UNM FAMILY MEDICINE RESIDENCY

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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

9. The ability to recognize pathogenesis/pathophysiology, including:

Arthroscopy

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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10. Understanding of pediatric orthopedic conditions, including:

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

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

“Nursemaid’s" elbow

Entrapment syndromes

Baker's cyst

Treatment of lateral epicondylitis,

Osgood-Schlatter disease

Osteoarthritis

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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