The program aims are to graduate residents capable of independent practice and ready for deployed medicine, to provide background in all orthopedic disciplines, and to promote advocacy, research and self-directed, adult learning. Each class consists of 6 residents (3 Army and 3 Air Force).
Our goals created to reach the program aims are as follows:
Facilitate a balanced education that fits within the framework of the ACGME core competencies
Resident completion of sufficient case numbers for competency and confidence
Support an academic program that provides a foundation for adult learning
Foster a solid research foundation that furthers a spirit of investigation
Post-graduate year (PGY) I
All of intern year is completed in San Antonio. Six months are dedicated to orthopaedics during which interns will work on trauma and hand. They get early experience taking consults and trauma call, reducing fractures and trauma management. The remaining six months are dedicated to non orthopaedic rotations. Interns rotate through general surgery, neurosurgery, emergency medicine, ICU (including burn ICU), and MSK radiology.
Conferences/Training Courses: "Intern boot camp" (combination of lectures and cadaver and sawbones based labs), ATLS offered to those interns attending the Combat Casualty Care Course.
Second year residents remain in San Antonio and begin having increased responsibility with in-house primary call and supervising interns who are first call for consults. From this point forward all rotations are orthopaedic disciplines. Second year residents rotate through trauma, foot and ankle, sports, and adult reconstruction. They work directly with and are supervised by the chief residents and staff and take an active role in teaching and supervising the interns.
Conferences/Training Courses: AO or OTA Basic Fracture Course
Third year of residency is comprised of orthopaedic rotations at SAMMC (hand, pediatrics, tumor), University Hospital in San Antonio, Rady Children's Hospital San Diego, and the San Antonio VA system. Third years take trauma call and pediatric call during the course of their outside rotations. They earn more independence as more operative experience is gained.
Conferences/Training Courses: The Rocky Mountain Arthroplasty Course (Denver, CO) or the annual American Association of Hip and Knee Surgeons Annual Resident Arthroplasty Course.
Fourth year marks the end of in-house call, call schedules vary based on rotation, but it is all home call. Residents rotate at SAMMC through spine, foot and ankle, and tumor. They complete away rotations at the United States Air Force Academy in Colorado Springs, CO. They also work with the San Antonio Orthopaedic Group for adult reconstruction and at The Children's Hospital of San Antonio for a pediatric rotation. Residents gain more autonomy in the operating room and get to participate in a variety of experiences at different facilities which broadens their surgical experience.
Conferences/Training Courses: Enneking Seminars in Musculoskeletal Pathology.
PGY V (Chief year)
Chief residents remain in San Antonio for the entire year. During this final year of general training, residents finalize their skills in operative specialities pertinent to generalists and any military practice. They are also charged with the education of junior residents. Depending on their schedules, chief residents rotate through Trauma, Sports, Adult Reconstruction and Hand. Chief Residents have day and night call responsibilities supervising the junior residents and the operating room.
Conferences/Training Courses: Three elective courses are offered based on the chief residents’ needs/desires. Each PGY5 will attend one of the following courses
Arthroscopy Association of North America & Society of Military Orthopaedic Surgeons Shoulder Arthroscopy Course
AO Advanced Principles of Fracture Management Course (gives additional focus on management of more complex periarticular, pelvic and acetabular fractures)
International Congress for Joint Reconstruction Hip & Knee Course (includes small group didactics and cadaver based labs with a renowned international faculty)
Academics are weekly on Wednesdays from 0700-1100. The curriculum heavily utilizes case-based learning and peer-to-peer teaching. Faculty surgeons provide additional expertise during their lectures. Quarterly Visiting Professors provide in-depth knowledge and experience over a two-day visit. Subspecialty-based journal club is conducted monthly. The program incorporates simulation and sawbones/cadaver labs regularly. Common components:
Built-in team training with team specific curriculum
Surgical indications conference
M&M conference monthly
Surgical simulation Labs
Surgical cadaveric skill sessions
Comprehensive Competency-Based Education--direct observation of surgical and clinic performance with extensive structured feedback. Innovative quantitative determination of resident skills pioneering education beyond ACGME and ABOS requirements.