Review Detail

9.2 6 10
Florida August 14, 2007 20392
UF Health Gainesville Orthopaedic Residency
(Updated: November 30, 2013)
Overall rating
 
9.2
Staff Surgeons
 
10.0
Didactics/Teaching
 
9.0
Operating Experience
 
10.0
Clinical Experience
 
9.0
Research
 
9.0
Residents
 
10.0
Lifestyle
 
9.0
Location
 
8.0
Overall Experience
 
9.0

Program Review

Staff / Faculty / Chairman
Since the last update Dr. Scarborough has continued to add faculty.
Dr. Parvataneni has become a very busy joint surgeon who is a tremendous asset to the program. He has taken a very active role in our adult reconstruction educational curriculum.
Dr. McFadden has joined the trauma team giving us a total of 3 surgeons on the trauma service. This allows us to have 1-4 trauma rooms running every day during the week.
Dr Spiguel has joined as faculty and divides his surgical time between oncology and trauma.
Dr Blakemore has been hired to pediatric orthopaedic faculty, and will be starting January 2014. The department is also in the process of hiring at least one more pediatric orthopaedist within the next year. In the interim, the junior residents will continue to work with Dr.’s Frick and Stanton from Nemours Children’s Hospital.
Dr King (Shoulder and Elbow) has also joined faculty and divides his time between the VA and UF. At UF, he has a relatively general orthopaedic practice in which he does pediatric and adult trauma, knee and shoulder arthroscopy, and shoulder trauma and arthroplasty. At the VA, his practice will be focused on sports, shoulder (including arthroplasty), and elbow surgery.
Didactics / Teaching
We continue to have conference every morning from 6:45- 7:50. Conference starts with a review of the overnight trauma and then proceeds to a resident or attending led lecture/discussion. We are attempting to move away from teleconferencing and have recently been given a new lecture hall that can accommodate the entire department. We still receive an iPAD which is very helpful for journal clubs and reading for cases. The majority of conferences now have at least one attending from the specialty giving conference present to assist in discussion.
Outside of the month of November, we have ensured to have a monthly journal club dedicated to one subspecialty. In addition, the shoulder and elbow faculty hold bimonthly meetings on Monday afternoons where they review landmark articles. Within the last year, the adult reconstruction faculty has also started an arthroplasty journal club that is held every other month. Their journal club is composed of reviewing recent and landmark articles as well as the presentation of specific cases from each attending relevant to the topics.
Operating Experience
Without question, this is the strongest part of our program. Our rotations remain the same as from the previous posts. From the beginning of the residency we are encouraged to participate in the operating room. Interns are expected to be present for cases and assist. Beginning second year you begin to act as the primary surgeon on cases. On trauma, you are expected to take the lead role on most nails and ankle fractures with a chief resident or fellow assisting you. On our VA service as a second year you split the case load with the chief and are expected to be able to get through a simple TKA by the end of your rotation. You also continue to do trauma and some scopes.
The operative experience continues to grow throughout residency and by the time you are a chief on trauma as a PGY-4 you are frequently doing complex periarticular cases as the primary surgeon. During your chief rotation at the VA, you are expected to be able to perform complex revision arthroplasty cases.
We do have Trauma, Oncology, Hand, and Shoulder/Elbow fellows. Fortunately, these fellows historically have been knowledgeable, advanced technically, excellent instructors, and great to work with. They have served to only enhance the residents experience. I have found that the fellows will often actively take the role of attending in the OR and clinic, serving as an instructor, rather than interfering with our education. I have never had a fellow take a case from me that I was very interested in.
Clinic Experience
This experience is relatively unchanged from previous posts. We have become more accustomed to EPIC, but continue to find it less efficient than dictating notes. On most services you spend 1-2 days in clinic. Most services have PA’s or ARNP’s that assist in clinic and with answering patient phone calls. We continue to be able to cover games for UF athletics including running out of the tunnel with the team and being on the sidelines for football games.
Two years ago, our department started an Orthopaedic After-Hours clinic that is voluntarily staffed by PGY-3’s and older who are in good standing with the Clinical Competence Committee. This clinic is an ACGME-approved moonlighting experience in which residents receive $300 per week night and $400 for Friday night and Saturday afternoon clinics. The clinics are usually about 4 hours long.
Research Opportunities
There are many research opportunities available. The challenge is getting involved in the midst of one’s busy schedule of clinical activities, but most residents manage to do this. Each division with an associated fellowship has enough research activity for residents to get involved, and among the other divisions there is a wealth of clinical material and guidance to get a project started. The electronic medical record system has made data gathering for projects more straight forward as well. There has been a push for residents to get involved at an earlier stage, and there have been efforts to try and involve junior residents with active projects at an earlier stage. The department’s research division has research staff assigned to each division and this helps with the paperwork associated with IRBs and the like.
Residents
Each resident class comprises four residents, making up a total of 20 residents in the current batch of residents; a great group of people from diverse backgrounds and different parts of the country/world. The daily conferences and the fact that most of the residents are in one location translates to frequent interactions that encourage camaraderie. All the residents help each other when help is needed such as call exchanges are needed. This includes exchanging calls, covering OR and clinic days, or assisting with life outside of work. During the summer, fall, and winter, we all attempt to get together at least bi-weekly as a group to get to know the rotating medical students. We also tend to get together around the holidays. The residents who are on-call over Thanksgiving, Christmas, and New Years will usually get together. Residents with swimming pools will have cook-outs during the spring and summer. Saturday’s in the fall are frequently occupied by tailgating and watching college and professional football games together.
Lifestyle
Call: The night float system is used for night time in-house ER/Floor coverage from Sunday through Thursday night. It has been in place for 7+ years within the residency program and works very well. Two PGY 2s rotate on the trauma service together, and alternate amongst themselves to cover day time duties and night float. It works out to a total of 3 months of night float in their PGY 2 year. While this can occasionally be rather busy, these 2 trauma residents do not take weekend call while on the trauma service. It provides good continuity of care for the often challenging (medically and socially) trauma patients, permits duty hour compliance, and also frees up the other PGY 2s and the PGY3s to concentrate on the rotations that they are on during the week. The night float system is seen as “taking one for the team”, and is uniformly seen as a good solution where one’s good will is paid back by the succeeding class of residents. Chief resident call is home call. Considering that attending surgeon presence is mandatory in the OR for operative cases, the chief residents are called in to the hospital for appropriate indications.
ACE rotation: One of the strengths of the chief year is still a fixture in the rotation schedule for the PGY5 class. This time has been used by residents to rotate at other centers outside of the UF hospital system (up to four weeks) and otherwise to allow the residents to participate in activities of their choosing. Often there are surgical cases that welcome the participation of a senior resident and this most often where the PGY5 residents will end up.
Moonlighting opportunities: As mentioned in the previous post, there are 3 opportunities available to residents; OrthoCare clinic, VA Compensation and Pension clinic, and covering High School Football games. Some of the fee schedules have been adjusted since.
Healthcare: The implementation of the PPACA likely played a large role in the new health insurance plan (GatorCare Self insurance plan for UF and the UF College of Medicine). The new plan is still reasonable (there are now co-pays and deductibles which have to be met) but is not as good as the previous “Cadillac” plan the residents were given. Eye and dental plans are not a part of the insurance plan.
Location / Housing
Gainesville is a college town with a very reasonable cost of living.
A regional airport is within a 15 minute drive from the ‘downtown’ Gainesville, and within 30 minutes of most other major parts of town. Delta, US Air, United, American Airlines all have regional carriers that fly out of Gainesville. 3 other major airports with much better connectivity are within a 2 hour drive (Jacksonville, Orlando, Tampa). Natural sights are close by, and beaches are under 2 hours away (east and west).
Some residents own their houses, while others rent; either way housing is affordable. Traffic is not much of a problem most of the time. Around the late afternoon, traffic can be slightly backed up on a couple of the main arteries running away from the hospital, but this is only noticeable as one compares this to the light traffic everywhere else.

Gainesville is the size of a larger college town. This area is known for the accessibility to outdoor activities. The city is very biker and runner friendly. There are a number of trails that are excellent for exploration with beautiful views. There are several running and biking events held every year that attract a decent number of people. In addition, there are a number of natural springs with crystal clear water that provide opportunities to either cool-off in the summer or cave-dive. The area also has a number of areas with excellent fishing opportunities including streams, rivers, lakes, the Gulf of Mexico, and the Atlantic Ocean. Another popular activity in the summer is to go scalloping in the Gulf of Mexico off of Steinhatchee.
The area also has several golf courses, and as a resident, you can golf at the Mark Bostick Golf Course at the University of Florida. Some UF faculty and residents also enjoy hunting and using the skeet and target ranges around Gainesville. For those who have an interest in horses, Ocala (40 minutes south of Gainesville) is considered one of the horse breeding capitals of the country.
Obviously, University of Florida dominates the sporting events in Gainesville. It is very to survive without being a Gator fan, as we have recently had residents from Alabama, Auburn, Georgia, Vanderbilt, Kentucky, Louisville, Clemson, South Carolina, Colorado, Louisiana State University, Miami, and Baylor. Many of the faculty have season tickets, and at times are willing to give them away to the residents. All-in-all, obtaining tickets to the games is not difficult. For professional sports, the closest teams are the: Jacksonville Jaguars (about 1 ½ hours away), Tampa Bay Buccaneers, Lightning, and Rays (about 2 hours and change), and the Orlando Magic (about 2 hours and change).
Limitations
Foot/Ankle experience – 1-2 OR and 1.5 clinic day per week when on the dedicated Foot and Ankle Service.

Spine experience – Currently, there is only one operative spine faculty member. We have no spine trauma call

Peds experience – Currently involves PGY2 residents rotating in Orlando 4 days per week for a total of 13 weeks in their 2nd year. This will probably change after Dr. Blakemore becomes more established and the second pediatric faculty member is hired.

Research – Getting projects off the ground can be difficult; a combination of IRB roadblocks and the difficulty inherent to coordinating meetings with various staff members in the midst of a busy schedule. That said, with recent emphasis from faculty, junior residents are getting involved at an earlier stage and are further on in research that recently graduating residents were at a comparable PGY level.
Overall Rotation Experience / Conclusion
At the University of Florida, we have a relatively laid-back program. The attending physicians are all very approachable. Although we treat them with the utmost respect, the traditional hierarchy seen at other programs is not present. Previous residents have worked hard to earn the reputation of being one of the hardest working and most reliable groups in the hospital. The general surgery services have traditionally enjoyed having our interns on their services because of our work ethic, diligence, and commitment to patient care. A co-resident exemplifying anything less than this is considered to be unacceptable.
This program has followed the trend of most other programs in the country in that a majority of the graduates will perform a fellowship after graduation. The following is a breakdown of post-residency plans: 1 private practice general orthopaedist, 3 hand fellowships, 3 spine fellowships, 5 sports fellowships, 3 trauma fellowships, 1 oncology fellowship, and 2 adult reconstruction fellowships. All of the graduates note that the only reason they went on to do fellowships was to obtain advanced training to improve marketability.
The graduates of this program have a reputation for working in the community as very successful and well-respected private-practice surgeons. Former residents practice not only in all parts of Florida but also throughout the United States.

Qualification

I am a current resident of this program.
Date of Rotation
2009-2014
CM
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