TOP 5 ACADEMIC ORTHOPAEDIC SURGERY RESIDENCY PROGRAMS

i thought this thread was interesting to read. We're about to start applying to programs so i thought it would be relevant to ask about good academic programs again.

Most places it seems will have you well prepared to practice orthopaedics, but for those who want to go into academics, is this list still accurate or have there been any recent changes or updates?

This "debate" gets old to see and unfortunately confuses some of those just applying. This is solely RESEARCH DOLLARS that is accrued by the various departments and not a reflection of the EDUCATION that you receive. At that these monitary amounts are largely accrued through grants submitted by BASIC SCIENCE researchers (i.e. NIH, etc.) and the percentage of CLINICAL research dollars are usually a much smaller percentage of the total pot.

Your education is a product of the ratios of residents to attendings and the degree of meaningful mentorship that they provide, the gamut/diversity of case scenarios that you observe, and how much time that is afforded for reading aside from personal time, scut time, and call time. Seek this information out through your aways, on the interview trail, and through talking with the current residents. You will get the general impression of each of the programs by seeking this information out and can thus make an informed decision.

Remember, all the patient cares about after the surgery is whether their ailment is repaired. A name in iteself cannot accomplish that without any substance.[/b]

WHAT A NAME COPIER!!!
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(Above)

I have been curious about NIH trends for a while, so I finally compiled this list. Sorry, lots of data, and I cannot figure out how to show it in a better format here. If interested, it might be better to cut and paste into excel. But anyways, here are the past 5 years of NIH awards to 'medical schools' in the dept of ortho. The format is]

Quality, not quantity. Look at who's writing the landmark papers, not wasting research money doing crappy studies

My username inspiration was a play on words of Bo Diddley the blues/rock n' roll guitarist.....correct last name spelled DIDDLEY, not Diddly.

Just pulling your chain....didn't know that there was an original out there.

A little unknown program- University of Toledo- those guys are well rounded and have a lot of hands on starting PGY2, and take a look at their scores! I am considering an away there.

This makes a lot of sense. However, for those of us new to all of this, may I ask, is it reasonable to think that institutions with larger NIH funding would offer a "trickle down" of greater magnitude to the residents? In other words, would the indirect costs coming from these large grants, which are typically re-distributed to the department chairs as discretionary funds, be of benefit in the training of residents through the purchase of newer equipment, the establishment and maintenance of training labs, etc.?

Just a thought. Input from those senior folks (or anyone) in the know is welcome.

In brief.

No, you should not assume any "trickle down." Labs are expensive to run and the grants are associated with budgets, none of which would ever include "some stuff for the residents".

The labs at my institution do have opportunities for resident research, but time to do basic science without a dedicated research YEAR is hard to come by. Also, we are encouraged to find our own funding via OREF, NASS, etc.

Noted; thanks.

I'm just quoting this because it's awesome.

Your "clinician" is only able to do the operations because the "prick" did the research and studies telling him what to do. Academic surgeons are very skilled in the OR and take on a MUCH more challenging caseload then community surgeons. They are responsible for doing the studies that investigate the implants and techniques that eventually come to market. So to answer your posted question...for a straight forward case both community or academic orthopod are fine. For challening cases/revisions, then academic orthopod no doubt. Also as an aside, the volume of cases at academic centers is exponentially higher then community programs. So don't be fooled. The bow tie pricks are operating non-stop. Where do you think they get the patient outcome data for their studies? To applicants...keep this in mind and take all these posts with a grain of salt. Mine inclusive.

dj

DJ,

Not the throw fuel on the continual "academic vs community program pissing contest" fire, but there are a couple of things you say that are simply not true. I am not trying to weigh in on which setting provides "better" training, because I firmly believe both to play an important role in Orthopedic education, depending on one's career goals.

First, to state that academic programs have "exponentially more" cases than community programs is not true. My experience talking with different residents during training is the opposite is true. While academic programs often provide a wider variety day to day, most community programs offer a higher volume of bread and butter cases. Again, I'm not trying imply one is superior, but community programs often offer more case volume. This is often a function of the staff to resident ratio, which is often higher at community programs. Many community programs draw their staff from larger groups of private orthopods and tend to have fewer spots per year than the academic programs.

Also, to imply that community surgeons are inferior to academic surgeons when it comes to "challenging cases / revisions" is a gross generalization that you cannot support with data or fact. I currently work in a practice with no residency affiliation (community or academic) and my joint partners do revisions all the time with, in my opinion, perfectly acceptable proficiency. They just don't write a paper every time they do one.

Again, the purpose of this post is not to proclaim the superiority of either style of training, but to point out to those early in their orthopedic training that gross generalizations are rarely based on fact. There are brilliant, gifted surgeons in both academic and community based programs, as well as hacks that I wouldn't let operate on my dog.

i have been away from this forum for a while so forgive me, i have not read all of the replies on this post.

i completely agree with earthdawg.

like many of you, i had the misconception that some how academic programs where better. of course, it is were many of the surgeons that write the papers are. therefore, they must be good.

the true is, there are some very good to excellent programs that are considered to be community that are very academic (Carolinas, Union Memorial) and vice versa. the line now has become blurred.

the true questions are were will you get the best operative skill and were will you get the best research opportunities.

for research, go where there is a lot of research published. that's simple.

for operative skill, traditionally most academic programs are where many difficult cases get send and many community programs do bread and butter cases. those are just generalizations.

for a young resident, ortho years 1,2,& some of 3, u don't need the difficult, complex, crazy cases (difficult revision TJA, arthroscopic cuffs, PSO's, replants). these cases are wasted on you because you don't have the basic frame work to understand these cases and to be able to build upon previous experience. these case are better for upper level residents and fellows. for the younger residents, you need the lots of the bread and butter cases (fractures, primary arthroplasty, scopes, carpal tunnels) so that you can build on you understanding of surgical technique and anatomy. understanding this need, going to a program that will give you early exposure complex cases does not really benefit your education. it's fun and "cool" to say you were involved, but did you really do the case and understand what you did. the answer is usually no, except for the few extraordinarily talented residents ( i have some across only one, he could do but didn't completely understand).

the best programs give you a taste of everything at the appropriate time. there are NO programs without flaws. there are good and bad surgeon in both types of programs. there are brilliant surgeons at both types of programs. i recommend you go where you feel you will get the best training that suites you style of learning.

indeed it is a long time.. and when was the last time you updated your blog?? I've given up on checking on it!

yes I'd like to see an update on your blog too! Good to hear from you.

Welcome back. I love your blog, too. I hope to see more of it in the future. I like all the Tool quotes as well.

This blog is written in a sort of Wu-tang Shaolin storytellin' style.

He writes both, but hasn't updated that one in forever plus a few weeks, I guess he has a good excuse though.

Putting aside USNWR rankings of the "hospital," let's start a discussion about the Top 10 academic programs vs. the Top 10 training programs (hands-on operative experience in all areas of orthopaedics).

Top 10 Academic: HSS, Harvard, Mayo, Jefferson, Rush, Iowa, Pitt, Duke, WashU, UW

Top 10 Training Experience: Pitt, Brown, Case Western, Stanford, NYU-HJD, Wisconsin, Rochester, UW, Vanderbilt, Iowa

Curious to hear everyone's thoughts...

Top Academic programs: HSS, Harvard, Mayo, UW, NYU-HJD, UPenn, Duke, WashU, Iowa, Cleveland Clinic, UCSF.

Top Experience programs: Iowa, Emory, Campbell Clinic, UTSW, Carolinas, Case Western, Rochester, Miami, Maryland, UCSF.

Most "balanced" in regard to exposure to both academics and operative experience: Iowa, UCSF, Campbell Clinic, Carolinas, Case Western, and Emory.