Iowa very much believes in graduated responsibility, whenever possible. Therefore, the R2s seem to do more primary knees,IM nails, tumor biopsies, ankle fractures, scopes, and ACLs than the more senior residents. However, because there are so many cases, they often find themselves as the first assist on more complicated cases like the crazy tumor resections, Ganz osteotomies, or acetabular fracture reductions and pinning/plating, etc. Obviously, when it is an R2 assisting the attending on something like a Ganz or modular replacement, they are being walked through it as opposed to doing it autonomously like the senior residents, but I would be afraid of the program that had R2s osteotomizing the ischium without supervision.
I think Iowa has about the ideal mix of friendly faculty, excellent clinical and operative teaching, plenty of clinical material and autonomy, and about the most broadly-based and forward thinking think-tank in all of orthopaedic academics. I may be biased, but if you can stand the winter and the smaller town feel of Iowa City, you cannot find a better place to spend 5 years learning orthopaedics.
