Objectives of Clinical Fellowship in Paediatric Orthopaedics
The division of Paediatric Orthopaedics at McGill University includes two hospitals:
1. The Montreal Children Hospital
This is an integral part of the MUHC (McGill University Health Science Centre). This 240 acute care hospital is a state of the art institution offering services in all paediatric sub-specialities. It is a level 1 trauma centre for children. Paediatric orthopaedic clinical activities in this hospital consists of three operating days a week, a daily fracture clinic, weekly spine clinic, rheumatology clinic once a month, monthly spina bifida clinic and neuromuscular clinics.
2. Shriners Hospital for Children
This is a 40 bed acute care children hospital specialized in neuromuscular conditions. Clinical activities in this hospital include seven operating days a week, clinics in all paediatric orthopaedic sub-specialities, including general orthopaedics, hip clinic, limb-length discrepancy, spina bifida, cerebral palsy, hand and upper limb, spine deformities and scoliosis, amputee and prosthetic clinic , sports medicine, rhizotomy and spasticity clinic and Botox clinic.
There are 6 full time orthopaedic surgeons in the paediatric division including : Dr Francois Fassier, chief of Paediatric Orthopaedics, Dr Reggie Hamdy, chief of staff – Shriners Hospital, Dr Thierry Benaroch, Site Director at the Montreal Children Hospital, Dr Chantal Janelle, Dr Jean Ouellet and Dr Neil Saran. These six orthopaedics surgeons share their time between the Shriners and the Montreal Children Hospital and also cover all the emergency calls at the Montreal Children Hospital.
All trauma cases are performed at the Montreal Children Hospital as well as complex cases that may need special care or intensive care unit such as spinal deformities and hip problems. All elective out patient visits and elective surgical cases are performed at the Shriners Hospital.
The objectives of a clinical fellowship vary according to the individual needs of each clinical fellow. As the paediatric orthopaedic service at McGill offers a full spectrum of sub-specialities, the clinical fellow can choose in which area he/she would like to have more in-depth exposure and training. As a general role, the goal of the fellowship is to offer to the clinical fellow a wide range of exposure to all orthopaedic problems in children as much as possible.
Duties of the clinical fellow include clinical, teaching, and research activities.
A. Clinical Duties
1. Out-patient clinics
It is expected that the clinical fellow will assist a designated staff person in at least two clinics a week at the Shriners Hospital and one clinic a week at the Montreal Children Hospital. He/she will rotate between different staff persons. The clinical fellow will also be responsible for a separate clinic at the Shriners Hospital where he/she will see new patients. He/She will directly report to the orthopaedic staff who is doing a clinic at the same time as his/her clinic at the hospital and it will be this orthopaedic staff who will be responsible for the clinic.
It is also expected that the fellow will play a major role in a least one fracture clinic per week at the Montreal Children Hospital under the supervision of a designated staff person.
2. Operative duties
The fellow will assist at both the Montreal Children Hospital and the Shriners Hospital. The exact role of the fellow in the operating room will be discussed before the surgery between the staff, the resident and the fellow. It is up to the discretion of the staff to decide how much responsibility the fellow will have in the operating room. As a general role – in bilateral cases – one side could be performed by the resident and the other by the fellow. In very complex cases such as hip osteotomies or other procedures that are expected to be performed only by paediatric orthopaedic surgeons, the fellow may be the first assistant or even perform part or whole of the surgery. This will be discussed pre-operatively. However, under no circumstances will the training of the resident be jeopardized by the fellow.
The clinical duties also include participation of the fellow in all the clinical rounds of the paediatric orthopaedic division both at the Montreal Children Hospital and the Shriners Hospital.
B. Teaching duties
The Clinical fellow will be responsible for the monthly journal clubs, he/she will also participate in resident teaching such as the weekly Friday morning teaching to the resident.
C. Research duties
It is expected that the clinical fellow will complete at least one clinical research project, and is it also expected that he/she will present the results of this research in National or International meetings and will submit this study for publication.