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Department of Orthopedic Surgery

Day In the Life of an Intern

Master
Content

Jonathan Hagedorn, M.D.

The intern year provides a broad exposure to a variety of surgical and non-surgical specialties, with a focus on the management of the surgical patient as well as musculoskeletal disorders. Interns are given the opportunity to work closely with upper level residents and attendings on all rotations. Rotations are one month each. Because of changes in the number of orthopedic months allowed, interns will now be doing six months of orthopedics and six one-month blocks of other specialties (SICU, Neurosurgery, Vascular Surgery, Plastic Surgery, Emergency Medicine, and Musculoskeletal Radiology/Rheumatology).

Interns will now spend six months on orthopedic surgery rotations. These rotations provide an excellent introduction to the evaluation and management of a variety of musculoskeletal conditions and orthopedic patients in multiple settings. Residents quickly become adept at the evaluation and management of conditions, ranging from simple fractures to complex orthopedic injuries in polytrauma patients. Interns have the opportunity to see and evaluate patients in the orthopedic clinic, on the inpatient floor, as well as in the emergency room and urgent care center. Interns are provided with support and education from senior residents and attendings. Call averages every fourth night, and residents generally have two golden weekends every month.

A rotation in the SICU provides the intern an exposure to the management of critically ill surgical patients. Interns have an opportunity to actively participate in the evaluation and assessment of surgical patients both pre-operatively and post-operatively. Overall, this is a very useful and educational rotation.

The neurosurgery rotation provides a good exposure to the management of patients with a variety of neurosurgical conditions. Residents are exposed to a wide range of spinal pathology, including trauma, degenerative disease, and deformity. This is also a great opportunity to review the care of critically ill patients in the Neurosurgery ICU. Call averages every third day.

The vascular surgery rotation at the Michael E. DeBakey Veterans Affairs Medical Center is an opportunity to learn vascular anatomy as well as the management of soft tissue wounds. The MEDVAMC is the referral center for four states–this means that there is no shortage or lack of variety of cases. Interns are expected to participate in the operating room. Call averages every fourth day. This is a very educational experience and is highly regarded by the orthopedic residents.

The plastic surgery rotation at the MEDVAMC provides an introduction to the management of soft tissue, especially as it relates to orthopedic injuries and surgical procedures, including hand surgery. This tends to be a hands-on rotation with the expectation that you will be actively involved in the operating room every day. This rotation provides a great opportunity to work on suturing and other basic surgical skills.

A rotation in the emergency room at Ben Taub Hospital gives the intern the opportunity to work up a variety of medical problems as well as participate in the care of trauma patients in the shock rooms. As the orthopedic resident, ER attendings will give you the opportunity to do as many reductions, joint aspirations, etc. as possible. This serves as a nice adjunct to the orthopedic surgery rotations.

The combined rheumatology and radiology month is a good opportunity for exposure to the management and evaluation of rheumatologic conditions, as well as a very beneficial introduction to musculoskeletal radiology. Interns spend the morning reviewing interesting cases with the musculoskeletal radiology attending at the MEDVAMC. In the afternoon, the residents participate in the rheumatology clinic. This is an educational and beneficial experience. There is no call requirement and weekends are off.

Overall, the first year provides the intern with a solid base of knowledge, focusing on musculoskeletal problems as well as the management of the surgical patient. Call responsibilities are very manageable, and there are several rotations with no call. Socially, interns will quickly feel as though they are part of the program. There are happy hours and social events nearly every week, which means you will become close with your co-interns as well as the rest of the orthopedic residents and attendings. This source of support should not be overlooked. In addition, while on your other rotations, most services understand the importance of the intern attending the weekly lecture series that the orthopedic residents attend.