Our residency program is run on a “mentorship/preceptee” basis. Each resident works 1-on-1 with the assigned attending for a 10-week block. This system allows the attending to ascertain the level of competence of the resident in all realms of patient care, and permit progressive assumption of responsibility.

Adult Orthopaedic Surgery, including Joint Reconstruction

Residents participate in two adult reconstruction rotations (PGY 2 and PGY 5). The adult reconstruction rotations involve residents in the diagnosis and management of lower extremity disorders, appropriate forms of bracing and nonsurgical management, and surgical management ranging from arthroscopy to total joint replacement. PGY3 residents complete an orthopaedic oncology rotation where they are also exposed to principles and techniques of joint and soft-tissue reconstruction. Residents on the sports, hand, and foot and ankle services also participate in joint replacement procedures of the shoulder, elbow, hand, and ankle.

Pediatric Orthopaedic Surgery, including Pediatric Trauma

Residents are first exposed to Pediatric Orthopaedics during their PGY-1 year, where at least 2 days per week are spent on Pediatric Orthopaedics during their 6 month Orthopaedic rotation. Residents also complete one rotation in pediatric orthopaedics during their PGY3 year and one during their PGY4 year. These rotations expose residents to the full range of pediatric musculoskeletal disorders. Residents also participate in multidisciplinary clinics (spina bifida), where they have the opportunity to learn from faculty in other related disciplines. Residents on the pediatric rotations frequently participate in the care of pediatric trauma patients. Moreover, as there is no separate pediatric call team, all residents on call participate daily in the care of children with a range of fractures, including patients with multisystem injuries under the primary care of the pediatric surgery department. During their WakeMed rotations during the PGY3 year, residents also encounter the gamut of pediatric trauma, from playground to high-energy injuries. The pediatric emergency department at WakeMed is one of the busiest children’s EDs in North Carolina. Residents also participate in pediatric care during their hand, oncology, and sports medicine rotations.

Trauma, including Multisystem Trauma

Residents complete trauma rotations at UNC during the PGY2 and PGY5 years and at WakeMed during the PGY3 year. These rotations expose residents to all aspects of fracture care, from low- to high-energy injuries. Residents work closely with the general surgery trauma service in the coordinated care of patients with multisystem injuries. In addition to this time spent on a dedicated trauma service, all residents are routinely exposed to fracture management during call responsibilities.

Residents complete spine rotations in the PGY2 at UNC and PGY3 at WakeMed. These rotations focus on care of adult spine patients, including patients with disk disease and adult deformity. Residents participate in a multidisciplinary spine clinic and learn the contributions of other specialties to surgical and nonsurgical spine care. Residents have extensive exposure to spine trauma through spine trauma call, which is shared with neurosurgery at UNC. Residents at WakeMed also participate in spine call and elective spinal surgery. The two pediatric surgery rotations at UNC are also a comprehensive spine experience, where residents learn surgical and nonsurgical treatment of spinal deformity and trauma in this age group.

Hand Surgery

Residents complete 2 rotations in hand at UNC; one as a PGY 2 and a second rotation as a Chief. Further hand surgery experience is obtained at WakeMed as a PGY3. Residents at WakeMed participate in a weekly hand conference, consistently attended by UNC-affiliated physicians, private practice hand surgeons, as well as many hand therapists. This multidisciplinary conference focuses on all aspects of hand care, including trauma. This conference is in addition to the didactic curriculum provided at UNC. Residents have extensive exposure to hand trauma. Residents are on daily hand call at WakeMed, while hand call at UNC is shared with plastic surgery.

Foot Surgery in Adults and Children

Residents complete one rotation in foot and ankle surgery during the PGY3 year. As in all rotations, residents are exposed to surgical and nonsurgical care, taught a thorough history and physical, and learn principles of bracing, orthotics, and prosthetics.

Athletic Injuries, including Arthroscopy

Residents complete three sports rotations during their training, as PGY2, 4, and 5. These rotations involve care of athletic injuries and residents participate in team coverage of university and high school teams. The UNC Department of Orthopaedics is the sole orthopaedic service for all collegiate athletics at UNC. In addition to surgical management of injuries, residents have a complete exposure to all aspects of sports medicine, including issues such as strength training and conditioning, concussions, and heat stroke/exhaustion. In addition to learning arthroscopic and open treatment of athletic injuries during this rotation, residents also participate in arthroscopic procedures during their trauma, hand, oncology, and WakeMed rotations.

Metastatic disease

Residents participate in an oncology rotation during their PGY4 year, where they see patients and perform surgeries on patients with metastatic disease, as well as primary tumors of the musculoskeletal system. Residents also participate in the care of cancer patients with pathologic and impending fractures during trauma call. Through these clinical experiences and core curriculum lectures, residents learn the principles of appropriate care of patients with metastatic disease, including the role of medical/pharmacologic management, radiation therapy, minimally invasive palliative procedures (e.g. cryoablation/cementation), and appropriate indications for internal fixation or prosthetic replacement of skeletal lesions. Residents are taught to treat not only the metastatic lesion but also to evaluate the entire patient and to understand the often challenging issues involved in appropriate care of these patients. Residents also participate in Sarcoma Tumor Board meetings, where pathology and imaging studies are reviewed and the patient’s cancer care is discussed in a multidisciplinary setting.

Intern Rotations, include

Six months of Orthopaedics and one month each of Trauma, Plastics, Physical Medicine and Rehab, ED, Pediatric Surgery and SICU.