Resident Duties

Chief Resident - General Responsibilities

The chief residents are directly responsible to the attending physicians on each of the services. Their duties, in part, are to

  1. Supervise patient care and operating room procedures
  2. Round with associate residents and attendings
  3. Take night call in rotation with other chief residents
  4. Supervise emergency room care when on call, including review of records and x-rays of patients treated by the assistant or associate resident for that particular on-call period.
  5. Coordinate and direct the interns, residents and associate residents to provide service with minimal delay to Emergency Department patients.
  6. Be in attendance at all emergency or semi-emergency operative procedures when on call.
  7. Participate in the outpatient clinic with the attending orthopaedic surgeons. With the increasing use of ambulatory surgery centers and day of surgery admission, this is an important part of the educational experience.
  8. Organize conference schedules for Basic Science, Fracture Conference, Core Curriculum and Grand Rounds.
  9. Supervise the preparation of Indications Conference, Morbidity/Mortality Conference and Grand Rounds.
  10. Participate in the clinical education of the orthopaedic associate residents, housestaff and students.
  11. Present M&M and Quality Assurance conferences monthly throughout the year.

Executive Chief Resident (ECR)

Each resident will serve as the executive chief resident while assigned to the Chairman's service and is directly responsible to the Chairman of the Department. The ECR will provide supervision to all of the orthopaedic residents. Specific duties include:

  • Preparation of a weekly schedule of conferences each month.
  • Supervision and staffing of all outpatient clinics
  • Arrangement of vacation & meeting schedules, with approval of Department Chairman
  • Maintenance of communication between Department Chair and residents.
  • No vacation time, meetings, etc. should be scheduled while the chief resident is on the Joint Replacement rotation.

Other Specific Chief Resident Responsibilities

  1. The chief resident assigned to the Spine Service will evaluate consultations regarding patients with spine problems or injuries. Active participation in medical student instruction is expected.
  2. The chief resident assigned to the Pediatric service will work with the Chief of this section and the other members of the Pediatric team and will be responsible for evaluation and care of the patients on the service.

Residents Assigned To Affiliated Hospitals

During the second and third years of the Orthopaedic residency program, each resident will have rotations at the Roanoke affiliated hospitals as well as at the University of Virginia. At each of the hospitals, the residents are responsible for the care of the orthopaedic patients, preparation of conferences and rounds, and the teaching of medical students, surgical residents and interns in the various hospitals. The residents must be available for emergency operative procedures which are assigned to part-time faculty.

The residents will be responsible for preparing and presenting two orthopaedic grand rounds during the academic year in addition to organizing and presenting conferences at each of the respective hospitals. The staff service orthopaedic clinic will be the primary outpatient responsibility of the orthopaedic residents at each of the respective hospitals.

The housestaff office provides a furnished one-bedroom apartment to each resident during his/her Roanoke rotations.

Junior Residents Assigned To UVA Medical Center

The junior resident is responsible to the chief resident and attending surgeon on the various services. Duties are, in part:

  1. The primary care of patients on the service.
  2. Daily work rounds on the patients and accompanying the attending and chief resident on rounds. Work rounds are to be completed prior to surgery, but no normal dressing changes are to be done before going to the operating room. Appropriate notes in the patients' charts are to be made at that time.
  3. Workups, to include complete history and physical examination on all elective and emergency admissions on the individual service. The elective admission list may be found in the Admitting Office, and it should be checked daily. Emergency and/or scheduled admissions are to be recorded on the 6 East bulletin board.
  4. To see all Orthopaedic consultations in the E. R. and emergency consultations in house with the private attending.

Emergency Department Night Call

  1. The associate resident on ER call will handle all emergency room consults between 4 p.m. and 11 p.m. The resident will evaluate and present each patient to the attending physician on call, and will accompany surgical cases to the operating room. The In-House resident will handle emergency room calls while the ER resident is in the operating room. The In-House resident will handle all calls from the floor, all inpatient consults, and all ER consults between the hours of 11 p.m. and 8 a.m.
  2. Your duty is to inform the chief resident on call of all emergency admissions to the individual service before addmission is arranged. It is the chief resident's responsibility to insure that the attending orthopaedic surgeon has seen the patient pre-operatively and is available for assistance during the operative procedure.
  3. Before leaving each day, each resident should sign out to the resident on in-house call and provide complete information about existing or anticipated problems on the service. It is necessary to check the 6 East blackboard the first thing each morning for admissions and messages.

Operating Room Schedules

Surgery is to be scheduled through the Department Admissions Office. The Chief Resident is responsible for the sequence of cases and for any additions or subtractions. The information required includes a realistic appraisal of the amount of time necessary to complete the procedure, use of the intensive care unit and estimated blood loss.

The Orthopaedic residents responsible for first cases at VASC or the main O.R. will be in the operating room and changed into O.R. attire by 7:30 a.m. Usually two to three orthopaedic teams operate daily from 7:30 a.m. to 3:30 p.m. and one from 7:30 a.m. to 5:30 p.m.

The emergency patients should be booked with the O.R. Staff and  Anesthesia.