UNM FAMILY MEDICINE RESIDENCY
ROTATION OBJECTIVES
ORTHOPEDICS
GOALS
The goal of the Orthopedics rotation is to provide learning opportunities that will enable residents to develop the knowledge, skills, and attitudes necessary to:
1.
Perform physical examinations of large and small joints of the body.
2.
Diagnose acute and chronic musculoskeletal problems.
3.
Diagnose and treat urgent/emergent musculoskeletal problems.
4.
Understand the roles of the orthopedic surgeon, physiatrist, and physical therapist.
5.
Appropriately consult the orthopedic sub-specialists.
OBJECTIVES
PATIENT CARE OBJECTIVES
The resident demonstrates the ability to:
 obtain, document and report developmentally, age and specialty appropriate history
 perform, document and report developmentally, age and specialty appropriate physical examination
 generate an appropriate differential diagnosis
 make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment
 develop and carry out patient management plans
 counsel and educate patients and their families in a clear, respectful and culturally conscious manner
 use information technology to support patient care decisions and patient education
MEDICAL KNOWLEDGE OBJECTIVES
Upon completion of the rotation, residents will demonstrate:
1. Understanding of normal anatomy and physiology
2. Understanding of normal growth and development
3. The ability to perform a musculoskeletal history
4. The ability to perform a large and small joint examination
5. Understanding of basic laboratory tests, including:
 ESR
 ANA
 Rheumatoid factor
 CBC
 Joint fluid etc.
6. The ability to interpret basic musculoskeletal radiographs
7. The ability to appropriately use CT, MRI, & radionuclide scanning
8. Understanding of the indications and techniques of:
 Arthrograms


Myelograms
Arthroscopy
9. The ability to recognize pathogenesis/pathophysiology, including:
 Joint pain, swelling, and erythema
 Muscular pain, swelling and injury
 Minor and major musculoskeletal trauma
 Major long bone fractures
 Hand/foot/wrist/ankle fractures
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 Major joint dislocations
 Finger/toe dislocations
 Major tendon injuries
 Knee mechanics and common injuries
 Bone and joint deformities
 Bone and joint infections
 Metabolic bone diseases
 Musculoskeletal congenital anomalies
 Compartment syndromes
 Avascular necrosis of hip/lunate/scaphoid/navicular/calcaneus
Child battering 
10. Understanding of pediatric orthopedic conditions, including:
 Congenital hip dislocation
 Legg-Calve-Perthes disease
 Osgood-Schlatter disease


Slipped capital epiphysis
Clubfoot
 Intoeing (metatarsus adductus, tibial torsion, femoral torsion)
 Knees: genu varus and valgus, chondromalacia patellae
 Salter-Harris classification of fractures
11. Understanding of basic radiograph interpretation
12. Understanding of basic orthopedic treatment/management modalities
 Pharmacology: NSAIDS, steroids, muscle relaxants, and antibiotics
 Supportive devices: braces of back, knees, ankles, and wrists
 Rehabilitation issues
Physical therapy
Occupational therapy

Work hardening and disability
Psychosocial issues
Physiatric referral
Surgery
Basic knowledge of rationale behind wires, pins, plates
Artificial joint replacement
13. The ability to manage and treat basic orthopedic conditions, including:
 Natural course of disease


Costochondritis
 Osgood-Schlatter disease
 Osteoarthritis
 Treatment of lateral epicondylitis,
 “Nursemaid’s" elbow
 Entrapment syndromes
Baker's cyst
 Metabolic bone disease: osteoporosis, Paget's disease
 Acute and chronic low back pain
 Sciatica
14. The ability to develop a cooperative relationship with an orthopedic surgeon.
15. The ability to apply the principles of prevention of orthopedic injuries, including:
 Pre-participation screening
 Conditioning and training
 Injury prevention
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 Physical fitness
 Bone loss and osteoporosis screening and management
PRACTICE-BASED LEARNING AND IMPROVEMENT OBJECTIVES
The resident:
 recognizes his/her own strengths and limitations
 asks questions as an engaged, critical learner
 locates, appraises, and assimilates evidence from scientific studies related to their patients’ health problems
 uses information technology to manage information, access on-line medical information, and support their own education
INTERPERSONAL AND COMMUNICATION SKILLS OBJECTIVES
The resident:
 makes organized and effective oral presentations
 elicits and provides information using effective listening, nonverbal, explanatory, questioning, and writing skills
 communicates with the patient, family and members of the healthcare team in a timely, developmentally and culturally appropriate manner
 works effectively and respectfully with others as a member or leader of a health care team or other professional group
PROFESSIONALISM OBJECTIVES
The resident:
 accepts responsibility for patient care
 never misrepresents patient care information
 consistently performs in a punctual, reliable and collegial manner
 demonstrates dress, hygiene and manner of speech that consistently reflect appropriate standards
 demonstrates a commitment to excellence and on-going professional development
 demonstrates sensitivity and responsiveness towards patients’ , colleagues’ and team members’ gender, age, culture, disabilities, ethnicity and sexual orientation.
SYSTEMS-BASED PRACTICE OBJECTIVES
The resident:
 practices cost-effective health care and resource allocation that does not compromise quality of care
 advocates for quality patient care and assist patients in dealing with system complexities to minimize discomfort or confusion
 recognizes that the patient is part of greater system and provides care in a manner that supports continuity.
PROCEDURAL SKILLS
Upon completion of this rotation, residents will:
1. Demonstrate proficiency in:
 Managing simple, stable, closed, nondisplaced fractures
 Managing tendonitis
 Managing sprains and strains
2. Demonstrate understanding of indications and contraindications for the following techniques and procedures:


Joint aspiration
Joint and musculoskeletal injections of local anesthesia and steroids
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


Simple casts
Management of complicated fractures in pediatrics and adults
Dislocation reduction
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