During the program, fellows will be exposed to the following training:
- Management and surgery of polytrauma patients
- Management of nonunions, malunions and infections
- Clinical research and resident teaching
The basis for a fellow's training and education will be through clinical training, conferences and didactics, and research opportunities.
Providing patient care is an important aspect of our Orthopaedic Trauma Fellowship Program. Fellows will examine patients admitted through the emergency room, outpatient and private offices; evaluate consults; and serve as a source of experience and knowledge to the resident staff.
The fellow on call will be notified of orthopaedic trauma by the orthopaedic attending on call. The fellow has the opportunity to evaluate complex orthopaedic trauma problems in the emergency room and to formulate a treatment plan.
Emphasis is placed on resuscitation and the orthopaedic trauma surgeon’s role in the management of unstable patients. In addition to the formal emergency room consultation (written by the resident), fellows are expected to document their involvement. Supervision will be provided by the attending staff. Trauma fellows do not admit patients to the hospital or independently staff operating room cases.
Fellows direct their call schedule, with assistance from the trauma service coordinator. For any changes needed, fellows should notify the coordinator at least 4 weeks prior. The final schedule is submitted to the administrative scheduler by the 1st of the month.
The inpatient orthopedic trauma service includes three attendings:
- A chief resident (PGY-5)
- A PGY-4 resident
- One or two PGY-1 residents from general surgery, emergency medicine, or anesthesia
The chief resident directs team administration. There is also a midlevel who is dedicated to the orthopaedic trauma service.
Our orthopaedic trauma fellows actively participate in the research program of the Department of Orthopaedic Surgery at the Wake Forest School of Medicine.
You’ll be encouraged to develop and pursue your own individual projects, and may also participate in other ongoing research. You may be expected to engage in both anatomic dissections as well as clinical and basic science research.
You’ll have full access to the Department of Orthopaedic Surgery’s Research Laboratory, which has over 1,500 square feet of dedicated space. The lab includes:
- A small animal surgical facility
- An extremity laboratory
- Access to animal housing facilities
- Significant computer support and orthopaedic operating room equipment (including an arthroscopy setup)
- Staff including two full-time PhD supervisors, two full-time laboratory technicians, a research secretary, a research center administrator, a research intern and two clinical research data coordinators
Prior to graduation, each fellow must complete one manuscript and have it ready for submission.
Conferences and Didactics
Formal training in orthopaedic trauma is an integral component of the Orthopaedic Trauma Fellowship Program. Training includes conferences, discussion and lectures.
The weekly trauma conference takes place on Monday mornings and involves the presentation of cases from the previous week. Discussion focuses on pre-operative workup, indications, critique of post-operative x-rays, and discussion of rehabilitation and expected outcomes.
Morbidity and Mortality Conference
On the first Wednesday of each month, trauma fellows participate in a department-wide morbidity and mortality conference. Every other month an orthopaedic trauma case will be selected for discussion.
Grand Rounds Conference
Trauma fellows participate in a department-wide grand rounds conference on Wednesday mornings.
Daily Triage Discussion
Trauma fellows meet each morning at 5:45 am to discuss and triage the trauma from the previous evening’s call team. The on-call senior from the previous night, the orthopedic trauma attending who is staffing the trauma room that day, research staff and our orthopedic trauma nurse coordinator are also present. Decisions regarding prioritization of cases for the day and indications are emphasized.
A didactic lecture series for the orthopedic house staff covers core curriculum topics specific to orthopedic trauma. Fellows are expected to attend and to present two or three topics per year to the residents.
A weekly fellow-specific lecture is given by an attending on Friday mornings prior to orthopedic trauma clinic. This lecture is geared directly to the trauma fellow and involves higher-level topics with an emphasis on complex decision-making.
The Orthopaedic Trauma service hosts a quarterly journal club that includes all trauma faculty and orthopaedic residents. Fellows select the topics and articles, with mentorship from the trauma faculty. After a resident or fellow presents a paper, a question and answer discussion period is held.