James H. Herndon, MD, MBA

Residency Program Director's Corner

This is the 10th anniversary of The Orthopaedic Journal at Harvard Medical School (formerly The Harvard Orthopaedic Journal…but therein lies a story). It began with the first edition in 1999 and has been a wonderful publication, produced by our residents, for alumni and friends. It has also served as a great recruiting tool for medical students. Just as everything seems to be changing these days…so is our journal. This year for the first time it is entirely digital. Only the title page and table of contents are being sent to you in print…the entire volume is contained in the attached CD. We hope you like it.

As I mentioned in last year’s report we had just completed an internal review of our residency program. I included the Partner’s Education Committee’s commendations and recommendations. We have implemented many of the changes recommended. This fall…in September…we will host our RRC’s specialist site visitor for our cycle of accreditation. In preparation for this visit, as well as a discussion on needed expansion…yes again by another two residents per year…of our residency program to take advantage of the growing teaching opportunities at the BIDMC, we held a HCORP retreat on Saturday, January 5, 2008. Participants included the executive committee, a faculty representative from each hospital, two residents from each year (PGY 2 thru PGY 5) and two recent graduates currently in their fellowship at MGH or BWH. A large body of data was discussed: our residents surgical experience at each PGY year for the past four years and graduating residents…bench - marked against national data of all graduating residents provided by the RRC; analysis of the residents’ evaluation of the specialty services at each hospital and faculty for the 2006-2007 academic year; and an anonymous survey completed by all residents of every rotation they had experienced and every faculty member they had worked with during their training to date.

Results of the retreat and many subsequent discussions involving the residents and faculty and executive committee include some important changes and improvements as well as some continued issues. The most significant improvement is the lengthening of most of the rotations to two or three months instead of the current four weeks...beginning 6/25/08. The residents worked very hard on developing a final schedule which has been approved…lead recently by Mark Price with the help of Mike Glotzbecker and built on a foundation started by Andy Jawa and George Dyer. The new schedule is terrific and gets us back to a schedule similar to the one we had a few years ago.

Some concerns remain including the duty hour requirements of the ACGME…specifically compliance with the required 10 hours off between shifts and 80 hour work weeks...difficult goals to reach in some areas, but mandated by the ACGME. Another concern is that the number of fellows has increased tremendously in the last 5 years…126%; whereas the increase in fellows in orthopaedic specialties in the US was only 34% during the same period. It is troubling that we now have as many/or more fellows at the MGH and BWH combined than we have residents. This increase of fellows in our program became very apparent as we reviewed our program with the anonymous survey and listened to the residents in preparation for our retreat. We continue to work through these issues and I believe we will resolve them before our site visit.

The new office for our residency program director and program coordinator are now opened on White 5, just below the Smith-Peterson Library. We are hoping to have one wall dedicated to pictures of our residents’ graduating classes. If any alumni can send in a photo of their graduating class it would be much appreciated.

Finally, on a personal note…this will be my last Residency Program Director’s Corner. I will be retiring from my administrative responsibilities after serving as a department chairman and/or residency program director for almost 35 years. I plan to stay on at MGH/BWH…teaching/mentoring residents and students, writing and speaking about patient safety and hopefully finish a book on the History of Orthopaedics at Harvard Medical School. I have had a wonderful experience playing a small part in the development of our next generation of young orthopaedic surgeons and am very proud of the numerous residents/ students I have touched during my career.

This year our residents have received numerous awards and serve in leadership roles including:

Chris Boulton:
Best Third-Year Ortho Teaching Resident, Journal of Trauma

Brian Haus:
OREF/DePuy Resident Research Grant: “The Effect of Skeletal Maturity on Anterior Cruciate Ligament Healing.”

Mike Glotzbecker:
AOA-OREF Zimmer Resident Leadership Forum attendee at the Combined AOA/COA meeting in Quebec City, Canada in June.

Manish Sethi:
Chair of the AMA resident section that has 30,000 members. Grant for 75,000 to study Defensive Medicine in Massachusetts.

Coleen Sabatini:
Serves as one of the Resident Board Members of the J. Robert Gladden Orthopaedic Society.

John Kadzielski:
HMS Teacher/Mentor award from the Medical Students

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