HSS Trauma Training?

I recently rotated at HSS and asked the same quesion of the residents and attendings. Heres the answer I got:

The residents spend a bunch of time at a Level 1 trauma center in Queens during their 2, 3, and 4 year. They give you a car to get there and back every day from Manhatten. The residents get to operate a lot there especially the 2s and 3s. They also spend time on the fracture service at NYH doing reductions and some trauma surgery. Their trauma attending Dr Helfett is very good and a very nice guy with a good reputation.

Thats what I heard while there.

I heard about that hospital in queens too... i believe its New York Hospital of Queens, and from what I hear that is not exactly the busiest hospital. ?

There are no superb trauma experiences in any of the New York City programs mainly due to the distribution of trauma to several trauma centers around/outside the city. The program with perhaps the best trauma experience in likely NYU-HJD because they send their residents to Harborview in Seattle or Shock trauma which are regional trauma centers with huge volumes. I rotated at HSS and the residents there agreed that trauma was relatively weak but it was improved from being non-existent before. Helfet is well respected but he is more academic about it - by no means do they see any appreciable volume of trauma at HSS or NYPres.

I agree that trauma is a central part of orthopaedics and we'll all be taking trauma call at some point. You should consider that when making your rank list. HSS is a great program (among several) but it has it's weaknesses (lack of trauma, clinical experience, peds). No program is perfect in every way - they all have their own strengths. Just find the one that fits your interests most closely.

I have seen the best orthopedic hospitals on usnews and as an MSIII i wanted to know if that correlates with residency experience and training. What is the best program to be at in NYC? Does the fact that HSS and J&D are trauma light mean that they are "easier" programs. Do you still get adequately trained? Any input on the programs from Philly as well. Send me a PM if you have any thoughts.

I don't think HJD is light in trauma. They rotate at both Bellevue and Jamaica hospitals, both level 1 trauma centers, and then half of the residents go away for additional trauma (at Seattle or Baltimore).

I don't know how accurate US News is because it even says HSS is a trauma 1 center, which it is definitely not (correct me if I am wrong.) That might make for an easier residency?

keep in mind that there are differing governing bodies that declare who is a "level 1" center. A place may be considered level 1 by the state but not have applied/passed the ACS(American College of Surgeons) criteria. The ACS website has a list of places it recognizes as trauma centers (I-III). You ay be surprised by some hospitals that are not on there but are certainly busy centers that are state certified level 1 centers. For example, is st louis only washU, not SLU is listed as a level one but SLU sees as much or more trauma ans both are considered level 1 centers as is another private place in the county. here is the list

As a current HSS resident and former medical student at Brown I have a few comments on this thread.

First, the HSS building proper does not have an ER; however, the building is connected by an above-street corridor to next door New York Presbyterian Hospital-Cornell (Cornell) which is a level 1 trauma center from the standpoint of diversion and resources. That is, no traumatic case is ever diverted away from Cornell. This is true for most of the hospitals mentioned so far in NYC, including New York Hospital Queens (NYHQ which is part of the Cornell system), Bellevue, Jamaica, etc. In addition, no cases are ever referred out of Cornell/HSS because of a lack of expertise or resources, while large numbers of cases are referred in for definitive care (i.e.. "cold" trauma). In terms of orthopedic operative experience, I would argue that the volume of definitive fixation/ reconstruction may be most important, followed by volume of cases addressing complications of attempted fixation or reconstruction. For HSS residents, that translates into 3 busy orthopedic trauma OR rooms (one at HSS, one at Cornell, and one at NYHQ) on most days. That said, an even greater daily volume of trauma-related cases are treated by anatomic sub-specialists (e.g. foot & ankle, hand/forearm trauma, shoulder & elbow, spine, etc).

When talking about "trauma experience", it is important to define exactly what is being discussed and also what is important to you. Cornell and NYHQ have less primary high energy multisystem trauma than places like Harborview, Shock, and Rhode Island Hospital. However, we see more than enough to feel comfortable with the stabilization and damage-control orthopedic management of these patients. With respect to the definitive care of complex extremity/pelvic trauma and sequelae, the experience is excellent for HSS residents (see above paragraph). With respect to bread&butter trauma and urgent-care type trauma, you will likely feel comfortable and wish that you had fewer of these cases to do by the 3rd year at HSS. The cases that we could use more exposure to are spine trauma. We do not take primary call for spine at any point during the residency, which limits the exposure to acute spine trauma. Although many of the residents here think that is a good thing, HSS is working on adding that aspect to the resident experience.

Another factor to consider when discussing trauma experience is the timing of trauma exposure. Trauma call for HSS residents, like some other programs, is covered by residents on the orthopedic trauma rotations at NYPH and Cornell. There is no night float and minimal cross-coverage from non-trauma rotations. The PGY-1 spend 7 weeks on orthopedic trauma services, PGY-2’s nearly 8 months, PGY-3’s 7 weeks, PGY-4’s 12 weeks, and PGY-5’s 6 weeks. This does not necessarily translate into an “easier” residency, but this type of manpower allocation does allow for a more focused educational experience on both trauma and non-trauma rotations.