Clinical Learning Opportunities
Our orthopaedic residency program offers an organized educational program with appropriate
supervision and a strong base of varied clinical experiences. The faculty is committed to teaching
and has a record of scholarship and research activity. At UTMB, residents see enough volume for an
excellent clinical experience, but not so much that it interferes with their overall education.
Our department enjoys strong support from the hospital, medical school, other academic departments as
well as hospitals and specialty centers in the surrounding area. Although residents are well supervised,
they will be given opportunities to assume increasing responsibility as their capabilities develop.
PGY 1 - Intern Year
The resident’s first year includes six months of orthopaedics, and six months divided between various
surgical subspecialties. The current schedule includes Orthopaedic rotations in Joint Arthroplasty,
Sports Medicine, Pediatrics, TDCJ, and Foot and Ankle. Other rotations consist of Vascular Surgery,
Neurosurgery, Surgical ICU, Burns, and Night Float/Trauma Acute Care.
PGY2 – PGY5
After the intern year, residents begin rotations through the UTMB Orthopedic Surgery Clinical Services.
Residents will also rotate through hospitals and specialties in Houston and the surrounding area.
The volunteer faculty at these participating institutions are crucial in providing the great variety
of clinical education provided here.
St. Luke’s Episcopal Hospital
Texas Orthopaedic Hospital
MD Anderson Cancer Center
The Sports Medicine service emphasizes sports medicine and acute and chronic disorders of the knee and shoulder. Educational objectives include:
- Knowledge of anatomy and biomechanics of knee and shoulder.
- Knowledge of sports medicine, emphasizing off-season training methods, pre-participation exam and disqualifying
conditions, on-the-scene exam for injury, and criteria for return to play.
- Knowledge of early- and long-term knee and shoulder rehabilitation, including modalities, exercise, and orthotics.
- Ability to use arthroscopic diagnostic and surgical techniques for managing disorders of the shoulder, knee, elbow, and ankle.
- Ability to evaluate and surgically treat knee and shoulder disorders utilizing joint replacement, arthrodesis, and other techniques as needed.
- Ability to evaluate and non-operatively manage chronic knee and shoulder disorders.
- Ability to evaluate and manage, both operatively and non-operatively, extremity trauma, including fractures, with emphasis on the shoulder and knee.
The Joint Arthroplasty service emphasizes reconstructive surgery of the hip, including proximal femoral
and pelvic osteotomies, arthroplasty, and fixation of pelvic fractures. Educational objectives include:
- Knowledge of anatomy and biomechanics of hip and pelvis.
- Knowledge of early and long-term rehabilitation of patients with hip disorders and evaluate and manage chronic hip disorders non-operatively.
- Knowledge of principles of prosthetic design and materials in total hip replacement and to evaluate and plan prosthetic and non-prosthetic arthroplasties.
- Ability to evaluate and operatively manage chronic hip disorders using techniques including joint
replacement, non-implant arthroplasty, osteotomy of the pelvis and hip, and arthrodesis.
- Ability to evaluate and manage extremity trauma with an emphasis on the pelvis, hip and upper femur, both operatively and non-operatively.
The Pediatrics Orthopaedics service deals with all aspects of pediatric orthopaedics. Educational objectives include:
- Knowledge of normal and abnormal musculoskeletal development and anatomy.
- Ability to assess and manage common pediatric orthopaedic disorders including developmental dislocation of the hip,
scoliosis, avascular necrosis of the hip, slipped capital femoral epiphysis and clubfoot.
- Ability to assess and manage pediatric neuromuscular diseases, limb length discrepancy,
common angular and torsional variations, and pediatric trauma both operatively and non-operatively.
The Spine Surgery service manages adult spine problems, including degenerative disease, infection, trauma, and tumors. Educational objectives include:
- Knowledge of the anatomy of the spine, spinal cord, and nerve roots.
- Proficiency in assessing low back and neck pain and non-operative and operative management
with specific emphasis on the psychological aspect of back pain. Knowledge of the sound principles of spine rehabilitation programs.
- Ability to assess and manage, non-operatively and operatively, acute disc herniation of the lumbar, thoracic, and cervical spine.
- Ability to assess and manage spinal trauma, both non-operatively and operatively.
- Ability to assess and manage spinal tumors, primary and metastatic, with the same approach that is used in the trauma principles of reconstructing the spine after extensive spinal resection.
- Ability to assess and manage spinal disorders, such as spondylolisthesis, adult scoliosis, and post-traumatic deformities.
- The residents will become comfortable in the use and handling of modern spinal instrumentation, including hooks, rods, plates, pedicle screws, and wires.
Foot and Ankle Surgery
The Foot and Ankle service manages patients with acute and chronic disorders of the foot, particularly those with diabetic ischemic foot disease,
as well as foot, ankle, and leg trauma. Educational objectives include:
- Knowledge of anatomy and biomechanics of the foot and ankle.
- Ability to assess and manage, operatively and non-operatively, chronic foot disorders including bunions and other dynamic deformities and motor and sensory deficits.
- Ability to assess and manage acute disorders of the foot and ankle including inflammatory states.
- Ability to perform operative reconstruction of the foot and ankle, including arthrodesis.
- Ability to assess and manage, operatively and non-operatively, trauma to the foot, ankle, and leg.
- Knowledge of identification and antibiotic susceptibility of organisms.
- Ability to plan and execute long-term non-operative management of complex musculoskeletal infection, including chronic osteomyelitis and diabetic foot infection.
- Knowledge of long-term rehabilitation.
- Ability to plan and execute operative management of complex musculoskeletal infection, including debridement, antibiotic bead implantation,
reconstruction with and without bone lengthening or transport (Ilizarov), arthroplasty, and arthrodesis.
The Hand Surgery service deals with acute and chronic disorders of the hand, wrist, elbow, and shoulder, including tumors and congenital anomalies
and upper extremity trauma. Educational objectives include:
- Knowledge of anatomy and biomechanics of the upper extremity.
- Ability to assess and manage acute upper extremity problems, including inflammatory states and infection.
- Ability to assess and manage chronic upper extremity disorders, including rheumatoid arthritis, motor and sensory deficits, and resulting deformities.
- Ability to assess and manage hand and upper extremity trauma including fractures, tendon, nerve, and vascular injuries.
- Proficiency in microsurgical techniques.
General Orthopaedics and Texas Department of Criminal Justice (TDCJ)
The Texas Department of Criminal Justice (TDCJ) Service is a general orthopaedic service, meeting the orthopaedic needs of the inmates of the Texas
Department of Criminal Justice System. Educational objectives include:
- Knowledge of the anatomy and biomechanics of the shoulder, knee, hand, and foot.
- Knowledge of early- and long-term shoulder, knee, hand, and foot rehabilitation, including modalities, exercise, and orthotics.
- Ability to manage chronic knee, shoulder, hand, and foot disorders.
- Proficiency in the arthroscopic diagnosis and surgical management of shoulder, knee, elbow, and ankle disorders.
- Ability to operatively manage shoulder, knee, hand, and foot disorders, including joint replacement and arthrodesis.
- Ability to operatively and non-operatively treat extremity trauma, including fractures, of the shoulder, knee, hand, and foot.
The UTMB Department of Orthopaedics and Rehabilitation offers a broad rehabilitation experience for the orthopaedic resident.
A multidisciplinary team approach to patient care is a prominent feature of patient care, both in the inpatient setting and in the clinic.
The orthopaedic resident has extensive opportunities to participate in and direct the team’s treatment of patients. These experiences as
well as participation in journal club, lectures, and faculty teaching rounds lead to an in-depth understanding of both short- and long-term management
strategies to optimize functional outcomes and quality of life.
Educational objectives are to increase the residents knowledge and ability in the following areas:
- Ability to recognize and manage complications of orthopaedic and neurologic impairment including immobility, spasticity, pain, paralysis, sensory loss, and cognitive deficits.
- Ability to order ancillary services, monitor functional progress, and direct the multidisciplinary team.
- Ability to measure functional outcomes including independence in daily living skills, mobility, vocational potential, and psychosocial adjustment.
- Knowledge of impairment, disability, and handicap measures and community resources, including assistive technology to optimize functional independence and vocational productivity.
- Ability to implement both nonsurgical and surgical treatments of contractures and the potential complications of these treatments.
Both junior and senior residents take call, averaging once every seven to eight nights. Due to the level of activity in UTMB’s emergency room,
the resident can expect to be busy on call nights dealing with orthopaedic trauma.