Teaching Program

Resident education is the primary focus of our teaching program in Orthopaedic Surgery at Children’s Hospital. We continue to have 6 Harvard residents here in their 3rd year for a 6-month rotation. This group is complemented by one resident from Dartmouth and one from Lenox Hill Hospital. Traditionally, one resident per year has been interested in pediatric orthopaedics and has pursued this specialty in fellowship. The number of residents who choose pediatric orthopedic surgery remains rather constant over the years. There are two photographs (Figures 4a, 4b) shown of our residents, each taken at the end of the 6-month rotation with some of the faculty present. Given the disbursed nature of our faculty in satellites and scattered about the Boston area, finding the full complement of 28 orthopaedic surgeons at one time for a photograph is nearly impossible.

In addition to the residents, we have 3 pediatric orthopaedic fellows, 3 Sports Medicine fellows, one hand fellow, one tumor fellow and one hip fellow at Children’s. We take great care to be sure that the relationship between the fellows and residents remains positive and that neither impact negatively on the education of the other. In doing this, we have had increasing attention paid to the distribution of cases by Dr.s Young-jo Kim and Michael Glotzbecker in trying to ensure that both the resident and the fellow experience is optimal both in terms of ambulatory care and surgical management.

The pediatric orthopaedic fellows (Figure 5) from last year included Dr.s Hill, Upasani and Vuillermin. Jaclyn Hill was a resident in the Harvard Combined Orthopaedic Program and is going on to Houston to join the faculty at Texas Children’s Hospital, along with Scott Rosenfeld and Howard Epps, both having completed the program here at Children’s. Carley Vuillermin came to us from Melbourne, Australia where she will at some point be returning to do pediatric hand and upper extremity surgery; however, at the present time, she is pursuing an upper extremity fellowship with MaryBeth Ezaki at Texas Scottish Rite Hospital in Dallas. Dr Salil Upasani came to us from the University of California San Diego for a one-year fellowship and has returned to that institution. Our goal in pediatric orthopaedic fellowship is producing full-time faculty members in academic institutions and all three of this year’s fellows are headed in this direction. The hip fellow, Stephanie Pun (Figure 5), spent one year with us, focusing on adolescent and young adult reconstructive hip surgery; she will return to her institution of origin, Stanford University, where she will join the orthopaedic faculty.

There was a change this year in resident assignment which allowed us to have a one-year research rotation in our basic science lab. Brian Kelly, PGY4, spent the entire year focusing on basic science research in intra-articular healing of ACL and rotator cuff. In doing this, he was supervised by Martha Murray who is an incredibly successful NIH researcher and former resident in the Harvard Combined Program. She does 20% clinical work primarily focused on knee surgery, both meniscus and cruciate ligament reconstruction.

Dr. Donald Bae (Figure 6) has taken on the task of developing a simulation program for teaching pediatric orthopaedic residents as well as medical students, with the able assistance of Travis Matheney. The simulation program includes learning to sew, place casts on limbs, cut casts without getting cast saw burns, and to do complex osteotomy as well as triangulate and tie knows in the arthroscopic world. Just as the ACGME is requiring simulation to be part of an orthopaedic program, we are developing a focused teaching program in a simulation environment to facilitate resident education.

It is of note that Dr. Waters will join the Executive Committee of the Harvard Combined Orthopaedic Residency Program, as he is assuming the chairmanship of the department at Children’s, replacing me. Dr. Young-jo Kim is the new Director of the Pediatric Orthopaedic Fellowship. Dr. Kim is also the Director of the Adolescent and Young Adult Hip Program, replacing Dr. Michael Millis in this capacity.

For those of you who spent time at Children’s in the 1970’s and l980’s, I am sure you are wondering what has happened to Dr. John E. Hall, one of our most revered teachers and former chairman. John now resides with Frankie in Toronto, near his family. As luck would have it, the Pediatric Orthopaedic Society of North America held its annual meeting in Toronto this year and we were able to arrange a reception at which Dr. Hall could meet with former residents and fellows from our program as well as POSNA members from around the world (Figure 7). It was great to see Dr. Hall and be able to renew friendships with this talented man who introduced the modern concepts of spine and hip surgery to the world through his work at Boston Children’s Hospital.

An annual event at the POSNA meeting is the Alumni Dinner (Figure 8). Each year, we have a dinner for all prior Harvard residents, fellows and staff. Our numbers have swelled to over 80 people in attendance this year at the Toronto meeting which reflects the ongoing success of our program, as well as the prominence of our graduates.

The high point of our teaching program each year in the fall is the Grice Lecturer. This year, MaryBeth Ezaki, M.D. was our 26th David Grice Visiting Professor. Dr. Ezaki (Figure 9) is Professor of Orthopaedic Surgery at the University of Texas Southwest and a renowned upper extremity surgeon at Texas Scottish Rite Hospital in Dallas. Her presentation was on Congenital Thumb Reconstruction. The guest lecturer presentation is complemented by a series of talks from residents, fellows and staff providing an educational experience away from the clinical responsibilities of the hospital (Figure 10).

The academic program is complemented by a banquet (Figure 11) at which residents, fellows, staff and spouses can relax and enjoy an evening, reinforcing the bonds of friendship which will carry on throughout our careers.