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Orthopaedic Surgery Residency Clinical Rotations

The overarching priority of the clinical training at the U-M Medical School Department of Orthopaedic Surgery Residency Program is to produce technically skilled surgeons who will provide exceptional care to their future patients.

We aim to give our residents experience in all subspecialties early in their training to allow for the polishing skills and focus on specific aspects of orthopedics during their senior years. The structure of the clinical rotations underwent a significant revision for the 2020-2021 academic year.

The goals of the rotation schedule are to:
  1. Allow for experiences in all subspecialties before finishing the PGY-3 year
  2. Provide adequate time on service to learn more about diagnosis and treatment of orthopedic conditions and work to improve surgical technique. We have found 2-month blocks to be ideal for this purpose.
  3. Allow elective time in the PGY-3 and PGY-5 years to explore specific training areas and progress toward career goals
  4. Provide flexibility in rotation options to adequately cover all services while putting residents in areas to maximize training opportunities
  5. Ensure junior residents and senior residents work together as much as possible
See Where Training Takes Place

Clinical rotations are completed at University Hospital, Mott Hospital, Ann Arbor VA, and Trinity Health, all of which are in Ann Arbor. We also run multiple ambulatory surgery centers around the Ann Arbor area. No one location is more than a 30-minute drive from University Hospital. All subspecialties other than pediatric orthopedics and orthopedic oncology are represented at St Joseph Mercy Hospital.

View Orthopaedic Surgery Facilities & Spaces
Structure of Rotations
PGY-1 year

Our intern year is designed to provide first-year residents with the foundation they will need to become orthopedic surgeons. Rotations offer early exposure to orthopedic subspecialties while working alongside more senior residents. Organizational and interpersonal skills are developed along with significant knowledge and experience growth within orthopedic surgery. Experience in non-orthopedic patient care is gained by completing five off-service rotations. Intern rotations are one month in length. The orthopedic rotations include trauma, foot and ankle, spine, and night float at UH, and one month on Trinity Health trauma. The interns also participate in a dedicated orthopedic skills month. The remaining five months include rotations in vascular surgery, general pediatric surgery, Trauma-Burn ICU, hand surgery at UH, and SICU at Trinity Health.

PGY-2 through PGY-5 years

Rotations during the PGY-2 through PGY-5 years are two months long and span multiple practice locations and types. Residents can tailor their time in such a way to allow for a broad experience in all areas of orthopedics while focusing on certain subspecialty areas to build on career-focused goals.

Residents will spend two to four months at Trinity Health every year with rotations on trauma, arthroplasty, foot and ankle, spine, or sports. Two two-month blocks at the Ann Arbor VA are completed as PGY-2 and PGY-5 years. The remainder of the training is done at the University of Michigan-based locations. There is a two-month block of protected time for research during the PGY-3 year. During the PGY-4 year, each resident will rotate on an “operative orthopedics” rotation that provides a broad operative experience spanning multiple subspecialties. Residents can choose an elective two-month block during the PGY-3 year and again during the PGY-5 year. This allows each resident to get a more in-depth experience before selecting a fellowship direction and additional experience in an area of resident choosing before graduation.

Each resident’s time is balanced between the clinic and the operating room. We feel strongly that a significant part of becoming an exceptional orthopedic surgeon requires developing skills outside of the OR. Clinic time is spent seeing patients, understanding the physical exam, developing indications for surgical intervention, and learning how to manage complications. For all services, time in the clinic varies between one and two days per week. Most of the services have advanced practice providers (either physician assistants or nurse practitioners) who assist in the care of both inpatients and outpatients.

The call is handled differently at each institution. UH, coverage is done by a PGY-3 resident on a night-float-specific rotation. Mott coverage is divided between PGY 2-4 residents who take turns covering nights one week at a time. Trinity Health range is divided between PGY 2-4 residents who take nightly calls with the following post-call day free. With 40 residents in the program, the call burden is manageable.

Subspecialty Details

Time spent during training: 7 months

Levels of rotation: PGY 1, 2, 4 and 5

Locations of rotation: University of Michigan and Trinity Health

Goals of the Rotation:
Residents will gain experience managing all types of orthopedic trauma, from the bare hip and ankle fractures to complex peri-articular fractures, pelvis and acetabular fractures, and post-traumatic conditions. The trauma program at the University Hospital cares for patients with an average ISS score higher than any other in Michigan. St Joe’s is a level 1 trauma center with a volume of trauma higher than UH, but with lower acuity. Dr. Ahn leads the trauma division at U of M. Dr. Hake and Dr. Perdue cover orthopedic trauma at both hospitals. The volume of orthopedic trauma seen between U of M and St Joe’s provides a busy, well-rounded trauma experience. Our residents become highly skilled at managing simple and complex fractures as the level of autonomy is typically higher in the trauma service.

Faculty cover both University of Michigan Medical School and Trinity Health:

Time spent during training: 6 months

Levels of rotation: PGY 2, 4 and 5

Locations of rotation: University of Michigan and Trinity Health

Goals of the Rotation: 
The adult reconstructive rotation aims to provide a broad educational base for orthopedic residents to prepare them to be competent general orthopedic surgeons, including certification by the American Board of Orthopaedic Surgery. Training in adult reconstruction is based primarily at the University of Michigan, although residents get a significant experience at St Joe’s. Residents see many reconstructive procedures, including primary total hip and knee replacements and complex revision procedures. Opportunities to gain experience in partial knee replacements, anterior total hip arthroplasty, and outpatient joint replacement are plentiful.

University of Michigan Medical School Faculty:

Trinity Health Faculty:

Time spent during training: 7 months

Levels of rotation: PGY 2, 3 or 4 and 5

Locations of rotation: University of Michigan and Trinity Health

Goals of the Rotation: 
The purpose of the orthopedic sports medicine rotation is to provide a broad educational base for orthopedic residents to prepare them to be competent orthopedic surgeons, including certification by the American Board of Orthopaedic Surgery.

The Sports Medicine experience within our program is fantastic. Residents get to see academic and private-practice sports medicine with opportunities for coverage of the multiple University of Michigan and Eastern Michigan University sports. The U of M and St Joe’s faculty are focused on teaching and provide a wide variety of cases to learn from. Residents will have high exposure to general sports medicine problems of the knee, shoulder, hip, and elbow. A unique feature of our program is a full volume of hip arthroscopy, complex knee surgery (e.g., cartilage, multi-ligamentous reconstructions, pediatric sports), and complex open shoulder reconstruction and replacement surgeries. The sports medicine division provides a robust academic curriculum with dedicated weekly sports medicine journal club and case conferences.

University of Michigan Medical School Faculty:

Trinity Health Faculty:

Time spent during training: 3 months

Levels of rotation: PGY1 and PGY3

Locations of rotation: University of Michigan and Trinity Health

Goals of the Rotation: The purpose of the orthopedic Spine Rotation is to provide a broad educational base for orthopedic residents to prepare them to be competent orthopedic Surgeons and to prepare them for the American Board of Orthopaedic Surgery certification. The Spine Service will educate and provide high-quality learning in spinal care. Residents will be exposed to complex cervical and thoracolumbar cases during the rotation. They will gain experience in navigation, a microscope, and robotics. Residents rotate on the spine service during their 1st and 3rd years. Additional experiences in spine surgery are available as electives.

University of Michigan Medical School Faculty:

Trinity Health Faculty:

Time spent during training: 3 months

Levels of rotation: PGY 1 and 3

Locations of rotation: University of Michigan and Trinity Health

Goals of the Rotation:
The purpose of the orthopedic foot and ankle rotation is to provide a broad educational base for orthopedic residents to prepare them to be competent orthopedic surgeons, including certification by the American Board of Orthopaedic Surgery. During the Foot and Ankle rotation, residents will become adept in managing the disease processes and mechanical problems related to the foot and ankle to provide them with the comprehensive knowledge and surgical skills to recognize and successfully recognize and treat orthopedic foot and ankle problems.

University of Michigan Medical School Faculty:

Trinity Health Faculty:

Time spent during training: 4 months

Levels of rotation: PGY-2 and PGY-3

Locations of rotation: University of Michigan Medical School and Trinity Health

Goals of the Rotation:
The purpose of the orthopedic hand rotation is to provide a broad educational base for orthopedic residents to prepare them to be competent orthopedic surgeons, including certification by the American Board of Orthopaedic Surgery. During the rotation, residents will develop core elbow and hand surgery knowledge. Understand the indications for non-operative and operative treatment of a broad range of clinical conditions involving the hand, wrist, forearm, and elbow regions. To develop surgical skills, experience, and judgment related to a wide range of hand, wrist, forearm, and elbow disorders/conditions.

University of Michigan Medical School Faculty:

**Currently interviewing for two positions

Trinity Health Faculty:

Time spent during training: 2 months

Levels of rotation: PGY-4

Locations of rotation: University of Michigan

Goals of the Rotation:
The purpose of the Orthopedic Tumor Oncology Rotation is to provide a broad educational base for orthopedic residents to prepare them to be competent Orthopedic Surgeons and to prepare them for the American Board of Orthopaedic Surgery certification. The musculoskeletal tumor rotation aims to provide a broad education in caring for patients with musculoskeletal tumors.

The tumor service has two attendings - Drs. Sybil Biermann and Geoff Siegel. Residents rotate on the oncology service as a 4th year. The Tumor service manages benign and malignant primary bone and soft tissue tumors and bone metastasis. This service does large limb salvage procedures using implants and/or allograft and teaches residents how to care for critically ill cancer patients and communicate in a multidisciplinary approach with our colleagues in the Medical and Radiation Oncology services.”

University of Michigan Medical School Faculty:

Trinity Health Faculty: none

Time spent during training: 6 months

Levels of rotation: PGY 2, 4 and 5

Locations of rotation: Mott Children’s Hospital

Goals of the Rotation:
The purpose of the pediatric orthopedic rotation is to provide a broad educational base for orthopedic residents to prepare them to be competent orthopedic surgeons, including certification by the American Board of Orthopaedic Surgery. The pediatric orthopedic service has a significant impact on resident training in general orthopedics as well as the coordination of many competencies.

The service consists of a 2nd, 3rd, and 5th-year resident. A nurse practitioner also helps with clinic and inpatient responsibilities and two physician assistants help with some operative cases. On this service, you will take care of the entire spectrum of pediatric orthopedics, including scoliosis (idiopathic, congenital, neuromuscular), developmental dysplasia of the hip, trauma, lower extremity deformity, clubfoot, and other pediatric foot conditions.

University of Michigan Medical School Faculty:

Trinity Health Faculty: none

Time spent during training: 4 months

Levels of rotation: PGY2 and 5

Locations of rotation: Ann Arbor VA

Goals of the Rotation: 
The orthopedic service at the Ann Arbor VA is directed by Dr. David Patterson, with additional faculty coverage from Drs. Siegel and Lien. Other UM orthopedic faculty are available for exceptional cases and clinics as needed. Residents rotate at the VA during their 2nd and 5th years. The VA orthopedic rotation aims to provide a comprehensive resident-directed clinical. The VA offers resident training in community trauma, routine hip, knee, and shoulder arthroplasty, general and complex hand, sports medicine, and joint preservation. At every level of education, the goal is to increase knowledge, skill, judgment, and independence.

Faculty:

Time spent during training: 2 months

Levels of rotation: PGY-4

Locations of rotation: University of Michigan

Goals of the Rotation:
The purpose of the Operative Orthopedics rotation is to allow senior-level residents to gain knowledge and experience in a variety of different subspecialty areas before their PGY5 year. This rotation will allow residents to focus on preoperative planning, communication, and honing technical skills in the operating room. Since residents rotate through all services except orthopedic oncology before their PGY-4 year, they will have some experience working with all faculty. The possibility of operating on doing an ACDF one day, a revision of total hip the next, followed by fixing a scaphoid fracture the next, will be an experience that will require a new set of skills and preparation.

University of Michigan Medical School Faculty: All

Time spent during training: 4 months

Levels of rotation: PGY 3 and 5

Locations of rotation: Any

Goals of the Rotation: 
We recognize that each resident has career goals and expectations. The main goal of our program is to help our residents prepare for whatever career path they are on. The Elective rotation during the 3rd and 5th years is to gain focused knowledge and competence in an orthopedic subspecialty of the resident’s choosing. Residents can choose rotations in any subspecialty area in all practice locations. They are even free to choose additional research time as long as all standards for graduation are on track to be met. We also encourage residents to plan off-site rotations if they would like to enhance their experience.

University of Michigan Medical School Faculty: Any

Trinity Health Faculty: Any

Time spent during training: 2 months

Levels of rotation: PGY-3

Locations of rotation: University of Michigan

Goals of the Rotation:
Before graduation, residents must complete a publishable quality research project, either a clinical or basic science. Residents in their 3rd year are given two months to work on clinical or bench research, or an anatomy project may be completed. This fits our overall research curriculum, where dedicated time during the PGY-2 year is spent designing and starting a project. Some residents use this time in the lab, in data preparation, or in writing and submitting their manuscripts. This resident does not have clinical responsibilities during this time but is responsible for assisting in our anatomy curriculum.