Although most orthopaedic residents are satisfied with the orthopaedic surgery components of their internship year, many believe that orthopaedic knowledge and surgical skills training are lacking, according to data presented during the American Orthopaedic Association’s Council of Residency Directors meeting.
Effective July 1, changes in the PGY-1 curriculum require interns to participate in 6 months of orthopaedic rotations instead of 3 months. To gather baseline data prior to these changes taking effect, Thomas W. Throckmorton, MD, David R. Richardson, MD, and I conducted a web-based survey from July through September 2011; responses were received from nearly 100 orthopaedic surgery residents who had concluded their PGY-1 year.
The residents were queried on all aspects of their education and training. Survey questions included demographics, time spent on internship rotations, surgical case logs, conference/research participation, and satisfaction levels.
The survey results revealed that most residents (91 percent) were very satisfied with the orthopaedic surgery components of their internship year. Nearly all interns participated in the maximum amount of time allowed on orthopaedic rotations, which at the time was 3 months. Furthermore, most interns attended orthopaedic conferences, and almost half reported active involvement in orthopaedic research during the PGY-1 year.
However, fewer residents were satisfied with other aspects of the internship year. Just 58 percent of respondents reported being satisfied with the amount of orthopaedic knowledge gained during the first year. Fewer than half (46 percent) reported being satisfied with their nonorthopaedic rotations, and an even lower number (44 percent) were satisfied with their acquisition of surgical skills. In addition, fewer than half of the respondents (48 percent) believed the internship year was good preparation for the coming years of residency.
The survey also examined differences between small (5 or fewer interns) and large (6 or more interns) programs (Fig. 1). Interestingly, compared to interns in larger programs, interns from smaller programs reported more surgical cases during their PGY-1 year, as well as greater satisfaction with all aspects of the orthopaedic internship.
Interns from smaller programs were more satisfied with their rotations and with their acquisition of orthopaedic knowledge and surgical skills than those in larger programs. They also thought that the intern year was better preparation for the coming years of orthopaedic residency.
In addition to the longer orthopaedic rotations, mandatory training in surgical skills is now part of the internship year. It remains to be seen how these changes will affect intern experiences and satisfaction. The data gathered in the study may be used as a baseline to assess the impact of the curriculum changes. With more orthopaedic rotations and dedicated time to surgical skills, the hope is that intern experience and satisfaction with the PGY-1 year will greatly improve.
Robert F. Murphy, MD, is a PGY-5 resident at the University of Tennessee–Campbell Clinic and the resident member on the AAOS Council on Education. He can be reached at firstname.lastname@example.org