The PGY-1 year is primarily spent at Thomas Jefferson University Hospital (Jefferson Health). It is a transitional year designed to teach the basics of care and evaluation of the surgical patient. Intern year includes three eight-week Orthopaedic Surgery rotations and six four-week rotations, coordinated with the Departments of Surgery, Emergency Medicine, and Nonoperative Orthopaedics. 

During the 24 weeks on Orthopaedics, 16 weeks are spent at Jefferson Health and eight weeks at Bryn Mawr Hospital. At Jefferson Health, PGY-1s learn how to care for patients on the Ortho Trauma and Spine services. This includes managing floor patients, seeing consults, performing procedures, and scrubbing operative cases. Eight weeks at Bryn Mawr Hospital further expose the PGY-1 to basic fracture care and orthopaedic patient management. PGY-1s spend time evaluating and treating fractures in the emergency room, managing in-patients, and participating in surgeries.

Interns spend an additional four weeks on outpatient nonoperative sports medicine. This familiarizes PGY-1s with patient evaluation and work-up in the outpatient setting, and provides exposure to a wide range of nonoperative treatment modalities.

Four-weeks rotations on Vascular Surgery, Plastic Surgery, General Surgery Trauma, and in the Surgical ICU provide the PGY-1 further instruction in the management of complex surgical patients, with skillsets directly applicable to orthopaedics. Four weeks of Emergency Medicine allow additional experience seeing and triaging consults, and formulating treatment and disposition plans.

The last month of intern year, all six residents return to the orthopaedic service to allow for transition to PGY-2 year.

The PGY-3 year is focused on increasing residents’ responsibilities and developing subspecialty-specific orthopaedic skills. This year will prepare trainees for the responsibility and independence expected of a senior resident. While PGY-1 and PGY-2 residents spend much of their time on inpatient services, the PGY-3 year is more outpatient-predominant subspecialties. This includes immersive preceptor-style rotations in Foot and Ankle, Shoulder and Elbow, Hand, and Sports. Each rotation includes subspecialty specific didactics, in addition to the residency-wide didactics.

PGY-3s also spend 14 weeks at Nemours Children's Hospital in Wilmington, DE. This renowned children's hospital provides house staff a firm understanding of pediatric orthopaedics. Resident responsibilities include operating, clinics hours, and seeing inpatient and emergency room consults at this level 1 pediatric trauma center. PGY-3s work closely with rotating residents from other programs, including Mt. Sinai in NY, Seton Hall in north Jersey, Rowan in south Jersey, and Georgetown in Washington, DC. Finally, PGY-3s enjoy a protected research rotation.

The PGY-4, as a senior resident, assumes increased independence and responsibility. On most rotations, PGY-4s act as service chiefs, overseeing a team of junior residents. This is the case during two rotations of general orthopedics at Bryn Mawr Hospital, with four operative days per week comprising a mixture of joint arthroplasty, spine, sports, hand surgery, and community trauma.

During an orthopaedic trauma rotation at Jefferson Health, the PGY-4 spends most of the day in the operating room, gaining experience treating high-acuity, complex trauma. In addition, the PGY4 oversees the intern on trauma, triaging consults and assisting with procedures. An orthopaedic oncology rotation at Jefferson Health includes robust experience in the workup and treatment of primary and metastatic bone and soft tissue lesions. As part of its NCI-designated Cancer Center, Jefferson has one of the nation’s few designated sarcoma centers. As a member of the orthopedic oncology team, residents work with subspecialized counterparts in medical and radiation oncology, musculoskeletal radiology, and pathology to treat patients.

Other PGY-4 rotations include Hand Surgery with the Philadelphia Hand to Shoulder Center, with exposure to microsurgery and replant, Sports Medicine, and a Vacation Cross-Coverage rotation covering operative days for co-residents on their scheduled vacations.

PGY-5 year is designed to fine-tune decision making, surgical, and leadership skills, to equip residents with the tools needed to be successful practicing orthopaedic surgeons. The year includes rotations in trauma at a busy level two trauma center, spine surgery, joint arthroplasty, shoulder and elbow, sports, and upper extremity surgery. In addition, each PGY-5 has administrative duties and takes backup call at Jefferson Health. At the end of the PGY-5 year, the orthopaedic resident is expected to demonstrate the clinical skills and orthopaedic knowledge appropriate for a graduating chief resident.