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Program overview

Curriculum and didactics

The core of Geisinger’s Orthopaedic Residency Program is our unique preceptorship style approach to surgical training: As a resident, you will be paired one-on-one with attendings for three-month blocks. Since its inception in 1960, preceptorship teaching has fostered close supervision and graduated autonomy. This model allows the teaching staff to better evaluate and improve upon your ability, encouraging earlier autonomy in both the clinic and the operating room.

This level of teaching has successfully trained well-rounded, confident, capable surgeons with the ability and skill set to practice general orthopaedic surgery or to apply for highly competitive fellowships.

Outcomes

Our program has a long tradition of exceptional performance on the annual orthopaedic in-training examination. For the past 15 years, our residency program has consistently scored above the 95th percentile on our performance on the Orthopaedic In-Training Examination (OITE), and most recently the 99th percentile! We take pride in our curriculum and prepare you to excel in the fundamentals of orthopaedic knowledge and in the operating room.  

Curriculum program structure

PGY1

We emphasize early exposure to orthopaedics. As a PGY1, you’ll rotate within the orthopaedic department for six months, the maximum time allowed by the ACGME. This comprises a total of four-and-a-half years of pure orthopaedic rotations. The first six months of intern year are non-orthopaedic rotations, which include:

  • Trauma surgery
  • Plastic surgery
  • Emergency medicine
  • Radiology
  • Anesthesiology
  • Vascular surgery

The second half of your intern year is dedicated to junior orthopaedic rotations. These usually include trauma, upper extremity, spine, pediatrics and adult reconstruction.

PGY 2-5

After intern year, residents rotate throughout all the orthopaedic subspecialties. You are integral team members of each subspecialty service and serve as a key part of patient care. 

From PGY2 year through graduation, you’ll be paired with an attending on service for three-month blocks. Your schedule mimics that of your attending partner — typically two operative days and two clinic days per week. This model allows you to become proficient with preoperative evaluation and planning, postoperative care, assessment of outcomes and participate in continuity of care. In the OR, progressive surgical autonomy and independence are given to those residents who demonstrate they are capable of operating in a safe and efficient manner.

Clinical services

  • Adult reconstruction
  • Foot and ankle
  • General orthopaedics
  • Hand, wrist and microvascular
  • MSK oncology
  • Pediatric orthopaedics
  • Shoulder and elbow
  • Spine
  • Sports medicine & arthroscopy
  • Trauma

PGY 2 – PGY 5 sample rotation schedule

  • Monday: GMC clinic
  • Tuesday: GMC operating room
  • Wednesday: Outpatient clinic
  • Thursday: Outpatient surgery center/operating room
  • Friday: Half-day clinic, half-day research

Operative experience

We strongly believe that early hands-on supervised experience in the operating room is a driving factor to the success of future surgeons. On average, Geisinger orthopaedic residents log approximately 2,500 to 3,000 operative procedures by the end of residency.

You will pair one on one with attendings for three-month blocks, progressively working toward total patient care, surgical skills and fracture management. This allows us to produce compassionate, knowledgeable and technically competent orthopaedic surgeons.

Call schedule

From PGY2 (October – June) through PGY5, you’ll take orthopaedic call from home. Call covers all aspects of adult and pediatric trauma and care for all orthopaedic surgery inpatients. When not on call, you are free from clinical responsibilities. We believe the night float system employed by most programs constitutes a significant loss of educational time and a disengagement from clinical learning.

During the first three months as a PGY2 (July – September) you’ll take call with an upper-level backup. This allows you, as a junior resident, to learn the essentials of independent emergency orthopaedic care in preparation for taking call individually.

Starting in October of PGY2 year, solo call begins. PGY2 – PGY5 residents share call equally.

  • One attending, one resident
  • Monday – Thursday: 1/9 on average
  • Weekend: 1/4 on average

Didactics

Daily protected teaching time is a mainstay of our program. Our dedication to daily education has led to exceptional OITE scores, ranging from the 96th to 100th percentiles for the past five years. We also have the added benefit of a devoted orthopaedic skills lab, allowing for both sawbones and anatomic procedural development.

  • Senior resident directed review of the current Orthopaedic Knowledge Update: Tuesday – Thursday, 6:30 – 7 a.m.
  • Daily protected didactic conference for all orthopaedic residents: 7 – 8 a.m.
  • Monday morning trauma conference
  • Monthly Morbidity, Mortality and Management (M&M&M) conference (a Geisinger-only conference)
  • Anatomic specimen dissections; skills lab
    • Prepared by PGY1 residents as part of the fall curriculum and led by subspecialty staff, this conference includes extensile dissections to review relevant anatomy and describe the surgical approaches that are performed.
  • Orthopaedic Knowledge Update (OKU) review
  • Bioskills lab, alternate Fridays in the skills lab
    • Arthroscopy towers
    • Sawbones
    • Anatomic specimen
  • Journal club
    • The Journal of Bone & Joint Surgery review
    • Journal of the AAOS review
    • Multiple sub-specialty reviews

Conferences

We encourage our residents to take part in yearly national conferences to enhance knowledge, improve skills and be exposed to innovation withing our specialty. These courses are supported by the residency outside of each residents allocated annual CME benefits.

PGY2: Orthopaedic Trauma Association – Resident Course
PGY3: International Pediatric Orthopaedic Symposium
PGY4: Specialty conference of resident’s choice
PGY5: American Academy of Orthopaedic Surgeons Annual Meeting
PGY5: Miller Review Course for ABOS Step One Written Boards

Geisinger Musculoskeletal Institute Research Team

As a resident, you’ll be encouraged to take advantage of the tremendous research opportunities and research support offered through the devoted MSK research team. Assistance is available for developing ideas, obtaining IRB approval, pursuing funding, statistical analysis and submitting final papers to national meetings and peer-reviewed journals.

In addition to basic science and clinical research, the research team has been driving groundbreaking epidemiologic and outcomes-based research in the field of orthopaedic surgery. Research is further facilitated through the funding of three full-time research fellows in orthopaedic upper extremity research, orthopaedic trauma and adult reconstruction.

You’ll be encouraged to complete a junior project (case report or case series) and a senior project (cohort study or clinical trial). Generous financial support for resident travel to local and national presentations is provided from departmental funds and the office of Graduate Medical Education.

Additional research resources

  • An EMR pairing with Epic dating back nearly 20 years, providing extensive clinical data
  • A systemwide MyCode® genomics database with access to complete genomic sequencing of over 100,000 patients
  • Trauma database dating back to 2004
  • Standard collection of patient-reported outcome measures collected via OBERD platform in MSK clinics
  • Cost and utilization data available through Geisinger’s integrated health system and health plan

Key personnel

  • Chris Grandizio, DO, upper extremity research
  • Daniel Horwitz, MD, trauma research
  • Mark Seeley, MD, pediatric research

Additional MSKI research team

  • Kenneth Sams, senior research coordinator
  • Idorenyin F. Udoeyo, statistician
  • Sarah Richards, research coordinator
  • Emilee Barton, research coordinator
  • Daniel Hayes, research assistant
  • Erica Krebs, research assistant

Learn more about our research team.

2022 Publications

  • Grandizio LC, Choe LJ, Klena JC. A Comparison of histologic and intraoperative visual assessments of transverse carpal ligament during revision carpal tunnel release.The Journal of Hand Surgery (US). 2022; 47(9):P900.e1-900.e5. doi:https://doi.org/10.1016/j.jhsa.2021.07.030
  • Foster BK, Malarkey WM, Mettler AW, Volarich KT, Kahlon S, Hopkins DR, Udoeyo IF, Grandizio LC. Shoulder and elbow arthroplasty videos on YouTube: an analysis of video content and quality.Seminars in Arthroplasty: JSES. 2022; 32(2):211-217. doi:https://doi.org/10.1053/j.sart.2021.09.003.
  • Wongworawat MD, Incrocci M, Crumlish CF, Klena J. Effect of remote proctoring of the orthopaedic in-training examination on scores.JAAOS Global Research & Reviews. 2022 Feb;6(2).
  • Grandizio LC, Rocha DF, Foster BK, Udoeyo IF. Evaluation of a comprehensive telemedicine pathway for carpal tunnel syndrome: a comparison of virtual and in-person assessments.The Journal of Hand Surgery (US). 2022; 47(2):111-119.
  • Rae M , Rocha DF, Hayes DS, Haak M, Maniar H, Grandizio LC. Formal patient complaints and malpractice events involving orthopaedic spine surgeons: a ten-year analysis.Spine. 2022; 47(14):e521-526. doi: 10.1097/BRS.0000000000004272
  • Foster BK, Malarkey WM, Maurer TC, Rocha DFB, Udoeyo IF, Grandizio LC. Distal biceps tendon rupture videos on YouTube: an analysis of video content and quality.Journal of Hand Surgery GO. 2022; 4(1):3-7.
  • Grandizio LC. Warnick EP, Gehrman MD, Klena JC. The effect of salary compensation for time spent teaching in an orthopaedic residency program: an analysis of teaching performance reviews.JAAOS Global Research and Reviews. 2022; 6(1): e21.00307. doi: 10.5435/JAAOSGlobal-D-21-00307
  • Malarkey WM, Klena JC, Grandizio LC. Wrist arthrodesis for post-traumatic arthritis.Operative Techniques in Orthopaedics. 2022; 32(1):100949. doi:https://doi.org/10.1016/j.oto.2022.100949Jan 31:100949.
  • Gehrman MD, Grandizio LC. Elbow ulnar collateral ligament injuries in throwing athletes: diagnosis and management.Journal of Hand Surgery (US). 2022. 47(3): 266-273. doi:https://doi.org/10.1016/j.jhsa.2021.11.026
  • Grandizio L, Choe L, Follett L, Laychur A, Young A. The impact of self-efficacy on nonoperative treatment of atraumatic shoulder pain. Journal of Osteopathic Medicine. 2022;122(6):297-302. doi: https://doi.org/10.1515/jom-2021-0132
  • Grandizio LC, Boualam B, Shea P, Hoehn M, Cove C, Udoeyo IF, Dwyer CL, Klena JC. The reliability of the CTS-6 for examiners with varying levels of clinical experience.Journal of Hand Surgery (US). 2022; 47(6): 501-506. doi:https://doi.org/10.1016/j.jhsa.2022.01.024
  • Delma S, Ozdag Y, Baylor JL, Grandizio LC, Klena JC. A Comparison of acute versus chronic thumb ulnar collateral ligament surgery using primary suture anchor repair and local soft tissue advancement.Journal of Hand Surgery GO. 2022; 4(3):141-146.  doi:https://doi.org/10.1016/j.jhsg.2022.02.008
  • Ozdag Y, Luciani AM, Delma S, Baylor JL, Foster BK, Grandizio LC. Learning curve associated with operative treatment of terrible triad elbow fracture dislocations.Cureus. 2022;14(7): e27156. doi: 10.7759/cureus.27156
  • Nester JR, Ozdag Y, Hayes DS, Baylor JL, Pallis M, Grandizio LC. Center of rotation mismatch in total shoulder arthroplasty relative to surgeon experience.Seminars in Arthroplasty: JSES. 2022;32(4):707-714. doi:https://doi.org/10.1053/j.sart.2022.07.005.
  • Foster BK, Rocha DF, Hayes DS, Ozdag Y, Udoeyo IF, Grandizio LC. The impact of smoking on delayed osseous union after arthrodesis procedures in the hand and wrist.Journal of Hand Surgery (US). August 2022. doi:https://doi.org/10.1016/j.jhsa.2022.05.016
  • Grandizio LC, Mettler AW, Warnick EP, Delma S, Baylor JL, Ozdag Y, Klena JC. Intraoperative conversion from endoscopic to open carpal tunnel release: a systematic review and case series.The Journal of Hand Surgery (US). August 2022. doi:https://doi.org/10.1016/j.jhsa.2022.06.020
  • Ozdag Y, Foster BK, Grandizio LC. Pathologic periprosthetic fracture after radial head arthroplasty: a report of 2 cases.JBJS Case Connector. 2022; 12(3):e22.00107. doi: 10.2106/JBJS.CC.22.00107
  • Baylor JL, Nester JR, Olsen HP, Pallis M, Akoon A, Grandizio LC. Prevalence of amyloid deposition in patients undergoing surgical repair of traumatic distal biceps tendon ruptures.Journal of Hand Surgery GO. 2022; 4(6):344-347. doi:https://doi.org/10.1016/j.jhsg.2022.08.008
  • Foster BK, Hayes DS, Constantino J, Garsed JA, Baylor JL, Grandizio LC. Reporting bias in systematic reviews and meta-analyses related to the treatment of distal radius fractures: the presence of spin in the abstract. HAND. September 2022. doi:10.1177/15589447221120848
  • Luciani MA, Mayers Y, Warnick EP, Udoeyo IF, Klena JC, Grandizio LC. Trends in the management of fifth metacarpal neck fractures.The Journal of Hand Surgery (US). October 2022. doi:https://doi.org/10.1016/j.jhsa.2022.08.008
  • Foster BK, Baylor JL, Delma S, Ozdag Y, Hayes DS, Grandizio LC. The impact of cement mantle characteristics on early loosening in primary total elbow arthroplasty.The Journal of Hand Surgery (US). 2022; 47(12): 1146-1156. doi:https://doi.org/10.1016/j.jhsa.2022.07.020
  • Baylor JL, Torino DJ, Udoeyo I, Dwyer CL, Grandizio LC. Results of single-incision distal biceps tendon repair for early-career upper-extremity surgeons.JSES International. October 2022. doi:https://doi.org/10.1016/j.jseint.2022.09.013
  • Luciani AM, Baylor JL, Akoon A, Grandizio LC. Controversies in the management of bicondylar fractures of the distal humerus.The Journal of Hand Surgery (US). November 2022. doi:https://doi.org/10.1016/j.jhsa.2022.10.006
  • Grandizio LC, Barreto Rocha DF, Hayes D, Warnick EP, Doyle CM, Suk M, Klena JC, Horwitz DS. An analysis of formal patient complaints, risk, and malpractice events involving orthopedic trauma surgeons during a 10-year period.Orthopedics. November 2022. doi:https://doi.org/10.3928/01477447-20221129-05
  • Ozdag Y, Baylor J, Hayes D, Grandizio LC. Arthroscopic removal of the polyethylene glenoid component after total shoulder arthroplasty: a systematic review.Journal of Shoulder and Elbow Arthroplasty. December 2022. doi:https://doi.org/10.1177/24715492221142967