Visiting Medical Students: Clerkship Description

Watch our residency video to get a glimpse of our dynamic training program and the collaborative, supportive culture that makes our team truly exceptional. Experience hands-on learning in Orthopaedic Surgery with UCSF’s Visiting Medical Student Program. Sharpen your skills in musculoskeletal anatomy, patient care, and surgical techniques while working alongside top experts in trauma, sports, spine, and more. Apply now for a unique educational opportunity at San Francisco General Hospital and Parnassus Campus.

Clerkship Description

Overview

Students will be assigned to one of the many “services” within the Department of Orthopaedics umbrella for the duration of the 4-week rotation. 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.  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 then both nonoperative and operative treatment.  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. 


Orthopaedic Surgery Sub-specialties

Though the various specialties treat different conditions, the basic diagnostic and operative principles are universal. Orthopaedic sub-specialties with the specific conditions treated are listed below:

  • Arthroplasty - arthritic conditions of the hip and knee including primary and revision hip and knee replacements.
  • Orthopaedic Trauma (University service @ Mt. Zion/Parnassus) – traumatic MSK injuries including complex fractures, dislocations of the extremities and pelvis
  • Sports Medicine – athletic and non-athletic injuries and conditions in patients of all ages to include rotator cuff tears, shoulder arthritis and instability, meniscus and cartilage injuries of the knee, ACL and other ligament tears and many others. 
  • Spine – Conditions of the cervical, thoracic and lumbo-sacral spine including disorders due to degenerative pathology, deformity, trauma, tumor, and infection. The surgeries on the spine service encompass minimally invasive and open surgical approaches to the spine, including anterior and posterior approaches.
  • Pediatric Orthopaedics – MSK conditions and injuries in neonates, children and adolescents. Cover all areas of the body and conditions from broken bones to developmental deformities to manifestations of conditions such as cerebral palsy to scoliosis
  • Hand, Elbow and Upper Extremity – Injuries of the hand, wrist and elbow including trauma, nerve injuries, degenerative conditions, and congenital conditions.
  • Foot and Ankle – injuries and disorders of the foot and ankle – sports injuries, arthritis, tendon injuries/dysfunction
  • Orthopaedic Oncology – benign and malignant tumors of the soft tissues and bones of the extremities and pelvis


Diversity of Clinical Sites

In conjunction with assigned service and subspecialty, students are assigned to specific clinical sites: UCSF (which encompasses Parnassus, Mission Bay, the Orthopaedic Institute, and Mt. Zion), Zuckerberg San Francisco General Hospital (ZSFGH), the Children’s Hospital of Oakland (CHO), or the Veteran’s Affair San Francisco (VA). 

  • On the UCSF rotation, you will spend the four-week rotation with one of the many orthopaedic surgery subspecialty services (Arthroplasty, Spine, Sports, University Service (Parnassus Trauma), Pediatrics,  Hand, Ortho Oncology, or Foot & Ankle.) 
  • If assigned to ZSFGH, you will be on either the Blue (Trauma/Spine) or Gold (Trauma/Hand/Foot/Sports) services. 
  • The CHO rotation is based in Oakland and you will be on the Pediatric Ortho service for the entire month. 
  • The VA rotation is based at the San Francisco VA Campus. 


Goals

The course is geared toward 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 theevaluation, 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. Call will be at ZSFGH, the level 1 trauma center. Students assigned to ZSFGH will take weeknight calls. Students assigned to UCSF and VA 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. 

Objectives

By the end of your 4-week rotation:

  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, level of interest in acquiring knowledge (as demonstrated during conference, clinic and the operating room), 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 with translate to a great understanding of orthopaedic management. 


How to apply


UCSF will only be accepting applications submitted on-line through the Association of American Medical Colleges (AAMC) Visiting Student Application Service (VSAS), available at https://www.aamc.org/students/medstudents/vsas/. We currently do not accept International or Canadian medical students.

Applications will be processed beginning February 3, 2025, and decisions will begin being made in Mid-April.

If you have any questions, feel free to reach out to dan.peterson@ucsf.edu


Rotation Specific Information

Arthroplasty

Faculty: Drs. Thomas Barber, Jeff Barry  Stefano Bini, Erik Hansen, Derek Ward, and Claudio Diaz

Trainees: R5, R2 + Fellows

Main locations: Mt. Zion (surgical cases), OI (clinics, occasional outpatient procedures), occasional cases at Parnassus

Weekly Schedule:

- rounding daily (M,Tu,Th,Fri) before other clinical duties

- Clinics and OR running most days. 

- Wednesday noon preoperative conference (go over cases and imaging for the following week)

Teaching Conference: 

- Tues AM arthroplasty conference with rotating topic schedule

Common Cases: total knee and total hip arthroplasties, revision hips and knees, hip fractures


Orthopedic Oncology

Faculty: Rosanna Wustrack, MD, Melissa Zimel, MD, Kiauntee Murray MD

Trainees: UCSF Ortho R3, UCSF Fresno R2

Main Locations: UCSF Mission Bay Hospital, UCSF Moffitt-Long Hospital

Weekly Clinical Schedule

- rounding daily (M,Tu,Th,Fri) before other clinical duties

- Clinics and OR running most days. 

- Thursday AM Tumor Board at MB Conway Building

Teaching Conference:

- Thursday AM, didactics, preoperative and postoperative conference after Tumor Board

Common Cases: Open Biopsy of mass, Benign and Malignant Mass Excisions, Limb Reconstruction (Proximal Femoral Replacement, etc)


Foot & Ankle

Faculty: Dr. Kirsti Olson and Dr. Dan Thuillier 

Trainees: R2 and R5

Main locations: Clinic at the OI, OR at the OI and Mt. Zion. Smaller outpatient cases are done at the OI, whereas larger foot fusions or ankle replacements are done at Mt. Zion.

Weekly Schedule:

- Monday- OR at MZ(Dr. Olson) or Clinic at the OI (Dr. Chen) 

- Tuesday- Pre-op conference at 6:45AM followed by OR at the OI (Dr. Thuillier)

- Wednesday PM clinic w Dr. Olson at OI

- Thursday- OR at the OI (Dr. Olson) or Clinic at the OI (Dr. Thuillier) 

- Friday- OR at MZ (Dr. Thuillier) or OR at OI with Dr. Chen 

Teaching Conferences

Foot and ankle teaching is conducted on Thursday mornings at 6:45 AM and will rotate on the following topics:

- Anatomy and foot biomechanics

- Disorders of the first ray (hallux valgus, hallux rigidus)

- Diabetic foot and infections of the foot

- Arthritis of the foot and ankle

- Acute and chronic ankle injuries

- Tendon disorders (posterior tibial tendon dysfunction and flat foot)

- Neurologic disorders of the foot and ankle

Common Cases: ankle fractures, ankle and foot fusions, achilles tendon repairs, ankle arthroscopy and ligament reconstruction, total ankle replacements, and bunion corrections.


Sports Medicine

Faculty: Drs. Benjamin Ma, Brian Feeley, Sara Edwards, Alan Zhang, Drew Lansdown, Elly Laroque, Nicolas Colyvas, Nirav Pandya, Stephanie Wong

Trainees: R4, R2, 3 fellows.

Main Location:  The primary clinical location is at the Orthopaedic Institute. Surgery is either at the OI or Mt. Zion.

Weekly Schedule:

Monday - Clinic or OR at the OI, 530 pm - evening indications conference or didactics

Tuesday - Clinic or OR at the OI or Mt Zion

Wednesday - Grand rounds and didactics, then Clinic or OR at the OI

Thursday - Clinic or OR at the OI

Friday - Clinic or OR at the OI

There are 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.

Common cases: shoulder arthroscopy, knee arthroscopy, rotator cuff repair, meniscus debridement, ACL reconstruction, shoulder arthroplasty


Hand, Elbow and Upper Extremity

Faculty: Nikki Schroeder, Igor Immerman, Nicolas Lee, Matt Masem, Lauren Santiesteban, Lauren Shapiro, Gopal Lalchandani

Trainees: R5 and R2, 1 fellow

Main Location:  The primary clinical location is at the Orthopaedic Institute. Surgery is typically at the OI or Mt. Zion.  Other locations include Parnassus and Mission Bay (pediatric or tumor cases)

Weekly Schedule:

Monday – Clinic or OR at OI

Tuesday - OR at the OI or Mt. Zion

Wednesday - Grand rounds and didactics, then OR at various locations 

Thursday - Clinic or OR 

Friday – Indications Conference, 645sm at OI, Clinic or OR 

Teaching Conference:

Monday at 6:45 AM at OI Hand POD, 2nd Fl

Common cases: carpal and cubital tunnel release, trigger finger, distal radius fractures, mass excisions, tendon repairs, elbow fractures, finger fractures


Ortho University Service – Parnassus/Mt Zion

A diverse rotation experience in orthopedic trauma that encompasses orthopedic emergency room/inpatient consultations, surgical fixation of fractures, and surgical repair/osteotomy and reconstruction of complex nonunion/deformity. The location site also provides possible exposure to other inpatient sub-specialities that include hip/knee arthroplasty, spine, oncology, foot/ankle, shoulder arthroplasty. 

Faculty: Drs. Morshed, Kandemir, Shearer, Toogood, Ding

Trainees: R1, R3, R4 and R5 resident

Main Location: UCSF Parnassus and Mt. Zion

Weekly Schedule:

M- Rounding then OR/orthopedic consultation

Tu- Rounding then OR/orthopedic consultation

Wed- Rounding then education then OR/orthopedic consultation

Thu- Rounding then OR/orthopedic consultation

Fri- Rounding, Trauma conference, then OR/orthopedic consultation

Common cases: Open reduction internal fixation of hip/femur/tibia/humerus. Intramedullary fixation of hip/femur/tibia. Repair/bone grafting of nonunion (e.g. Masquelet, bone transport)


Spine

The UCSF Orthopaedic Spine service treats a wide variety of spine disorders ranging from spinal stenosis through complex deformity correction. As a sub-I, you will be an integral part of the team and will have the opportunity to work closely with residents, fellows, and attendings in the OR, clinic, and wards. This is a busy service often with complicated patients, and you will get the chance to see and do a great deal. Active participation and initiative are highly encouraged

Faculty:

Gold Team: Drs. Sigurd Berven, Alekos Theologis, Vedat Deviren, 

Blue Team: Drs. Lionel Metz, Bobby Tay, Shane Burch 

Trainees: R2 (gold) and R3 (blue) resident, 3 fellows

Main Location: Parnassus and Mt. Zion

Weekly Schedule:

M- 6AM Rounds on 7L, 7AM Indications conference, 8AM OR or Clinic at Parnassus Campus

Tu- 6AM Rounds on 7L, 7AM Teaching Conference in Orthopaedic Library (MU301), 8AM OR or Clinic at Parnassus Campus

Wed- 6:30AM-11AM Orthopaedic Department Teaching Program including Grand Rounds and Basic Science.  Genentech Hall, Byers Auditorium.  Mission Bay Campus. 

Thu- 6AM rounds on 7L, then OR or Clinic at Parnassus Campus

Fri- 6Am Rounds on 7L then OR or Clinic at Parnassus Campus.

            * All students will attend at least 1 full day of clinic per week during the rotation.

Teaching Conference: 

- Tuesday 7 AM in Parnassus Millberry Union Orthopaedic Library (MU301)

* All students will prepare a 15 min presentation to be given on the second Tuesday of their rotation.  Topics will be assigned by the senior resident on the service.

Common Cases: Decompressive surgeries in the cervical and lumbar spine, Spinal Fusions including anterior and posterior approaches to the spine for decompression and instrumentation.


Pediatric Orthpaedics at BCHO (Oakland)

This rotation provides a comprehensive experience in the care and treatment of pediatric patients. 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 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: Drs. Nirav Pandya, Ishaan Swarup, Coleen Sabatini, Sanjeev Sabharwal, Jason Jagodzinski, Donald Kephart, Michael Chau 

Trainees: UCSF R2, R3

Main Locations: UCSF Children’s Hospital Oakland 

Weekly Schedule: 

Teaching Conference:

Common Cases: club foot (Sabatini), limb deformity (Sabharwal), hip dysplasia (Swarup), peds spine (Swarup, Metz), cerebral palsy (Jagodzinski, Kephart), sports injuries (Pandya, Chau)


Pediatric Orthpaedics at BCHSF (San Franicsco)

Faculty: Dr. Mohammed Diab, Dr. Jaclyn Hill 

Trainees: UCSF R4

Main Locations: UCSF Benioff at Mission Bay 

Weekly Schedule:

Common Cases: Supracondylar humerus fracture closed reduction percutaneous pinning, Posterior spinal fusion for adolescent idiopathic scoliosis, Periacetabular osteotomy / varus derotational osteotomy for hip dysplasia, flexible nailing for both bone forearm fractures/tibia fractures/femur fractures, hip spica cast application for femur fractures


ZSFG (Zuckerberg San Francisco General)

Ortho Trauma – Gold Team

This service covers Level I orthopaedic trauma at SFGH as well as elective ortho sports, hand and foot consults/surgeries. 

Faculty:

-Trauma: Dr. Utku Kandemir, Dr. Dave Shearer, Dr. Saam Morshed, Dr. Anthony Ding 

- Hand: Dr. Nicolas Lee, Dr Anthony Ding, Dr. Nicole Schroeder

- Foot: Dr. Dave Shearer, Dr. Charles Parks (podiatrist)

- Sports: Dr. Michael Davies

Trainees: R5 (chief), R4 (hand-focused resident), R3, R2, R1

Main Locations: ZSFGH 

Weekly Schedule:

Rounds at ~0600 every morning (contact chief resident for exact time), Consult review and table rounds at 0645 every morning except Wednesday AM on the 1st floor of Pride Hall, STF room

Monday: 730am OR all day

Tues: 730am Pre-op/postop conference, 9am Hand clinic 

Wed: 630 am Grand rounds/teaching in Mission Bay; PM clinic (Shearer, Ding)

Thurs: 730am OR all day

Friday: 730am Trauma teaching conference, 9am Hand OR or clinic with Drs. Morshed, Kandemir

Teaching Conference: 

Hand teaching conference on Tuesday at 4:00PM after clinic

Trauma teaching conference on Friday at 7:30AM 

These conferences have a large didactic component as well as hand on learning in the Surgical Training Facility with sawbone labs and wet cadaveric labs. At the end of your rotation, you will be expected to give a 10 minute case presentation during subspecialty conference.

Common Cases: Cases are quite diverse and range from hip fracture fixation, complex pelvic ring/acetabular surgery, ACL reconstruction, meniscus debridement, any and all hand and foot surgeries

Ortho Trauma – Blue Team

This service covers Level I orthopaedic trauma at SFGH as well as elective arthroplasty and spine surgery. 

Faculty: Dr. Meir Marmor, Dr. Paul Toogood, Dr. Ashraf El Naga, Dr. David Gendelberg, Dr. Mark Xu, Dr. Kudret Usmani 

Trainees: R5 (chief), R3, R2, R1

Main Location: ZSFGH

Weekly Schedule:

Mon: ~6am rounds, 6:45am fracture conference, 7:00am table rounds, 7:30am pre/post-op conference, 9am-end of day 3M clinic (Arthroplasty/Trauma) 

Tues: ~6am rounds, 6:45am fracture conference, 7:00am table rounds, 7:30am-end of day OR (Arthroplasty, spine, trauma cases)

Wed: ~6am rounds, 6:45am fracture conference, 7:00am table rounds, 9am-end of day OR (Arthroplasty, spine, trauma cases)

Thurs: ~6am rounds, 6:45am fracture conference, 7:00am table rounds, 9am- end of day Trauma/Spine 3M clinic

Fri: ~6am rounds, 6:45am fracture conference, 7:00am table rounds, 7:30-end of day OR (trauma cases)

Teaching Conference: 

Trauma teaching conference on Thursday at 7:30AM 

These conferences have a large didactic component as well as hand on learning in the Surgical Training Facility with sawbone labs and wet cadaveric labs. At the end of your rotation, you will be expected to give a 10 minute case presentation during subspecialty conference.

Common Cases: total knee/total hip Arthroplasty, hip fractures, ankle fractures, tibia/femur fractures, septic joint incision and debridement, spine surgeries (mostly trauma)


San Francisco Veterans Affairs (SFVA)

This rotation provides a comprehensive experience in the care and treatment of general orthopaedic patients in the VA population. 

Faculty: Drs. Hubert Kim, Alfred Kuo, Alexis Dang, Alan Dang, 

Trainees: R5 (chief), R3 

Main Locations: SFVA 

Weekly Schedule:

            M: Rounding, then 7:30 AM OR; 12:00PM preoperative and postoperative conference; PM clinic

            Tues: Rounding, then OR

            W: PM Fracture clinic

            Th: Rounding, then OR
            Fri: Rounding, then OR

Common Casesshoulder and knee scopes, primary and revision arthroplasty, foot and ankle, as well as trauma cases.

###