Yale Arthroplasty Fellowship Program Summary 2021

January 26, 2021

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00:00Greetings. This is a summary
00:05presentation regarding the Yale
00:07Arthroplasty Fellowship with an
00:09overview highlighting features related
00:11to the August 2020 two position.
00:13I'm doctor Rubin,
00:15associate professor and chief of the
00:17total joint service here at Yale.
00:21So, greetings from New Haven.
00:22This is the School of Medicine's
00:24Sterling Hall of Medicine,
00:25which is the home base of the
00:27medical library, the Deans Office.
00:29This is a quick view inside
00:31the historic medical library.
00:33It's a beautiful building.
00:35And each fall they decorate
00:37the book tree inside there.
00:39So in this presentation I want to go over.
00:42Some information about the yellow
00:44orthopedic surgery residency to
00:45familiarize you with our program.
00:47Of course,
00:47the division of Adult reconstruction
00:49here at Yale faculty activities within
00:51the division programs and initiatives
00:53that were working on fellowship
00:55benefits and responsibilities,
00:56and some summary points for consideration.
01:01So first about the residency,
01:03doctor Latanza is our new chair and Doctor.
01:06Sochi is the program director
01:08for the Orthopedic residency.
01:10We have quite a fantastic group of residents.
01:13We have 5 per year for the five
01:16years and two fellows. Currently.
01:18One is her spine surgery split
01:20with neurosurgery as well as
01:22one for orthopedic trauma.
01:24Our fellows are present or residents.
01:26I should say are hardworking,
01:28diverse, dynamic,
01:29outgoing and generally pretty happy.
01:31I think they.
01:32They really like the program and they
01:34contribute to this sort of high level of
01:36energy and accomplishment of our program.
01:38Residents rotate in the total joint
01:40services A13 and A5 as shown here in.
01:42The residents have a lab block for
01:44dedicated research in their 3,
01:45four and five year.
01:48Young Haven Hospital is kind
01:49of split into two locations.
01:51One is York Street campus.
01:53An one is the SRC campus.
01:55the York Street campus is the home
01:57base for the hospital network.
01:59It's the flagship hospital has
02:01the level one trauma center,
02:02Smilow Cancer Center,
02:03young Haven Children's Hospital
02:05and it's the home base.
02:06Accordingly for the orthopedic
02:08trauma program.
02:08Ortho oncology,
02:09Pediatrics and some spine in hand.
02:11Depending on the on call volume,
02:13residents to the ER consoles there in
02:15Stafford Hospital 24/7 is a resident room.
02:18Excellent cafeteria,
02:18Anna.
02:19Legendary set of food carts
02:20down the street on Cedar Street
02:22that are there year round.
02:23Just down the street is the same Rachels
02:25campus which was an independent hospital.
02:27That yell acquired a number of
02:28years ago and is now considered
02:30part of Yale New Haven Hospital
02:32over that side of town.
02:33We have the total joint service.
02:35The sports app are extremely service.
02:36The hands find foot and
02:38ankle services are all based.
02:39There are hip fracture program
02:41is based at this institution and
02:43we all participate as faculty in
02:45the hip fracture called.
02:46Which is a dedicated call
02:48pool just for that program.
02:50Mcgivney is the outpatient surgical center.
02:52We have 6 hours and a procedure suite there
02:55that's only for orthopedics and spine,
02:57and we do outpatient total joints there,
02:59amongst among other procedures like foot,
03:01sports,
03:02hand, etc.
03:04In total we have approximately 19
03:06full-time aips to do all the ER
03:08consoles at Saint Ray Fields and
03:10work closely with our program for
03:12case coverage in overnight coverage.
03:14The hospital itself was founded
03:16in 1826 with 13 beds and has
03:18grown significantly through the
03:20acquisition of other hospitals
03:22in the in the local region.
03:23We have 15141 beds at the
03:25two hospitals in New Haven,
03:27which can constitute a the big
03:29flagship element in the system,
03:31which has about almost 2600 beds.
03:33Young hit hospitals ranked and
03:35US news and World Report across
03:36multiple specialties,
03:37including for orthopedics,
03:38and we're very pleased about that.
03:40In terms of the size of the hospital,
03:42we rank is the 6th largest hospital in
03:44the country and as a health system,
03:46we're certainly in the top 10 as well.
03:50The health system looks something
03:51like this where it spans from left
03:54to right from Greenwich Hospital
03:55up to Bridgeport and Milford,
03:57which were connected Young Haven
03:59Hospital in the center and then
04:01towards the eastern end of the state is
04:03Lawrence of moral in Westerly Hospital.
04:05With this means is we have a
04:07very large network of clinics
04:09in hospitals and facilities,
04:10including urgent care partnerships.
04:12There's two helicopters that fly and
04:14all the complex trauma revision,
04:15joints, hip fracture type cases that
04:18need to be transferred or sent to us.
04:20Get downtown.
04:22Orthopedic practice is based in New Haven.
04:25As you see here we have offices in Milford,
04:28Guilford in the suburbs.
04:29This was a northaven practice site
04:32which was closed after Covid and we're
04:34opening an office here in the fall.
04:37Clinical sites in New Haven.
04:38This is the main young Haven Hospital campus.
04:40This is the SRC campus and they're
04:42just a few blocks away and we
04:44have our orthopedic office here
04:45at Yale Physicians Building.
04:47We have dedicated office space
04:49for faculty over here in grand
04:51rounds is held here on Cedar Street
04:53in the medical school complex.
04:55Our residents have trauma bone board
04:57every Wednesday morning and section
04:59specific conferences every Thursday
05:01Friday morning from 7 to 11 is dedicated
05:04academic time with morbid immortality,
05:05grand rounds, etc.
05:08Normally before Covid we had a
05:10Thursday morning conference.
05:11We're all together with our
05:12students residents pasm PTS.
05:14But of course,
05:15after covid,
05:15everything is on zoom like everywhere else.
05:18So currently we're on zoom and
05:20probably stay that way for the
05:22foreseeable future throughout the year,
05:24there's many education programs
05:25run by the residents,
05:26including Journal club, Sawbones Sessions,
05:28cadaver Labs, anatomy labs, etc.
05:31We try to have sawbones workshops
05:33periodically at least once or twice a year,
05:34and the past few years you've done,
05:36you can see here we did a total
05:39joint saw bone for hip and knee.
05:41And then recently we had the Depew
05:43team come through in the fall of
05:452020 with the mobile lab and we all
05:46masked up and went to the lab and
05:48our residents got to do hip and knee
05:50cases with computer assistance and
05:51fluoro guidance and other things that
05:53are new technologies were playing
05:54with so this is a view of us in the
05:56lab and so we continued even with
05:58their masks to have our education.
06:00Yellow Orthopedics is known for many things,
06:03one of which is the tip to apex distance
06:05with Mike Baumgardner and Dieter Lindskog,
06:08which is really set the bar
06:10for hip fracture management.
06:11Francisley runs orthopedic research
06:13program which is continuing to grow
06:15with a lot of really interesting
06:17projects and translation work.
06:18He's a very well funded researcher.
06:20John Grauers worked extensively publishing
06:22an ortho informatix and database research,
06:24as well as the dense classification
06:26scheme as shown here.
06:27And of course Dr. Kegan.
06:29I have published the direct anterior.
06:31Approach textbooks as shown there.
06:32So those are some of the
06:33things among many others
06:34that our program is known for.
06:36What about fun things to
06:37do in around New Haven?
06:39Of course, there's an annual
06:40ski trip with the residents and
06:41attendings that's on hold from Covid,
06:43but in the past it's been a
06:45lot of fun for a lot of people.
06:47Certainly working out as
06:48an orthopedic pastime.
06:48We called the orthopedic library,
06:50but you just have to be
06:51careful you don't overdo it,
06:52like one of our chief residents who
06:54used to be a former professional
06:56fitness model shown on the right.
06:58Hiking is very popular.
06:59The southeast coast of Connecticut
07:00is absolutely beautiful,
07:01and there's a lot of outdoor activities,
07:03waterfalls, lakes, coastal scenery,
07:04so that's really enjoyable
07:05and very easily accessible.
07:06But the thing that New Haven is
07:08known for more than it almost
07:10anything else is pizza.
07:11And of course,
07:12the claim to fame is Frank Pepe's.
07:14There's a lot of debate about modern
07:16versus bar pizza among a few others.
07:18There's some really wonderful
07:19restaurants all over the city.
07:20This is on the coast,
07:22which is called shell and bones.
07:23One of our favourites,
07:24and there's a Restaurant Week in the fall,
07:27so there's a lot to do,
07:28and there's a lot of pizza.
07:30Eat so it's it's good eating
07:32if you want to go,
07:33you know toe to toe with any
07:35other place in the country.
07:36USA TODAY has ranked Pepes and
07:38Sally's and monitoring the top 10
07:40to 11 and if you look at the far
07:42right we have five of the top 100
07:44pay places in the top 50 of that report.
07:47And so that's the famous white
07:49clam pizza on the bottom right of
07:51Pepes to show you the ovens there.
07:53Lots of activities include wineries
07:55around the state and breweries
07:56which have become kind of a
07:58really craft is kind of a boom of
08:00craft brewing and craft wineries.
08:01Alot of nice places to visit
08:02for picnics and family.
08:03Time is the football game.
08:05Every every fault they would yell
08:06bowl shown here with the Harvard Yale
08:08Game which is a every other year.
08:10Among other games that come through
08:11there and one of my favourites is the
08:13ice hockey rink over Ingalls Rink,
08:15shown here. It's a lot of fun.
08:17It's a it's a tight environment.
08:18Everyone is packed in there screaming
08:20and yelling and it's it's a lot of fun.
08:22You really right on the ice watching
08:24the players. Around New Haven.
08:26This many museums,
08:27the art Gallery and other places.
08:28There's three casinos within an hour
08:30of our locale theater and locally
08:32you can get to New York in about
08:35an hour and a half on the train.
08:362 hours to Boston,
08:37and certainly short trips to New Hampshire,
08:40Rhode Island, Vermont, etc.
08:41To enjoy New England.
08:43Resort casinos are very close by
08:45sort of dangerously close by,
08:46but offer a lot of fun as well
08:48as entertainment that come acts
08:50that come through performers and
08:52concerts and professional events,
08:53etc. So let's talk about the division
08:56of adult reconstruction for a moment.
08:58Our division is now staffed
09:00full time with my colleagues.
09:01Doctor Deering are soy,
09:03Jenna Bernstein, David Gibson, myself,
09:04Dan Wisnia and we have another full
09:07time faculty member who will be coming
09:10on board October 1st later this year.
09:12We also have emeritus faculty members.
09:14Chris Keggy enrich Pelcer and
09:16Joseph were senior members.
09:17It does a few days during the week in clinic,
09:21in the OR as well.
09:23We have three section piese in APR ends
09:25and we're looking to hire again for
09:27another as we expand pre covid arthroplasty.
09:30Case volume was about 1400
09:32cases as covid approach.
09:33We were looking at 1600 for that
09:35fiscal year and then we're going
09:38to continue growing from there.
09:40Announcement that Doctor O'Connor,
09:41who some of you may know from
09:43various activities in teaching,
09:44is departing yell in February
09:462021 to take on a new role in
09:48a national organization.
09:49So she's leaving our faculty at that time.
09:53So let's go inside the hospital bit
09:54SRC hazoor is one and two look like
09:56this as well as it may give me.
09:58All the hours are based on this.
10:00Model where we have 6 brand new
10:02hours that look exactly like this
10:04there about 660 square feet,
10:06highly equipped and highly adaptable
10:07for any type of orthopedic or spine
10:10case overhead videos and in the key
10:12rooms for capturing video and recording.
10:14We have a variety of technologies
10:16that are available,
10:17including our digital software,
10:19which is Ortho View striker NAV
10:21at SRC Stryker Mako which have two
10:23units at Milford Hospital which is
10:25now part of our teaching faculties
10:27or destinations and ciety based
10:29custom planning for PS I as well as
10:32custom implants such as conformist
10:34or try flanger are available.
10:36We want a number of words and we're
10:39pleased to share this with you.
10:40Best poster words at office in 2018.
10:42Top poster 2019 at the AOA.
10:45There's me at the August meeting
10:47couple years ago.
10:48Recently Dave Moho,
10:49one of our senior residences,
10:50worked diligently on orthopedic
10:52video theater.
10:52Ann has allowed us to win two
10:54awards in 2020 and 21.
10:56Looking at various topics
10:58surrounding the anterior approach.
11:00Our section is continued to grow.
11:02Our fellowship begins officially
11:03in August 1st,
11:042021 and then in October that
11:06year were planning to have another
11:08full time section faculty member
11:10who's contract is in progress.
11:12We're opening a new office North
11:14of New Haven and Wallingford,
11:16CT in fall and on going recruitment
11:18exists for another par section as
11:20well as full time faculty member at
11:22Greenwich Location as well as the West Haven,
11:25CT VAMC,
11:26which is mainly an arthroplasty
11:28service at that hospital.
11:30We're pleased in our residents have
11:32shown tremendous interest since
11:332017 and have pursued careers in
11:35arthroplasty at various fellowship programs,
11:37including Lenox Hill, UVANYU,
11:38Orthocarolina and Stanford.
11:39One of our chief residents is
11:42pursuing this fellowship next
11:43year at University of Ottawa,
11:45and we have two residents currently
11:48going through the match cycle.
11:50Our naugler arthroplasty fellow
11:52is doctor Eric McDonald,
11:53who did undergrad at UC Berkeley
11:55and mechanical engineering and
11:56study at UCSF for medical school,
11:58and stayed for orthopedic residency there.
12:00We look forward to welcoming document
12:03Donald in August as our first fellow.
12:06Section challenges I think you know
12:08anywhere else has similar challenges
12:10dealing with some of the government
12:12programs and insurance companies
12:13regarding bundles and regulations,
12:15and reimbursements and all
12:16these types of things.
12:18Impatient only rules,
12:19outpatient surgery pressures, etc.
12:20In our big health system,
12:22one of the biggest issues just simply
12:24coordinating all the logistics from
12:26the office to the OR to the discharge
12:29into rehab all those types of things.
12:31Trying to make it all electronic
12:33and seamless for the patient.
12:35We're working on standardizing updating
12:37our forms policies and procedures to
12:39make them all electronic and make it all
12:41flow well for that patients experience.
12:43We're now using electronic case
12:45booking forms and consent forms,
12:46and we have a new phone triage system
12:48that is matched to our very large
12:51practice to help manage the call volumes.
12:54Some of the section news were part
12:56of the AJRR as we are one of the
12:58largest contributors in the state of
13:00Connecticut across the whole yield system,
13:02we have maintained,
13:03achieved and maintained advanced
13:05certification for hip replacement as
13:07well as knee replaced in Witcher 2
13:09separate programs and our hospital at
13:10SRC actually has five Joint Commission
13:12programs for hip and knee replacement
13:14as well as total shoulder replacement,
13:16spine surgery and hip
13:17fracture and accordingly,
13:18when we got the hip fracture
13:20program certification,
13:20we became the only hospital in the US
13:23that has all five of those under one roof.
13:26And I think that really lends itself
13:28to the experience of the hospital
13:30as well as the experience of our
13:32residents and PA staff managing
13:34those cases along with us.
13:36Just a little introduction to some
13:38of our faculty on some of the
13:40things that they're working on.
13:42Dan Wisnia is assistant professor looking
13:44at School of Engineering projects and
13:46he has dual appointments for teaching
13:48at both parts of the University.
13:50Teachers are really nice undergrad slash
13:52graduate course in orthopedic implant design,
13:54which we've got a chance to teach at
13:56Dan has gotten funding for research
13:57through the YCC I grant program
13:59looking at computational modeling
14:01for treatment of femur prosthetic
14:03fractures and using a supercomputer
14:05to do some of those things.
14:08He's got four projects that have been
14:10accepted at the OS meeting this February,
14:12as shown here,
14:13so some really interesting work
14:15in progress across some of the
14:17department's that we have during
14:19our soy is assistant professor.
14:21He's AAA train in arthroplasty,
14:22trauma, and hip preservation.
14:24He does PCOS, hip Arthroscopy,
14:25as well as primary and complex
14:27during placement. As an interest.
14:29Of course in hip preservation,
14:31FA ion is working a number of projects
14:33associated with assessment of Cam
14:35lesions and predictive modeling,
14:37etc. After Gibson is a clinical
14:39associate professor of research.
14:41Interest had been published on
14:42negative pressure wound therapy
14:44for hip and knee replacement.
14:45Looking at race and outcomes following
14:47total joint surgery as well as
14:49disparities in orthopedics and looking
14:51at simultaneous bilateral surgeries,
14:52which Doctor Gibson has done hundreds
14:55or thousands of over the years.
14:57Now to Bernstein's assistant professor
14:59at one of our newest surgeons here
15:01started practice on September 1st, 2020.
15:03She's now been appointed as the Co.
15:05Director of the Yale Hip Fracture Program,
15:08as well as working with me on the
15:10orthopedic infection Workgroup.
15:11She has some projects in health
15:13and gender disparities,
15:14as well as an active membership in the
15:17Ocas women in Arthroplasty Committee.
15:20Myself,
15:20I've been working on looking at
15:21the value of fellowship and a
15:23few projects surrounding outcomes
15:25related to fellowship training,
15:26and I'm very involved Doctor Grauer in
15:29our research group which meets on Friday
15:31mornings with students and residents.
15:33We have two full time medical
15:34student researchers per year
15:36looking at large database research,
15:38nesquik national inpatient sample,
15:39national readmission database,
15:40the Open Payments database,
15:41the PNP,
15:42which is their narcotics database
15:43in the state of Connecticut.
15:45Pearl diver in Covid databases,
15:47and we're constantly plugging
15:48through some of those things to.
15:50Look at outcomes into various
15:53research questions.
15:54I'm very pleased to talk about the
15:56total hip book that we published on the
15:58direct anterior approach with Doctor Keggy.
16:00We launched that in 2016.
16:01Really it was received very well
16:03by the orthopedic community,
16:04for which I'm grateful and with
16:06Doctor Door who recently just passed,
16:07called it that Bible, he said,
16:09would be the Bible for anterior surgeons,
16:11and certainly believe that's the case.
16:13The publisher also believes that the case,
16:15and they've renewed the book,
16:16and we have a second edition
16:18forthcoming in late 2021.
16:20I published a hip replacement book for
16:22patients in June 2019 and a similar
16:24book looking at knee replacement is
16:26forthcoming from the Johns Hopkins Press.
16:29We have a number of active research
16:31protocols and this is just a sampling of
16:34the many things that are going on at Yale.
16:37There's sort of too many to list,
16:39but lots of interesting projects that
16:41are going on everything from database
16:43research to anesthesia research,
16:44infectious disease research, Nurse Navigator,
16:46an optimization, anemia protocols,
16:47navigation research, other things.
16:50Some of the programs.
16:51Of course,
16:52the highlights are the
16:53Nurse Navigator program.
16:54We had, foreigners,
16:55navigators,
16:55we keep expanding to a few more and
16:57it's expanding across various sites.
16:59We published our data on our initial
17:01pilot series in the Journal of
17:03Arthroplasty and submitting a larger
17:05series soon to the nursing Journal.
17:07Our nurses are very enthusiastic
17:08members of our division and really
17:09work very closely with our patients.
17:11So it's a model the fellow
17:13will be exposed to.
17:15Just as an example,
17:16our first 100 patients
17:17had outcomes shown here,
17:19whereby the historical cohort
17:20did not do quite as well
17:22as the optimization cohort with the nurse
17:25interventions really reduce the length
17:26of stay the ER visits at 30 or 90 days,
17:29and we had a preponderance of discharge
17:31to home, we publish that data.
17:33In fact, locally at Yell,
17:35there's an annual clinical redesign
17:37nursing submission in the hospital
17:38system for quality improvement.
17:39We won the award in 2019 for our projects.
17:43Another interesting project was the
17:45Mcgivney Advanced Surgery Center,
17:46which is our outpatient program.
17:48This was a former cancer treatment center
17:50that was repurposed from orthopedics under
17:52the direction of Mirror Connor and others,
17:54and now we have six hours
17:56in a procedure suite.
17:57It's right at our SRC campus in
18:00the patients can pull right in.
18:02There is valet parking.
18:03All the equipment is shared with
18:05ormeno or through a commonly shared an
18:07updated sterile supply in the basement,
18:09and just as an example in our first
18:12year I did 61 total cases over there.
18:14Including partial knees,
18:15total knees and total hips, and overall,
18:17we had two ER visits in one patient.
18:20No re admissions,
18:20SSI or reoperations.
18:21The second year is continued,
18:23and at this point I'm doing about
18:2530% of all of my cases outpatient and
18:27about 60% of my surgeries for all
18:29hip and knee or home the next day.
18:32So it's really had a pretty big impact
18:34on our our practice of arthoplasty yell,
18:37and we've worked with Doctor Jen Lilley
18:39who directs our Anesthesia Fellowship,
18:41nerve block protocols to publish some
18:44of our experiences here as shown.
18:47In the community we've been involved
18:49with the Arthritis Foundation
18:50as a nice partnership.
18:51Each year,
18:51we've sponsored or participated
18:53in the Jingle Bell Run,
18:54which is held locally to raise
18:55money for the Arthritis Foundation
18:57to benefit our patients for
18:58education and also to fund research.
19:00So this is our team in 2019,
19:02on a very cold day,
19:04we raised a good deal of money and
19:06we helped raise quite a bit of
19:09money for the Arthritis Foundation.
19:11Doctor Kelly has a long history
19:13with our program.
19:14It's worth mentioning the International
19:16Fund for Orthopedic education.
19:17Doctor Keg is still active with our
19:19group as a professor emeritus and does
19:22quite a bit of fund raising and development.
19:25His history is that the key orthopedic
19:27foundation was based in Waterbury, CT,
19:30an affiliate with Waterbury Hospital,
19:31but had a partnership with the
19:34University and help trained residents
19:35as well as US surgeon such as myself.
19:38In fact,
19:39in arthroplasty hosted numerous fellows,
19:40almost 250 from overseas.
19:42Especially in the Baltic nations.
19:45As well as from Russia,
19:46Vietnam etc.
19:47Over many many years.
19:48In addition,
19:48he traveled and did lectures and teaching
19:51all over the all over the world.
19:53And when he came down to yell,
19:55he moved that program down.
19:56Here he was awarded the 2019 Humanitarian
19:58Award from the connected with.
20:00Society is shown and some wonderful
20:02words displayed here about Doctor Kagan.
20:05His background.
20:07We've been pleased in the
20:08first couple of years since
20:10we restarted the program directly at
20:12Yale New Haven Hospital in partnership
20:14with the Yale University School of
20:16Medicine to host individuals from Turkey,
20:18China, Republic of Georgia,
20:19Vietnam, and Latvia. Our program.
20:20Of course, this year,
20:22during Covid is suspended,
20:23but we have great interest for
20:25from all over the world.
20:26To continue this and we look forward to
20:29hosting our international Fellows once again.
20:32This is an example for Doctor
20:34Huang from Vietnam.
20:35He and his wife were visiting with us
20:37and we're able to bring together art
20:39endings and spouses an residents and
20:42have a wonderful going away dinner to
20:44celebrate his three months with us.
20:46Present gifts and exchange
20:48ideas and and really,
20:49it's a nice exchange of of cultural
20:51traditions as well as surgical traditions,
20:53and I think it enriches
20:55the experience at Yale.
20:57I got the chance as a faculty member
20:59to travel to Lafia and meets with
21:01the Department to do some teaching
21:02there under the guise of this program
21:04and you can see I was able to take
21:06in some of the cultural elements
21:08of the city and travel with Doctor
21:10scooters around locally in the country
21:12to learn more about the country.
21:13In addition,
21:14I traveled to the National Congress
21:16of Costa Rica,
21:16North Peak Society in the fall
21:18of 2019 in similar manner,
21:19did some teaching and traveling,
21:21and it was really a wonderful experience.
21:22So we're looking to have our
21:24fellowship be funded for two weeks
21:26so that our fellow will be able to.
21:28Pick a destination that is focused in
21:31arthroplasty and travel in a fully
21:33funded manner for two weeks in the
21:35second half of the fellowship year.
21:37A brief word about the fellowship
21:39benefits here at Yale.
21:41This was updated recently,
21:42so these are the current pgy
21:446 salaries as shown in.
21:45This usually increases a few
21:46percentage points a year.
21:48Salary comparison certainly is more
21:49more value for the dollar in New Haven.
21:52Places like New York or Boston,
21:53so it's a little bit easier to live
21:55or rent with the family locally
21:57in our in our communities,
21:59which is I think is very attractive
22:01feature as well as coastline living.
22:03Other things.
22:03Vacation is listed as two to four
22:05weeks and we'll talk about that
22:07in a minute professionally.
22:08We can talk about it as needed.
22:11Housing is not provided.
22:12Moving expenses or not provided
22:13an just a word of note.
22:15Young Haven Hospital does specify that
22:17drug testing is required just as an FY I.
22:20Conference time is estimated for two
22:22weeks for travel to major meetings
22:24like the iOS or the office group.
22:27I usually teach at the ICR anti
22:29Hip course which is held each
22:31October as well as this industry
22:32funded fellowship training courses.
22:35Of course,
22:35we anticipate vacation for about 2 weeks,
22:38including the Yellow Medicine
22:39week of the holiday recess,
22:41as well as two weeks of funded travel.
22:43From the generosity of the Kimball
22:46Fund International orthopedics.
22:48Call will be expected in
22:49terms of the faculty member
22:51taking call in the hip fracture called Panel.
22:53The fellow will participate as a junior
22:55faculty member in that call panel as
22:57the year goes on and we're currently
22:59formulating a total joint call panel,
23:01much like we have a pediatric on call
23:03and spine panel and hand panel, etc.
23:05The volume of our cases really warrants
23:07this moving forward as we grow our
23:09faculty office in clinic will be
23:11targeted to AC Jimmy average of 1
23:13day per week with the faculty on the
23:15service and rounding is expected with
23:17the resident team during the week.
23:19A research they'll be involved in
23:21course with at least one project,
23:23and there's many,
23:24many things going on at our institution,
23:26so we expect to see participation
23:29at national level.
23:30Fellowship responsibilities will
23:31be teaching in our weekly Thursday
23:33morning conference that's the
23:35resident LED conference.
23:36We also will host the
23:38complex slash revision case.
23:39Conference will be fellow LED
23:41conference focused on the details
23:43of individual revision cases.
23:44There will be annual didactic lectures
23:46in the resident academic calendar to
23:48participate in surrounding arthroplasty.
23:50Monthly Arthroplasty,
23:51Fellowship Consortium,
23:51which we participate online with
23:53many other programs.
23:54There's certainly medical
23:55students and residents,
23:56and PA is rotating with
23:58us almost all the time.
24:00And then weekly conference participation
24:02at the main program with grand rounds
24:05and monthly Eminem academic appointment.
24:07Fellows are clinical instructors,
24:08orthopedic surgery at Yale School of
24:11Medicine will be appointed accordingly.
24:13So in summary,
24:14we have one fellowship program
24:16trainee per year at Yale and will
24:19complement the resident program,
24:21which has 25 residents.
24:22We will emphasize mentorship and
24:24professional development of that
24:26individual according to their own needs,
24:28will highlight the decision making
24:30process in total joint arthroplasty
24:32with critical thinking skills,
24:34especially focused on complex
24:35cases in revision cases.
24:37Individualized training will
24:38be accomplished with graduated
24:40responsibilities and called duties.
24:41To prepare the fellow for
24:43independent practice.
24:44And there will be a rapid
24:46transition towards that independent
24:47practice throughout the year.
24:48I think it will be a responsive
24:50and adaptive training experience,
24:51and we'll get to hear more from
24:53our new fellow next year who will
24:55provide some input on that as well.
24:58Just a word about case volumes or
25:00division currently is performing
25:01about 1600 cases per year at the
25:03main hospital Young Haven Hospital.
25:05In addition to that,
25:06separately we have 500 hip fracture
25:08cases per year that come through.
25:10We run the OR for that,
25:11almost on a daily basis.
25:13We're planning for approximately 1800
25:15to 2000 cases as of a year from now
25:17as we have the additional faculty
25:19member on board and COVID is resolved
25:21of fellow should expect to perform
25:235 to 600 cases with an estimate 15
25:26to 20% complex and revision work.
25:29In terms of our vendors for primary,
25:31hip and knee,
25:32we have contract with five vendors including
25:35Tip you Exact Smith and Nephew Stryker,
25:37and Zimmer.
25:37Conformance is also on this list.
25:39Revision and infection cases.
25:41We can basically pull implants from
25:43any company as needed,
25:44but we certainly work with those
25:46main 5 vendors and we update those
25:49contracts systemwide across our
25:50seven hospitals every two years.
25:52Our key focus areas are direct anterior
25:54approach with expert instruction.
25:56We also have a busy unit
25:58Unicompartmental program.
25:58Outpatient arthroplasty programs,
25:59which the fellow will participate in.
26:01We have a total joint Nurse Navigator
26:03program which is evolving and has
26:05come quite a long way which will
26:08benefit the education the fellow
26:09and the care of the patient.
26:11We have 15 to 20% of our cases
26:14are complex and revision joints.
26:15We deal with quite a number of
26:17infections and Perry prosthetic
26:19fractures and almost not a week
26:21goes by or we have more than.
26:23We don't have more than a few of these
26:25coming in almost a weekly basis exposure.
26:28Various technology,
26:29including PS.
26:29I custom implant navigation,
26:31robotics,
26:31etc will be incorporated as part of
26:33the experience and we have a very
26:36busy hip fracture program here,
26:37which is a certified program with
26:39more than 500 cases per year in
26:41outcomes that are tracked and numerous
26:44studies presented on those things.
26:46We have extensive academic and research
26:48opportunities and we have embraced the
26:50video option for fellowship interviews,
26:52even pre covid.
26:53And of course this year is all remote access.
26:56You know interviewing because of covid.
26:59And the unique feature as well to
27:01highlight before once again before
27:03we finish that we have a self funded
27:05experience for two weeks for arthroplasty,
27:07fell to designate a destination
27:08somewhere in the world that they
27:10can define based on their interests.
27:12It can be in Europe, in Africa and Asia, etc.
27:15South America.
27:15Wherever you'd like to go,
27:17you have to have a structured program,
27:19a mentorship and a mentor in that location,
27:21which will host Yuan will fund it.
27:24And we look forward to that being
27:25a really primary experience for
27:27our fellow and a really unique
27:29fellowship experience that I don't
27:31think to my knowledge is present.
27:32In any other fellowship in the
27:34United States at this time.
27:36Important note for the match guideline,
27:38the Fellowship candidates are prohibited
27:39from making any statements about
27:41the ranking process and we are not
27:42allowed to reach out after the fellowship.
27:44So we hope that you will ask the questions
27:47during the interview that can be answered.
27:49If there's any questions,
27:50please bring those up during your
27:51session and please see the Office Code
27:53of Conduct Sheet which outlines those.
27:55Of course I want to stop here and say
27:57thank you for reviewing our program.
27:59My contact information is presented here.
28:01If you need to reach me through
28:03email is probably the best bet
28:05or through my assistant.
28:06We wish everyone luck in the match
28:08and we thank you for taking the time
28:10to review this program and learn
28:12about our Earth Posse Fellowship.
28:13We're excited to share that information
28:15and look forward to meeting.
28:16Thank you.