PGY-1 (intern year)
The PGY-1 is designed to provide a broad based general medical experience with an emphasis on those experiences essential to a surgical specialty. Interns rotate through surgical subspecialties, which include orthopaedic surgery-2 months; pediatric surgery-1 month; neurosurgery-1 month; general surgery/trauma-2 months; emergency services-1 month; plastic surgery-1 month; rehabilitation-2 weeks; radiology-2 weeks; vascular surgery-2 months and ICU surgery- 1 month. While assigned to the orthopaedic service, the resident will see patients in the emergency department, clinics, and on the hospital floors. When assigned to other services, the resident will be under the supervision of the appropriate faculty and will have no assigned duties in the orthopaedic department.
PGY-2 (1st year in orthopaedics)
The PGY-2 begins the formal instruction and training in orthopaedics with assignment to the emergency department, operating suite, inpatient wards and the subspecialty rotation foot and ankle surgery. The rotations at this level will occur at bi-monthly intervals. Four months of the first year will be spent on the orthopaedic service in the emergency department. While assigned to the emergency department, the resident is responsible for all orthopaedic patients seen in the emergency department, both private and unassigned. The resident is to be immediately available in the hospital at all times. Two months of the elective rotation will be spent on the inpatient service, which includes admission work-up, preoperative evaluation, and participation in operative procedures, postoperative care, and discharge planning. The other two months of the elective rotation will be spent in outpatient surgery with a strong emphasis on sports medicine. The resident will be under the direct supervision of the attending. The remaining four months will be spent on foot and ankle under the direction of fellowship-trained orthopaedic surgeons. Time will be spent in both the private surgeon’s office as well as hospital clinics. PGY-2 residents will be assigned anatomy conferences and lectures to be presented to the department.
PGY-3 (2nd year in orthopaedics)
The rotations at the PGY-3 level will be every four months. The second-year resident will be assigned to both inpatient and outpatient services. There are rotations to private offices for hand, tumor/spine, and rthroplasty experience. Clinical assignments will vary according to the service. Unscheduled cases added to the OR schedule shall primarily be the responsibility of this level unless a conflict exists. The resident assigned to hand will devote two mornings to this rotation and any other time necessary to enhance the educational experience. The resident assigned to tumor/spine service will devote two mornings and one afternoon to each rotation and any other time necessary to enhance the educational experience. The resident assigned to the arthroplasty rotation will devote two mornings and any other time necessary to enhance the educational experience. Night call will be in the emergency department for four months and on the inpatient service for the remaining eight months. The resident will be assigned certain conferences and lectures to be given during this year. The on-call assignment will be one rotation on the first-call and two rotations on the second-call roster.
PGY-4 (3rd year in orthopaedics)
Residents at this level will bear increased responsibility for the care of patients assigned to them. This includes increased level of participation in operative procedures, in postoperative and rehabilitative management, and increased independence in the outpatient department. One rotation will be at the Shriners Hospitals for Children, Greenville Hospital. All educational and clinical responsibilities will be under the direction of the faculty and staff of the Shriners Hospitals for Children. The resident on this rotation will be relieved of all clinical and educational responsibilities at Greenville Memorial Hospital including all educational conferences. One rotation will be on sports medicine. The majority of this rotation is at the outpatient surgery centers with four fellowship-trained sports medicine orthopaedic surgeons. All types of arthroscopy and ligament reconstruction is taught. Both private and hospital sports clinics allow for learning the exam, diagnosis and non-operative treatment of sports related injuries. In order to continue emphasizing basic science, the PGY-4 on the sports rotation is expected to prepare and present materials for the pathology/basic science conference bi-weekly under the direction of GHS faculty. The other rotation is on the Orthopaedic Trauma Teaching Service. The resident will assist the senior resident in the evaluation and management of all orthopaedic trauma patients under the direct supervision of the two fellowship-trained orthopaedic traumatologists. The resident will assume an increasingly responsible role in the management of these patients in both the inpatient and outpatient settings, with emphasis on continuity of care. Every effort is made to ensure that the residents see the trauma patients in follow-up either in the private office or the hospital clinic over the four month period.
PGY-5 (4th year in orthopaedics)
Residents at this level will be expected to assume responsibility for all patients on the Orthopaedic Trauma Teaching Service and any others assigned to their care. A four month rotation is at the Shriners Hospitals for Children, Greenville Hospital, during which all clinical and educational assignments will be under the direction of the staff and faculty of the Shriners Hospital. The resident on this rotation will be relieved of all clinical and educational responsibilities at Greenville Memorial Hospital including all educational conferences. The resident assigned to the Elective Service for four months will participate in both inpatient and outpatient surgery. This rotation gives the resident the opportunity to polish his/her skills both inside and outside the operating room. It also allows for the resident to focus on any special areas of interest. As chief on the Elective Service the resident will have the responsibility of making resident assignments to all electively scheduled operative cases. The resident is responsible for presenting orthopaedic complication (M&M) conference monthly. The resident is also responsible for all administrative functions during this period, some of which include the call schedule, vacation requests, and clinic staffing. The other four months is spent on the Orthopaedic Trauma Teaching Service. The resident is responsible for the evaluation, treatment, rehabilitation, and general care of all patients assigned to the Orthopaedic Trauma Teaching Service. This resident is expected to be knowledgeable about patients under his/her care. The organization and presentation of the patients at case surgical review conference, held weekly, is the responsibility of this resident.
Curriculum
All basic science topics and general orthopaedic subjects are covered in our regular conference schedule. Each sub-specialty area is covered during the specific rotation as well as in the general conferences. Regular general and specialty journal clubs are held.
Subjects of general interest: ethics, economics, legal issues, research design, etc are covered in a core curriculum series. Multiple educational seminars with invited guest professors are held each year.
Sample Rotation
The educational contributions provided by a core of fellowship-trained faculty include basic sciences, emergency services, foot and ankle surgery, hand surgery, spine surgery, joint arthroplasty surgery, sports medicine, adult reconstruction, orthopaedic trauma surgery, pediatric orthopaedics, and orthopaedic oncology.