Orthopedic Surgery Residency Program
The Madigan Army Medical Center Orthopedic Surgery Residency Program is a five year ACGME accredited program leading to eligibility for certification by the American Board of Orthopedic Surgery.
Our program has long tradition of producing exceptional orthopedic surgeons. There are three residents at each level of training. Over the past 10 years 100% of Madigan orthopedic residents have passed the orthopedic boards. The program routinely scores above the 90th percentile on the orthopedic in-training exam.
The training experience at Madigan combines didactic training with exposure to a broad spectrum of outpatient and inpatient orthopedics. All major subspecialties are represented including: Sports Medicine, Adult Reconstruction, Spine, Foot and Ankle, Hand, Trauma, Orthopedic Oncology, Pediatric Orthopedics and General Orthopedics. The goal is to provide consistent training to all residents in the core specialty areas. A fellowship trained staff orthopedic surgeon supervises each rotation. Rotations are generally two to four months in length. With the large active-duty, dependent and retiree population in the area, residents see the full spectrum of operative and non-operative orthopedic diseases.
Orthopedic Intern Year (PGY1)
The PGY1 year is a categorical orthopedic internship designed to meet the ACGME requirements while providing the maximal amount of orthopedic rotations which includes a diverse mixture of non- orthopedic surgery rotations (General Surgery, Vascular Surgery, Burn/Plastic Surgery, Emergency Medicine, Intensive Care Unit, and Radiology) and orthopedic surgery rotations. Rotations are four weeks in length. All rotations are located at the home program site with the exception of emergency medicine and burn/plastic surgery, which are done at Harborview Medical Center in Seattle.
First Orthopedic Year (PGY2)
The objective of the first orthopedic year (PGY2) is to expose residents to clinical orthopedics, basic orthopedic evaluation, fracture and trauma management. First orthopedic year residents are introduced to basic surgical techniques and clinical evaluation of patients under the tutelage of senior residents and the teaching staff. During the PGY2, the main focus is general orthopedics, adult reconstruction, sports medicine, foot and ankle, and pediatric orthopedics. In the first portion of the year, during our intensive anatomy tutorial, it is the first year residents’ obligation to perform the weekly cadaver dissections and to prepare a discussion of the prosection.
Second Orthopedic Year (PGY3)
PGY3 residents are more intensively exposed to specialized areas of orthopedics. All residents have a three-month trauma rotation at Harborview Medical Center in Seattle. During this junior trauma rotation, the second orthopedic year residents are assigned to one of two orthopedic trauma teams and participate in the evaluation of trauma patients in the emergency room and spend time on the ward managing patients with both orthopedic and multi-system trauma. The residents continue their formal training in pediatric orthopedics. Training consists of a three-month rotation at Seattle Children’s Hospital and four months at the Shriner’s Hospital in Spokane. Additional rotations include orthopedic subspecialty rotation at Madigan.
Third Orthopedic Year (PGY4)
PGY4 residents continue rotations on orthopedic subspecialty services at Madigan and their research projects. Residents also do a three month rotation in Adult Reconstruction at Puget Sound Orthopedic in Lakewood, Washington, and two month rotation in Orthopedic Oncology at Polyclinic in Seattle.
Fourth Orthopedic Year (PGY5)
PGY5 residents have an ever increasing level of responsibility. Residents continue subspecialty and elective rotations, and do a two month rotation as trauma chief resident at Harborview Medical Center in Seattle. They assume major responsibility for the evaluation of orthopedic and multi-system trauma, and surgical responsibility for the care of trauma victims. PGY5s also do a four month rotation at Madigan as the administrative chief resident. Duties include planning, scheduling, and organizing didactics, journal club, morbidity and mortality conference, guest lectures and organizing Wednesday academic schedules. PGY5s continue to increase their responsibility and independence in clinic and in the or under the staff supervision.
During a typical week, residents will spend two days in clinic. One half-day in clinic is generally devoted to pre-op visits or in the cast room. The remainder of clinic time is spent working directly with their subspecialty staff. The resident works with staff in the operating room two other days per week. Most residents perform 1400-1600 surgical cases throughout their residency. All residents are required to participate in research. Residents receive at least two to three months free of clinical duties for dedicated research over their residency.
Our weekly schedule is as follows: Monday through Friday the day formally begins at 7 a.m. with morning report. During morning report all call cases from the previous twenty four hours are presented. On Monday all cases from the weekend are presented. Cases are reviewed and discussed with all staff and residents present. Residents are expected to present pertinent information from the literature as well as answer questions demonstrating their understanding of the case and appropriate treatment. Wednesday mornings are devoted to academics which includes morning report, post- operative conference, Grand Rounds, lectures, review of various orthopedic knowledge updates and fracture texts.
The Orthopedic Surgery Service at Madigan is a tightly knit group with a clear sense of teamwork. Together, the residents and staff participate in a number of sporting activities and social events.
Medical students interested in applying for Madigan’s Orthopedic Residency are strongly encouraged to do a rotation on the Orthopedic Surgery Service. This allows for an evaluation of the candidate’s knowledge base, commitment, work ethic, and communication skills, and is critical part of the selection process. The optimal time frame is July to October.