2019-2020 Guide to Resident Rotations

Overview

The LSU Orthopaedic program gives residents early autonomy in the operative suite that progresses throughout their residency. Residents, as early as PGY-2, operate independently with appropriate senior resident supervision. As a graduate of our program, you will gain the necessary confidence and move on to your respective institution feeling well-equipped to handle various orthopaedic cases. 

Residents contribute and take part in weekly/monthly didactics. Monthly grand rounds with guest lecturers are attended by both residents and faculty. A highlight of the didactic curriculum is the monthly cadaver labs often led by world-renowned surgeons. 

 

 

Our program boasts a very large volume of penetrating trauma and orthopaedic injuries incurred from such trauma, and our residents are expected to master the diagnosis and treatment these orthopaedic injuries. Residents run services and clinics with minimal oversight and are held to high expectations. Our residents are comfortable in handling complex trauma cases and the basic fracture patterns one would encounter in a community practice setting. They are comfortable managing complex poly-trauma patients and managing long bone fractures. We get a well-rounded training focused on trauma with plenty of focus on the orthopaedic subspecialties. 

Access to a level-1 trauma center, a pediatric orthopaedic service, and an orthopaedic oncologist all in the same city under the LSU umbrella, makes our program unique. Additionally, our residents spend much of their training with a high-volume private practice in Baton Rouge, LA and at a high-volume community hospital in Lafayette, LA. Residents get ample clinical/operative experience in all orthopaedic subspecialties and see a wide variety of common to rare/complex pathology. Because of our early and frequent experiences in the operating room, our graduating residents feel comfortable either moving on to fellowship training or to general practice.

All of our residents receive an annual stipend in the amount of several hundred dollars for orthopaedic texts which they can use at their discretion. Thanks to generous donations from our alumni, all incoming residents will receive personalized lead and loupes. Additional support/funds exist for each residency year to travel to courses.

PGY-1

• Children's Hospital - New Orleans, LA
  • Pediatric Orthopaedics (3 months)
    • Rotation with faculty focusing on pediatric orthopedics, orthopedic oncology, and scoliosis
    • As an intern, this is a unique rotation that offers a very hands-on operative experience
    • Monthly grand round presentations
    • Daily fracture conference discussing previous day's surgical cases and emergency department consults (educational)
    • Monthly journal club
    • Call with Chief Resident (PGY-4)
    • Extensive experience in fracture reduction, splinting, casting
    • Extensive research opportunities with children's faculty
• VA Medical Center - New Orleans, LA
  • General Orthopaedics
    • Residents will spend one day a week scrubbing cases with Dr. Christopher Marrero
• University Medical Center - New Orleans, LA
  • Orthopaedic Trauma (3 months)
    • Responsible for day-to-day floor coverage and consult management from 7A-7P
    • Early high volume hands-on operative experience
    • Extensive experience with fracture reduction, fracture management, and management of poly-trauma patients
    • High-volume penetrating trauma
    • Experience with orthopaedic trauma, foot/ankle surgery, sports medicine, spine, trauma, degen, MIS, deformity and oncology
  • Neurosurgery (1 month)
    • High-volume private practice neurosurgery practice
    • No call
    • Scrub Spine cases only
    • Minimal clinic; primarily operative experience
  • Plastic Surgery (1 month)
    • Learn the basics of soft tissue coverage in relation to orthopaedic trauma
    • No overnight call
    • Help manage day hand consults
    • Majority of cases scrubbed are Hand Cases
    • Experience in flap coverage, skin grafting, and dermal biologic substitutes
  • Musculoskeletal Radiology (1 month)
    • Attending directed experience in reading MSK radiology
    • Experience in reading MRIs
  • General Surgery Trauma (1 month)
    • Experience at high-volume Level 1 trauma center
    • Experience in managing poly trauma patients with both visceral and orthopedic injuries
    • 24-hour call with the trauma team
    • Work with emergency department personnel/trauma surgeons in trauma activations
  • Burn Surgery (1 month)
    • Learn the basics of treating soft tissue injuries
    • Extensive experience with skin grafting, dermal substitutes, soft tissue management
  • Trauma Intensive Care Unit (1 month)
    • Learn the basics of managing poly trauma patients, triaging and injuries
    • Call with trauma chief and second-year resident
    • Experience in central line placement, chest tube management, etc.
  • Adult Reconstruction (3 months)
    • Work directly with staff performing both primary and complex revision total hip and total knee arthroplasties
    • Heavy hands-on experience, 3-4 cases per week
      
      • Wednesday: OR
      • Thursday: Clinic
    • Wide variety of Adult Reconstruction cases, such as AVN of the hip, hip and knee deformities, periprosthetic  infections, use of spacers, constrained and hinge devices, segmental replacements
    • Splits responsibilities with PGY-2s and PGY-4s

PGY-2

• University Medical Center - New Orleans, LA
  • Orthopaedic Trauma (6 months)
    • 2 days of clinic per week
    • 2 operative days a week (Tuesday/Thursday)
      • Extensive experience in the basics of orthopedic trauma
      • High-volume femur nails, tibial nails, ankle fractures, peri-articular  fractures, pelvis/acetabulum, upper extremity trauma, ortho poly trauma
      • High-volume level one trauma center with penetrating trauma
      • Extensive experience in managing gunshot wounds with orthopedic injuries
      • Extensive experience in managing polytrauma orthopedic surgery patients
      • Bi-monthly foot/ankle operative days with Dr. Meredith Warner
      • Experience in knee/shoulder arthroscopy, ACL reconstruction, rotator cuff reconstruction
    • Shared call with a second PGY-2 resident
      • Extensive experience in a fracture reduction, hand trauma, spine trauma
      • Alternating months of hand call, spine call every five weeks
    • Responsible for daily rounding on floor patients and shared responsibilities for floor management
    • Extensive experience with multi-disciplinary management of patients; working with physical therapist, occupational therapist, social workers
    • Dedicated PA-C for orthopedic trauma service responsible for floor management and social work/DME
    • Experience with orthopaedic trauma, spine, trauma, degen, MIS, deformity and oncology
  • Pediatric Orthopaedics (3 months)
    • Shared call pool with PGY-2/PGY-3/PGY-4 residents
    • Extensive experience in fracture reduction, splinting/casting, fracture management
    • High-volume surgical practice with extensive experience in Basic pediatric orthopedic cases and scoliosis surgery
    • Responsible for assisting/overseeing intern responsibilities
    • Rotating services with specific attendings for approximately two weeks
      • Experience with sports, scoliosis surgery, orthopedic oncology, general pediatric orthopedics

PGY-3

• Baton Rouge Orthopaedic Clinic - Baton Rouge, LA
  • Sports Medicine
    • Learn the basics of sports medicine physical exam, evaluation, and diagnosis
    • Learn interpretation of advanced imaging studies
    • Extensive experience with shoulder and knee arthroscopy, hip arthroscopy elective weeks available if desired by the resident
    • Call is at a Level 2 trauma center that functions as a Level 1 - only take unreferred ER calls for new consults when your assigned attending is on call “LSU Call” (call for LSU post-op patients only and NOT new consults is q3)
    • Baton Rouge has their own journal club which many program alumni practicing in the region attend
    • General orthopaedics OR at a university-owned surgical center one day per week
    • Hands-on experience with many “bread and butter” cases - high amount of autonomy in the OR
    • Have the opportunity to work with the team physicians for LSU football during the fall season
    • Working with the football team includes attending practices, attending post-practice clinics at the stadium, and the potential to be on the sidelines on gameday with the team if interested   
    • Cover an assigned high school football team during home games
    • If you are not on the rotation during the fall, the opportunity exists to participate with other LSU athletes (baseball season, etc.)
•  Oschner Medical Center - Kenner LA (suburb of New Orleans)
  • Arthroplasty
    • Work with three physicians specializing in adult reconstruction
    • 2-3 days a week of OR time and 2 days of clinic per week 
    • Learn the evaluation and management of knee and hip arthritis as well as complex conditions such as failed prior arthroplasties 
    • Gain experience in preoperative templating total joint arthroplasty cases
    • Have the opportunity to scrub cases in shoulder arthroplasty with our PD, Dr. Hartman, if desired
    • Call is at a community hospital and is 5 days per month for new consults 
    • Call is a great experience to see more geriatric trauma/hip fractures and is an adjunct to the type of traumas seen the first 2 years of residency at the Level 1 trauma center
    • Call for postop patients only is every other night
    • Attend conference in New Orleans every Wednesday morning
• Lafayette General Orthopaedic Hospital - Lafayette LA
  • General Orthopaedics
    • Excellent general orthopaedic surgery experience
    • Resident's will have their own clinic with their own nurse
    • Surgeries booked from clinic will be booked under the resident's name into their own OR
    • Opportunity to tailor the experience based on the resident's interest by booking more cases of the category you want more experience with (ACL reconstruction, complex extremity trauma, shoulder arthroplasty, hand/upper extremity surgery, etc.)
    • No ER call and no weekends
    • Extremely high amount of autonomy in the OR - faculty serves more of a supervisory role which fosters an atmosphere for resident decision making and troubleshooting
    • Resident is in charge of picking all vendors/implants for the planned cases which is an extremely valuable learning tool for future practice
    • One morning a week will scrub 1-2 Knee/Hip/Shoulder arthroplasties with a community surgeon before clinic starts
    • Video conference with New Orleans weekly on Wednesday mornings
• Hand Center of Louisiana - New Orleans LA
  • Hand Surgery
    • 2-3 OR days/week and 2 days of clinic
    • Operate at both a private surgical center based around hand surgery, as well as at University Medical Center (UMC)
    • Opportunity to work with one of the most well-known hand surgeons in the United States
    • Excellent level of autonomy in the OR
    • Resident gains experience in preoperative planning and implant selection for all cases at UMC
    • Take trauma call with the trauma team 2 days per month at UMC, there is no other call obligation
    • No weekend clinical responsibilities
    • Gain experience with “both sides” of hand surgery at both locations - the traumatic “mangled extremity” and more chronic outpatient conditions at the other facility
    • Attend weekly Wednesday morning academic conferences and monthly journal clubs in New Orleans

PGY-4

• University Medical Center - New Orleans, LA
  • Orthopaedic Trauma (3 months)
    • 2 days of clinic per week
    • OR 2x a week
    • Flex Friday: foot/ankle cases, arthroplasty cases, or protected education time on Fridays
    • Upper-level home call, upper-level resident typically comes in for cases
    • Responsible for teaching and supervising junior residents in the OR, providing support for consults
    • Responsible for choosing case order, positioning and implants for OR cases
      • Residents learn to consider overall workflow of the OR
      • Must have good understanding of when and why to use which companies for cases
    • Coordinates trauma specific weekly teaching
      • Usually choose 3-4 articles per week to discuss Monday morning
    • Support junior resident at weekly indications conference
    • Experience with orthopaedic trauma, spine, trauma, degen, MIS, deformity and oncology
  • Spine
    • Large volume of ALIF, lateral interbody fusion, as well as adult deformity, as the tertiary referral center in the area
    • Spine call is 1-week q5-6 weeks
    • See a wide variety of acute pathology
  • Orthopaedic Oncology
    • Work with Dr. Cable at UMC
      • OR Wednesday
      • Clinic Thursday
      • OR/Clinic Friday
    • Tertiary referral center for the entire state, parts of Texas, and Mississippi
    • See many “Zebras”
    • Work closely with pathology, MSK radiology, radiation oncology, and surgical oncology teams
    • Provides a great introduction to oncology for all residents
    • Leave the rotation comfortable with a tumor workup
• Children's Hospital - New Orleans, LA
  • Chief Resident
    • Coordinate junior residents at Children's Hospital
    • Mentorship model, change attending weekly
    • Handle concerns and call schedule
    • Responsible for supervising intern on Children's Hospital rotation
    • Goal is for intern to be proficient in upper and lower extremity reductions and casts, so they are ready for call as a PGY-2 and PGY-4
    • Opportunity for increased autonomy if demonstrate technical ability and desire
• Baton Rouge Orthopaedic Clinic - Baton Rouge, LA
  • Foot & Ankle
    • Work with a former LSU resident with his large, high-volume private group
    • 2 days of clinic, 2 days of OR + see patients at the LSU Medicaid Clinic in BR
    • Learn valuable and very applicable clinical and surgical skills
    • Help cover Dr. Lalonde's “city call”
    • Free lunch every clinic
    • A chance as an upper level resident to take a step back and get invaluable insight into a very successful private practice model
  • Adult Reconstruction (3 months)
    • Work directly with staff performing both primary and complex revision total hip and total knee arthroplasties
    • Heavy hands-on experience, 3-4 cases per week
      • M/T:OR/clinic
    • Wide variety of Adult Reconstruction cases, such as AVN of the hip, hip and knee deformities, periprosthetic  infections, use of spacers, constrained and hinge devices, segmental replacements

PGY-5

• University Medical Center - New Orleans, LA
  • Orthopaedic Trauma Chief
    • Head of the orthopaedic trauma service
    • In charge of coordinating ORs, call cases, implant vendors
    • Take backup home call for a junior resident and primary call for LSU Ortho patients
    • In charge of setting up the LSU Orthopaedics journal clubs
    • Teach “bread and butter” trauma surgery to junior residents while receiving increased autonomy in complex cases
    • Experience with orthopaedic trauma, spine, trauma, degen, MIS, deformity and oncology
• Baton Rouge Orthopaedic Clinic - Baton Rouge, LA
  • General Orthopaedics Chief
    • In charge of your own general orthopaedic clinic
    • Have 2-3 OR days a week with extremely high levels of autonomy
    • Coordinate schedules, implants, etc.
    • Have the opportunity to do a half day clinic every week at Angola State Prison Farm
    • Can tailor experience based on your interests
    • In charge of arranging Baton Rouge journal clinic
    • Take “LSU” call only, no call for new consults
    • Work with subspecialized surgeons in the area to help cover complex cases at the LSU ASC
• Lafayette General Orthopaedic Hospital - Lafayette, LA
  • General Orthopaedics Chief
    • Similar to description of PGY-3 Lafayette rotation, you are in charge of the service
• Oschner Medical Center - Kenner, LA (suburb of New Orleans)
  • Sports Medicine 
    • Work with our Residency Director, Dr. Hartman
    • Great experience advancing skills in complex shoulder and knee surgery
    • Have the opportunity to do arthroplasty cases several days a month with high levels of autonomy
    • ER home call 5 days a month at a community hospital