Program Review
Staff / Faculty / Chairman
Dr. Weiner is the department chair - he is a Summa grad and is orthopaedic oncology trained (which is unique of itself as many programs do not have a dedicated tumor surgeon). We get an excellent (but not over-kill) two months of tumor as 3s which helps us do well on that part of our in-training.
Dr. Junko is the PD - he is also a Summa grad and is F&A trained. Both guys love the program and they are huge resident advocates. They make sure we take care of our patients and that we take care of each other. Both are sticklers for the rules - there's no fudging on work hours. But, with the amount of call we take and the number of cases we do there's no need. These two guys are extremely approachable and down to earth. They ask for our imput on rotations, the match list...almost everything. Plus, they're big on turning over responsibility in the OR early on - you'll do the case if you're prepared, and you'll also often dictate the op note. They're big on letting residents struggle through critical intra-op decision making; not just banging a hammer or turning a screw. They are not reckless, however, and they supervise appropriately.
Dr. Weiner holds a welcome party for the interns in late June each year at his house. Some of the other attendings also hold parties at their homes. This promotes closeness among residents and attendings which often translates to increased trust in the OR.
Finally, the staff we work with is top notch. We operate at two hospitals - St. Thomas and Akron City. Most cases are done at St. Thomas which is partially owned by Crystal Clinic Orthopaedic Center (a large private group in town). The ORs are completely dedicated to CCOC cases and the scrub techs and circulator nurses are fantastic at their jobs. When patients are admitted post-operatively, they get nurses who are used to working ONLY with ortho patients which means they don't call the residents for simple things that other nurses would not know.
All this adds up to a great experience with a very high case volume and facult/staff who genuinely care about patients and resident education.
Didactics / Teaching
Conference is from 7-8 each morning with a longer grand rounds every Friday. M&M takes the place of grand rounds one Friday per month. Residents present their surgical indications on their house patients (i.e. their personal clinic patients) at the start of grand rounds each week which allows for good discussion amongst faculty and fellow residents.
An informal "fracture conference" is held among residents in the physician's lounge at breakfast each morning where the on-call residents show their fractures from the night before and senior to junior resident teaching takes place.
The chiefs put together the daily didactic conference schedule a month in advance and it's usually very educational. More often than not, conference is presented by an attending physician and is occasionally multi-disciplinary (tumor conference includes pathology, heme/onc, and radiology). The radiologists and orthotics/prosthetics guys also play a big role in the conference schedule. Again, much of it is driven by what resident's feel we need.
Operating Experience
Second to none. Our program is a jewel for people who want to start operating on day 1 of intern year and not stop until graduation. The fact that we work with so many attendings from EVERY ortho sub-specialty is huge. We do a tremendous number of total joints and spines (we have 4-5 dedicated total joints surgeons and almost all the surgeons do primary knees and hips). We have 4 spine surgeons, six hand surgeons, one tumor surgeon, four F&A surgeons, three shoulder/elbow surgeons, three sports surgeons, and one dedicated traumatologist. With a huge pediatric hospital in Akron, we rotate with 5-6 pediatric orthopods who are equally terrific.
This is the first year that interns have had to log cases and just to give an idea of our experience: I scrubbed 160 ortho cases (in three months of ortho) - 30 cases were pediatric and 130 were adult. I'm not including ER procedures - these are operative procedures where I was scrubbed with the attending and no other residents were present.
Part of the reason this is possible is our unique intern year. The RRC stipulates that an ortho intern year can only contain three months of ortho. However, in addition to those three months, we take ortho call even on other services for a total of 8 months of ortho call as interns. This is nice because it means we don't waste our time dealing with general surgery consults and instead focus on orthopaedic consults even when we're doing general surgey months. We enter our second year ready to knock out any consult and be competent on many basic ortho cases (endos, nails, basic fractures, etc).
Our chiefs are extremely well prepared for fellowship or private practice. Most of them enter fellowship to hone a skill - not learn a new one.
Our operative experience is extremely well-balanced. I rotated at places where they could knock out complex traumas virtually unsupervised as 3s but had never held a scope. I wanted a program with balance. What sold me on Summa was visiting as a student and watching a chief scope a knee as quickly and accurately as the attending.
We are a rare program that offers "choice" months as upper levels. This essentially allows upper levels to cherry pick the cases they want. So, if they intend to do a sports fellowship, they can spend extra months doing only shoulders, knees, etc. In addition, time is built in as 4s to actually rotate at programs where we might be considering a fellowship.
Bottom line - when you finish at Summa you'll have the cases numbers to be an excellent general orthopod, OR to be well-prepared for fellowship. For people who want to work hard and operate a lot, it doesn't get any better than Summa.
Clinic Experience
This was another huge selling point for me on Summa. We do some traditional service-based clinic with our attendings but not as much as other programs. As we all know, the educational benefit of doing clinic that way varies by attending and service. What's really special about Summa is that starting as a 2, we have a half day a week of house clinic where we see our own house patients. We follow them for any orthopaedic condition from first visit, to surgery, to post-operative care. It's a great way to start seeing what an orthopaedic practice will be like and to assume an "attending" role with your own patients.
Research Opportunities
Research opportunities are there if you want them but the resources seem to wax and wane with hospital funding. We do have the ability to do basic science research at NEOMED (our affiliated med school) or Akron University. As you can imagine, there are ample students and faculty willing to help and some of our residents have done some amazing research. Many residents choose to do their research at Akron Children's hospital since more of the faculty are involved in clinical projects there. While research is a requirement and is encouraged, it is not pushed so it doesn't take away from operative experiences. There is a month of dedicated research in the 2nd year and the 3rd year. However, residents still take call during these months which means they often scrub add-on cases.
Residents
Hands-down the best thing about our program. Our residents all work hard, take care of our patients, and take care of each other. We all get along and we all enjoy getting together outside of work for all sorts of activities. Most of us are married with kids (though a few hold-outs exist) and we help each other take care of our families. I moved my wife and 1 year old daughter to Akron from out of state and it has never been an issue. The other wives took my wife in and they do something together almost every day of the week. I can't say enough good things about how well our residents work together. The trade-off is we never dump on each other. If a consult comes in at 6:59am, the person on call sees it before going home. I like this kind of cooperative spirit and it was one of the greatest assets to me about the program.
Lifestyle
Call is pretty tough at Summa, but it is intentially tough because it's meant to be part of our education. 2s and 3s CURRENTLY take in-house call about 8 times per month. 4s take in-house call about 4 times per month. 5s take in-house call about once a month. However, with the work hour restrictions knocking out post-call OR time, our program is in a transition to a senior home call system. The concern of going to this system has been that a lot of the upper level to lower level teaching we have always valued by having a junior and senior in house will be lost. However, such as system will ensure 3rd-5th years get to operate as much as possible without being "post-call". Currently, we plan to have the upper level resident stay in-house until about 10pm to help knock out consults. They would then go home and only come in if they were needed. Given the quality of our residents, I have no doubts that they would come in if asked.
Location / Housing
I'm not going to lie and pretend that Akron is the greatest city I've ever been to. But remember - you're starting residency - why would you want to be in a place that would make you wish you WEREN'T in the hospital? Akron has everything you could need and Cleveland is only 30 minutes away. There are some great outdoor activities including skiing nearbye. The Akron-Canton airport is a fantastic advantage with cheap flights on delta and airtran to multiple destinations. Cost of living is low but be prepared for hefty property taxes if you buy a home.
My wife and I are from the South and we've been very happy here. People are friendly and laid back. Fortunately, our first Ohio winter was mild, but I understand they can be pretty brutal. Summer and Fall here are terrific and I don't view living in Akron as a down-side at all.
Limitations
Not a great research infrastructure if that's your thing. You can certainly do it, but as I mentioned it may require tieing in with NEOMED or Akron U. Residents have no problem completing their research requirements, but it can be frustrating. The only other limitation is also one of the benefits of our program. We cover two hospitals when we're on call. Fortunately, they're only about a five minute drive but at 2am that can be a frustrating drive! Our call rooms are at St. Thomas which is the main hospital where we operate and where most of our patients are. However, all traumas go to City, a Level 1 Trauma Center and we often are called there for traumas, ER consults and floor consults.
Overall Rotation Experience / Conclusion
I couldn't be happier to be at Summa. I rotated at some great programs that are well known but none of them have what Summa has. The number of cases we do, the number of attendings in every specialty we work with, and the culture of helping each other out make this one of the greatest programs I came across on the interview trail. In the end, residency is what you put into it - just showing up won't make you a good surgeon. But, you'll never lack for opportunities at Summa.
