PGY-1 – Orthopedics

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Musculoskeletal Care 

Rotation Coordinator: Ed Paul, MD  

Description of Rotation and Educational Experience: 

  • This curricular component is taught in part in a one-month block rotation under the supervision of our Family Medicine providers as well as Orthopedic Surgeon and Sports Medicine specialists. 
  • In addition, part of this curricular component is a longitudinal experience taught over the three years of residency in which residents evaluate and manage acute and chronic MSK pathology under the supervision of Family Medicine, Sports Medicine and Orthopedic faculty. 

Teaching Methods: 

  • Patient encounters in the hospital and outpatient clinic during the one-month block rotation 
  • Patient encounters in the Family Medicine clinic, Sports Medicine clinic, Procedural clinic and hospital 
  • Precepting during clinic time 
  • Didactic sessions during noon conference 

Outpatient Patient Care Skills and Knowledge: 

  • Practice-Based Learning and Improvement:
  • Learns and improves via performance evaluation 
  • Learns and improves at the point of care 
  • Learns and improves via feedback 
  • Monitors practice with a goal for improvement 
  • Patient Care and Procedural Skills:
  • Clinic and Urgent Care management of both acute and chronic MSK complaints 
  • Physical Exam components to evaluate specific joints, muscles, tendons and ligaments  
  • Indications for imaging, understanding appropriate image type to order 
  • Splinting/Bracing 
  • Pain management including:
  • US guided joint injections 
  • Trigger point injections 
  • Understanding Prolotherapy, PRP, stem cells 
  • Indications for referral to Orthopedic specialty providers 
  • Indications for surgical intervention 
  • Post surgical management of MSK complaints 
  • Inpatient Care Skills and Knowledge:
  • ER, OR and ward management of acute MSK injuries 
  • Pre-, intra- and post-operative management of patients presenting for surgical management of MSK pathology 
  • Systems-Based Practice:
  • Transitions patients effectively within and across health delivery system 
  • Recognizes system error or inefficiency and advocates for system improvement 
  • Medical Knowledge:
  • Demonstrate growth toward mastery in clinical knowledge of above domains 
  • Interpersonal and Communication Skills:
  • Works and communicates effectively within an interprofessional team 
  • Communicates effectively with patients and caregivers 
  • Professionalism:
  • Accepts responsibility and follows through on tasks 
  • Appropriate utilization and completion of health records 
  • Exhibits integrity and ethical behavior in professional conduct 

Evaluation and Feedback: 

  • Learners will be given regular formative feedback by faculty during their rotation and are encouraged to have an explicit mid rotation progress feedback session to help guide performance 
  • Faculty will complete formal evaluation through New Innovations at the end of the rotation 
  • Learners will evaluate faculty and the rotation through the New Innovations platform 

Reading List: 

Pfenninger & Fowler’s Procedures for Primary Care 

Internet resources: 

  • Uptodate 
  • Dynamed 
  • AAFP 

Sample Schedule: 

 Monday Tuesday Wednesday Thursday Friday Saturday 
 Ortho Rounding Ortho Rounding  Ortho Rounding  Ortho Rounding  Ortho Rounding  Ortho Rounding
AM Ortho Clinic Ortho Clinic Ortho Clinic FM Clinic Ortho Clinic 
PM Ortho Clinic FM Clinic Ortho Clinic FM Didactics Ortho Clinic  

Author: Brandon Abbott
Associate Program Director. My passions are teaching and watching the light bulb go off. I benefited from fantastic mentorship and inspiring clinical instruction and hope to pay it forward!