Variability in training Experience during orthopaedic surgery post-graduate year-1

This article was migrated. The article was marked as recommended. Background: Recently, the orthopaedic surgery PGY-1 curriculum was redesigned to maximize time spent on orthopaedic surgery rotations. Additionally, surgical skills modules were introduced to standardize curricula for orthopaedic interns in the United States. Objective: The purpose of this study is to determine the implementation of the curriculum guidelines were implemented on a national level. Methods: An anonymous survey with 14 multiple choice questions was electronically distributed to program directors (PDs) for all ACGME-accredited orthopaedic surgery residency programs in the US (n=163) in January 2017. Seventy-nine of the 162 PDs (49%) completed the survey in its entirety. Results: The most common non-orthopaedic rotations included: general surgery trauma (67/79=85%), surgical/medical intensive care unit (60/79=76%), plastic and burn surgery (56/79=71%), musculoskeletal radiology (44/79=56%), and vascular surgery (40/79=51%). Seventy-two of 162 residency programs (91%) have a formal surgical skills curriculum for first-year residents, separate from intern boot camp. A variety of training modalities were utilized to teach the interns, most commonly saw bones for fracture fixation (68/79=86%) and cadaveric specimens for surgical approaches (63.79=80%). Conclusions: While all PGY-1 orthopaedic residents are now required to spend six months on orthopaedic rotations, the remaining six months are variable. These non-orthopaedic rotations are likely determined by the PD and available services at the trainee's institution. This variability has granted PDs the opportunity to individualize the intern experience by maximizing each institution's assets and designing their own surgical skill curriculum to train their interns using the resources available.