Orthopedic Surgery Residency Program

An x-ray style image of the human body, showing the skeletal structure. Several joints are highlighted with a bright yellow circle with red radiating outward from the centre. The background is a blue radial gradient. White text says 'Welcome to the Discipline of Orthopedics Residency' in the bottom-left corner.

Program Overview

The overall goal of the Orthopedic Surgery Residency Program is to train orthopedic surgeons to provide compassionate, contemporary musculoskeletal surgical care to the community with standards in keeping with those defined by the Royal College of Physicians and Surgeons. This pursuit encompasses a primary goal to train competent orthopedic surgeons who are ready to either proceed directly to practice general orthopedic surgery in a community setting or to progress to a clinical fellowship of their choice in an orthopedic surgery subspecialty. Our philosophy is to not only train towards surgical competence, but also for success in non-medical expert roles and balance in life in general, in an effort to encourage our residents to become well-rounded practitioners who are capable of collaboration and cooperation in the workplace and the community.

The five-year program is designed to produce a "general" orthopedic surgeon. The Royal College anticipates Orthopedic Residency to launch the Competence By Design program in 2020.

By the end of the program, all orthopedic residents should be able to demonstrate the following:

Education

  1. To provide the best possible educational experience in a productive environment.
  2. To adhere to the Goals and Objectives of the CanMEDS program set forth by the Royal College of Physicians and Surgeons in Canada.
  3. To foster a commitment to lifelong learning.
  4. Within the framework of the program using different aspects of clinical and non-clinical work and evaluation the program hopes to instill a lifelong commitment to the CanMEDS principles and learning.

Research

  1. To stimulate and foster scholarly research in both basic and applied medical science as we continue to create and evaluate new musculoskeletal knowledge.
  2. It is the goal of the program to train orthopedic residents to be competent in research design and execution and to understand the importance of research indirectly and directly in the practice of orthopedic surgery.

Personal Development

  1. To develop in our residents those qualities that will be critical to leadership in an ever changing Canadian health care environment-integrity, professionalism, scholarship, collegiality, creativity and compassion.
  2. As a result of community involvement, internationally activities and Royal College activities undertaken by individuals in the program it is hoped that residents will recognize the commitment to community and scholarly activity as an essential part of the health advocate, scholar and professional role of the orthopedic surgeon and incorporate it into their own practice.

Patient Care

  1. To provide the highest level of complete musculoskeletal care for the people of Newfoundland and Labrador.

All orthopedic residents are automatically enrolled in Surgical Foundations, which is a Royal College Competence By Design (CBD) program completed in the first 18-24 months of general surgery residency. You will complete this program along with first-year residents in orthopedics and obstetrics and gynecology.

We have one mandatory rural rotation of three months duration in the PGY 3 year. This is done in Gander, NL; Corner Brook, NL; Saint John, NB or at another community hospital site approved by PGME and the Program Director.

A three-month elective is scheduled in the PGY 4 year and residents are encouraged to travel for this time, exposing themselves to areas of interest.

Clinical Rotations

YEAR ROTATIONS DURATION (4-week blocks) Location (Notes)
PGY1 Internal Medicine 1 HSC
Rheumatology 2 week rotation 1 SCMH
Physiatry 2 week rotation 1 LMC
Vascular Surgery 1 SCMH
Orthopedic Surgery 2 HSC
Orthopedic Surgery 3 SCMH
Research 1 HSC
General Surgery 1 HSC (ACS)
Orthopedic Surgery 1 JCHC
Orthopedic Emergency 1 HSC/SCMH
Elective 1 Resident's choice
PGY2 Orthopedic Surgery 1 HSC
Orthopedic Surgery 1 SCMH
Neurosurgery 1 HSC
ICU 8 weeks HSC
Radiology 5 weeks HSC
PGY3 Orthopedic Surgery 1 HSC
Plastics 1 HSC
Orthopedic Surgery 1 SCMH
Core Community 1 Resident's choice
PGY4 Orthopedic Surgery 1 SCMH
Elective 1 Resident's choice
Orthopedic Surgery 1 HSC
Orthopedic Surgery 1 JCHC
PGY5 Orthopedic Surgery 2 HSC**
Orthopedic Surgery 1 JCHC
Orthopedic Surgery 1 SCMH

Legend

HSC - General Hospital, Health Sciences Centre, St. John's, NL
LMC – Dr. L.A. Miller Centre, St. John's, NL
JCHC - Janeway Children's Health and Rehabilitation Centre, Health Sciences Centre, St. John's, NL
SCMH - St. Clare's Mercy Hospital, St. John's, NL
** PGY 5 will either do two HSC rotations or two SCMH rotations

New Schedule for Ortho Residents 2022-23

PGY 1

Internal Medicine (1 block)
General Surgery (1 block)
Emergency (1 block)
Radiology (1 block) maybe PGY 2
Vascular surgery (1 block)
Ortho (mix adult/peds - (8 blocks)

PGY 2

ICU (2 blocks) – maybe PGY 1
Neurosurgery – (3 blocks)
Ortho (8 blocks)

PGY 3

Plastics (2 Blocks)
Community (3 Blocks)
Ortho (8 blocks)

PGY 4

Electives (3 blocks)
Ortho (adult/peds 10 blocks)

PGY 5

Ortho (adult/peds 13 blocks)

Orthopedic Surgery Residency Program in CBD

(Adapted from https://www.royalcollege.ca/rcsite/cbd/what-is-cbd-e)

Competence by Design (CBD) is the Royal College of Physicians and Surgeons of Canada’s major change initiative to reform the training of medical specialists in Canada. It is based on a global movement known as Competency-based medical education (CBME), and is led by the medical education community. The objective of CBD is to ensure physicians graduate with the competencies required to meet local health needs. It aims to enhance patient care by improving learning and assessment in residency.
 
CBD can be explained as:

  • Stages of training
  • Clear learning objectives
  • Residents observed
  • Observations documented
  • Committee Reviewed
  • Progress to the next stage

CBD is a hybrid CBME model designed to work within the Canadian context, and combines a time-based and an outcomes-based approach to learning. It reviews the design, implementation, assessment and evaluation of each specialty program across Canada’s 17 medical universities, using CanMEDS 2015 as an organizing framework of competencies.
 
In CBD, progression of competence occurs within a structured but flexible curriculum consisting of five core components. More specifically, in a competency-based approach, competencies required for practice form a framework and are accordingly organized into a progressive sequence. Promoting resident progression forms the basis for the design of all curricular elements: learning experiences that are tailored to the acquisition of competencies, instruction that is competency-focused and assessment that is programmatic in approach.

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