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Curriculum for Orthopaedic Surgery Residency

The orthopaedic competency-based education curriculum began in 2016. This exciting and innovative educational program was developed with the support of the ACGME and ABOS and fulfills ACGME and ABOS requirements. The curriculum is designed to maximize residency educational opportunities and learning efficiencies, leveraging the extensive and diverse clinical practice of the faculty and the advanced learning resources at Duke University. The curriculum is created based on the rich traditions and leadership of the outstanding orthopaedic education at Duke, and is enhanced by the integration of advanced strategies for adult learning including surgical simulation, self-directed learning, and improved methods of evaluation and providing feedback to the resident.

The goals of the competency-based educational curriculum include ensuring the mastery of general orthopaedic core competencies and to provide opportunities for advanced training through a selective curriculum tailored to individual interests during the final two years of residency.  Core competencies will emphasize clinical decision-making, comprehensive patient care, and technical skills from office-based procedures to the operating room. A progressive model of learning and responsibility will emphasize core concepts such as anatomy, technical skills, and basic surgical principles in order to integrate these key concepts into patient care activities.

Importantly, skills inherent to all of orthopaedic surgery will be highlighted by longitudinal exposure throughout one’s residency training.  A structured curriculum for research, leadership, and non-technical skills such as diversity, patient safety, and ethics/professionalism has been created to supplement a resident’s interests and his/her lifelong learning strategies.

One-on-one teaching: In the form of tutorials in the clinic and the operating room. These tutorials develop competency in clinical skills including history taking, fundamental musculoskeletal examination, interpretive skills, problem-solving/decision-making, preoperative planning, operative techniques, and postoperative care.

Anatomy/Surgical Skills Labs are a key component of interactive learning and are valuable experiences for appreciating the importance of surgical anatomy and surgical exposures.  These lab experiences are emphasized in the development of our competency-based education curriculum.  Currently, the Duke Human Fresh Tissue Laboratory (HFFTL) is used for a basic procedure skills curriculum for junior residents and for subspecialty core curriculum labs.

Didactic/Socratic teaching, which occurs in 11 weekly, dedicated conferences: Core Interactive, Specialty Core, Grand Rounds Conference, Core Rounds, Fracture/Trauma Conference, Core Skills, and seven subspecialty conferences including Adult Reconstruction, Hand/Upper Extremity, Foot/Ankle, Spine, Sports, Oncology, and Pediatric Orthopaedics.

Each orthopaedic subspecialty hosts a monthly journal club. 

Residents attend 350+ orthopaedic conferences each academic year – each with an emphasis on case-based learning and interactive sessions.

Research: Residents have numerous opportunities in all fields of orthopaedic surgery in which to participate in basic scientific and clinical research. Over the last 30 years, over 270 Duke residents have presented 627 papers at regional, national and international meetings and have published over 670 manuscripts in refereed journals. Understanding the basic principles of scientific research, developing and nurturing a research idea, and completing a research project will be supported through a mentorship model in the new curriculum, encouraging the development of ideas and the advancement of basic principles and existing treatment strategies.

Rotations

In the first year, rotations are based on guidelines provided by the American Board of Orthopaedic Surgery, which requires six months devoted to non-orthopaedic surgery rotations.

  • Non-Orthopaedic Rotations
    • Multi-system trauma (1 month)
    • Surgical intensive care (1 month)
    • Plastic surgery (1 month)
    • Vascular surgery (1 month)
    • Basic surgical skills (1 month)
    • Physical Medicine and Rehabilitation (1 month)
  • Orthopaedic Rotations
    • Trauma (3 months)
    • General Orthopaedics (6 weeks)
    • Scope basics (6 weeks)

In years two through five, residents rotate through most orthopaedic subspecialties at least twice—once as a junior resident and later as a senior/chief resident. The rotations are education-based, with residents having experiences on all services with graduated responsibility based on experience, performance, and competence.  As a part of the orthopaedic curriculum development, Senior Residents (PGY-4 and -5) will have an opportunity to develop elective rotations in areas of their choosing to advance their knowledge base and experience with operative cases of greater complexity or to complete research with a structured proposal.

  • PGY-2/ PGY-3
    • Sports Medicine
    • Trauma
    • Oncology
    • Hand
    • Foot
    • Adult Reconstruction
    • Adult Spine
    • Durham VA
    • Duke Regional Hospital
    • Basic Science/Research
    • Pediatric Orthopaedics-Duke/CHOA
  • PGY-4/ PGY-5
    • Sports Medicine
    • Trauma
    • Hand
    • Foot
    • Adult Reconstruction
    • Adult Spine
    • Durham VA
    • Duke Regional Hospital
    • Pediatric Orthopaedics-Duke/CHOA
    • Elective