Featured Research

from universities, journals, and other organizations

Changes needed to ensure quality of new orthopedic surgeons

Date:
January 4, 2010
Source:
Hospital for Special Surgery
Summary:
Changes are needed in the programs that train orthopedic surgeons to ensure these doctors are adequately trained, according to a new study.

Changes are needed in the programs that train orthopedic surgeons to ensure these doctors are adequately trained, according to a study by researchers at Hospital for Special Surgery (HSS) in New York City. The study, which analyzed feedback from heads of orthopedic programs around the country, appears in the January issue of the Journal of Bone and Joint Surgery.

Related Articles


"Before this study, we at Special Surgery thought that we were the only hospital dealing with these complicated challenges," said Laura Robbins, DSW, vice president of education and academic affairs at HSS. "As a result of this study, we have come to realize that as a nation, the prominent training programs around the country are grappling with these same issues."

Because the field of training surgeons in general, and particularly orthopedic surgeons, has changed dramatically, investigators at HSS set out to identify the challenges faced by programs. They invited input from heads of well-established orthopedic residency programs across the country including New York University School of Medicine, University of California at Los Angeles Medical Center, Duke University School of Medicine, Johns Hopkins University School of Medicine, and Case Western Reserve University. The study analyzed survey responses from 17 heads of orthopedic programs around the country and feedback from 12 of these individuals gathered during a two-day meeting held at HSS.

Participants were asked to evaluate whether the traditional residency model is appropriate for the training of future surgeons and to discuss current approaches that have been successfully implemented in orthopedic training programs. The group identified four basic areas of need: addressing compromises to the learning experience caused by work-hour restrictions, identifying a body of core orthopedic knowledge with specific goals and expectations, developing common benchmarks to measure and improve program effectiveness, and addressing the challenges caused by generational differences between faculty and residents.

"One of the biggest factors challenging the education of orthopedic surgeons is the work-hour restrictions which have severely affected what residents are able to learn and do within the five years of training," Dr. Robbins said. "The public has read a lot in the media about work-hour restrictions for trainees, particularly surgeons. The Institute of Medicine recommended back in July that they would not tolerate any violations to the work hour restrictions -- being that residents work no more than 24 hours, have shift breaks and one day off in seven. While we are meeting that mandate, it is a big challenge, because the resident no longer treats the patient from pre-surgery to post-surgery, greatly compromising the learning of continuity of care."

Dr. Robbins pointed out that patients may suffer as well. While physician assistants and hospitalists step in, so the resident can go home, nobody truly knows the patient from beginning to end. "The resident traditionally used to be the one person who knew the patient from the beginning of care to the end of care, because they were here during the day and during the night on call," Dr. Robbins said. "The issue today gets to the heart of patient safety and quality." The Accreditation Council for Graduate Medical Education first instituted work-hour restrictions in 2003.

Dr. Robbins said a solution to this problem has not been identified yet. "Most programs are saying we really need to look at the curriculum and modify the residents' rotations, so that the resident gets the exact training and experience they need, but what that is specifically is unknown at this point," she said.

Another big issue identified was addressing generational and gender differences. "The residents of today are a very different generation than the current senior surgeons. They approach training very differently in that they have multiple priorities, becoming good surgeons while they juggle family and extra activities as a whole. The trainees and the surgeons of the past were more focused on their careers first," Dr. Robbins said. Residents today also want to learn via electronic technology, which is vastly different from the way older surgeons learned. Dr. Robbins reported that programs are lagging behind in providing educational modalities via electronic technology. On a gender front, more women are going into orthopedic surgery and there are more challenges like maternity leave affecting programs.

Dr. Robbins added that orthopedic programs need to accept more trainees into programs. The number of residents accepted into orthopedic programs has been capped for more than 20 years, but there is an increasing demand for orthopedic surgeons. "We know from projections in studies that there won't be enough orthopedic surgeons in the future for the baby boomers who will need joint replacements," Dr. Robbins said. "The groups that establish how many trainees you have and how many surgeons you need really need to be looking at this and making some very broad sweeping recommendations."

According to Dr. Robbins, there was a sense from the two-day meeting that the American Medical Association and the American Board of Orthopedic Surgeons are concerned that there is a problem. However, there have not been any solid recommendations. "The common theme is that we have a problem as a country in training the orthopaedic surgeons of tomorrow yet there are no specific solutions," said Dr. Robbins. "Our goal is to bring back this group in the Spring to focus on coming up with specific recommendations."

Dr. Robbins is also an associate scientist in the research division at Hospital for Special Surgery and an associate research professor of social work in medicine, Weill Cornell Medical College. Other authors of the study include Mathias Bostrom, M.D.; Edward Craig, M.D.; and Thomas Sculco, M.D.


Story Source:

The above story is based on materials provided by Hospital for Special Surgery. Note: Materials may be edited for content and length.


Cite This Page:

Hospital for Special Surgery. "Changes needed to ensure quality of new orthopedic surgeons." ScienceDaily. ScienceDaily, 4 January 2010. <www.sciencedaily.com/releases/2010/01/100104135826.htm>.
Hospital for Special Surgery. (2010, January 4). Changes needed to ensure quality of new orthopedic surgeons. ScienceDaily. Retrieved April 1, 2015 from www.sciencedaily.com/releases/2010/01/100104135826.htm
Hospital for Special Surgery. "Changes needed to ensure quality of new orthopedic surgeons." ScienceDaily. www.sciencedaily.com/releases/2010/01/100104135826.htm (accessed April 1, 2015).

Share This


More From ScienceDaily



More Health & Medicine News

Wednesday, April 1, 2015

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

7-Year-Old Girl Gets 3-D Printed 'robohand'

7-Year-Old Girl Gets 3-D Printed 'robohand'

AP (Mar. 31, 2015) — Although she never had much interest in prosthetic limbs before, Faith Lennox couldn&apos;t wait to slip on her new robohand. The 7-year-old, who lost part of her left arm when she was a baby, grabbed it as soon as it came off a 3-D printer. (March 31) Video provided by AP
Powered by NewsLook.com
Solitair Device Aims to Takes Guesswork out of Sun Safety

Solitair Device Aims to Takes Guesswork out of Sun Safety

Reuters - Innovations Video Online (Mar. 31, 2015) — The Solitair device aims to take the confusion out of how much sunlight we should expose our skin to. Small enough to be worn as a tie or hair clip, it monitors the user&apos;s sun exposure by taking into account their skin pigment, location and schedule. Matthew Stock reports. Video provided by Reuters
Powered by NewsLook.com
Soda, Salt and Sugar: The Next Generation of Taxes

Soda, Salt and Sugar: The Next Generation of Taxes

Washington Post (Mar. 30, 2015) — Denisa Livingston, a health advocate for the Dinι Community Advocacy Alliance, and the Post&apos;s Abby Phillip discuss efforts around the country to make unhealthy food choices hurt your wallet as much as your waistline. Video provided by Washington Post
Powered by NewsLook.com
UnitedHealth Buys Catamaran

UnitedHealth Buys Catamaran

Reuters - Business Video Online (Mar. 30, 2015) — The $12.8 billion merger will combine the U.S.&apos; third and fourth largest pharmacy benefit managers. Analysts say smaller PBMs could also merge. Fred Katayama reports. Video provided by Reuters
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
 
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:  

Breaking News:

Strange & Offbeat Stories

 

Health & Medicine

Mind & Brain

Living & Well

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:  

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile iPhone Android Web
Follow Facebook Twitter Google+
Subscribe RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins