Orthopaedic Surgery

Program Overview


About

The UMKC School of Medicine’s Orthopaedic Surgery program is a five-year orthopaedic residency as required by the American Board of Orthopaedic Surgery (ABOS), with four residents in each year.

Teaching

The faculty are dedicated to the active education of our residents. We use interactive techniques in conference and rounds which will require all residents in attendance to participate. Residents are expected to develop treament plans for their patients and be able to defend their thought processes in developing the plan. High academic achievement and the ability to utilize a fund of knowledge is stressed.

Educational Benefits

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  • Fully funded, department-sponsored meeting every year
  • Optional industry-sponsored meeting or conference yearly
  • Orthopaedic textbook provided to every resident on a yearly basis
  • PGY-1 residents receive personalized surgical loupes
  • Resident with highest OITE score each year recieves personalized OR lead
  • Stipend for travel to present research at local, regional or national meeting
  • Protected time to work on basic surgical skills
  • Full integration of the ABOS’s 17 basic surgical skills modules
Conferences

The bulk of the formal teaching conferences are held at Truman Medical Center on Wednesday mornings, 6:30 to 9:30 a.m. The ten-week Anatomy Module comprises the bulk of the Wednesday morning conferences during the first quarter of the academic year. Wednesday morning conferences include orthopaedic faculty presentations, resident presentations, hands-on surgical skills sessions, and other invited speakers. Almost every month (10 times per year), the Wednesday conferences are held at Children’s Mercy Hospital for pediatric orthopaedic surgery grand rounds. At Children’s Mercy, the hospital’s faculty present a review and update of cogent topics covering the gamut of pediatric orthopaedics over a two-year period. PGY-2 through PGY-5 residents are required to present at least one formal grand rounds presentation per year at the Truman Medical Center Grand Rounds, usually sometime after the annual Orthopaedic In-Training Examination in November. PGY-1 residents are able to attend the department’s formal teaching conferences during their internship.

A one-hour conference is held every Thursday morning, 6:30 to 7:30 a.m., usually at TMC. Thursday is a late OR start day at Children’s Mercy and Saint Luke’s, allowing residents to be present for first-case starts on those days. Journal Club is held on the first Thursday of each month at TMC. The Saint Luke’s orthopaedic grand rounds is held the second Thursday of each month at Saint Luke’s and is a review and update of a myriad of adult musculoskeletal topics by the hospital’s faculty.

A regular Saturday morning case conference is held on the first and third Saturdays of each month, August through May, at Saint Luke’s, 7:00 – 8:00 a.m. The senior residents and sports medicine fellow present cases for review by the faculty to help become better prepared for their oral board examinations.

Rotations

PGY-1 residents are assigned to a series of rotations which will fulfill the new ABOS requirements. The internship schedule; includes six months of orthopaedic surgery (three months at TMC and six weeks each at Saint Luke’s and Children’s Mercy), one-month rotations in neurosurgery, anesthesiology, and musculskeletal radiology; and three months of  general surgery and critical care.

The PGY-2 residents are assigned three-month rotations at TMC – Hospital Hill, TMC – Lakewood, Children’s Mercy, and Saint Luke’s (Spine Service). The PGY 3 resident will spend three months at TMC and Children’s Mercy. Additonally, there will be three-month rotations on the joint service and three months on the arthroscopy service at Saint Luke’s. As a PGY-4 the rotations will be: two months on a research rotation; one month of musculoskeltal oncology at the University of Kansas, three months of sports medicine at the Kansas City Orthopaedic Institute; 3 months at TMC – Lakewood; and three months at Saint Luke’s (foot and ankle surgery). As a PGY-5, the resident will be the chief resident for three months at Saint Luke’s and Children’s Mercy, and spend six months at TMC. Our residents graduate with exceptional surgical experience. Most seniors will have more than 2400 major surgical cases by the time they graduate. Our residents become quite talented in the OR, with good technique and surgical judgement.

Resident Research

All residents are expected to complete a research project prior to graduation. In the PGY-2 year, the resident is to present a grand rounds presentation, hopefully on a subject which may lead to a research topic. By the end of the PYG-2 year, a research topic and faculty research collaborator are to be selected. By the end of the PGY-3 year the project is designed, IRB approvals garnered and funding obtained. A dedicated two-month research rotation occurs during the PGY-4 year. During the PGY-5 year, the resident is to present the project at our Department Research Day and submit for other local, regional, and national or international presentations. The research project must be submitted ready for publication and presented at an orthopaedic meeting as a requirement for graduation.

Work Hours/Call

Residents’ duty hours are carefully regulated to ensure compliance with the 80-hour work week requirements of the Accreditation Council for Graduate Medical Education (ACGME). The rotations use alternate shift schedules and at-home call to achieve this goal. Residents are not on call more often than every third night on average and receive a 24-hour period free of clinical responsibility every seven days. Because of these work-hour requirements, moonlighting is NOT allowed in this program.

Contract

A sample resident contract is available for review at:
http://med.umkc.edu/gme/salary_benefits/UMKC_Resident_Contract.pdf

Salaries

Residents are employees of the University of Missouri. Current salaries are competitive with midwestern programs.

2016-2017 Resident Salaries By PGY
PGY-1 $51,005
PGY-2 $52,867
PGY-3 $54,590
PGY-4 $56,620
PGY-5 $58,385
PGY-6 $60,547
Benefits

More information on benefits is available here.

  • Three weeks paid vacation (21 calendar days, including weekends)
  • Professional liability coverage
  • Sick leave (1 day per month for each month of employment, up to 72 days)
  • Health insurance (2 plans)
  • Dental and vision benefits
  • Long-term disability
  • Tax deferred annuity program controlled by the resident
  • Accidental death and dismemberment Program
  • Life Insurance, 1x annual salary, at no cost – with options to increase at variable costs
  • Flexible benefits program through health care and dependent Ccare spending accounts
  • Pharmacy-residents can utilize the Truman Medical Center pharmacy and receive employee discount savings
Evaluations

Every six months residents are evaluated on their progress toward the understanding of 16 orthopaedic surgery milestones, defined by the ACGME and the ABOS. These milestones are:

1. Anterior Cruciate Ligament 9. Adult Elbow Fracture
2. Ankle Arthritis 10. Hip and Knee Osteoarthritis
3. Ankle Fracture 11. Hip Fracture
4. Carpal Tunnel 12. Metastatic Bone Lesion
5. Degenerative Spinal Conditions 13. Meniscal Tear
6. Diabetic Foot 14. Pediatric Septic Hip
7. Diaphyseal Femur and Tibia Fractures 15. Rotator Cuff Injury
8. Distal Radius Fracture 16. Pediatric Supracondylar Humerus Fracture

Each of these 16 milestones is evaluated for medical knowledge and patient care.

In addition, residents are evaluated four times a year, immediately following each three-month rotation in the following areas, as recommended by the ACGME:

    • Systems-based practice
    • Practice-based learning and improvements
    • Professionalism
    • Interpersonal/communication skills

Additionally, a resident’s demonstration of morals and ethics are to be rated as either satisfactory or unsatisfactory.

One month prior to the evaluation meeting, the faculty are sent the evaluation form and asked to score the resident on a scale of 1-4 (unsatisfactory-outstanding). Faculty members are also asked to record any comments on the form, specifically necessary for a score of 1 or 2.

The faculty member signs and dates the form and returns it to the program director on or before the day of the evaluation meeting. All faculty members are invited to attend the evaluation meeting.

At the evaluation meeting, each resident’s performance is discussed in detail. Comments are recorded and used in combination with the completed evaluation form by the program director to complete an evaluation of the resident for the rotation.

Each resident meets with the program director to discuss the evaluation. Residents are asked to sign the faculty evaluation and are given a copy of all written evaluations and forms.

For complete details on the evaluation rubric and details of what these terms mean, as well as expanded details of each milestone, please visit the ACGME’s website.

Following the final evaluation of the year, the program director determines if the resident will be promoted and/or graduated. All resident appointments are for 12-month periods. Residents not reappointed as a result of poor performance may utilize the grievance process.

Clinical Competency Committee

The UMKC Orthopaedic Surgery Clinical Competency Committee (CCC) consists of Program Director Dr. James Bogener, Department Chairman Dr. Mark Bernhardt, Department Vice-Chairman Dr. Akin Cil, Associate Program Director Dr. Tim Badwey, Associate Program Director Dr. Nigel Price, Dr. Charles Rhoades, and Dr. John Anderson.  The CCC meets periodically and determines the residents progress in the 16 orthopaedic surgery milestones.