Study Calls for Changes in Training of Orthopedic Surgeons

Changes are needed in the programs that train orthopedic surgeons to ensure these doctors are adequately trained, according to a study by researchers at Hospital for Special Surgery in New York, published in the January issue of the Journal of Bone and Joint Surgery, according to an HSS news release.

Researchers evaluated feedback from 17 heads of orthopedic programs across the country, including New York University School of Medicine, University of California at Los Angeles Medical Center, Duke University School of Medicine, Johns Hopkins University School of Medicine and Case Western Reserve University, and from 12 of these individuals gathered during a two-day meeting held at HSS, according to the release.

Participants were asked to evaluate whether the traditional residency model is appropriate for the training of future surgeons and to discuss current approaches that have been successfully implemented in orthopedic training programs. The group identified four basic areas of need: addressing compromises to the learning experience caused by work-hour restrictions, identifying a body of core orthopedic knowledge with specific goals and expectations, developing common benchmarks to measure and improve program effectiveness and addressing the challenges caused by generational differences between faculty and residents, according to the release.

Work-hour restrictions was named as the biggest factor, which require residents work no more than 24 hours, have shift breaks and one day off in seven. This can be problematic in training as residents no longer treat patients from pre-surgery through post-surgery, compromising the continuity of care, according to the release.

Generational and gender differences also played a part in affecting the training of orthopedic surgeons, as residents today balance training with family life and more extra activities than their mentors, according to the release. The desire to learn via electronic technologies was another complicating factor. The increased number of women surgeons going into orthopedics also meant more challenges, such as maternity leave, affecting training programs than in the past.

Researchers also noted that orthopedic programs need to accept more trainees, as the demand for orthopedic surgeons is increasing. "We know from projections in studies that there won't be enough orthopedic surgeons in the future for the baby boomers who will need joint replacements," Laura Robbins, DSW, vice president of academic affairs at HSS, said  in the release. "The groups that establish how many trainees you have and how many surgeons you need really need to be looking at this and making some very broad sweeping recommendations."

Read the release on orthopedic training programs.