Michael Curry, M.D.
Second year of orthopedic surgery residency at Baylor College of Medicine is regarded by many to be your most demanding year of residency. You are finally finished rotating “off-service” and can now focus all of your attention to learning orthopedics. As in your other years of residency, you have five 10-week rotations during your PGY-2 year: three blocks at Ben Taub Hospital, one block at the Michael E. DeBakey Veterans Affairs Medical Center and one block at Texas Children's Hospital. The majority of your second year is spent in the emergency and clinical settings, where you learn how to manage acute trauma, as well as inpatient and outpatient orthopedic management. You will also begin to develop your surgical decision making and operative skills.
Ben Taub is a Level I trauma center that everyone grows to love. It is here that you will spend most of your time training, not only in second year, but also across all years of training. You will see every type of orthopedic trauma imaginable, and you will also see the most common orthopedic injuries (probably more than you would like). As a second year, your responsibilities reside mostly with the “Bone Beeper” (i.e., consult pager) and in clinic. Your days will typically start at 6 a.m. where all orthopedic consults from the previous day are presented, and a quick run through of the current inpatients are discussed. You then round on your own patients (based on who you have admitted and/or who you have operated on), and then it’s off to one of the busiest clinics you will ever work in. You may also be in and out of clinic all day tending to consults in the emergency room if you’re carrying the Bone Beeper. You will also occasionally be called up to help in the operating room. We have an established “night float” system in place for the Bone Beeper, which means you may either be on days for a week, on nights for a week or not see consults for a week.
When you are on call, you will remain very busy and most likely feel overwhelmed at times. Don’t worry, everyone has been there and everyone makes it through. With time, you become efficient and start to even enjoy some of the consults you get, as you realize the rewarding aspect of managing trauma acutely. Perhaps the best thing about Ben Taub is it’s a great team environment, as there are 2 chiefs, a PGY-4, a PGY-3, three PGY-2s and even an intern or two.
The MEDVAMC rotation as a PGY-2 is another demanding rotation. The main reason it is a tough rotation is because you have almost all of the responsibilities outside of the OR. Contrary to the large team atmosphere at Ben Taub, you are on your own as a junior resident here (hence the increased responsibility). You will also be with a PGY-4 and two chiefs; however, they spend most of their time in the OR. Your day will usually start around 5:30 a.m. when you round on all of the inpatients. There is usually a conference at 6 a.m. or 6:30 a.m., then you’re back to the MEDVAMC for clinic (every day). The good news is you have a nurse practitioner to help with the orders, disposition issues and other various floor tasks. The bad news is you are also responsible for any consults from 6 a.m. to 6 p.m. every day except weekends. While at the MEDVAMC, you are in the “general call” pool, meaning you only take overnight calls once every six or seven days on average.
Texas Children’s Hospital is our Level I trauma pediatric hospital. While you stay busy here, you do have five physician’s assistants to help manage the load. This means offloading a lot of the floor and consult responsibility during the day which equates to lots of time in the OR. Yes, you still have clinic and you have to help the PAs with reductions from time to time, but the vast majority of your time is spent in the OR. Here, it is just you and a PGY-4. After rounding every morning around 6 a.m., you and the PGY-4 take a look at the OR schedule and choose which cases you each are going to do. If there isn’t much going on in the OR, which is very rare, you can go to clinic and help the attendings out (who really appreciate it!). You are also back in the “general call” pool while at Texas Children’s, so you have to be around to manage consults at least until 6 a.m., when the general call person on that day takes over.
Overall, while your second year of residency will likely be your most demanding, it is also a time where you are learning the basics and fundamentals of orthopedics, and really building your confidence in preparation for your senior residency years. You will, without question, become very comfortable managing virtually any acute orthopedic trauma. You will also build a great understanding of how to manage patients in an inpatient and clinical setting.
