The Chief Resident's Banquet is a wonderful time for alumni to come back to Seattle to meet friends and wish the graduating residents a fond fairwell.

Dr. Frederick Matsen, Department Chairman stands with Dr. Emma Woodhouse and Dr. Ben DuBois at the Chief Residents' Banquet. Five years have passed quickly, but Dr. Woodhouse and Dubois will stay on at the UW and will participate in the Shoulder and Elbow fellowship under the direction of Drs. Matsen and Winston Warme.

Director's comments

Attendees at the Chief Resident's Banquet, June 2003 held at the Seattle Tennis Club.

Family & friends

Resident power

2001 Orthopedic Residents (and families)

Picnic with 2002 Orthopedics residents

Dr. Howard Chansky, Chief of Service at Veterans' Administation Hospital congratulates Kevin Klineberg (R3) on being a new Dad! Being an Orthopedic resident and being a father will keep your life pretty busy!

Introduction

About the residency program

Program overview statement

The University of Washington Department of Orthopedics and Sports Medicine is one of the leading academic orthopedic departments in the United States. It ranks among the top four departments in terms of current NIH funding, is the only orthopedic department to have a VA Rehabilitation Research & Development Center of Excellence, and is the only department to have two medical centers (HMC and UWMC) consistently in the U.S. News and World Report’s Honor Roll.

Seven endowed research chairs and a research professorship nurture the scholarly activity of the Department . On this foundation, the Department offers the only academic residency program for our five-state area, which is one-quarter the landmass of the country. The UW Orthopedic Residency has graduated three current departmental chairs, international leaders in sports medicine, orthopedic traumatology, foot and ankle surgery, shoulder and elbow surgery, joint reconstruction, pediatric orthopedics, spine surgery and orthopedic research.

The clinical components of our residency are firmly routed in medical centers dedicated to teaching in the context of excellence in patient care. Harborview Medical Center is the region’s premier level one trauma center. It is also the site of the region’s premier foot and ankle program. The University of Washington Medical Center with its Roosevelt Bone and Joint Surgery Center is the region’s center of academic reconstructive orthopedic surgery. The Veteran’s Affairs Puget Sound Health Care System is the regional center of major joint reconstruction, spine surgery, hand surgery and tumor surgery for veterans. Children’s Hospital and Regional Medical Center is the site of the leading pediatric orthopedic program in the northwest. The Seattle Cancer Care Alliance is the home of one of the largest sarcoma programs in the country. Virginia Mason Medical Center provides the soundest academic approach of all the private medical centers in the region. On top of this foundation, our program is enjoying substantial growth. The new UW Sports Medicine Clinic, integrally situated within the athletic training complex and stadium, provides state-of-the-art, exclusive care to UW's 700 varsity student-athletes. In addition, it is the preeminent referral center for the University and greater-Seattle community and the only academic sports medicine program in the northwest. The new East Side Specialty Center provides clinic access to UW orthopedists for those individuals living on the east side of Lake Washington. The new Regional Hand Center at Roosevelt is prospering along with its immediately adjacent outpatient operating rooms. The Spine Surgery Center, a collaborative program with Neurosurgery, will soon open at the Roosevelt Bone and Joint Surgery Center. Our new relationship with Northwest Hospital has given birth to a large and growing program focused on pediatric hand deformities. Our new affiliation with Puget Sound Spine and Sports Medicine facilitates access for these highly selected patients to access the excellence offered by the UW. In the fall, the UWMC Surgical Pavilion will open creating opportunities for the ideal patient experience in ambulatory surgery.

This exciting clinical and scholarly environment enables us to attract and retain an outstanding academic faculty consisting of thirty-three full-time academic orthopedic surgeons and ten full-time PhD investigators along with ten full-time acting instructors. We plan to add five more full-time clinicians over the next five years.

Perhaps the most special element of the program is the profound partnership that exists between the residents and the faculty. Decisions regarding clinical rotations, research participation, didactics, lectureships and recruitments are made in collaboration. This dynamic approach to the evolution of the residency as the program grows will assure that we continue to train the orthopedic leaders of the future.

Residency Video Download:

• Residency Research and Education Fund Video (Windows Media Format) (14.79 MB)

From the chair of the resident selection committee

Dear Orthopedic Residency Applicant:

Thank you for your interest in the Orthopedic Surgery Residency Program at the University of Washington.

The University of Washington Orthopedic Surgery Residency Program is a fully approved and accredited five year program which begins with the PGY-I year. Most of our residents are selected during their senior year of medical school and are required to successfully complete a PGY-1 year of training at the University of Washington under the direction of the Department of General Surgery. Candidates will be selected into the program through the National Resident Matching Program (NRMP) at the PGY-1 level.

We will be participating in the Electronic Residency Application Service (ERAS) for the 2005 Match. Please contact your Student Affairs Office for processing procedures for ERAS applications.

Currently, eight residents will be selected for PGY-1, 2006.  There are eight residents at  PGY-II  level of training, and six residents at PGY-III,  PGY-IV and PGY-V. This is not a pyramidal program and once a resident is accepted at the PGY-I level, it is expected that he/she will complete the program assuming satisfactory performance.

We require a letter of recommendation and transcript from your Dean. In addition, we require three letters of recommendation with the University of Washington recommendation forms. Input from senior orthopedists are particularly helpful, but they should only be used if you are well known to that individual. Because interview time is limited, and because we do not wish to waste the applicant's time or money, only competitive applicants are invited to meet with the selection committee. We ask that you not make frequent calls regarding the possibility of an interview. You will be notified by mail and then appropriate arrangements can be made. Interviews are usually held during the month of January. In order to assure complete and timely review of your application, we strongly urge you to have all materials in by November 01, 2005.

We attempt to select residents who are good doctors, who will be a pleasure to have in our program for five years, and who will reflect well on our program once they have completed it. Thus, in the applications and interviews, we are looking for evidence of clinical skills, personality and character, ability to work hard, and past achievements whether it be in medicine, research, athletics, the arts, or other fields. We are very proud of our program and want to continue to fill it with good people.

I hope that this letter and the rest of the program description will answer most of your questions about the University of Washington Orthopedic Residency Program. I would be happy to try to answer any others if you would care to send them to me.

Thank you again for your interest.

Respectfully,
Douglas P. Hanel, M.D., Professor
Director, Orthopedic Education

Application instructions

1. Contact your Student Affairs office for processing procedures for ERAS applications.
2. Submit the following items through ERAS:
   • Completed ERAS application
   • Personal statement
   • Medical School Transcript
   • Three Letters of recomendations plus the recommendations form (Microsoft Word) as part of the letter
   • USMLE Transcript
   • Medical School Dean's Letter
3. After the screening process, you will be notified, by mail, whether you will or will not be invited for an interview.

Calls are welcome if you would like to know the status of your application (e.g. to check what items are missing). Call Angela Weiss at (206) 598-9960.

Our address

Application Downloads

About the rotation

The hip and knee reconstruction rotation offers an excellent experience under the supervision of fellowship-trained faculty.

While hip and knee reconstruction is performed at all of our medical centers, this third year rotation is based at the University of Washington Medical Center. It is under the supervision of John Clark M.D. and Seth Leopold M.D..

During this rotation emphasis is placed on the comprehensive evaluation of patients with degenerative and inflammatory conditions of the hip and knee.

Goals & objectives

Our goals are to teach the essentials of hip and knee reconstruction relevant to a general orthopedic practice.

During this rotation, residents learn to perform a thorough assessment and management plan for individuals with hip and knee conditions. This will often include consideration of systemic factors such as age, immune compromise, rheumatoid arthritis, urinary tract problems, and potential for pulmonary and cardiac problems.

Residents learn preoperative planning osteotomy and primary and revision arthroplasty including the elements of implant selection and detailed "templating".

Residents read activity during this rotation. There is a reading list that is updated by regular review of the current literature. Emphasis is placed on the JBJS Current Concepts as well as the Journal of Arthroplasty.

In the clinic, residents learn the principles of evaluation of the hip and knee, including the history, physical exam, radiography, and ancillary tests. This experience provides a context for understanding the natural history of OA, RA, Perthes, CDH, SCFE, AVN, joint sepsis, fractures, and of many joint procedures. On the inpatient service the residents learn the details of care of patients having surgical procedures. This includes thromboembolic prophylaxis, pain management, physical therapy, and discharge planning. In the operating room the residents learn the surgical approaches to the hip and knee as well as the specific elements of joint.

About the rotation

This rotation deals with pediatric orthopedic surgery covering all aspects from birth to adulthood.

This service is complemented by two full time pediatric orthopedists, Kit Song M.D. and Greg Schmale M.D., and consultant faculty members from the UWMC in tumor Conrad) and hand (Hanel, Allan). A pediatrician fellowship trained in Sports Medicine sees patients with non-operative pediatric orthopedic problems.

Residents have two rotations at Children's during their third year and one during the fifth year as the Chief Resident in Pediatric Orthopedics. These rotations meet the requirements of the Resident Review Committee for certification by the American Board of Orthopedic Surgery.

The R5 is the resident leader and directs the daily assignments for floor work and operative cases. The R5 works directly with the staff to discuss educational needs and advanced clinical experience for himself and The R3’s.

The R3 is responsible for emergency triage, evaluation and admission of patients from the emergency room. There is a third R3 equivalent from the orthopedic program at Madigan Army Hospital that shares in these duties. In addition the daily activities of managing pre and post-operative care is directed by the R5 and carried out by the R3.

The chain of command and responsibility is readily apparent and easily defined from the R3 through the section head.

Goals & objectives

Our goals are to teach the essentials of the specialty relevant to a general orthopedic practice as well as the foundation for fellowship training.

Residents are expected to achieve a sound knowledge base, including reading the standard texts of Lovell and Winter, Tachdjian, Rockwood and Green, Morrissy, and Canale and Beaty as well as the Pediatric OKU.

In the Emergency Department, residents become proficient in the management of emergent conditions such as trauma and infection. In the Operating Room, residents learn to perform fixation of traumatic injuries and other procedures within the scope of a general Orthopedist. In the Outpatient Clinic, residents develop the knowledge base to effectively and completely tackle non-emergent problems that are present in the office setting. On the Inpatient Service residents learn the daily care of in house patients.

An indications/ pre- and post-operative conference is held each Wednesday from 6:30-8:30 am. Residents have access to the list of patients to be discussed and are expected to be prepared to contribute to the discussion of each case. A didactic teaching conference is held each Thursday from 6:45-7:30 am; this conference follows a schedule based on the Pediatric OKU. A case-based topics in pediatric orthopedics conference is held Fridays from 7:00-8:00 am; this conference is tailored by the residents to meet their needs but generally follows a schedule based on Staheli’s Practice of Pediatric Orthopedics.

About the rotation

The foot reconstruction rotation offers an excellent experience under the supervision of fellowship-trained faculty.

This fourth year rotation is based at the University of Washington Medical Center and Harborview Medical Center. Mondays are spent with Nancy Kadel M.D. in the operating room at the University of Washington Medical Center. Tuesday through Friday are spent with Sig T. Hansen M.D., Bruce Sangeorzan M.D. and Steve Benirschke M.D. at Harborview Medical Center.

During this rotation emphasis is placed on the comprehensive evaluation of patients with degenerative, inflammatory and post traumatic conditions of the foot and ankle.

Goals & objectives

Our goals are to teach the essentials of foot and ankle reconstruction relevant to a general orthopedic practice.

During this rotation, residents learn to perform a thorough assessment and management plan for individuals with foot and ankle conditions. This will often include consideration of systemic factors such as age, immune compromise, rheumatoid arthritis, urinary tract problems, and potential for pulmonary, cardiac and coagulopathic problems and Diabetes Mellitus.

Residents learn preoperative planning of primary and revision ankle arthodesis, arthroplasty, and re-alignment procedures for malunion and acquired foot deformity.

Residents read actively during this rotation. There is a reading list that is updated by regular review of the current literature and primary textbooks.

In the clinic, residents learn the principles of evaluation of the foot and ankle, including the history, physical exam, radiography and ancillary tests. This experience provides a context for understanding the natural history of OA, RA, Post traumatic AVN, sepsis, fractures, and charcot joints associated with Diabetes Mellitus. The evaluation of soft tissue imbalance is paramount to this service.

On the inpatient service the residents learn the details of caring for patients after surgical procedures. This includes DVT prophylaxis, pain management, physical therapy and discharge planning.

In the operating room the residents learn the surgical approaches to the foot and ankle and become facile with those procedures that are performed routinely by a general orthopedist.

About the rotation

The hand service is a region specific orthopedic rotation that covers all aspects of hand surgery.

The hand service is directed by Dr. Trumble and includes faculty from the VAH (Dr. Sack), HMC Dr’s Allan, Hanel, Sack, Vedder) and the University Medical Center (Sack, Trumble and Vedder). The hand service is seamlessly coordinated with the section of Plastic Surgery (Dr. Vedder). The educational goals are the same in each location.

The specific details are listed below but the overall goal is for the residents to gradually develop the skills necessary to function independently and be able to handle those cases which would be managed by a general orthopedist or plastic surgeon. Graduated responsibility is afforded to each resident dependent upon their skills, knowledge of orthopedics and level of confidence.

An R-2 at HMC assists with clinic one day per week and is in the OR one day per week. The remainder of the week this R2 is part of the general HMC Orthopedic Team. An R-4 is a full time "hand resident", operating on Mondays, Tuesdays, Thursdays and Fridays. This resident is in the University hand clinic on Wednesdays. Call for this service is shared amongst the plastic residents (2) and the hand fellows (3). Although call covers the University, Children’s and Harborview, 95%+ of the call time is spent at Harborview.

Goals & objectives

Our goals are to teach the essentials of the specialty relevant to a general orthopedic practice as well as the foundation for fellowship training.

Residents are expected to achieve a sound knowledge base, including reading the standard texts of Operative Hand Surgery, reviewing the ASSH video entitled Examination of the Hand, reviewing ASSH video regarding nerve decompression, learning to draw and label a schematic of the hand intrinsic mechanism in the digits, achieving an understanding of the segmental innervation of the upper extremities, and using the List of Selected Readings to prepare of surgical cases and to answer other clinical questions.

In the clinical arena, residents learn to synthesize a management plan for patients with hand problems by conducting a thorough and efficient clinical history and physical examination, understanding the implications of systemic, emotional, and situational factors to the treatment of hand disorders, understanding the indications for and interpretation EMG/NCV and SSEP, understanding the indications for and interpretation of standard radiographs, CTs, MRIs, and sonograms of the hand understanding the relevant basic science and anatomy (gross and arthroscopic) related to the hand and wrist, and presenting basic treatment options, including home exercises, medications and surgery along with the alternatives and risks of each.

Residents develop an understanding of the diagnosis and treatment for a core group of traumatic lesions (including fractures, tendon injuries, dislocations and instability problems, nerve injuries, soft tissue loss, reflex sympathetic dystrophy and amputations), non-traumatic disorders (including arthrosis, compression neuropathies, tendinitis, contractures, ganglions, tumors, and palsies).

Finally, residents learn the elements of efficient and safe hand surgery, including preoperative planning, positioning and preparation, surgical approaches, and the techniques of tendon repair, fracture fixation, nerve repair, nerve decompression, the management of tendinopathies, and soft tissue coverage.

About the rotation

The Virginia Mason Rotation provides an experience at a private medical center, with emphasis on joint reconstruction and arthroscopy.

The Virginia Mason Hospital is located in downtown Seattle. The fourth year rotation at Virginia Mason is under the supervision of Paul Benca M.D. who along with John Buckmiller M.D., Tom Green M.D., Mike Morris M.D., Ray Robinson M.D. and Lyle Sorenson M.D. comprises the teaching section of orthopedics at this institution. The faculty is board certified and fellowship trained. Most importantly, the residents frequently recognize Virginia Mason faculty for their excellent teaching efforts. These faculty help the resident achieve expertise and abilities in preoperative indications, preoperative planning, and the conduct of primary hip and knee arthroplasty. Residents also learn knee and shoulder arthroscopy, ACL and other ligament reconstructions.

Although the primary emphasis of this rotation is sports medicine and adult reconstruction the resident is exposed to a variety of general orthopedic issues, including primary shoulder surgery, orthopedic oncologic procedures, and the general spectrum of orthopedic trauma comprising general orthopedics.

Clinical duties will include coverage of inpatient and outpatient call, including first call to the Emergency Room and the floors in the evenings and on weekends on a prearranged schedule. This is a light call burden with the resident being called into the hospital only one or two times per rotation. There is no specific clinic duty due to the fact that one day a week is spent in the research and the remaining four days are spent doing operations. It is expected that the resident meet every patient he or she operates upon preoperatively and follow that patient post operatively while in the hospital.

Goals & objectives

About the rotation

The shoulder and elbow rotation offers an excellent clinical and academic experience under the supervision of fellowship-trained faculty.

Rick Matsen and Winston Warme along with two acting instructors provide the faculty core of the shoulder and elbow team. Our focus is on the practical evaluation and management of the full range of shoulder and elbow conditions. As the regional referral center for both simple and complex problems, we have the opportunity to treat patients with cuff disease, instability, arthritis, post-traumatic deformities, and failed previous surgery.

During this rotation residents gain a basic knowledge of shoulder and elbow anatomy and pathology through clinical experience and through reading current journals and texts, such as Practical Evaluation and Management of the Shoulder, as well as from viewing Dr. Harryman's video entitled "Safe and Effective Surgical Approaches to the Shoulder" and “Mechanisms of Glenohumeral Stability”.

On this rotation residents learn the anatomy of the brachial plexus as well as the segmental innervation of muscle movements, reflexes and cutaneous sensation in the upper extremity. They learn the clinical and surgical anatomy of the shoulder and elbow so that surgery can be performed safely and efficiently.

We have found that a thorough grasp of the principles of the shoulder and elbow lead to an intuitive approach to evaluation and management of patients with problems in these domains.

Goals & objectives

To acquire the necessary expertise for a general orthopedist to diagnose and treat problems related to the shoulder and elbow.

Each resident rotating on the Shoulder and Elbow Service will be expected to:

• Obtain a basic knowledge shoulder and elbow anatomy and pathology.
• Be able to synthesize a management plan for patients with shoulder and elbow problems.
• Be able to perform efficient and safe surgical intervention.

About the rotation

The Sports Medicine rotation provides an overview of the prevention and treatment sports related injuries involving both the elite level and recreational athlete.

The new UW Sports Medicine Clinic, integrally situated within the athletic training complex and stadium, provides state-of-the-art, exclusive care to UW's 700 varsity student-athletes. In addition, it is the preeminent referral center for the University and greater-Seattle community and the only academic sports medicine program in the northwest.

This third year rotation in sports medicine is under the supervision of John Green III M.D. who along with Roger Larson M.D., Nancy Kadel M.D., Carol Tietz M.D., Christopher Wahl M.D., and John O’Kane M.D. comprise the core physicians dealing with the University of Washington athletic programs as well as surrounding area high schools. The faculty is board certified and fellowship trained.

These faculty help the resident achieve expertise in preoperative indications, preoperative planning, and performance of procedures dealing with the injured athlete. Reflecting the frequency of injury this rotation emphasizes knee, shoulder, hip and elbow arthroscopy, ligament reconstruction, cartilage restoration as well as the treatment incurred by sports activities.

Clinical duties consist of two day long clinics per week, and two operative days. One day per week is spent on research. The resident on this service does share emergency call with the other residents assigned to the University Medical Center.

Goals & objectives

The resident on this service acquires the skills necessary to evaluate the injured athlete, determine the need for intervention, outline which procedure would best suit the individual and become facile with those procedures that would be performed by a general orthopedist.

While residents obtain exposure to sports medicine throughout the program, one rotation in the third year is devoted exclusively to this subspecialty.

During this rotation, emphasis is placed on managing the inpatient and out patient sports medicine patients in a way that is appropriate and satisfying to the patients, nurses, consulting physicians, and attending surgeons. Residents present the salient points of the week's cases at conferences, participate teaching medical students the basics of sports medicine examination and evaluation while on the sports medicine service.

About the rotation

The VA is a general orthopedic rotation.

• General orthopedics is directed by Dr. Chansky with the assistance of Dr. Greenlee. Doctors Fred Huang and Craig Arntz also attend on a monthly basis.
• The hand service at the VA is directed by Dr. Sack and has the same goals for resident education as the rest of the university hand rotations.
• The PACT service is directed by Dr. Sangeorzan and is focused on the care of veterans with vascular disease and diabetes as well as foot and ankle pathology. Dr. Sangeorzan also directs the foot and ankle service.
• The spine service is directed by Dr. Mirza and this service has the same goals as the other university spine services.

Goals & objectives

The three rotations emphasize graduated responsibility.

The R-2 continues to manage the orthopedic inpatients and shares responsibility for covering the emergency room. In addition the R-2 covers the PACT clinic and is the primary resident covering all amputations. The R-2 typically first or second-assists on other cases.

The R-4 functions as the primary resident surgeon on most of the basic and intermediate level orthopedic cases. He or she is responsible for "templating" most of the primary total joint cases and for ensuring the presence of the necessary equipment and components.

The R-5 is the resident primarily responsible for the orthopedic service, including the inpatient service and the surgical schedule. The R-5 reviews the cases of all patients scheduled for surgery by the R-4 resident and supervises the R-2 and R-4 residents in clinic. The R-5 is the primary resident surgeon on the most complicated cases. In addition the R-5 supervises the R-2 on the more basic surgical cases. It is expected that the R-5 will discuss all surgical cases with the appropriate attending.

About the rotation

Goals & Objectives

The orthopedic resident experience on the orthopedic oncology service involves attending an educational multidisciplinary oncology conference and clinic. In addition, residents attend surgical cases with Drs. Conrad and Weisstein on two different surgical days at the University. Their care of inpatients and outpatients is in collaboration with the orthopedic attendings, the tumor ACE, and the physician assistant. Differential diagnoses for adult benign and malignant bony lesions, and benign and malignant soft-tissue lesions, in addition to metastatic disease and pseudotumors and dysplasias are experienced in high volume on this high-volume service. Residents are expected to understand the basic principles of initial evaluation and differential diagnosis in addition to principles of biopsy and the basic indications for chemotherapy, radiation therapy, and overall prognosis for different tumor categories.

Pediatric service is structured in a similar way around a multidisciplinary clinic and conference. Medical oncologists attend the multidisciplinary clinics and, thus, the residents in both pediatric and adult tumor services have a primary contact with medical oncologists, radiation therapists, and a nurse oncologist on both services.

Clinical projects are encouraged for both the adult and pediatric services. Basic science programs revolve around the molecular or genetic basis of sarcomas, in addition to metabolic imaging with PET scan and a prospective protocol for the assessment of clinical outcomes in all patients.

Questions?

Thank you for your interest in the Orthopedic Surgery Residency Program at the University of Washington.

If you have additional questions not addressed on this web site, please call Angela Weiss at (206) 598-9960.

Or mail your request to:

Residency Program Coordinator
University of Washington
Department of Orthopedics
UWMC Roosevelt II - Box 354743
Seattle, Washington 98105