Clinical Responsibilities of Fellows
The clinical fellow is treated as a junior faculty member within the Department of Pediatric Orthopaedics at Cincinnati Children's Hospital Medical Center and is expected to accept and respond to this responsibility in an appropriate fashion.
Under the supervision of faculty members the fellow will attain and exercise this responsibility in a graduated fashion. Initial close supervision of the fellow's decision making process concerning simple and complex pediatric orthopaedic problems is expected to evolve into a more independent but still supervised one concerning these same problems as the fellow develops into a budding pediatric orthopaedic surgeon. This process includes formal operative privileges at Cincinnati Children's Hospital Medical Center for fellows demonstrating appropriate competence and credentials.
Outpatient Services
The clinical fellow is expected to progressively increase his / her ability to independently assess pediatric orthopaedic patients and formulate treatment plans in the outpatient setting. This process will begin with the fellow observing / learning from the respective faculty members and progress towards the fellow performing independent patient evaluations, synthesizing pertinent information, and formulating a treatment plan that is simply confirmed or only modified slightly by faculty members.
Teaching Rounds
Formal teaching rounds are conducted by the full-time pediatric orthopaedic faculty every Monday (7 pm to 8 pm) and Wednesday (10 am to 11 am). The x-rays of all orthopaedic in-patients are reviewed along with both pre- op and post-op x-rays for the week's surgical cases. These rounds include both residents and fellows and are aimed at:
- Discussing indications for upcoming surgical cases
- Assessing post-operative radiographic outcomes
- Providing an additional forum for treatment decisions for orthopaedic inpatients.
Inpatient Services
The clinical fellow is expected to make rounds on orthopaedic in-patients whose surgery they were involved with. This provides invaluable information concerning post-op care of pediatric orthopaedic patients. The ability to appropriately recognize and treat post-operative complications is also acquired via such interaction with in-patients as well as discussion with faculty members.
The fellow will also participate in formal bi-weekly teaching rounds (Mondays and Wednesdays) and ask appropriate questions of faculty members so as to solidify key concepts.
Operative Pediatric Orthopaedics
In order to develop appropriate evidence-based treatment plans, the clinical fellow is: expected to extensively research the literature and comprehensively pre-op plan all surgical procedures with which they will be involved. Through this process they not only increase their pediatric orthopaedic intelligence quotient, but also increase their ability to ask faculty members appropriate level questions that reflect true understanding of both the technical and cognitive aspects of
pediatric orthopaedic surgery.
Emergency Services
Clinical fellows will be involved with the evaluation and treatment of pediatric orthopaedic patients who require emergent / urgent operative intervention. Initially this process will involve an orthopaedic resident whose initial patient evaluation and subsequent discussion with a faculty member results in a decision to move ahead with emergent / urgent orthopaedic surgery. The clinical fellow on call will then be notified and participate in the care of the patient.
This process is intended to evolve to a point where the fellow is contacted first by orthopaedic house-staff, evaluates the clinical situation, and then makes a treatment decision which is either supported or modified by a faculty member. Finally, the fellow who has attained formal operative privileges will function as a junior faculty member and develop and implement operative treatment plans that are subject to the approval of the supervising faculty member.
