Medical Student Clerkships

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Welcome to ORSU 7200, a required clerkship in Orthopaedic Surgery.

You will do your rotation at one of six different sites: University of Minnesota Medical Center, Gillette Hospital in St. Paul, Minneapolis VA Medical Center, TRIA Orthopaedic Surgery Center in Edina, or Regions Hospital in St. Paul.

You can do either a 2- or 4-week rotation at these sites, except for Regions and the VA, which only offer 4-week rotations. These five different sites offer different and unique experiences for the student. For example, at Gillette Hospital, pediatric orthopedic pathology is encountered. At Regions hospital, there is a significant exposure to trauma cases. The TRIA rotation focuses more on primary care type orthopedics. 

Overview

The overall goal for the rotation is for the medical student to have an opportunity to evaluate and treat common orthopaedic problems. Whether or not you go into Orthopedics, you will encounter musculoskeletal disorders. For example, low back pain is a very common complaint. Also, because of the aging population, disorders such as hip and knee arthritis and osteoporotic fractures will be seen more frequently. And so we want you to be exposed to these common problems.

Specific objectives include being able to:  

  • Do a comprehensive history and directed physical examination of the musculoskeletal system
  • Use proper terminology to describe signs, symptoms and treatment of common injuries and disorders of the musculoskeletal system
  • Develop differentia; diagnoses and outline a plan for treatment, including operative and non-operative treatment

Expectations

After you sign up for the rotation, we will contact you typically via email regarding where to go on the first day, as well as any paperwork that needs to be done ahead of time. Arrive a little before 7am on your first day to attend the morning conference, followed by the orientation where the specifics of the rotation are typically discussed in greater detail. 

Our expectations include:

  • Make the most out of the learning opportunity 
  • Be engaged and take responsibility for your learning
  • Be a good member of the team, which typically includes the attending, residents and yourself
  • Meet the attendance requirements set forth by the medical school
  • Be present for the scheduled activities in a punctual manner
  • Behave professionally at all times, placing patient care above everything else

In addition, we expect that you will read on the cases that you encounter, and specifically read on cases that you will be involved with in the operating room. This is the best way for you to learn. It will help what you observe in the operating room to make sense. You will be provided with a reading list and a copy of the textbooks for the rotation. 

On top of your clinical exposure, you will get a chance to participate in the different morning conferences, to observe, and in certain sites, to present cases. These conference schedules vary from site to site but attendance of these conferences is a requirement. The conference schedules will be laid out for you during your orientation and can also be seen in Moodle.

Grading

This is a pass/fail course. The requirements for a passing grade are clearly outlined in the moodle site. A passing grade is based on clinical evaluations by attending and resident physicians, performance on the end of rotation exam, and attendance. You also must have completed your patient log.

For students

The orthopedic surgery selective consists of 2-4 week rotations concentrating on the areas of general orthopedics, sports medicine, and pediatrics. Each selective will be geared toward the students desired orthopedic interest and will hopefully allow for greater variability in a student's overall experience.

Requirements

Each student will be expected to learn the objectives as outlined in the course description. Depending on the student's selected rotation, he or she may be required to perform additional activities such as training room coverage or event coverage. The student will be expected to attend the conferences that are currently active in the residency curriculum. He or she may be requested to present cases at these conferences. The overall experience will be a mixture of diverse clinical exposure in addition to operating room activity. The extent of the student's involvement in the operating room will be at the discretion of the orthopedic attending.

Goals and Objectives

The purpose of this course is to provide an opportunity for students to evaluate and treat common orthopedic problems encountered in ambulatory patients.

Upon completion of this course, the student should be able to do the following:

  • Perform an adequate orthopedic history and physical examination of the musculoskeletal system, including assessment of joint motion and grading of muscle strength of the major muscle groups of the extremities.
  • Use of proper terminology to describe signs, symptoms, and treatment of common injuries and disorders of the musculoskeletal system.
  • Develop a differential diagnosis of common orthopedic conditions and outline a treatment plan to establish the proper diagnosis, description of physical findings, and inclusion of pertinent laboratory, x-ray, and special studies.
  • Learn to apply suitable splints and casts for common extremity injuries.

Evaluation

Evaluations will be based on the system currently used by the University of Minnesota Medical School. 2/3 of the student's grade will be weighed toward the clinical evaluations provided by orthopedic faculty members. The remaining 1/3 of the course grade will be based upon the student's performance on a multiple-choice examination. The questions on the examination will be entirely based upon the required readings as outlined below. Students taking either a 2-week or a 4-week rotation will have an examination consisting of 50 multiple choice questions.

Grading

This course is pass/fail. Requirements for pass include:

  • Attendance: Must fulfill the attendance requirement as stated by the medical school.
  • Exam: This is given at the end of the rotation. [Must have at least 70% correct.]
  • Patient Log: Must turn in the completed Patient Log in PxDx.

Note: Exam and PxDx Log must be completed by end of rotation.

If a below expectation mark is obtained on an evaluation, the clerkship director contacts evaluator to discuss merits of passing student.

Required Reading

The required readings will consist of multiple, brief chapters from the Essentials of Musculoskeletal Care, edited by Walter B. Green, M.D. The chapters will be directed at the student's particular area of interest. All students will be expected to read the chapters concerning physical examination of each musculoskeletal region. In addition to the required reading list, further reading may be recommended by the clinical faculty to augment the student's learning experience.

For educators

The Department of Orthopaedic Surgery has the responsibility of establishing a good foundation of knowledge and skills for the students in the management of musculoskeletal disorders. All attending physicians and residents should know and understand the objectives for the course. This sets expectations for the rotation and establishes accurate and fair basis for evaluation. The educators should also be familiar with the student reading list for the rotation. 

Setting expectations should be an initial activity. We encourage you to sit down with the student to set expectations on Day 1 of the rotation. The session should include:

  • Going over the student schedule for the two weeks
  • Understanding student goals
  • Clarifying your expectations of students regarding patient care; getting their expectations during the rotation
  • Informing students what you value in student performance

The clerkship committee expectations of students are detailed in the evaluation forms found on E*Value. Upon completion of this course, the student should be able to do the following:

  • Perform an adequate orthopaedic history and physical examination of the musculoskeletal system, including assessment of joint motion and grading of muscle strength of the major muscle groups of the extremities
  • Use of proper terminology to describe signs, symptoms, and treatment of common injuries and disorders of the musculoskeletal system
  • Develop a differential diagnosis of common orthopaedic conditions and outline a treatment plan to establish the proper diagnosis, description of physical findings, and inclusion of pertinent laboratory, x-ray, and special studies
  • Be familiar with the application of splints and casts for common extremity injuries

Timely feedback from faculty and residents is critical. Feedback should address areas of strength as well as those needing improvement or change. Ideally, the feedback should provide the opportunity to identify and correct any problems noted during the course. Any potentially serious deficiencies in student performance should be brought to the attention of the site coordinator as early in the rotation as possible. You should also obtain formal mid-rotation feedback from the student.

Supervision

The site director at each teaching site bears the primary responsibility for the development and maintenance of a program to fulfill the learning objectives of the orthopaedic clerkship. The site director is responsible for organizing the specific ward and operative activities during the rotation, and is expected to address any issues or problems that are encountered. The site directors should periodically remind the different faculty members and residents of the objectives of the course. The site directors are also primarily responsible for the timely submission of student evaluations through e-value.

The attending physician has the primary responsibility for educating students in the ward, clinics, and operating room. All of the physician-teachers with whom the student has contact are expected to serve as positive role models. Faculty and residents are encouraged to provide students with positive direction through both questions and assignments. The students are expected to have read about the cases going on in the OR and faculty are encouraged to teach by asking questions and actively explaining different parts of the operative procedure to the student. In the clinics, give the students an opportunity to obtain their own history and physical examination, and provide feedback regarding this. Furthermore, the clinics and operating rooms are not only excellent sites for education, but is also a venue where potential future orthopaedic careers can begin. 

If possible, provide the student the opportunity to do a short presentation on a specific topic. Encourage preparation by students prior to clinics and operative sessions by engaging them and letting them actively participate in patient care.

Externships

We have a number of medical students who come and rotate with us. If you are one of them, you may find the following information useful:

Here you will find our process for applying as a visiting medical student. All applications from LCME accredited schools are handled through VSAS and are controlled by our medical school administrative office, not the individual departments that a student may which to rotate with. Since this is the case, we ask that you keep our department in the loop, so please let us know what you are thinking and wish to do and we will do our best to get you in with our program.

There you will find links, documents, and info on residency sites, policies, and more. At Hennepin (ORSU 7191) and the VA (ORSU 7190), you would be on service with our G3s and G5s at both locations; in some respect, these rotations would give you the best feel for our program and would also give you serious exposure to the “meat and potatoes” of orthopaedic surgery. If you come to the University-Fairview campus (ORSU 7185), you will see more specialized orthopaedic care: spine, ankle/foot, tumor, shoulder, knees, sports; while the predominate faculty is at the University campus, students often get more out of coming to this rotation if they have been exposed to other general orthopaedic service.

We also have a pediatric orthopaedic rotation available at Gillette Children’s Hospital (ORSU 7188), a site that is consistently rated as having top educators. If you are interested in applying to our residency program, any rotation at these sites would be regarded seriously and faculty at all these sites are involved in our resident selection committee. If you come to the University Fairview campus, the rotations can be tailored-fit to special interests (e.g., hand/sports/spine). Please note that ORSU 7200 is s required course for UMN medical students and is not open to visiting medical students. 

On this webpage, you may click on the course title and that will bring you to a description page; at the top of each of these description pages is a link to course availability for the academic years. We recognize that often our rotation schedules do not mesh with visiting students’ availability. We may be flexible with our scheduling if requests are made far enough in advance and do not conflict with our own medical school. Our summer sessions can be very busy and fill quickly and some key faculty may be on holiday; again applying for a rotation early is best.

Registration for visiting students will be processed after the add/cancel deadline for UMN students, in order to give first priority to our own medical students. If you have trouble ascertaining that timeline, we can assist in providing such information. VSAS may not be open when you want to apply; again this is controlled by our medical school administration. Please let us know what you are thinking and what dates you want, including 3/4/6 week rotations. The medical school will process your application, but we have the ability to modify schedules and are in contact with the medical school about all applicants for away rotations.

Grading

Grading for away rotations is based on your own school’s criteria. We use an electronic evaluation process for all medical students called E*Value. You will be set up in this program and given an opportunity to both do evaluations and be evaluated. Based on the evaluations received from other educators (residents/attendings/faculty), we will generate a final evaluation which will be completed by our Clerkship Director, Dr. Edward Santos. It will be your responsibility to provide correct documentation from your “home” institution. Please keep this in mind if you come.

Additional links

If you are in need of housing, see the temporary housing website. Please also review our recommendations for a strong candidate to our program. No visiting student is automatically granted an interview with our program.

Email orthoed@umn.edu if you need any further assistance. 

Contact us

A_HarrisonAlicia K. Harrison, MD
Orthopaedic Surgery Clerkship Director
harri736@umn.edu

 

David JewisonDavid Jewison, MD
Orthopaedic Surgery Clerkship Director
jewi0005@umn.edu 

Larissa Lavrov
Medical Student Education Coordinator
612-273-4089
orthoed@umn.edu

Electives

For a detailed description of Orthopaedic Surgery Electives offered, please visit the Medical School information page