Residency/Fellowship

St. Luke's-Roosevelt Hospital Center
Department of Orthopaedic Surgery Residency Program

Mission Statement
General Description
Curriculum Description
Research Requirements
Residency Rotations
Resident Application Process
Work Hours
Salary Benefits
Parking, Apartment Rentals and Housing


MISSION STATEMENT

The primary mission of the department of orthopaedic surgery is to provide care of the highest quality to all orthopaedic patients presenting to St. Luke’s-Roosevelt Hospital Center, regardless of the patient’s race, religion, sexual orientation or ability to pay. To accomplish this task, we have an outstanding attending staff with fellowship training in all of the subspecialties of orthopaedic surgery. All of the attendings are board certified or board eligible and in the process of obtaining board certification.

We strive to provide education of superior quality to our orthopaedic residents, fellows, third and fourth year medical students from Columbia’s College of Physicians & Surgeons as well as fourth year students from medical schools over a broad geographic area. By practicing with the highest standard of care, we strive to advance the knowledge of our hospital staff, patients and the community. In order to provide this educational experience, our faculty covers all subspecialties in orthopaedic surgery and most hold teaching appointments at Columbia’s College of Physicians & Surgeons, including some with the rank of clinical professor.


GENERAL DESCRIPTION

St. Luke’s-Roosevelt Hospital Center (SLRHC) was formed in 1979 upon the merger of St. Luke’s and Roosevelt Hospitals. Hence, SLRHC consists of two sites located along Amsterdam Avenue on the Upper West Side of Manhattan. There is a continual flux of attendings, house staff, patients, and administrative personnel between these two sites. SLRHC is considered a single institution.

The Hospital Center maintains a close academic affiliation with the Columbia University College of Physicians and Surgeons. All academic appointments for the attending surgeons of the SLRHC Department of Orthopaedic Surgery are through Columbia University. However, the orthopaedic surgery residency of SLRHC is run as an entirely separate and independent entity from the Columbia-Presbyterian Hospital Orthopaedic Surgery program.

The residency program is currently approved for fifteen positions, three in each year of a five-year program. The PGY-1 residents (i.e. “interns”) are provided with a schedule of twelve one-month rotations controlled solely by the chairman of orthopaedics. These rotations are in compliance with the guidelines of the Residency Review Committee for resident education.

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CURRICULUM DESCRIPTION

The St. Luke’s-Roosevelt Orthopaedic Surgery program is an accredited five-year program with three residents in each year. The PGY-1 year is designed to give the first year residents experience in the surgical and non-surgical care of patients. They gain experience in and develop an understanding of surgical anesthesia, multi-system trauma, plastic surgery/burn care, intensive care and vascular surgery. This is accomplished with rotations on each of these services. In addition, the residents will spend no more than three months on the orthopaedic service during this year.

During years two through five the residents are instructed in all areas of orthopaedics including but not limited to spine, joint arthroplasty, hand, sports medicine, orthopaedic oncology, foot and ankle, trauma, pediatrics and rehabilitation.

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RESEARCH REQUIREMENTS

The Department of Orthopaedic Surgery maintains an active clinical research program. Residents are required to attend monthly research meetings. Each resident is required to participate in at least one research project which produces a manuscript of publishable quality. Multiple national presentations have been made and multiple peer-reviewed manuscripts have been published in the last few years.

There is also a yearly Research Day where residents formally present their research to the department.

Orthopaedic residents PGY-1 through PGY-5 are required to take the OITE during each year of their residency.

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RESIDENCY ROTATIONS

PGY-1: This year has been specifically designed to include the program requirements delineated by the RRC. Each resident will spend approximately ten weeks on the orthopaedic service. Fifteen weeks will be divided among emergency medicine, neurological surgery, and anesthesiology. The remaining twenty-seven weeks will be devoted to structured education in surgery including multi-system trauma, plastic surgery and burn care, intensive care, and vascular surgery. As a level one-trauma center at St.Luke’s, we are well equipped to provide exposure to multi-system trauma, intensive care, and vascular surgery. Each resident will rotate through an affiliated institution to gain specific experience with burns. Since both our emergency medicine and anesthesiology departments have residency training programs of their own, they have a strong tradition of teaching which greatly benefits our residents.

PGY-2: This year of orthopaedic residency is spent at the St. Luke’s site in a structured setting for didactic and practical instruction under the close supervision of the attending staff and PGY-5 orthopaedic residents. When on call, residents are the first line of orthopaedic consultation from our Level I emergency department and for inpatient consultations. In this capacity, residents perform initial evaluations, admission procedures and/or emergency room treatment, and provide clinic coverage. The clinics include general orthopaedics, fractures, spine, hand, and pediatrics. PGY-2’s perform and assist in a full spectrum of orthopaedic surgery. By the end of the year, the PGY-2 will be able to perform a complete musculoskeletal evaluation and will begin to feel comfortable with advanced trauma management. Attendance at all academic conferences is required.

PGY-3: During the 3rd post-graduate year, an emphasis is placed on enhancing technical skills in the operating room and fostering principles of non-operative and operative treatment. This year includes four months on the Hand Service at the Roosevelt site, five months of general orthopaedics and trauma at the Roosevelt site, and two months at Memorial Sloan-Kettering Cancer Center on the Bone Tumor Service. Research time is available during the 4-month rotation on the hand service. Additional time is available during the Rehabilitation-Radiology-Rheumatology rotation.

PGY-4: As a senior member of the orthopaedic team, the fourth-year resident begins to assume greater responsibility in patient management and surgical decision making. In addition, they assist in educating the more junior residents and the rotating medical students.

The year is separated into three four-month blocks:
Chief Resident - Roosevelt Hospital: The chief resident at Roosevelt Hospital is responsible for all of the administrative aspects of the clinical service. During this block, there is great operative experience in total joint surgery and sports medicine. The resident is also responsible for presenting cases at weekly Grand Rounds and Mortality and Morbidity meetings.

Research Chief: During this four month rotation, with a lighter on-call schedule, the resident is afforded time to work on research projects. In addition, because of the many operative cases at the Roosevelt Hospital site, there is ample opportunity to help assist on a wide variety of advanced cases in all the subspecialties of orthopaedics.
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Alfred I duPont Institute (Wilmington, Delaware) The duPont Institute is an international leader in the field of musculoskeletal disorders in children and offers an intensive exposure to a large volume of pediatric orthopaedics

PGY-5: During this fifth year of post-graduate training, each resident will begin to take on the responsibilities of an independent orthopaedic surgeon. This year integrates and refines the accumulated knowledge and clinical experience of the first four years. The entire year is spent at the St. Luke’s site where four months are spent as the senior administrative resident, four months are spent as the Chief Resident for Pediatrics and Spine, and four months are spent supervising the Hand Service. The entire year is spent teaching the PGY-2 residents the fundamentals of orthopaedic surgery. Research time is available during the 4-month Pediatric-Spine rotation. Additional time remains available during the other 8 months of the PGY-5 year at the St. Luke’s site.

Physician Extenders:
The Department of Orthopaedics employs two physician assistants, one at each site, who work closely with the residents on rounds, discharge planning and clinic coverage.

Clinical Clerkship for Medical Students:
There is a clinical clerkship for medical students that provides exposure to the specialty of Orthopaedic Surgery. The student will become an integral part of the service and is considered an important member of the team. Each student is expected to participate actively in the operating room, the specialty clinics and in all conferences. Night call is optional, but taking call every third night can provide valuable trauma service experience.

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RESIDENT APPLICATION PROCESS

There are a total of fifteen residents in the Department of Orthopaedic surgery, three each year, and they come from all parts of the country. The following medical schools are currently represented at our program:

Columbia University
Georgetown University
Jefferson Medical College
Mount Sinai Medical School
New York University
Northwestern University
University of Colorado
University of Medicine and Dentistry of New Jersey
University of North Carolina

Admission to the Orthopaedic Residency Program at St. Luke’s-Roosevelt Hospital Center is governed by the hospital bylaws and by the requirements of the Accreditation Council of Graduate Medical Education. Applications for positions are accepted from qualified students who have received an MD degree from an accredited medical school, at the time of entry into the program. The Program offers equal opportunity to all individuals who have the necessary qualifications.

The Orthopaedic Residency Program offers 3 positions yearly. All positions are filled through the National Residency Match Program (MATCH). All applications must be submitted to the Department through the Electronic Residency Application System (ERAS). To be considered, the application and all supporting documents must be complete. Supporting documents consist of an official transcript from the medical school, Dean’s letter, two additional letters of reference, a personal statement and USMLE scores. The scores on these exams must be consistent with Department standards.

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WORK HOURS

The Department of Orthopaedics will maintain compliance with the New York State Department 405 regulations governing resident work hours by monitoring the hours worked by its residents. The New York State regulations are:

1. No resident may work more than 80 hours/week over a 4-week period.
2. No resident may work more than 24 hours at a time. The hours a surgery resident is on-call in the hospital need not be counted towards the 80 hour weekly limit or towards the 24 hours/day limit and other scheduling arrangements can be developed for surgery residents, if the following regulations are met:
  a) During the time a resident is on-call he or she is generally resting.
  b) On-call duty is scheduled no more than every third day.
  c) Following an on-call night, the resident has 16 hours off.
  d) Policies and procedure are in place to relieve any resident who is fatigued due to an unusually active on-call night.

In addition, residents are to have one 24-hour period of time off every week.

On-Call Schedule:
PGY I Every third night in house
PGY II Every third night in house
PGY III Every third night at home
PGY IV Every third – fifth night (Depending upon rotation) at home
PGY V Every fourth night at home

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SALARY BENEFITS

St. Luke’s-Roosevelt Hospital Center has entered into a collective bargaining agreement and the Committee of Interns and Residents (CIR) has been certified by the NLRB as the representative for all house staff employed by SLRHC. All House Staff Officers covered by the CIR agreement shall, as a condition of employment, become and remain members of the CIR/SEOU in good standing during the term of their employment with periodic dues uniformly required as a condition of membership.


In accordance with the CIR agreement, the PGY salary scale is as follows:

PGY Level 7/1/01 4/1/02 4/1/03 4/1/04

PGY 1 $42,068 $43,751 $45,501 $47,321
PGY 2 $44,824 $46,617 $48,482 $50,421
PGY 3 $47,570 $49,472 $51,451 $53,509
PGY 4 $49,275 $51,246 $53,296 $55,428
PGY 5 $51,033 $53,074 $55,197 $57,405

The Chief Resident differential is $2,000.

· Health Benefits: House Staff Officers are part of the CIR’s health benefit plan.
· Meals: In addition to providing a free snack for House Staff Officers who are on duty, meals for teaching conferences up to five per program, per week, per resident are provided.
· Leave Time:
  - 12 paid sick leave days
  - 3 bereavement leave days (for death of mother, father, spouse, domestic partner, child, grandparent, brother or sister).
  - 4 personal days
  - 8 legal holidays
· Vacation: 20 paid vacation days
· Legal Holidays:
 

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New Years Day
Martin Luther King’s Birthday
Presidents Day (RH only)
Good Friday (SL only)
Memorial Day
July 4th
Labor Day
Thanksgiving Day
Christmas Day

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PARKING

Monthly parking rates range from $150 to $200 per month and are paid by payroll deduction after taxes. Each House Staff Officer with a monthly parking contract shall receive a voucher for each on-call shift to be used for parking overnight in a Hospital lot at the site where they do not have monthly parking. The vouchers will be distributed based on the scheduled number of monthly on-call assignments at the appropriate site, (e.g. if a house staff officer with parking privileges at the Roosevelt site is scheduled to be on-call 8 times at the St. Luke’s site in the month, he/she shall receive 8 vouchers that month).

APARTMENT RENTALS AND HOUSING

Housing is guaranteed to house staff in ACGME accredited programs who submit a completed application and a deposit in the amount of $800 by April 25, 2004. This amount will be applied to the first month’s rent. House staff officers shall be given priority for any vacancies in hospital-owned apartment buildings.

The hospital will maintain at a minimum the same ratio of housing units to house staff officers as currently exists. Upon reappointment, returning HSOs shall have the option of renewing their vacancy agreement.

Rents shall be adjusted only between residency years. The Hospital Center understands the need to provide housing to its HSOs at a cost that is fair and reasonably consistent with applicable laws and market conditions. It is agreed that rent increases for members of the bargaining unit who reside in Hospital housing will not exceed 5% in any year.

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