Performance and Competence

Performance

Competence

This concept includes proper performance of a task and adequate provision of patient care. Credentialing will be based on levels which parallel each year in training, and will include the subdivision of task completion with direct supervision and without direct supervision.

Levels of Competency in Orthopaedic Residency

Level 1: Arthrocentesis (adult and pediatric), wound debridement, primary and delayed wound closure, arthrotomy for irrigation or debridement, open reduction/internal fixation of ankle fractures, closed reduction/internal fixation of hip fractures, closed reduction/casting of extremity fractures, tendon repairs (except Zone 2 hand flexor injury) and tenotomy.

Level 2: Arthroscopy of knee and ankle, open reduction and internal fixation of major fractures, ligament repair or reconstruction, osteotomy or ostectomy, bone grafting (including harvest of autogenous graft), soft tissue procedures, small joint arthroplasty or fusion.

Level 3: Arthroscopy of upper extremity, tendon transfers, spine fusion, nerve repairs, large joint fusion, tumor biopsies.

Level 4: Major joint arthroplasty (including revision), posterior spine decompression, open treatment of complex fractures (pelvis, acetabulum, elbow) tumor excision, nerve or tendon grafts, arthroscopically guided treatment of joint injuries, arthroscopically guided ligament reconstruction.

Level 5: Not in the purview of the residency but may be pursued on an as-needed basis only with a qualified orthopaedic faculty member. Correction of a spinal deformity with instrumentation or free tissue transfer or limb reimplantation. Residents will not be considered expert in these procedures unless post residency subspecialty training is pursued.