|
Supervision/Responsibilities Manner of Supervision
At all training sites, the residents are supervised and taught by
a committed teaching faculty that are present in the clinic, on ward rounds,
the operating room, and in their private offices. As the residents gain
seniority, they assume increasing responsibility for all aspects of patient
care. The chief residents assume responsibility for the overall administration
of their teams or their services, act as educators and supervisors for
the more junior residents, and provide direct feedback to the educational
coordinator at their training sites and the program director about the
quality of patient care and the educational process. As a group, the chief
residents assess the performance of their junior colleagues and suggest
program changes to the regional education coordinator and the program
director.
Responsibilities in Patient Care Settings
Outpatient Assignments
The residents become familiar with non-operative as well as the pre- and
post-operative management of orthopaedic and like conditions in the outpatient
clinics and when they attend the private offices of the teaching faculty
at University Hospital (Doctor's Office Center), Children's Hospital,
and the New Jersey Orthopaedic Hospital. In the outpatient clinics, the
junior residents will evaluate their patients and then present their findings,
including history, physical examination, laboratory and x-ray results
to a more senior resident, and ultimately, the attending. Based on the
ensuing discussion, they then propose a further diagnostic and therapeutic
plan. The outpatient clinic is also an excellent place to discuss long
term care, the possible need for allied health professionals, and ethical
issues which are frequently encountered. The clinic is also the site where
such manual skills as cast application and removal, joint aspirations
and the management of minor wounds is instructed and supervised according
to residents' seniority.
Inpatient Assignments
At each training site, one or more orthopaedic teams are formed,
each headed by a chief resident. Under the supervision of the assigned
teaching faculty, each team covers an inpatient service and one or more
clinics, and a set number of call days. In rotation and again, under the
direction of the chief resident, each team also becomes responsible to
coordinate various regional teaching events. As in the outpatient clinics,
patient assessment, patient care, various manual skills, and administrative
tasks are taught and learned within the teams according to progressive
seniority.
Operative Assignments
The operative experience of each resident is dependent on his/her year
in training and ability. Throughout the training program, all operative
cases are carried out in the presence of teaching faculty. For each case,
residents are given increased responsibility in the preoperative planning
process, different portions of the operation and during postoperative
management. The residents are expected to be fully knowledgeable as to
diagnosis, treatment options, and procedures as well as instrumentation
of all surgical cases to which they are assigned. Generally, the resident
performing the majority of the surgical case is required to dictate the
operative note which is reviewed by the teaching faculty. Postoperative
care, discharge planning and long term care decisions are emphasized.
Emergency Department
Residents receive experience in the emergency department at all
hospital rotations. The University Hospital, Children's Hospital, and
Jersey City Medical Center have extremely active emergency rooms. The
residents are assigned to the emergency room when they are on call. They
make the initial contact with orthopaedic emergency patients, and with
the help of more senior residents, carry out the initial assessments and
investigations. No major treatment decisions are made without presenting
each case to the attending teaching faculty.
|
