Message from the Program Director

Welcome to the University of Saskatchewan Orthopedic Surgery Residency Training Program website!

Our program has had great success in training orthopedic surgery residents to become fully specialized in their field. The program has an extensive academic schedule but also allows significant exposure clinically and surgically for residents throughout their five years of training. The program teaches the CanMEDS roles and is designed based on the objectives of the Royal College of Physicians and Surgeons of Canada in Orthopedic Surgery.

Throughout the academic year there are extensive rounds that are pre-set and well-attended. These are mandatory for residents to attend with protected time. All of the subspecialty areas of orthopedic surgery are part of the training program and residents spend rotations in these areas throughout the residency program. Rotations have a favorable resident faculty ratio allowing close interaction with faculty in the clinical and surgical settings. Overall, residents are well trained to be a competent orthopedic surgeon at the time of their completion of the program. Also, there has been a very high success rate in passing the Royal College examinations in Orthopedic Surgery.

Please feel free to contact me or the administrative office if there are any specific questions regarding our program.

David Sauder, MD, FRCSC
Program Director
Division of Orthopedics
University of Saskatchewan

The Orthopaedic Surgery Residency Training Program at the University of Saskatchewan was established in the early 1960s by Dr. Eric Nansen, a general surgeon and Head of the Academic Department of Surgery.

For the first years, the training was done by the private practice orthopaedic surgeons practicing in Saskatoon. In 1966, Dr. William Kirkaldy-Willis became the first full-time academic head of orthopaedics, being attracted here from Nairobi. In Africa, Dr. K-W was known as the best orthopaedic surgeon between Cairo and Johannesburg, and as he would add, the only one. For the first years, he was able to attract many local graduates to undertake training in orthopaedic surgery, many of who remained in, and continue to practice in Saskatchewan.

With a decrease in local applicants in the early 1970s Dr. K-W went on recruiting trips to the UK. It was in a hotel in London that Dr. K-W and Dr. John Wedge (a graduate of the programme and a fellow in Oxford at the time) interviewed Dr. Ken Yong-Hing. Little did they know at that time that the three of them would be the core of academic program for the next 30 years. Of those recruited from afar, all remain in practice in Canada, most in Saskatchewan. Dr. K-W had a firm belief that research was the cornerstone to advancing orthopaedic knowledge and focused on low back pain, having developed an interest in spine treating TB cases in Africa. All residents were “strongly encouraged” to participate in research.

Dr. Wedge became the academic head/program director in 1981 and was succeeded by Dr. Yong-Hing in 1985. Dr. Geoffrey Johnston became program director in 1992 and was followed by Dr. William Dust in 2000 and Dr. King in September 2010. In 2002 Dr. Dust took over from Dr. Yong-Hing as academic head. In 2005 Dr. McKerrell assumed the role of academic head.

Our Mission is to provide high quality patient care and provide residents with solid fundamental training in clinical surgery and patient care, research, and teaching which allow them to evolve with and contribute to the ever changing nature of our specialty

The goals of the program mirror the goals of the Royal College for Orthopedic Surgery training and there are some specific goals as well.

1. The overall goal is to train a resident to be a well-rounded orthopedic surgeon capable of general orthopedic practice in Canada. This requires successful completion of the Surgical Foundations Exam and the Royal College Specialty exam.
2. Residents should be capable of entering any orthopedic fellowship program in North America and the English speaking world.
3. Residents are to be trained in all the CanMEDS competencies as they relate to Orthopedic Surgery.
4. Training is to be free of harassment and intimidation. The goal is to try to minimize stressful situations and learning environments as much as possible.
5. The learning environment will be one where safety for the resident is of the utmost concern.
6. Residents are to obtain a research experience with mandatory research projects in during the first four years of training. Residents can enter the Clinical Investigator Program for two years if further research experience is desired.
7. Residents are to gain significant clinical and surgical exposure in all aspects of Orthopedic Surgery. This includes trauma and non-trauma related Orthopedics.
8. A structured teaching curriculum will be provided throughout the year to cover all topics of Orthopedic Surgery.
9. Social events and retreats will occur to promote collegiality and help alleviate stress.
10. Faculty will help foster fellowship and career opportunities for residents as they near the latter half of residency.

We are a smaller sized training program with broad subspecialty experience available in the faculty, a highly dedicated group who devote exceptionally large amounts of time to all aspects of resident training.

• The clinical volumes and materials are adequate for training with an outstanding Ambulatory Care experience.
• 7 days per week, OR room available for urgent orthopaedic patients—greatly decreasing the amount of evening and night time operating.
• A comprehensive series of teaching rounds that are mandatory for the residents and always have staff members attending.
• The great majority of the teaching is located at one site which minimizes the amount of running around the residents have to do.
• The incorporation of our private practice community based faculty has created an outstanding experience not only in orthopaedics but also practice management.
• Being a smaller program we are very sensitive to the personal aspects of residency training and have more of a collegial relationship with the residents rather than the traditional teacher student relationship.
• A Surgical Foundations program and committee that is responsive to the needs of the orthopaedics training program

The Orthopaedic Surgery residency training program at the University of Saskatchewan is a five year program with the first two years spent rotating through Surgical Foundations.  The final three years are spent in Orthopedic Surgery.   In addition to satisfying the requirements of the Royal College of Physicians and Surgeons of Canada, our curriculum meets the requirements of the American Board of Orthopaedic Surgery. 

The academic year is divided into 13 blocks of 4 weeks.  Residents rotate through each of the subspecialty areas of orthopaedics:   adult reconstruction, upper limb, trauma, sports medicine, spine surgery, foot an ankle, pediatric orthopaedic surgery, community (office-based) rotations.

Most of the time in Orthopaedics is spent on preceptor based rotations with the remainder spent on the Trauma/ER service and office based selective rotations.  When doing office based rotations the resident spends time in the office learning not only orthopedics but also the practicalities of running an office as well as spending time in the OR and cast clinic. 

In addition to completing mid rotation and end of rotation face-to-face evaluations for residents on service, preceptors are also complete in-training evaluations for all residents.   Residents also meet with the program director on a quarterly basis for evaluation meetings.

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PGY1 and PGY2 (26 blocks)

 The first two years of training are spent in Surgical Foundations consisting of the following 26 blocks:

Orthopaedic Surgery: 17 blocks 

• 5 or 6 Trauma         
  
• 2 or 3 Pediatrics                        
• 2 Spine                               
  
• 2 or 3 Hip & Knee/Oncology  
  
• 2 Upper Extremity
  
• 1 or 2 Sports Medicine

Other: 9 blocks

• 1 General Surgery Trauma
  
• 1 Emergency
• 1 Neurosurgery
• 1 ICU
  
• 1 GIM   
  
• 1 Rheumatology
• 1 Research
• 1 Medical Imaging
• 1 Plastic Surgery   

PGY3 to 5 (39 blocks)

In their PGY3-5 years, residents are based at Royal University Hospital, Saskatoon City Hospital, and Regina General Hospital where they are assigned to either preceptor-based or office-based Clinical Teaching Units.

Residents spend a total of 21 blocks on preceptor-based CTUs with the remaining 18 blocks spent on community selectives, trauma service, electives, and academic enrichment.

To avoid conflicts, the residents are assigned which surgeon to work with on each day of the week (Monday-Thursday). Friday afternoon is the designated Research half-day. On these services the residents are responsible for the weekday ward care of the patients on their service. They are not responsible for the Discharge Summaries of these patients.

Preceptor Based Clinical Teaching Units (21 blocks)

• Hip & Knee Reconstruction plus Orthopaedic Oncology (5 blocks)  
  
  • Dr. William Dust, Dr. Anthony E. King and Dr. Trevor Loback
• Pediatric Orthopaedics (4 blocks) 
  
  •  Dr. Anne K. Dzus and Dr. Lauren A. Allen
• Upper Limb (2 blocks) 
  
  • Dr. Geoffrey H.F. Johnston and Dr. David Sauder
• Sports Medicine (4 blocks)
  • Dr. Mario Taillon and Dr. Mark Ernst
• Spine Surgery (3 blocks) 
  
  • Dr. Ken Yong-Hing, Dr. Allan Woo and Dr. Michael Spiess
• Foot and Ankle (3 blocks) 
  
  • Dr. Huw Rees, Dr. Trent Thiessen and Dr. Lee Kolla

Office-based Community Selectives (6 blocks)

Residents choose which staff person to work with on each day of the week and may choose which day to use as the Research half-day. At least one day per week must be spent in the office/clinic. Residents are not responsible for ward care of these patients however they are expected to follow the patients they have operated on. Residents are not responsible for Discharge Summaries of these patients.

• General Orthopedics
  
  • Dr. Dwight Loback and Dr. Jeffrey McKerrell
• General Orthopedics, Total Joints
  
  • Dr. Jans van der Merwe and Dr. Trevor Loback
• Sports Medicine, Upper Extremity 
  
  • Dr. David Kim and Dr. R. Cole Beavis
• Cold Trauma
  • Dr. Tousief Hussain, Dr. Elliott Pally, Dr. Andrew Urmson
• Spine, General Orthopedics 
  
  • Dr. R. Beggs (Regina)

Trauma/ER Service (9 blocks)

Preceptors: Dr. Tousief Hussain, Dr. Elliott Pally and Dr. Andrew Urmson

Resident commitments fluctuate with the number of residents on the service (anywhere from 1-4). These include making morning rounds with the “Second on Call” Surgeon, ward and ER coverage M-F (0800-1600h), assisting the “First on Call” Surgeon in the BoNE room, and attending fracture follow-up clinic. The senior resident on the service will have the responsibility for assigning residents daily duties. All residents on the service will be assigned time in the operating room. Residents are not responsible for Discharge Summaries of these patients.

This service has two orthopaedic surgery faculty involved with the residents each day:

The “First on Call” Surgeon operates in the “BONE Room” seven days per week. In the evenings and on weekends this surgeon covers call at RUH. This surgeon is different each of the weekdays. It is usually the same surgeon on call for a weekend

The “Second on Call” Surgeon covers the RUH ward (exclusive of elective orthopedic patients), ER and consults with the residents on weekdays (M-F). On evenings and weekends this surgeon covers call at Saskatoon City Hospital and is on backup call at RUH in the event a surgeon is needed to run a second OR.

Electives (2 blocks)

Elective rotations are available for 2 months during residency where residents can travel out-of-province or abroad for international orthopaedics. Residents can also choose to do a research elective.

Academic Enrichment and Knowledge Consolidation (1 block)

During the final year of training, and prior to the RCPSC Subspecialty Written Examination, one block is devoted to academic enrichment and knowledge consolidation.

Click on the links below to view/save the requirements:

• Specialty Training Requirements in Surgical Foundations
• Speciality Training Requirements in Orthopaedic Surgery

Surgical Foundations

• SF Objectives of Training

Orthopaedic Surgery

• Objectives of Training:
  • Hip & Knee Reconstruction and Musculoskeletal Oncology
  • Pediatric Orthopaedics
  • Sports Medicine
  • Foot & Ankle
  • Upper Extremity
  • Spine
  • Trauma
  • Community
• Royal College of Physicians and Surgeons of Canada:
  • Objectives of Training in Orthopaedic Surgery
  • Objective of Training for Surgical Foundations Training

College of Medicine Assessment of Postgraduate Trainees:  Guiding Principles

We have an intensive series of formal teaching rounds designated throughout the week (7 hrs/wk). The time is protected for these rounds and attendance is mandatory.  These teaching rounds cover all aspects of orthopaedics. There is always at least one and frequently more than one staff in attendance.

Most rounds have a staff surgeon course co-ordinator who determines the curriculum. Most run on a one or two year cycle that covers the breadth of the relevant area. The exception is Orthopaedic Grand Rounds where the choice of topics to be covered is left up to the PGY5 residents so that we may focus on areas in which they feel deficient.

The format may be case based discussions, topic based discussions or didactic lectures. Most of the lectures are prepared by a resident, however, may be given by the staff surgeon.

Compulsory academic sessions occur either at the beginning or at the end of the day. In this way residents are able to attend without having to move around in the middle of the day.

Orthopaedic Surgery Residency Training 2015-16 Academic Calendar

ROUNDS	INFORMATION	TIME
FRACTURE ROUNDS	Faculty are assigned to find cases illustrative of the fracture being discussed that week. Residents should carry out the appropriate reading and will be expected to discuss cases as in an oral examination. No formalized schedule - topics decided on weekly basis. Coordinator: Dr. A. Urmson	Mondays 5:00 - 6:00 PM Sept - June
EXTREMITY ROUNDS	The teachers include Plastic Surgery and Orthopaedic Surgery faculty. Residents are expected to be familiar with the hand/upper extremity or foot and ankle topic to be discussed. Coordinator: Dr. D. Sauder	Tuesdays 5:00 - 6:00 PM Sept - June
PEDIATRIC ORTHOPAEDIC ROUNDS	Wednesdays from 7:00 am – 8:00 am, September to June Relevant objectives and review papers are pre-circulated and the residents should be able to discuss them in detail. Coordinators: Dr. A. Dzus and Dr. L. Allen	Wednesdays 7:00 - 8:00 AM Sept - June
ANATOMY ROUNDS	Rounds consist of an initial didactic session prepared by a resident followed by demonstrations on prosected specimens in the Anatomy Lab. Residents are assigned a topic to prepare and discuss. Every resident must review the anatomy before the session. Coordinator: Dr. M. Taillon	Wednesdays 5:00 - 6:30 PM Sept - Nov
BASIC SCIENCE ROUNDS	Topics to be covered will be assigned to residents.  Objectives for each topic are provided. Residents should come prepared to discuss the topic. Coordinator: Dr. T. Loback	Wednesdays 5:00 - 6:00 PM Dec - June
SPINE ROUNDS	These rounds are combined with the Division of Neurosurgery and are an interesting case based format. Faculty present cases illustrative of the topic being discussed that week. There is no formalized schedule as topics are decided by faculty/residents the week before rounds. Coordinator: Dr. A. Woo	1st Thursday of the month 7:00 - 8:00 AM Sept - May
ORTHOPAEDIC GRAND ROUNDS	Presentations are evaluated by the residents and staff. Presentations will be made primarily by the residents with input from staff. The quality of the rounds will be almost entirely dependent upon input from residents. Topics to be discussed are determined by the PGY5 residents on weekly basis. Coordinators: PGY5 residents	Fridays 7:00 - 9:00 AM Year round
ETHICS/CanMEDS ROUNDS	These rounds take place twice a year for 1 hour, incorporated into Morbidity and Mortality Rounds which occur 6 times per academic year. Coordinator: Dr. A. King	See Morbidity and Mortality Rounds Schedule
MORBIDITY AND MORTALITY ROUNDS	Fridays from 7:00 - 10:00 AM in place of Orthopaedic Grand Rounds 6 times per academic year. Coordinator: Dr. J. McKerrell	6 times a year in lieu of Orthopaedic Grand Rounds
COMBINED ROUNDS	Combined Orthopaedic-Pathology-Radiology Rounds Coordinator: Administrative Resident	Fridays 8:30 - 10:00 AM 2-3 times per year
RESEARCH FORUM	In addition to providing a series of discussion sessions on research methodology, Research Forum provides the time and audience for the resident to discuss research at every stage—from development of the idea and research questions, through methodology, interpretation of results, discussion, conclusion, presentation and publication. Each resident research project has a faculty supervisor. Each resident is guaranteed one half day per week to work on research. No formalized schedule. Coordinator: Dr. E. Pally	Once a month 10:00 - 11:00 AM Sept - June
RESEARCH METHODOLOGY ROUNDS		Four times annually 5:00 - 6:00 PM Sept - June
JOURNAL CLUB	Hosted at a faculty member’s house, the hosting faculty picks a topic and assigns journal articles to residents.  Residents review and present their assigned article. The journal articles are then dissected and analysed by the residents. Discussion is preceded by supper. Coordinator: Dr. A. King	Bi-monthly
CLINICAL EXAM SESSIONS	Two staff surgeons will be available at each session to discuss various aspects of clinical examination in a more hands-on environment for the following orthopaedic topics: Hip and knee, spine, elbow and shoulder, hand and wrist, foot and ankle. Coordinator: Dr. A. King	Bimonthly Thursdays 5pm – 6pm

CanMEDS Framework

In 2001, the Royal College developed a diagram that illustrates the seven CanMEDS Roles and their interconnections.

Resident Evaluations

In a small program such as ours, progress is discussed between the preceptor and residents in a more informal, almost continuous manner. The residents are given the opportunity to comment on the structure and function of the program and its rotations.

The Program Director always has an "open door" to encourage residents to visit informally to discuss any concerns they might have or just to chat! A resident has the right to appeal any evaluation. Click here to review the Appeals Procedure.

Rotations Specific Evaluation Forms:

• Adult Spine: Jr. Resident --- Sr. Resident
• Community Orthopaedics: Jr. & Sr. Resident
• Foot & Ankle: Jr. Resident --- Sr. Resident
• Hip & Knee Reconstruction: Jr. Resident --- Sr. Resident
• Oncology: Jr. & Sr. Resident
• Pediatric Orthopaedics: Jr. Resident --- Sr. Resident
• Sports Medicine: Jr. Resident --- Sr. Resident
• Trauma: Jr. Resident --- Sr. Resident
• Upper Limb: Jr. Resident --- Sr. Resident

Rotation Specific Evaluations

Resident evaluation will occur quarterly at the end of each rotation. 

The surgeon(s) on the service will complete the appropriate evaluation form on one45 Webeval (an online evaluation and scheduling system).  This form will be reviewed by the Evaluation Committee (with additional input from faculty who worked with the resident during call and who have assessed the resident’s performance during oral exams and teaching rounds). 

Quarterly, the Program Director meets with each resident individually to discuss oral and written examination results, rotational evaluations and general progress. discuss the evaluation with them.  The rotation has not been successfully completed until this final step has occurred.

In the event of deficiency(s) that precludes successful completion of the rotation, the Program Director will discuss this with the resident at the quarterly meeting.  If difficulties are identified earlier in the rotation, a formal mid-rotation evaluation and meeting with the resident will occur.

Face-to-Face Evaluations

These mandatory evaluations occur at mid-rotation and end of rotation for rotations 2 or more blocks long.   These evaluations are to be initiated by the residents and submitted to the program admin office, and reviewed by Dr. King and the Evaluation Committee quarterly. 

360° Evaluations

For residents assigned to the trauma service, a 360° evaluation will be completed by the Orthopaedic Surgery Nurse Manager will obtain collective evaluations from nurses on the ward as well as physiotherapists and other staff.  These will be submitted to the program admin office and reviewed by the Evaluation Committee and Dr. King, Program Director. 

Faculty Evaluations

Residents have the opportunity to evaluate the orthopaedic faculty yearly.  This is done in an anonymous fashion using a CanMEDS based faculty evaluation form. 

Teaching Rounds Evaluations

Once or twice per year at the Resident Program Committee, each of the teaching rounds is evaluated and suggestions made for improvements.  If residents wish to have their views expressed anonymously they may do so through either the Elected or Appointed (Administrative) Resident Representative.

Rotation Evaluations

Once or twice per year at the Resident Program Committee, each of the Clinical Rotations is evaluated and suggestions made for improvements.  If residents wish to have their views expressed anonymously they may do so through either the Elected or Appointed (Administrative) Resident Representative.  

Research is an important part of the training program.  The Orthopedic Director of Research is Dr. Elliott Pally.  

Research Forum takes place monthly.

Surgical Foundations Residents are strongly encouraged to be involved in a research project. Research can be in the orthopaedic field or some other surgical field. Residents will present their projects at whatever stage of completion at the U of S Orthopedic Resident Research Day.

It is mandatory for residents to be involved in a research project in orthopedics or a related area in their 1st, 2nd, 3rd and 4th years.  This may be one project that extends over two years.   The project, at whatever stage of completion, will be presented at the U of S Orthopedic Resident Research Day.   It is not mandatory for PGY5 residents to be working on a research project.

Protected Time: While on orthopedic rotations residents will have a protected half day per week for research.  This time should be that which least disrupts the rotation they are on.  In most cases this time will be Friday afternoons.

Research Funding: Residents may access three sources of funding for research projects and/or for travel related to research:

1. Funds may be available through the Orthopaedic Resident Research account.  Funds in this account come from a number of sources:   alumni donations, patient donations, unrestricted industry grants, and miscellaneous sources.  Please talk to the program director about how to access these funds.
2. The Department of Surgery allocates $2000 per residency for each surgical resident.  These funds may be applied for travel related to research presentations (poster or podium). There is no application process to access these funds.  When submitting receipts for reimbursement a copy of the letter of acceptance of research poster/paper from the organization must be included.
3. Research funding is available for research projects, including conference travel for podium or poster presentations and may be applied for through the Department of Surgery Research and Graduate Studies Committee.

• 2016/17 Ortho Training Program Committees