Visiting Medical Students: Clerkship Description

Dear Medical Students,

Welcome to the UCSF Department of Orthopaedic Surgery! We are excited to offer the Orthopaedic Surgery elective to both UCSF medical students and visiting medical students.

This elective is designed to provide fourth-year medical students with clinical exposure to orthopaedic surgery in both clinical and operative settings, particularly for those interested in pursuing a career in the field. Students will work with world-class faculty who provide comprehensive musculoskeletal care across various hospital systems and patient populations. Our faculty are leaders shaping the future of orthopaedics and educators dedicated to training the next generation of surgeons.

This elective also offers an opportunity to learn more about our residency program and experience what it would be like to train at UCSF.

We look forward to welcoming you!

NS

Nicole Schroeder, M.D.
Clinical Professor
Chief, Department of Hand and Upper Extremity
Medical Student Clerkship Director

Course Overview

Our goal is to offer students an example of how an orthopaedic surgeon treats conditions of the musculoskeletal system through history and physical exam, imaging evaluation, and both nonoperative and operative treatment.  Students will be assigned to one of the many “services” within the Department of Orthopaedics umbrella for the duration of the 4-week rotation. The services are distributed according to subspecialty and primary sites (UCSF, San Francisco Veteran’s Affairs, Zuckerberg San Francisco General, and Children’s Hospital Oakland), and each service treats a unique mix of patients and musculoskeletal pathologies. You will be exposed to patient evaluation and treatment in three clinical areas: outpatient clinic, inpatient wards/ER, and the operating room.  We by no means expect a mastery of your assigned subspecialty over the course of the month, but we do hope you gain an understanding and appreciation of the basic principles.  

Check out our residency video for a look at our dynamic training program and the collaborative, supportive culture that sets our team apart. Discover hands-on learning opportunities in Orthopaedic Surgery through UCSF’s Visiting Medical Student Program.

Goals and objectives

The course is geared toward 4th-year medical students interested in pursuing residency training and a career in orthopedic surgery. 


Educational goals 

  1. Gain knowledge regarding the anatomy, pathophysiology, diagnosis, and treatment of diseases and conditions of the musculoskeletal system.  
  2. Comprehend the evaluation, medical management, operative technique, and post-operative care of orthopaedic patients.
  3. Learn the basics of three-dimensional surgical anatomy as it pertains to orthopaedic injuries.
  4. Learn the basics of reading and interpreting orthopaedic radiographs.
  5. Gain exposure to operative room scrubbing, surgical assisting, basic surgical skills


Functional goals

  1. Inpatient rounding, daily progress notes, team updates.  Weekend responsibilities for rounding will be at the discretion of the particular service assigned.
  2. Taking trauma call at ZSFG, the level 1 trauma center. Students assigned to ZSFG will take weeknight calls. Students assigned to UCSF and SFVA will share weekend calls.
  3. Participating in OR and clinic. The residents and fellows typically make the weekly schedule for clinic and operative coverage.  
  4. Be prepared for surgical cases by knowing about patient history, indications, anatomy, and basics principles of surgery.  The trainees and faculty can help identify appropriate sources for knowledge acquisition.
  5. Be prepared for clinic by reviewing patient charts prior to clinic.

Learning objectives
 

  1. The student will be able to perform a basic orthopaedic physical examination pertinent to the subspecialty assigned.
  2. The student will be able to read standard orthopaedic radiographs.
  3. The student will be able to analyze portions of the history and physical exam and deliver an appropriate differential diagnosis for certain pathologies associated with the service assigned.
  4. The student will be able to demonstrate appropriate professional behavior.


Method of evaluation
Rotating students are evaluated by the residents and faculty on their assigned service(s). The evaluation is based on performance during the rotation, including the ability to work as part of the clinical care team, quality of interactions with patients, colleagues, and interdisciplinary team members, knowledge acquisition, and professionalism.  

At UCSF, we understand that not all students will start our sub-internship with the same level of orthopaedic knowledge and/or experience.  We expect you to learn a great deal over the course of the rotation and hope that knowledge acquisition will translate to a greater understanding of orthopaedic management.

Orthopaedic Surgery Sub-specialties

Orthopaedic sub-specialties treat a range of conditions using universal diagnostic and operative principles. Below is an overview of each sub-specialty, including key information about rotations, faculty, locations, teaching conferences and common cases.

Arthritis and Joint Replacement, Arthroplasty (UCSF)

  • The Arthroplasty Service treats degenerative conditions of the adult hip and knee arthroplasty for idiopathic osteoarthritis to complex revision reconstructive surgeries due to periprosthetic joint infection, instability, deformity and dysplasia, rheumatologic conditions, osteonecrosis, implant wear, bone loss and bone defects.
  • Faculty: Dr. Thomas Barber, Dr. Jeff Barry, Dr. Stefano Bini, Dr. Erik Hansen, Dr. Derek Ward, Dr. Claudio Diaz
  • Trainees: R5, R2, and Fellows
  • Main locations: Mt. Zion (surgical cases), Orthopaedic Institute (clinics, occasional outpatient procedures), occasional cases at Parnassus
  • Teaching conference: Tuesday mornings – arthroplasty conference with rotating topics

Foot and Ankle (UCSF)

  • The Foot & Ankle Service treats a broad range of injuries and conditions, including sports injuries, fractures, arthritis, tendon disorders, diabetic foot, and deformities. Common cases include ankle fractures, ankle arthroscopy, ankle arthroplasty, ligament reconstruction, ankle and foot fusions, reconstruction and deformity correction.
  • Faculty: Dr. Kirstina Olson, Dr. Daniel Thuillier
  • Trainees: R2, R5
  • Main locations: Orthopaedic Institute, Mt. Zion
  • Teaching conference: Thursday at 6:45 a.m. – rotating topics on anatomy, biomechanics, arthritis, infections, injuries, and tendon disorders

Hand, Elbow and Peripheral Nerve (UCSF)

  • The Hand Service treats a wide range of conditions and injuries affecting the hand, wrist and elbow, including trauma and fractures, tendon injuries, sports related conditions, nerve disorders, vascular injuries, congenital disorders, degenerative disease, and tumors. The operative experience encompasses a broad spectrum of surgical techniques, including arthroscopic, arthroplasty, percutaneous, open, and microsurgical techniques.
  • Faculty: Dr. Nicole Schroeder, Dr. Igor Immerman, Dr. Nicolas Lee, Dr. Mattias Masem, Dr. Lauren Santiesteban, Dr. Lauren Shapiro, Dr. Gopal Lalchandani
  • Trainees: R5, R2, 1 fellow
  • Main locations: Orthopaedic Institute, Mt. Zion, Parnassus, Mission Bay
  • Teaching conference: Monday at 6:45 a.m. (Orthopaedic Institute)

Orthopaedic Oncology (UCSF)

  • The Orthopaedic Oncology Service treats soft tissue and bone tumors affecting the musculoskeletal system in both pediatric and adult populations. The most common cases include open biopsy, mass excisions, and limb reconstruction vs amputation.
  • Faculty: Dr. Rosanna Wustrack, Dr. Melissa Zimel, Dr. Kiauntee Murray
  • Trainees: UCSF Ortho R3, UCSF Fresno R2
  • Main locations: UCSF Mission Bay, UCSF Parnassus
  • Teaching conference: Thursday at 8 a.m. – Tumor Board and pre/post-op conference

Orthopaedic Trauma - University Service (UCSF)

  • The University Service provides a diverse rotation experience in orthopedic trauma that encompasses orthopedic emergency room and inpatient consultations, surgical fixation of acute fractures, and complex limb reconstruction of post-traumatic deformities, nonunions, osteomyelitis, and soft tissue defects.
  • Faculty: Dr. Saam Morshed, Dr. Utku Kandemir, Dr. Dave Shearer, Dr. Paul Toogood, Dr. Tony Ding
  • Trainees: R1, R3, R4, R5
  • Main locations: UCSF Parnassus, Mt. Zion, Orthopaedic Institute
  • Teaching conference: Friday at 7:30 a.m.

Orthopaedic Trauma (ZSFGH)

  • The Orthopaedic Trauma Service at ZSFGH is the level 1 trauma center for San Francisco and serves as a safety net hospital to the uninsured, underserved and indigent patient population. In addition to managing high acuity traumatic injuries, the orthopaedic trauma service provides both general orthopaedic and subspecialty care. The orthopaedic services at ZSFGH are divided into 2 teams based on subspecialties: the Gold Team for hand, sports, oncology, foot and ankle, and the Blue Team for pediatrics, spine, and arthroplasty services.
  • Faculty: Dr. Saam Morshed, Dr. Utku Kandemir, Dr. Dave Shearer, Dr. Paul Toogood, Dr. Tony Ding, Dr Ashraf El Naga, Dr David Gendelberg, Dr Mark Chu Xu
  • Trainees: R1, R2, R3, R4, R5
  • Main locations: Zuckerberg San Francisco General Hospital
  • Teaching conference: Friday at 7:30 a.m.

Pediatric Orthopaedics (BCHO & BCHSF)

  • The Pediatric Service rotation provides care at two sites, at Benioff Children's Hospital Oakland (BCHO) and San Francisco (BCHSF). They provide a comprehensive experience in the care and treatment of pediatric patients. Children's Hospital Oakland (CHO) is 1 of only 6 level 1 pediatric trauma centers in California, and sees a high volume of pediatric trauma cases each year. Additionally, the pediatric rotation provides a broad clinical experience across the spectrum of pediatric conditions: sports injuries, scoliosis, neuromuscular and congenital syndromes, hip conditions, growth disturbances and limb deformities.
  • Faculty:
    • Benioff Children’s Hospital Oakland: Dr. Nirav Pandya, Dr. Coleen Sabatini, Dr. Sanjeev Sabharwal, Dr. Ishaan Swarup, Dr. Jason Jagodzinski, Dr. Donald Kephart, Dr. Michael Chau
    • Benioff Children’s Hospital San Francisco: Dr. Mohammed Diab, Dr. Jaclyn Hill
  • Trainees: R2, R3, R4
  • Main locations: UCSF Benioff Children’s Hospital Oakland, UCSF Benioff Children’s Hospital San Francisco
  • Teaching conference: Varies

San Francisco Veterans Affairs (SFVA)

  • The VA Service rotation provides a comprehensive experience in the care and treatment of general orthopaedic conditions in the veteran population, including rotator cuff pathology, arthritic conditions of the shoulder, knee and hip, sports injuries, and fractures.
  • Faculty: Dr. Hubert Kim, Dr. Alfred Kuo, Dr. Alexis Dang, Dr. Alan Dang
  • Trainees: R5, R3
  • Main locations: SFVA
  • Teaching conference: Monday at 12 p.m. – indications and post-op review

Spine (UCSF)

  • Conditions treated: Disorders of the cervical, thoracic, and lumbosacral spine due to degenerative pathology, deformity, trauma, tumor, and infection.
  • Faculty:
    • Gold Team: Dr. Sigurd Berven, Dr. Alekos Theologis, Dr. Vedat Deviren
    • Blue Team: Dr. Lionel Metz, Dr. Bobby Tay, Dr. Shane Burch
  • Trainees: R2 (Gold), R3 (Blue), 3 fellows
  • Main locations: Parnassus, Mt. Zion
  • Teaching conference: Tuesday at 7 a.m. (Parnassus Millberry Union Orthopaedic Library)
    • All students must prepare a 15-minute presentation during their rotation.
  • Common cases: Cervical and lumbar decompression, spinal fusions (anterior and posterior approaches), instrumentation

Sports Medicine (UCSF)

  • The Sports Service rotation offers a broad multidisciplinary experience, collaborating with athletic trainers, primary care, physical therapy, and physiatry in the care of sports injuries in the adolescent and adult populations. Cases range across hip, knee and shoulder arthroscopic procedures, ligament and tendon repairs/reconstruction, and shoulder arthroplasty. There are additional options for medical students to get involved with sports team coverage during the weekends. Interested students should contact Dr. Lansdown about availability during their rotation.
  • Faculty: Dr. C. Benjamin Ma, Dr. Brian Feeley, Dr. Sara Edwards, Dr. Alan Zhang, Dr. Drew Lansdown, Dr. Elly Laroque, Dr. Nicolas Colyvas, Dr. Nirav Pandya, Dr. Stephanie Wong
  • Trainees: R4, R2, 3 fellows
  • Main locations: Orthopaedic Institute, Mt. Zion
  • Teaching conference: Monday at 5:30 p.m.
  • Other opportunities: Students may get involved with sports team coverage during weekends (contact Dr. Lansdown).