Program overview

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.

Publications

• Sumner K, Grandizio LC, Gehrman MD, Graham J, Klena JC. Incidence and Reason for Readmission and Unscheduled Health Care Contact After Distal Radius Fracture. Hand (N Y). 2020;15(2):243-251. doi:10.1177/1558944718788687
• Gehrman M, Cornell M, Seeley M. Iatrogenic Hip Instability After Hip Arthroscopy: Is There a Role for Open Capsular Reconstruction?: A Case Report. JBJS Case Connect. 2019;9(2):e0091. doi:10.2106/JBJS.CC.18.00091
• Zhang H, Fanelli M, Adams C, Graham J, Seeley M.  The emerging trend of non-operative treatment in paediatric type I open forearm fractures.   Journal of Children’s Orthopaedics.  11:306-309 (2017).
• Grandizio LC, Zhang H, Dwyer CL, Goldberg SH, Klena JC. Opioid Versus Nonopioid Analgesia After Carpal Tunnel Release: A Randomized Prospective Study. HAND. March 29,2019. Published Online ahead of Print.
• Slotkin S, Thome A, Ricketts C, Georgiadis A, Cruz AI Jr, Seeley M. Anterior Knee Pain in Children and Adolescents: Overview and Management. J Knee Surg. 2018 May 31(5):392-398. doi: 10.1055/s-0038-1632376

Presentations

Podium

• Gehrman MD, Graham J, Goldberg SH. Botulinum Toxin A & B cause vasodilation, prevent thrombosis, & increase flap survival: A systematic review and meta-analysis of Controlled Animal Studies.American Society for Surgery of the Hand, 2018. Boston, Massachussetts.
• Zhang H, Fanelli M, Adams C, Graham J, Seeley M. Non-Operative Treatment in Pediatric Type I Open Forearm Fractures.  Eastern Orthopaedic Association Meeting.  Miami Beach, Florida (2017).
• Fanelli MG, Cush C, Zhang H, Wagner B, Young A, Maddineni B, Grandizio LC, and Cush G “Geographic Distribution of Foot and Ankle Orthopaedic Surgeons Throughout the United States.”  American Orthopaedic Foot and Ankle Society Meeting. Sep 2020 San Antonio, TX.
• Illing DA, Rocha DFB, Ricketts CA, Wang A, Horwitz DS. Hematoma block vs bier block: radiographic outcomes after closed reduction of distal radius fractures using different anesthesia techniques. American Society for Surgery of the Hand. Sep 2019, Las Vegas.
• Foster B, Friedenberg S, Grandizio LC, Klena K. Carpal Tunnel Syndrome Telephone Screening Questionnaire to Decrease Electrodiagnostic Study Utilization for Patients in an Integrated Healthcare System. American Society for Surgery of the Hand. Sep 2019, Las Vegas.

Poster

• Gehrman MD, Goldberg S, Graham J, Klena JC, Sharma J, Grandizio LC. The Ability of Upper-Extremity Surgeons to Assess Patient’s Functional Status.
  • American Society for Surgery of the Hand, 2020. San Antonio, Texas.
• Gehrman MD, Pavis E, Klena JC, Grandizio LC. Gender Differences Between Hand Surgery Fellowship Faculty and Fellows: An Analysis of Post-Graduate Training Programs.
  • Resident & Fellows Course at American Society for Surgery of the Hand, 2020. San Antonio Texas.
• Gehrman MD, Graham J, Klena JC, Grandizio LC. The Ability of Upper-Extremity Surgeons to Predict Patient’s Coping Skills.
  • Eastern Orthopaedic Association Meeting, 2018. Amelia Island, Florida.
• Gehrman MD, Levin JM, Noonan KJ, Towles JD, Tueting JL. Optimal Method for Rerouting the Extensor Pollicis Longus Tendon to Improve Thumb Abduction: A Cadaveric Analysis.
  • American Society for Surgery of the Hand, 2016. Austin, Texas.
• Fanelli MG, Sanchez D, Ehrlich B, Graham J, Seeley M. “Using Fracture Asymmetry as a Predictor in the Treatment of Pediatric Lateral Condyle Fractures.” 
  • International Pediatric Orthopaedic Symposium (IPOS) presented by POSNA and AAOS (December 2019).
• Nester, J; Torino, D; Seeley, M. Incidence of Reoperation Rate in Children and Adolescents after Primary ACL Reconstruction.
  • American Academy of Orthopaedic Surgeons Annual Meeting 2020.
  • Eastern Orthopaedic Association Annual Meeting 2019, Rapid Fire Presentation.
• Torino, D; Kolessar, D; Damsgaard, C. Investigating tibial component implant-cement failure in the Attune Total Knee Arthroplasty system.                  
  • Presented at OREF NYU Regional Research Symposium. 
• Chorney M, Sylvestre D, Seeley M. Medial Epicondyle Nonunions in Children: Case Report With Overview and Management. J Am Acad Orthop Surg Glob Res Rev. 2019;3(2):e046. Published 2019 Feb 13. doi:10.5435/JAAOSGlobal-D-18-00046
• Chorney, M, Damsgaard C. Wear Properties of Dual Modular THA Implants.
  • Presented at 2018 Susquehanna Adult Reconstruction Society Meeting; Harrisburg PA.
• Akoon A, Torino D, Sumner KA, Grandizio LC, Heimbach J, Graham J, Klena JC. Examining the Frequency and Size of Skin Tears Following Collagenase Injection for Dupuytren Contracture Related to Pre Manipulation Contracture Size and Time to Manipulation.
  • 2018 American Association for Surgery of the Hand Annual Meeting, Phoenix, AZ.
• Foster B, Graham J, Dwyer CL. Patient Preference Ranking Tool for Anesthesia Options in Elective Hand Surgery.
  • American Association for Surgery of the Hand Annual Meeting 2020.