chapmans Orthopaedic Surgery (Third Edition)
  • Chapters
  • 104 Osteotomies about the hip
  • 105 Primary THA
  • 106 Failed hip arthroplasty
  • 107 Osteotomies about the knee for osteo arthritis
  • 108 Primary TKA
  • 109 Revision knee arthroplasty and arthrodesis
  • Orthopaedic knowledge update
  • Hip and knee reconstruction #3

OGME 4 Spine Goals and Objectives

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

  • Complex deformity
  • Post-traumatic kyphosis
  • Flatback syndrome
  • Failed back syndrome
  • Pseudoarthrosis
  • Adjacent segment degeneration
  • Demonstrate ability to interpret advanced imaging studies such as MRI/CT myelogram
  • Discuss various surgical approaches relevant to spinal disorders and formulate an appropriate surgical plan

Perform surgical procedures:

  • Halo application
  • Lumbar microdiskectomy
  • Anterior cervical diskectomy
  • umbar laminectomy
  • 1 or 2 level instrumented lumbar fusion
  • posterior cervical fusion with lateral mass screws between C3 and C6

Select appropriate diagnostic and therapeutic interventions for patients with postoperative complications:

  • Postoperative neurologic deficit
  • Epidural hematoma
  • Postoperative wound infection
  • DVT/pulmonary embolism
  • Dural tear/CSF fistula
  • Possess knowledge and demonstrate expertise in the discussion of the natural history of the systemic and specific conditions listed above
  • Demonstrate an advanced understanding of pathology, surgical anatomy and operative exposures
  • Assume a leadership role in planning patient care and teaching conferences on Friday morning lectures
  • Apply critical thinking in the appraisal of clinical studies read in the peer reviewed literature as well as in the treatment of patients
  • Direct the education for the more junior residents on the service

OGME 4 & 5 – Hand/Upper Extremity Goals 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.
  • Able to responsively and effectively demonstrate expertise in the finer points of hand and wrist history and physical examination, in addition to properly ordering the necessary radiographic evaluations, most appropriate to the differential diagnosis and perform appropriate algorithms (treatment plan) based on the patient and the diagnosis of the following conditions:
    • All conditions described at the PGY-3 level and arthritis of the hand, boutonniere deformity, Dupuytren's disease, flexor tendon injuries, fractures and malunions of the distal radius, fractures of the scaphoid, osteonecrosis of the carpus, fractures of the phalanges, fractures of the base of the thumb metacarpal, tumors of the hand and wrist, dynamic carpal instability, hand in cerebral palsy, the stroke hand, tendon transfers for radial and combined median-ulnar nerve paralysis, treatment of the rheumatoid hand, including thumb MP artrodesis and MCP interposition arthroplasty, basic wrist arthroscopy, ulnar sided wrist pain and instability and radial tunnel syndrome.
  • 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 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.
  • The Chief Resident will assist the PGY2/PGY-3 Resident with inpatient rounds and report in coordination with the PGY-3 Resident to the Attending Orthopaedic Surgeon as appropriate.
  • The Chief Resident responsibilities in the operating room include assisting the attending orthopaedic surgeon in all aspects of orthopaedic care. The actual performance of all or part of the operative procedure will be accomplished under the direct supervision or semi-independently in those situations deemed appropriate by the attending orthopaedic surgeon.