Trauma training occurs primarily at Harbor-UCLA Medical Center with rotations on the trauma service every year. The high volume, severity and complexity of the trauma that is seen at Harbor-UCLA provide outstanding training opportunities for residents. As the second busiest Level 1 Trauma center in Los Angeles County, Harbor-UCLA provides residents with a regular opportunity to treat multiply injured trauma patients and interact with multi-specialty teams. Pathology includes multi-system organ involvement as well as complex pelvic and acetabular fracture management. As a tertiary referral center, complex management cases provide a variety of challenges in decision-making and surgical management that contribute substantially to the development of critical clinical skills both in the operating room and in pre-op and post-operative management. Residents spend six months as a PGY2, and three months as a PGY3 as junior residents on the team. As a PGY4, residents take on heightened responsibility as a chief on the trauma rotation for three months and as a PGY5 spend three months as chief resident running the service. The rotation provides a comprehensive exposure to pre-admission assessment of the patient, intra-operative management, post-operative care, as well as long-term follow-up care.
Joint Reconstruction training exists at multiple facilities throughout the course of residency training. At Harbor, the PGY2 and PGY5 residents each spend a three-month rotation block on a subspecialty team whose primary focus is the management of the Orthopaedic Arthritis/Joint Replacement Service. Further training in Adult Joint Reconstruction is provided at Kaiser Permanente West Los Angeles and Santa Monica-UCLA rotations as a PGY4. Further exposure can be augmented into the Kaiser Permanenta Downey PGY5 rotation.
Sports Training occurs during both the PGY3 and PGY4 years while on the Sports Medicine subspecialty service at Harbor-UCLA for three months. Further training in Shoulder, Knee, and Hip Arthroscopy occur as a PGY4 at Kaiser Permanente West Los Angeles. Additional training can be pursued during the Kaiser Permanente Downey rotation as a PGY5 if the resident desires to further augment their Arthroscropy training.
Pediatric Orthopaedic experience begins at Harbor during the PGY2 year while on the Trauma/General and Spine rotations. Further training occurs in the PGY3 year while on the Harbor Peds rotation, focusing on General Pediatric Orthopaedics, Scoliosis, as well as Adolescent Sports Medicine. Pediatric Orthopaedic training continues in the PGY3 year at Children’s Hospital of Los Angeles with operative and clinical experience in treating Pediatric Spine and Hip Disorders, Cerebral Palsy, Upper and Lower Extremity Deformity, Adolescent Sports, and Pediatric Tumor Pathology. Pediatric training is solidified as a PGY5 when returning as chief on the Trauma/General and Spine services. Extensive experience is gained in the diagnosis and treatment of the spectrum of pediatric trauma and elective pediatric spinal disorders during this time.
Hand experience is abundant at Harbor with a plethora of hand pathology involving acute trauma related injuries, multiple digit re-implantation, post-traumatic reconstruction, rheumatoid reconstruction, and the management of common disorders of the hand such as peripheral entrapment neuropathies. With the size of Harbor’s patient population and the active life styles of that Southern California population, the hand service is exceptionally busy. Training begins in the PGY2 year on the Hand service and also during the Trauma/General rotation. As a PGY5, residents run the Hand service and in collaboration with the PGY5 on Trauma/General, manage elective and emergent hand patients in the clinics and operating rooms. Hand call is shared with Plastic Surgery, with Orthopaedic Surgery taking 2 out of every 3 days. More elective hand cases can be sought out while at Kaiser Permanente Downey as a PGY5.
Spine experience starts as a PGY2 on the Spine rotation at Harbor-UCLA during a 3 month block. Training continues during the PGY3 year with opportunities to participate in pediatric spine deformity cases at Children’s Hospital of Los Angeles. As a PGY5, residents are expected to run the Spine service at Harbor, managing the clinic and all operative spine patients. Further spine experience can be augmented while on rotation at Kaiser Permanente Downey as a PGY5.
Foot and Ankle training occurs while on subspecialty rotation as a PGY3 and PGY4 for 3 months each at Harbor-UCLA. The foot clinics are some of the busiest at Harbor-UCLA and the variety and severity of pathology enhances resident experience and training. On the Trauma/General Orthopaedic service, foot and ankle fractures are among the most common injuries treated. Extensive surgical experience is provided in the treatment of disorders of the adult foot and ankle. Further training in pediatric congenital and acquired disorders of the foot and ankle occurs during the Harbor-UCLA Peds rotation and during the Children’s Hospital of Los Angeles rotation as a PGY3. As a PGY4, the resident runs the Foot and Ankle service, managing inpatients and clinic patients, and performing elective foot and ankle cases in conjunction with the faculty.
Orthopaedic Oncology exposure first occurs during the 3 month rotation at Children’s Hospital of Los Angeles, where residents will be exposed to diagnosing and managing pediatric orthopaedic tumors. This experience is further solidified during the rotation at Santa Monica-UCLA as a PGY4. During this rotation, residents will be trained in diagnosing, managing, and treating the spectrum of Orthopaedic tumor pathology. Residents participate in clinics as well as performing resections and providing reconstructive services for orthopaedic oncology patients.
The Orthopaedic Intern year is a categorical intern year spent entirely at Harbor-UCLA where residents get exposure to a wide variety of surgical subspecialties that supplement and improve upon their orthopaedic education. The intern year consists of six months of Orthopaedics where interns will manage Orthopaedic patients on the wards, assist junior residents with consults including performing fracture reductions, splints, and casts, and gain early hands-on exposure in the operating room. There is also one month each in the services of Vascular Surgery, Plastic Surgery, General Surgery Trauma, Surgical ICU, and the Emergency Department. Furthermore, there is an “Introduction to Orthopaedics” series consisting of weekly meetings, such as OITE reviews and teachings of fundamental techniques in orthopaedics.