The McGill University Residency Program in orthopaedic surgery is a fully integrated program based at the Montreal General Hospital, Montreal Children's Hospital, Shriners Hospital, Jewish General Hospital and St. Mary's Hospital. These institutions have a total of over 200 beds devoted to orthopaedic surgery and they have busy clinics and emergency services.
The program is approved by the Royal College and the Collège des médecins du Québec, and meets the requirements of the American Board of Orthopaedic Surgery.
This program involves five years of training post M.D. degree (see below). The first year is core surgical training including general surgery, critical care, and rotations in various surgical specialties. The training is then completed with four years of clinical orthopaedic surgery, which includes subspecialty rotations and general orthopaedics. Appointment is made through the CaRMS match or the "Contingent Particulier - American Quota". Residents have progressively increasing responsibility for patient care in clinics, wards and operating rooms. Weekly hospital and subspecialty conferences and teaching rounds are held in all hospitals. A half-day of teaching including basic science and clinical topics related to orthopaedic surgery is held on a weekly basis with the time being protected for all residents to attend. These sessions can be didactic, practical, or both. Practical sessions are held at the McGill Simulation Centre, an invaluable resource for surgical residents. Excellent departmental library facilities are maintained. Residents participate in clinical research projects and are involved in the teaching of medical students.
Additional years of training can be arranged by the Program Director and they include studies in allied disciplines or periods of specialized orthopaedic studies and periods of training in other centres in this country or elsewhere. An optional year in a research laboratory (see Resident Research) can usually be arranged during or following the formal training for those who are interested. Projects under investigation are related to adult and paediatric orthopaedics, arthroplasty, bioengineering, cartilage physiology, spinal research and other subjects.
Detailed Summary of the Residency Program by Year
R1 & 2:
The first two years encourage the development of understanding of basic disease processes through contact with basic pathology and radiology. These first two years provide the framework of knowledge and surgical skills required to enter orthopaedic surgery and to pass the Principles of Surgery, Royal College examination. The R1 year is relegated to the development of clinical skills as they apply to surgery as a generic specialty. R2 rotations consist of orthopaedic training to acquire orthopaedic knowledge at a fundamental level – in particular, with regards to disease classification, surgical indication, and potential surgical complications. In both instances, the junior residents are under the direct supervision of the senior residents and appropriate attending staff. It is important that they attend outpatient clinics and assist in the operating room, as well as day surgery procedures. Patient assessment and clinical judgement along with the understanding of disease process are the goals during the first two years of training.
R3 & 4:
Progressive development of surgical and clinical skills with greater responsibility in areas of decision making and patient management are essential during these two years of training. R3 level residents must show adequate and improving clinical skills with regards to diagnostic ability, improving and expanding disease classifications and surgical indications for both traumatic and non-traumatic orthopaedic conditions. Indications for surgical intervention as well as appreciation of potential complications as expected to progressive expand throughout this year. He/She is also introduced to simple surgical procedures under direct supervision of senior residents and attending staff. R4s should show ability to reach appropriate surgical decisions and becoming increasingly proficient in the technical aspect of surgical procedures. They are expected to assist in educating the more junior residents and medical students.
Residents at this level must assume a major administrative role in organizing day-to-day ward activities as well as be responsible for orthopaedic teaching rounds and general service organization. They must show significant interest in teaching junior residents and medical students. As expected, R5 residents will act with a certain amount of autonomy in assessing consultations, in traumatic and non-traumatic orthopaedic patients. Surgical procedures must be conducted with confidence and residents are expected to reach a competent level in diagnosis, patient management, awareness and treatment of post surgical complications. They are expected to successfully pass the Royal College Examinations upon completion of this year.
The following rounds are compulsory for all residents rotating through the specific hospital or subspecialty:
- Department of Orthopaedic Surgery, Montreal General Hospital:
- Orthopaedic Trauma Rounds, from 7:00 to 7:15 a.m., daily
- MGH Orthopaedic Rounds, from 7:00 to 8:30 a.m., every other Thursday
- MGH Trauma Rounds, from 4:00 to 6:00 p.m., every Wednesday
- MGH Orthopaedic Oncology Rounds, from 6:45 to 7:15 a.m., every other Friday
- MGH Sarcoma Tumour Board, from 7:30 to 8:30 a.m., every Friday
- MGH Sports Rounds, from 3:30pm to 5:00pm., every other Tuesday
- MGH Spine Rounds, from 7:00am to 8:30am., every Wednesday
- Department of Orthopaedic Surgery, Jewish General Hospital:
- JGH Fracture Rounds, from 4:00 to 6:00 p.m., every Tuesday
- JGH Orthopaedic Grand Rounds from 7:00 to 8:30 a.m., every other Thursday
- JGH up-to-date teaching schedule
- Montreal Children’s Hospital and Shriners Hospital:
- MCH Fracture Rounds, from 7:30 to 8:30 a.m., every Monday
- Shriners Bedside Rounds, from 7:30 to 8:30 a.m., every Tuesday
- MCH Indication Rounds, from 4:00 to 6:00 p.m., every Thursday
- Shriners Grand Rounds, from 7:15 to 8:30 a.m., every other Thursday
- Shriners Teaching Rounds, from 7:15 to 8:30 a.m., every Wednesday and Friday
- Department of Orthopaedic Surgery, St. Mary’s Hospital:
- SMH Orthopaedic Grand Rounds, from 7:30 to 9:00 a.m., every Wednesday
- Subspecialty Rounds:
- Arthroplasty Rounds, from 4:00 to 6:00 p.m, every Thursday
- Spine Rounds, from 7:00 to 8:30 a.m. (MGH), every Wednesday
- Sports Medicine Rounds, from 3:30 to 5:00 p.m., every other Tuesday