Department of Orthopaedics

Resident Spotlight

Jestin Williams

The trauma rotation has also proved the most challenging. Because of the heavy influx of patients, you are always busy either in the operating room, seeing consults, or managing the floor.
- Jestin Williams, MD, PGY-1

2019 Curriculum - Step by Step

Weekly:

  • Wednesday 7am Conference at LSU School of Medicine (video conference available for out of town residents)
  • Faculty Talks (example for 2019-2020)
    • July 5 – Sports Upper Extremity Grand Rounds – Dr. Michael Hartman
    • July 10 – OITE Trauma Review – Dr. Peter Krause
    • July 18 – Sports Medicine Journal Club
    • July 24 – OITE Spine Review – Dr. Abhishek Kumar
    • July 31 – OITE Hand Review – Dr. Brandon Donnelly
    • August 2 - Basic Concepts in Orthopaedic Trauma - Dr. Peter Krause and Dr. Robert Zura
    • August 14 – OITE Review Foot and Ankle – Dr. Meredith Warner
    • August 15 – Trauma Journal Club
    • August 20 – Trauma Lower Extremity Didactic Lectures - Dr. Peter Krause and Dr. Robert Zura
    • August 28 – OITE Review Adult Reconstruction – Dr. Anna Cohen-Rosenblum
    • September 11 - OITE Review Sports - Dr. Michael Hartman
    • September 13 – Basic Science: Adult Reconstruction – Dr. Alex Betech
    • September 25 – Hail to the Chief – Dr. William Shelton (Chief Resident)
    • September 27 - Adult Reconstruction Didactic Lectures Dr. Vinod Dasa, Dr. Alex Betech, and Anna Cohen-Rosenblum
    • October 11 – Basic Science: Spine – Dr. Abhishek Kumar
    • October 16 – OITE Review Pediatrics – Dr. Carter Clement and Dr. Michael Heffernan
    • October 23 OITE Tumor Review – Dr. Matthew Cable
    • October 25 – Pediatric Orthopedics Didactic Lectures – Dr. Bill Accousti and Dr. Dominic Gargiulo
    • October 30 – OITE Review: Basic Science
    • November 8 – Dean MacEwen Visiting Professorship – Dr. Andrew Graydon (New Zealand)
    • November 22 – Foot and Ankle Didactic Lectures – Dr. Monroe Laborde and Dr. James Lalonde
    • December 4 – Quality Improvement/Patient Safety Project Updates
    • December 6 – Sports Lower Extremity Didactic Lectures Sports Lower Extremity Lab
    • December 18 – Hail to the Chief – Dr. Samuel Klatman (Chief Resident)
    • December 20 – Research Principles Didactic Lecture and Resident Research Update – Dr. Vinod Dasa
    • January 16 – Trauma Journal Club Extremity Didactic Lectures Trauma Upper Extremity Lab
    • January 31 – Healthcare Business/Policy – Dr. Carter Clement
    • February 7 – Basic Science Sports – Dr. Michael Hartman
    • February 21 – Spine Didactic Lectures – Dr. Abhishek Kumar
    • March 6 – Basic Science: Adult Reconstruction
    • March 20 – Adult Recon Grand Rounds – Dr. Alex Betech
    • March 25 – Hail to the Chief – Dr. Daniel Plessl
    • April 3 – Basic Science Lectures: Tumor – Dr. Matthew Cable
    • April 16 – Tumor Journal Club
    • April 17 – Tumor Grand Rounds – Dr. Matthew Cable
    • May 1 – Basic Science: Hand – Dr. Eric George
    • May 14 – Hand Journal Club
    • May 15 – Hand Grand Rounds – Dr. Brandon Donnelly
    • June 4 – Residency Training Journal Club
    • June 17 – Hail to the Chiefs – Dr. Kirk Jeffers (Chief Resident)
    • June 19 – Research Day and Graduation
    • June 24 – Quality Improvement and Patient Safety Project Updates
  • Case Conference (interesting cases) - resident lead presentation of rare conditions or interesting cases with an associated literature review and/or relevant question.
  • OITE Review - staff led reviews on the high-yield and highly tested OITE material within their subspecialty. These reviews are extraordinarily beneficial and a great adjunct to OITE studying. These lectures take place from July 1st to the time of the OITE.
  • Patient Safety (M&M) - resident led discussion of surgical cases with associated morbidity and mortality. These discussions give residents an opportunity to critically critique and examine all aspects of a case to determine via a root cause analysis, what when wrong. This lecture series also focuses on a relevant literature review on the topic(s) at hand. This lecture series gives residents a framework to think critically about cases when they go awry; this serves as a great educational modality for preparing residents for management of their future surgical complications.
  • Wednesday 8am Indications Conference for the UMC trauma service and adult reconstruction service
    • This is a presentation led by the PGY-2 residents presenting the upcoming weeks cases for pre-operative planning
    • This serves as a tremendous learning opportunity for the PGY-2 to understand surgical indications and learn the breadth of orthopaedic trauma. The PGY-2 is responsible to read and prepare to defend the indications for surgery and their choice of surgical approach, implants, and planning for potential complications. This conference has proved to be a challenge for PGY-2s; when reflecting on their year, they can attribute a lot of their growth to their collaboration with their upper level residents and their reading for indications.
  • Visiting Student Talk - a 10-15-minute talk on something from their lives outside of medicine. Past talks have included some amazing topics like pitching baseball, Tex-Mex food, the height of the person (or lack thereof).

Service Specific:

  • UMC Trauma: Review of OTA trauma lecture series and weekly discussion of trauma related articles on Monday mornings. Articles are selected on a themed basis, for example focusing on upper extremity trauma for several weeks. Residents will review articles in a relaxed environment which often sparks interesting discourse about current treatments and controversies.
  • Children’s Hospital:
    • Monday Morning Pre-operative Discussions: along with Children’s attendings we discuss each case for that week. This discussion leads to staff educating and explaining not only the operative plan but also the disease process, indication for treatment and specific tips for tackling similar cases. This also opens up discussion among attendings which allows for residents to hear how multiple physicians would treat the patient. 
    • Daily Check-Out: Involves the on-call staff going over the consults from the last 24hr’s with all of the residents present. This offers the staff time to critique and teach as well as explain their reasoning on why that specific decision was made
    • Friday Post-operative Discussions: similar to the Monday morning Pre-operative discussions, this allows for the residents and staff to go over the case. Staff and residents explain what went according to Monday’s plan and what may have changed and why.
    • Friday Bi-Monthly Pediatric Grand Rounds: A resident will choose a specific topic in pediatric ortho to discuss. These grand rounds typically spark discussion amongst the residents and staff and allow for a greater understanding of the chosen topic.
    • Monthly Friday Morning Journal Club: Articles are selected by staff and are discussed amongst everyone. Again, these discussions really allow residents to get a better understanding on how each attending approaches and treats these pediatric problems.
  • Joints Rotation Goals/Objectives
    1. Participate in the operative treatment of hip and knee osteoarthritis:
      1. Prepare for a weekly case conference to discuss the following week’s cases, including patient medical history, imaging, templating (pending software availability), implant considerations, as well as discussing the weekly topic (see below).
      2. Participation in cases on a graduated basis. By the end of the rotation, the PGY-2 should be familiar with exposure and femoral cuts (total knee arthroplasty), exposure, femoral neck cut, femoral broaching and acetabular screw placement (total hip arthroplasty). This is subject to resident preparation and skill level.
    2. Lead the floor management of postop total joint arthroplasty patients:
      1. Pre- and post-op orders
      2. Daily rounding
      3. Nursing education regarding inpatient care for total joint arthroplasty patients
    3. Participate in adult reconstruction clinic to learn the following:
      1. Appropriate indications for total joint arthroplasty, preoperative labs
      2. Optimization of modifiable risk factors
      3. Non-operative management of hip and knee osteoarthritis
      4. Postoperative care for total joint arthroplasty
    4. Participate in research projects:
      1. Help with consenting/inputting data for tissue bank study for total knees.
      2. Participate in ongoing QI projects for the total joints team (SCDs on the floor, joint camp outcomes).

    Weekly case conference topics:

    Week 1: TKA kinematics/alignment basics
    Week 2: TKA continuum of constraint
    Week 3: THA approaches
    Week 4: THA implant design
    Week 5: THA templating
    Week 6: Abnormal hip pathology (DDH, FAI, Dorr A or C)
    Week 7: Revision TKA approaches, implant considerations
    Week 8: Revision THA approaches, implant considerations
    Week 9: Recognizing PJI
    Week 10: Metal on metal THA
    Week 11: Periprosthetic fractures
    Week 12: TJA health policy controversies (BMI/smoking/DM cutoffs, bundling, outpatient surgery centers, etc)

Monthly:

  • “Tumor Talk” – a lecture series by Dr. Cable
  • Basic Science lectures (Monthly – Friday)
    • Resident/Faculty lectures on one Friday each month focusing on basic science topics related to both general orthopaedics and orthopaedic sub-specialties (e.g. bone biology, principles of fracture treatment, regional anatomy review, adult recon templating, etc.)
    • These lectures are given usually in part by faculty in their specific area of expertise.
      • For example, our spine surgeon Dr. Kumar once gave an informative talk on neuromonitoring to help junior residents understand the importance of its role in spinal surgery. These lectures solidify concepts and principles that form the foundation of the specialty. This lecture format often serves as a round table discussion on topics and is in a relaxed environment. Residents are excused from clinical duties to attend.
    •  Lectures are given by both faculty and residents from 1 - 4pm
  • Grand Rounds (Monthly – Friday)
    • 8am -12pm: resident/faculty/visiting professor grand rounds focusing on rotating topics
    • Industry sponsored cadaveric lab from 1- 4pm led by visiting faculty and upper level residents focusing on anatomy, approaches, and treating conditions from the discussions in grand rounds
      • e.g. Adult reconstruction grand wounds with afternoon cadaveric lab focusing on primary total knee arthroplasty (knee replacements) using Stryker’s products and experience with revision total knee arthroplasty components
    • The state-of-the-art cadaver lab is the highlight of our didactic education. Consistently, residents will have access to fresh cadavers with industry support to explore anatomy, surgical approaches, and techniques using implants. Labs are led by upper level residents and guest lecturers focusing on two to three key approaches/surgeries. The experience in the lab working on human tissue in a controlled environment has proved to be an invaluable learning opportunity. Moreover, our collegial relationship with industry representatives has offered our residents the ability to use industry labs at will to try products or practice for upcoming surgeries. The cadaver lab will be undergoing over a million-dollar renovation to update arthroscopy towers and equipment for our residents’ educational benefit.
    • We have had the opportunity to work one-on-one with world renowned surgeons in our lab on a regular basis. Also, we have a great alumni support; many of our recent and former graduates that reside in Louisiana will attend GR/lab. They serve as a wonderful resource in educating our residents in the lab.
      • e.g. residents had the opportunity to perform proximal tibia replacements with renowned orthopaedic oncologist and LSU Alumni Dr. Douglas Letson. Not only did residents get to work under the direct supervision of a world class surgeon, they each had the opportunity to perform a complex orthopaedic surgery with full industry support.
    • Recent Guest Lecturers:
      • Dr. Douglas Letson – CEO, Moffitt Cancer Center; Orthopaedic Oncologist
      • Dr. Louis Catalano - Hand Surgeon, NYU
      • Dr. Wael Barsoum – CEO, Cleveland Clinic Florida; former Adult Recon Fellowship Director, Cleveland Clinic
      • Dr. Heather Vallier - Tramatologist, Case Western
      • Dr. Dan Riew - Spine Surgeon, Columbia University
      • Dr. Mark Rekant - Hand Surgeon, Jefferson University
      • Dr. Keith Wapner - Chief of Foot & Ankle Surgery, University of Pennsylvania
      • Dr. Edward Perez - Traumatologist, Campbell Clinic
      • Dr. Paul Khanuja - Adult Recon, Johns Hopkins
      • Dr. Neel Anand - Spine Surgeon, Cedars Sinai Hospital
  • Journal Club (Monthly – Thursday)
    • Industry sponsored club meetings before grand rounds
    • Typically held at some of the finer establishments in New Orleans (e.g. Cochon, Shaya, Saba, Emeril’s, etc.)
    • Provides residents time to meet with one’s peers in some of the world class eateries of New Orleans to socialize and discuss current literature in preparation for grand rounds.
    • Review of relevant/current literature typically published by the visiting professor
    • Baton Rouge and Lafayette residents host similar journal clubs with alumni and faculty at their respective sites

Quarterly:

  • Hail to the Chiefs
    • This lecture series gives our chiefs an opportunity to present a topic of their choosing (orthopaedically related or unrelated). Historically, many chiefs have presented on a controversial or interesting topic within their matched subspecialty.

Annually:

  • Additionally, residents are encouraged to seek industry sponsorship for two courses of their choosing. Residents will need to make arrangements and schedule vacation time appropriately for additional conferences. Industry grants exist to help offset the cost of attending courses.