Orthopaedic Surgery

In order to develop appropriate evidence-based treatment plans, clinical fellows are expected to:

• Extensively research the literature (reading assignments or recommended reading)
• Prepare a comprehensive preoperative evaluation / plan
• Conduct intraoperative management or outline fully the intended surgical procedures with which they will be involved
• Follow-up with post-operative care and monitoring (including writing orders as required)
• Interact with patients and families before, during and after treatment

Through this process fellows not only increase their pediatric orthopaedic intelligence quotient, but also their ability to ask faculty members appropriate-level questions that reflect true understanding of both the technical and cognitive aspects of pediatric orthopaedic surgery.

The clinical fellow is expected to make rounds on orthopaedic inpatients whose surgery he was involved with or patients under the care of the assigned service. This provides invaluable education in the post-op care of pediatric orthopaedic patients. The ability to appropriately recognize and treat post-operative complications is also acquired through interaction with inpatients and discussion with faculty members. Fellows also participate in formal teaching rounds and ask appropriate questions of faculty members so as to solidify key concepts.

Clinical fellows are expected to progressively increase their ability to independently assess pediatric orthopaedic patients and formulate treatment plans in the outpatient setting. This process begins with fellows observing and learning from the respective faculty members. It progresses toward the fellow performing independent patient evaluations, synthesizing pertinent information and formulating a treatment plan that is confirmed or only modified slightly by faculty members.

Although trauma is not the focus of this fellowship, we realize the Clinical Fellow will experience trauma cases in her practice (either private or in a hospital affiliation). We have developed a short trauma rotation whereby the fellow can work with the on-call attending and have access to cases that come through the ED. This provides the fellow with invaluable experience.

Clinical fellows rotate for a three-month period. Clinical exposure to the other full-time faculty and other part-time faculty members is available and encouraged. Fellow work hours are consistent with ACGME 80-hour work week requirements. GME policies and procedures are readily available online for any fellow to review at all locations; a duty-hour hotline is available within the hospital for reporting violations.

Pediatric Orthopaedic Fellows are required to provide the chief resident backup call every other weekend each month (After 5 pm Friday / Saturday / Sunday / Monday to 6 am) and during the chief’s vacation and outdates (which occur quarterly) per ACGME requirements.

• Running the list with the residents each morning at 5:45 am to assign tasks for each patient, to the floor man, and to CNS and PNP.
• Each resident conducts rounds on the patients on his service and reports back to the group. If a resident has a particular concern about a patient, the fellow and resident should see that patient together and try to solve the problem.
• Review all X-rays of patients admitted the night before with the residents. Review X-rays of patients not admitted who had difficult or questionable reductions in the emergency department.
• On weekends, the fellow and residents on call round as a group on all of the patients. The fellow must be available to come in at anytime to assist in the ED or OR. The ortho chief assigns residents to do the weekly statistics during his absence and makes a cross-cover schedule for the residents prior to leaving.

Currently, the rotating residents are assigned on-call duties and the chief is their backup in case of an emergency. Since the fellow has chief backup, he will be exposed to some trauma that comes in during his backup weekend.
 

Moonlighting is not permitted during this fellowship. Refer to GME Policy and Procedure 14.0: Off Duty Work “Moonlighting” for Residents.

Alvin Crawford, MD – Two-month rotation. Specializing in deformities of the immature spine with intervention and instrumentation via video-assisted thoracoscopic surgery, neurofibromatosis , bone tumors, hip disorders.

Eric J. Wall, MD – Two-month rotation. Specializing in endoscopic scoliosis and pelvic osteotomy, sports growth plate arrest overuse syndromes, pediatric orthopaedic biomechanics, scoliosis correction spinal hemiepiphysiodesis, patent spinal correction system, identifying female athletes at high risk for anterior cruciate ligament (ACL) injury.

Charles T. Mehlman, DO, MPH – Two-month rotation. Specializing in musculoskeletal outcomes research, orthopaedic trauma, bone tumors, arthroscopic surgery, shoulder and elbow surgery, spine surgery, foot and ankle surgery, limb deficiencies in children.

Junichi Tamai, MD – One-month rotation. Specializing in hip disorders, sports medicine.

Viral V. Jain, MD – Two-month rotation. Specializing in spinal deformity, minimally invasive spine surgeries, limb lengthening and reconstruction, pediatric hip disorders.

Shital Parikh, MD – Two-month rotation. Specializing in sports-related injuries (sports medicine).

Roger Cornwall, MD – One-month rotation. Specializing in brachial plexus birth palsy, pediatric hand and wrist trauma, congenital hand and upper extremity abnormalities, complex pediatric elbow trauma and deformities, gymnast wrist.

Peter Sturm, MD – Two-month rotation. Co-Director of the Crawford Spine Center. Specializing in spine deformity, scoliosis, early onset scoliosis and pediatric orthopaedics.

Kevin J. Little, MD – One-month rotation - elective. Specializing in hand & upper extremity.

James J. McCarthy, MD – One-month rotation. Division Director. Specializing in cerebral palsy.