Review Detail

by John Langland     August 12, 2007    
(Updated: December 12, 2011)
Overall rating 
Staff Surgeons 
Operating Experience 
Clinical Experience 
Overall Experience 

It's the mad real world in New Haven.

Program Review

Staff / Faculty / Chairman
There are a large number of both community and university attendings, but things are intelligently designed such that the residents work most with the faculty most interested in teaching. The Chairman and Program Director are both resident advocates.
Didactics / Teaching
Our attendings don't do much spoonfeeding here, but at the same time there's not a lot of yelling and screaming. The best didactic sessions are typically delivered by our Grand Rounds speakers, who come from all over the country and are chosen by the residents (we very rarely have a local GR speaker, and there are only 10 resident-delivered GR a year). Usually the speaker will deliver a resident talk immediately prior to the formal Grand Rounds. It gives us a unique chance to learn about hip arthroscopy from Marc Philippon or knee dislocations from Greg Fanelli, things that you would otherwise have to pay big bucks to get at a course.
Operating Experience
Broad and thorough, with perhaps a slight emphasis on trauma (ideal for residency, if you ask me - after all, when you're on call in the future you're going to be dealing with open ankles and not ACL's). Speaking of that, Yale is a busy Level I Trauma Center (not at Grady or Big County levels, but appropriate for the residency size), with a catchment area from NYC to Hartford to Providence to Boston. Most of the fractures, even the hips and ankles, are done by the 2 staff traumatologists, so you'll learn how to approach even a "simple" case with some rigor.

Hand is a complementary mix of bread-and-butter with one of the university attendings and complex trauma with the other, along with a mix of other stuff done by the private guys.

Arthroplasty is not lacking for volume, with plenty of primary joints and few revisions, which is a good thing for residency. With Dr. Keggi's influence there is a bias towards the recently fashionable direct anterior approach for total hips (which he's been doing for decades).

Spine is definitely biased towards conservative indications and wide-open old school exposures, which is probably not the best thing for a fellowship but makes getting involved as a resident much easier. Speaking of fellows, there is one spine fellow, but he definitely doesn't get in the way, but rather helps out filling gaps in case coverage.

The peds experience runs the full gamut from fractures to scoli to congenital stuff. You'll never feel uncomfortable reducing and pinning a supracondylar in the middle of the night after graduating this program.

Foot so far is a one-attending experience (although most foot trauma is handled by the trauma faculty), and thankfully the podiatrists take ALL the rotten diabetic feet.

Sports is solid but could use more volume. That said, if you're going to do Sports you're going to do a fellowship, and your facility with the scope is not what's going to get you through that first night of attending call. We recently added a new shoulder attending, although he will be getting a fellow shortly, so I think that is a net neutral for the resident experience.

While we have twice as many oncology faculty as most programs, there are only so many tumors to go around, so I don't think we have twice the volume of the average program.

The "walk you through the case" dynamic is much more common than the "attending not scrubbed" dynamic, which is usually for the better, particularly since double-scrubbing is rare.
Clinic Experience
About 50/50 between attending office hours and resident-run clinics for the underinsured. The attendings whose office hours are covered are all keen on teaching, and the resident clinics are an excellent opportunity to work independently and exercise judgment.
Research Opportunities
There is plenty of time allotted for research: 10 weeks each in the PGY3, PGY4, and PGY5 years. In keeping with the spirit of the program, the decision of what and how much to do is the resident's to make. There is considerable faculty support, but relatively few canned projects to be dumped in the resident's lap. That said, the faculty is involved in writing review articles and book chapters too, so there are plenty of freebie writing projects to pad your CV and boost fellowship chances.
Nowhere is the camaraderie better than at Yale Ortho. Residents go from working closely together in the hospital during the day to hanging out together in the evening. About half the residents are married, so the camaraderie is different here than at a place like Miami; that said, the married residents are just as likely to hang out.
Yale is a unique combination of a gentleman's program and a blue collar program. The Chairman and the Program Director, with their bow ties and approachability, represent the "gentleman" side, while running from a polytrauma to a kid with a both-bone forearm fracture in the ED in the middle of the night represents the "blue collar" side. Another distinguishing aspect of the program is that PGY2's are eased into the consult resident role rather than being thrown into the fire right away. This makes the PGY3 year the most intense of the residency, although by this point the added experience and knowledge means that the increased level of autonomy and responsibility is more manageable. Our chiefs also work hard, with plenty of supervisory responsibilities; this is definitely not a program where chiefs come in only to operate. That means there's not much dumping on the juniors, and it also prepares the chiefs for the real world.

Hours are not an issue, but more importantly the hours worked are spent doing real work of educational value, not ridiculous scut to please attendings. It's easy and affordable to get the most out of New Haven, too (see below).
Location / Housing
New Haven is a funny combination of Ivy League and ghetto. There's certainly plenty of crime that happens in certain areas and times, but avoiding that shouldn't be an issue for anyone who has lived in an urban environment before. The stipend here is almost as high as what they pay in NYC, but your dollars go a lot farther here, so the standard of living is high. It's cheap to go out to bars and restaurants, and houses/condos are affordable too. You can even rent on the beach if you like.
If you're the kind of learner who needs someone yelling at you (or even coaxing you in a soft voice), you're better off looking elsewhere (believe me, there are plenty of programs like that). And if you learn best in a classroom environment/lecture format, this is probably not the place for you. But if you're a more experiential learner and a self-starter, you will feel comfortable and liberated here to really get the most out of the residency experience. And after all, you're going to rely on those means to keep yourself current throughout your orthopedic career, so there's no better time to start than in residency.
Overall Rotation Experience / Conclusion
I've been thrilled with my experience here at Yale. I would rank it #1 again without hesitation.


I am a current resident of this program.
Date of Rotation
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