Clerkships

The Department of Orthopaedics and Sports Medicine offers the following clerkships for interested medical students.

Please contact Christine Pallasigui, Medical Student Education Coordinator at cptin5@uw.edu or 206/744-4927 with any questions.


Adult Reconstruction (ORTHP 685)

Course Number: ORTHP 685
Credits: 8
Offered: 4 weeks full-time
Grading Notes: High Pass/Honors eligible
EValue Status: Availability pre-entered; searchable in EValue
Prerequisite: Completion of required third year Surgery clerkship
Clerkship Coordinator: Christine Pallasigui, 206-744-4927, cptin5@uw.edu
Clerkship site(s): Seattle, WA: Northwest Hospital
Permission Required: No
Surgical Selective: Yes

Goals:

  • Physical Examination of the Hip:
    • understand and be able to perform a complete physical examination of the hip
    • be familiar with special diagnostic tests for the hip
  • Physical Examiniation of the Knee:
    • understand and be able to perform a complete physical examination of the knee in older adults
    • be familar with special diagnostic tests for the knee in older adults
  • Arthritis of the Hip and Knee:
    • understand the basics of hip and knee arthritis
    • understand the basic of non-surgical treatment of hip and knee arthritis
    • be familiar with the role of surgery for patients with hip and knee arthritis
    • be familiar with the contraindications for hip and knee replacement

Objectives:

  • Identify, based on radiographic and clinical data the presence of osteoarthritis, avascular necrosis and other common degenerative conditions affecting the hip and knee.
  • Understand the general indications and contraindications for reconstructive (joint replacement) surgery on the adult hip and knee. 
  • The student should be able to demonstrate the ability to perform a focused history and physical examination on the adult hip and knee. The student should also be able to identify the common “red flag” signs that would contraindicate elective surgery on those joints.
  • The student will be able to identify conditions that warrant referral to the hip and knee service and also be able to formulate a plan for initial non-operative management of adults with degenerative conditions of those joints who present for evaluation.
  • Suggest appropriate diagnostic tests based on a differential diagnosis established after a history and physical examination. 
  • Suggest an appropriate course of non-surgical treatment for a patient presenting hip or knee arthritis.
  • Identify patients for whom surgery would not be appropriate.
  • In the operating room and/or clinic, students will be able to demonstrate and sharpen skills in basic surgical techniques such as knot-tying and suturing.
  • Students should be able to list the use of appropriate imaging studies for the common conditions affecting the adult hip and knee. 

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Disorders of the Spine (ORTHP 684)

Course Number: ORTHP 684
Credits: 8
Offered: 4 weeks full-time
Grading Notes: High Pass/Honors eligible
EValue Status: Availability pre-entered; searchable in EValue
Prerequisite: Completion of required third year Surgery clerkship
Clerkship Coordinator: Christine Pallasigui, 206-744-4927, cptin5@uw.edu
Clerkship site(s): Seattle, WA: UWMC/HMC
Permission Required: No
Surgical Selective: Yes

Goals and Objectives:

  • Initial evaluation of the spine:
    • understand and be able to perform a complete physical examination of the spine
    • special diagnostic tests for the spine
  • Disorders of the spine:
    • understand the differences between surgical and nonsurgical spine disorders
    • understand what disorders constitute a surgical emergency
    • understand the complete spectrum of nonsurgical management of spine disorder
    • understand surgical indications
    • understand the relative contraindications for spine surgery
    • understand the risks of spine surgery
    • understand the postoperative care and rehabilitation of spine surgery patients

At the end of the clerkship, the student should be able to:

  • Perform a thorough history and physical examination of a patient presenting with a spine abnormality.
  • Understand the appropriate diagnostic tests based on a differential diagnosis established after a history and physical examination.
  • Have a basic understanding of the type of surgery necessary for differing types of spine disorders.
  • Understand what types of problems are appropriate for primary care management and what spine problems require referral to a spine surgeon.

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General Orthopaedic Clerkship

Course Number: ORTHP 643 - Cody, WY
ORTHP 644 - Jackson, WY
ORTHP 650 - Billings, MT
ORTHP 655 - Boise, ID *not available for 2017-2018*
ORTHP 662 - Casper, WY
ORTHP 669 - Spokane, WA
ORTHP 680 - Seattle, WA
Credits: 8 (Spokane 4/8)
Offered: 4 weeks full-time (Spokane 2- or 4-weeks full-time)
Grading Notes: 4 weeks is High Pass/Honors eligible; 2 weeks is Pass/Fail only
EValue Status: ORTHP 643, 644, 650, 680: Availability pre-entered; searchable in EValue
ORTHP 655, 662, 669: Availability is set up after permission is granted; will not necessarily appear in EValue
Prerequisite: Completion of third year required Surgery clerkship
Compliance Notes: Varies based on site; contact clerkship coordinator
VA: Requires extensive credentialing paperwork submitted at least 4 weeks prior to start date
Clerkship Coordinator: Christine Pallasigui, 206-744-4927, cptin5@uw.edu
Clerkship site(s): Billings, MT: Ortho Montana
Boise, ID: Idaho Sports Medicine Institute
Casper, WY: Advantage Orthopedics & Neurosurgery, Wyoming Medical Center
Cody, WY: Big Horn Basin Bone & Joint
Jackson, WY: Teton Orthopedics
Seattle, WA: VAMC
Spokane, WA: Orthopedic Specialty Clinic of Spokane
Permission Required: No: ORTHP 650, ORTHP 680
Yes: ORTHP 643, 644, 655, 662, 669
Surgical Selective: Yes

Objectives:

  • Medical care of the orthopedic patient:
    • obtain necessary but not excessive preoperative studies according to published guideline
    • obtain appropriate consultations
    • triage patients who should be admitted to a medical service or intensive care unit
    • perioperative care and discharge of orthopedic patients.
  • Evaluation of patients in the emergency department
  • Outpatient orthopedics:
    • basic exam for each joint and spine
    • indications for appropriate radiographic and laboratory studies
    • appropriate period of follow-up, when to discharge patient from care
    • low back pain
      • when to work-up
      • imaging – what studies and when to get them
      • nonoperative treatment
    • osteoarthritis – primary and secondary, shoulder, knee, and hip
      • risk factors, history and physical
      • nonoperative management – literature
    • Manual and other basic skills:
      • suturing
      • dressings/casts
      • patient positioning, prepping and draping

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Musculoskeletal Oncology (ORTHP 678)

Course Number: ORTHP 678
Credits: 8
Offered: 4 weeks full-time
Grading Notes: High Pass/Honors eligible
EValue Status: Availability pre-entered; searchable in EValue
Prerequisite: None
Clerkship Coordinator: Christine Pallasigui, 206-744-4927, cptin5@uw.edu
Clerkship site(s): Seattle, WA: UWMC
Permission Required: No
Surgical Selective: Yes

The oncology rotation for medical students provides a basic understanding of the incidence of sarcomas and metastatic adenocarcinomas in adults and children. The general principles of oncology staging will be taught in addition to the fundamentals for imaging for staging and treatment parameters.

Goals and Objectives:
Students are expected to learn the influence of both primary sarcomas of bone and soft tissue in addition to the incidence of Metastatic disease involving the skeleton in adults and children. The requirements for diagnosis of each sarcoma subtype and the principles for staging and evaluation are all expected goals. Parameters and complications of treatment will also be reviewed and discussed with the students.

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Musculoskeletal Trauma (ORTHP 677)

Course Number: ORTHP 677
Credits: 8
Offered: 4 weeks full-time
Grading Notes: High Pass/Honors eligible
EValue Status: Availability pre-entered; searchable in EValue
Prerequisite: Completion of third year required Surgery clerkship
Clerkship Coordinator: Christine Pallasigui, 206-744-4927, cptin5@uw.edu
Clerkship site(s): Seattle, WA: HMC
Permission Required: No
Surgical Selective: Yes

General Orthoaedics, weighted toward musculoskeletal trauma.

Goals and Objectives:

  • Musculoskeletal knowledge base including:
    • the approach to diagnosis of musculoskeletal injuries
    • the treatment of simple musculoskeletal injuries
    • understanding the difference between isolated injuries and polytrauma
    • the biomechanics of tissue failure
    • basic principles of tissue healing
  • Musculoskeletal traumatic conditions including:
    • fractures
    • dislocations
    • soft tissue injuries such as sprains and ligament disruptions
    • conditions that affect mobility such as femoral neck fracture or spinal cord injury
  • During the 4 week clerkship, students should be able to identify and describe the most common surgical problems unique to orthopaedic trauma. These include fractures and dislocations of the upper and lower limbs, soft tissue injuries to the upper and lower limbs.
  • Understand the impact of trauma on physical and social function and the impact on family and society.
  • The student should be able to demonstrate the ability to perform a focused history and physical examination emphasizing neuro muscular function, sensation and motor control.
  • Diagnosis and management of musculoskeletal injuries.
  • In the operating room and/or clinic, students will be able to understand the anatomy, be able to interpret basic imaging studies of fractures and dislocations.

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Outpatient Orthopaedics (ORTHP 682)

Course Number: ORTHP 682
Credits: 8
Offered: 4 weeks full-time
Grading Notes: High Pass/Honors eligible
EValue Status: Availability pre-entered; searchable in EValue
Prerequisite: Completion of required third year Surgery clerkship
Clerkship Coordinator: Christine Pallasigui, 206-744-4927, cptin5@uw.edu
Clerkship site(s): Seattle, WA: UW Roosevelt Clinic, Northwest Hospital
Permission Required: No
Surgical Selective: Yes

Goals and Objectives:

  • Musculoskeletal knowledge base, including:
    • normal alignment and joint range of motion
    • basic biomechanics
    • basic bone pathophysiology
  • General musculoskeletal diseases, including:
    • bone and joint infections
    • hip conditions, such as osteoarthritis, rheumatoid arthritis, avascular necrosis
    • spine conditions, such as spinal stenosis, disc disease, adult scoliosis, back pain
    • foot conditions, such as bunions, flatfoot or cavus deformities, tendonitis
    • hand conditions, such as carpal tunnel syndrome, osteoarthritis and rheumatoid arthritis
    • shoulder diseases, such as recurrent dislocations, osteoarthritis, frozen shoulder
    • sports injury in the athlete
    • tumors of bone and soft tissue
  • Musculoskeletal trauma, including:
    • fractures and dislocations as treated in the Emergency Department
    • injuries managed in the outpatient setting
    • casting and splinting

What you will be able to do for musculoskeletal problems in adult outpatient setting, or what we expect at the end:

  • Make a correct diagnosis - know what you’re dealing with, and don’t miss anything important.
  • Perform an acceptable work-up – perform a basic but thorough evaluation, including physical examination, imaging studies, laboratories.
  • Provide the standard of care in the community – treat what you’re comfortable treating.
  • Seek an appropriate referral – ask for help when it is necessary and warranted.

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Pediatric Orthopaedics

Course Number: ORTHP 668 - Spokane, WA
ORTHP 676 - Seattle, WA
Credits: 8 (Spokane: 4 or 8)
Offered: 4 weeks full-time (Spokane 2- or 4-weeks full-time)
Grading Notes: 4 weeks is High Pass/Honors eligible; 2 weeks is Pass/Fail only
EValue Status: ORTHP 668: Availability is set up after permission is granted; will not necessarily appear in EValue
ORTHP 676: Availability pre-entered; searchable in EValue
Prerequisite: Completion of required third year Surgery clerkship
Compliance Notes: Varies based on site; contact clerkship coordinator
Clerkship Coordinator: Christine Pallasigui, 206-744-4927, cptin5@uw.edu
Clerkship site(s): Seattle, WA: Seattle Children's Hospital
Spokane, WA: Shriner's Hospital for Children
Permission Required: No: Seattle
Yes: Spokane
Surgical Selective: Yes

Goals and Objectives

During the 4 week clerkship, students should be able to identify and describe the most common topics:

  • Normal musculoskeletal variations of childhood, including:
    • developmental milestones
    • torsion, i.e. in-/out-toeing
    • flexible flatfoot
    • bow-legs and knock-knees
  • General musculoskeletal diseases of childhood, including:
    • bone and joint infections
    • hip diseases, such as developmental dysplasia, slipped capital femoral epiphysis
    • spine deformity, such as scoliosis, back pain
    • foot deformity, such as clubfoot
    • limb deficiency and limb length inequality
    • sports injury in the immature athlete
  • Musculoskeletal trauma, including:
    • fractures and dislocations as treated in the Emergency Department, injuries managed in the outpatient setting
    • casting and splinting

At the completion of the clerkship experience the student should be able to:

  • Make a reasonable and appropriate differential diagnosis.
    • Know the pertinent diagnostic categories and the likelihood of each.
  • Students should be able to demonstrate the ability to perform a focused history and physical examination emphasizing evaluation of the spine and extremities in the pediatric and adolescent patient.
  • Students should be able to choose the appropriate imaging studies for such conditions as hip dysplasia, Legg-Calve-Perthes disease and slipped capital femoral epiphysis, meniscus tears and anterior cruciate ligament disruptions and scoliosis.
  • Provide the standard of care in the community.
  • Know what you’re comfortable treating, and what should be referred.
  • Identify conditions that warrant referral to the relevant specialty.
    • These conditions include displaced limb fractures, especially those about the elbow, hip dysplasia, progressive scoliosis, knee cartilage and ligament injuries and bone and joint infections.
  • Ask for assistance when it is necessary and warranted.

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Preceptership in Orthopaedics (ORTHP 675)

Course Number: ORTHP 675
Credits: 4
Offered: 2 weeks full-time
Grading Notes: Pass/Fail only
EValue Status: Availability is set up after permission is granted; will not necessarily appear in EValue
Prerequisite: None
Compliance Notes: Varies based on site; contact the clerkship coordinator
Clerkship Coordinator: Christine Pallasigui, 206-744-4927, cptin5@uw.edu
Clerkship site(s): Seattle, WA: various community practices
Permission Required: Yes
Surgical Selective: Yes

The student will spend full time with the preceptor during all his/her working day in order to gain a better understanding of the diagnosis and management of problems of the musculoskeletal system as seen in a private orthopedic practice, both in the clinic and operating room. If the student has to drop the clerkship less than 4 weeks before the start of the rotation, it is the student’s responsibility to find another medical student to take his or her place.

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Shoulder and Elbow (ORTHP 687)

Course Number: ORTHP 687
Credits: 8
Offered: 4 weeks full-time
Grading Notes: High Pass/Honors eligible
EValue Status: Availability pre-entered; searchable in EValue
Prerequisite: Completion of required third year Surgery clerkship
Clerkship Coordinator: Christine Pallasigui, 206-744-4927, cptin5@uw.edu
Clerkship site(s): Seattle, WA: UWMC
Permission Required: No
Surgical Selective: Yes

Goals and Objectives:

  • Obtain a basic, relevant knowledge of shoulder and elbow anatomy and pathology. This may be achieved by:
    • reviewing Dr. Douglas Harryman's videos entitled, Safe and Effective Surgical Approaches to the Shoulder and Mechanisms of Glenohumeral Stability
  • Evaluate and develop management plans for patients with shoulder and elbow problems by: conducting a thorough/efficient clinical history and physical examination.
    • understanding the implications of systemic, emotional, and situational factors to the treatment of shoulder and elbow problems
    • understanding the relationship of conditions of the neck and brachial plexus to symptoms and findings in the shoulder and elbow area
    • understanding the indications for and interpretation of standard radiographs, CTs, MRIs, and sonograms of the shoulder and elbow
    • understanding the relevant basic science and anatomy (gross and arthroscopic) related to the shoulder and elbow
    • presenting basic treatment options, including home exercises, medications and surgery along with the alternatives and risks of each
    • understanding the diagnosis and treatment for a core group of shoulder problems including:
      • stability (atraumatic and traumatic instability)
      • stiffness (localized, global, idiopathic, diabetic, post-traumatic, and post-surgical)
      • smoothness (OA, RA, AVN, capsulorrhaphy arthropathy, cuff tear arthropathy, posttraumatic DJD, snapping scapula, and subacromial roughness)
      • strength (rotator cuff tears and nerve lesions)
      • biceps tendonitis
      • AC joint problems (DJD and separation)
      • trauma (clavicular, scapular, and proximal humeral fractures)
    • understanding the diagnosis and treatment for a core group of elbow problems including:
      • instability (acute and chronic ligament insufficiency)
      • stiffness (post-traumatic, post-surgical, heterotopic ossification)
      • smoothness (OA, RA, and post-traumatic DJD)
      • strength (distal biceps ruptures and nerve lesions)
      • medial and lateral epicondylitis
      • olecranon bursitis
      • loose bodies
      • entrapment neuropathies
      • trauma (distal humerus, radial head, olecranon, coronoid fractures)
    • understanding appropriate rehabilitation protocols and schedules for various shoulder and elbow problems, both conservative and post-operative

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Sports Medicine

Course Number: ORTHP 681 - Seattle, WA
ORTHP 686 - Boise, ID
ORTHP 688 - Spokane, WA
Credits: 8 (Spokane 4/8)
Offered: 4 weeks full-time (Spokane offers 2 & 4 week)
Grading Notes: High Pass/Honors eligible (2 week rotations Pass/Fail only)
EValue Status: Availability pre-entered; searchable in EValue
Prerequisite: Completion of required third year Surgery clerkship
Clerkship Coordinator: Christine Pallasigui, 206-744-4927, cptin5@uw.edu
Clerkship site(s): Seattle, WA: Sports Medicine Center at Husky Stadium, UWMC
Boise, ID: St. Alphonsus Regional Medical Center
Spokane, WA: Integrated Sports Medicine Rockwood, Valley Medical Center Spokane
Permission Required: No: ORTHP 681, 686
Yes: ORTHP 688
Surgical Selective: Yes

Students have “customized” experiences specific to their learning needs.

For Boise, ID clerkship, students work primarily in one subspecialty area (foot and ankle) and in one general orthopaedic clinic.

Goals and Objectives:

  • Perform and present a history and directed physical exam of patients presenting with sports-related musculoskeletal complaints.
  • Formulate a meaningful differential diagnosis of patients’ complaints, considering non-orthopaedic conditions as well as musculoskeletal conditions.
  • Become familiar with basic orthopaedic diagnostic and treatment strategies.
  • Become familiar with operative and non-operative treatment of common sports injuries.
  • Learn and understand principles of sports rehabilitation.
  • Understand unique aspects of orthopaedic surgical procedures, including meticulous sterile technique.

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Special and Away Electives

Orthopaedics Away Elective (ORTHP 697)

Course Number: ORTHP 697
Credits: Variable, max. 24
Offered: Full-time
Grading Notes: 4 or more weeks is High Pass/Honors eligible; less than 4 weeks is Pass/Fail only
EValue Status: Availability is set up after permission is granted; will not necessarily appear in EValue
Prerequisite: Permission from department. MS4 sutdents only. +
2 month application process
Compliance Notes: Variable based on away clerkship site
Clerkship Coordinator: Christine Pallasigui, 206-744-4927, cptin5@uw.edu
Clerkship site(s): Various outside WWAMI region
Permission Required: Yes
Surgical Selective: No

By specific arrangement for qualified students, away electives may be available at other institutions located outside of the WWAMI region. Interested students must contact the Department, provide thorough information regarding the away clerkship’s details, and obtain departmental approval at least two (2) months prior to registration.

At least two (2) months prior to the clerkship start date, students must contact the clerkship coordinator to arrange a meeting with the department’s director prior to finalizing the away clerkship rotation. Please note that students are ultimately responsible for the accuracy of the information given for evaluation and final grade submittal. The clerkship coordinator will notify the UWSOM Curriculum and Registration offices upon approval of the away clerkship rotation.

Evaluations: Departmental evaluations are required to be completed by faculty and student prior to receiving a grade.

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WWAMI Orthopaedic Special Assignment Elective (ORTHP 699)

Course Number: ORTHP 699
Credits: *, max. 24
Offered: Full-time
Grading Notes: 4 or more weeks is High Pass/Honors eligible; less than 4 weeks is Pass/Fail only
EValue Status: Availability is set up after permission is granted; will not necessarily appear in EValue
Prerequisite: Permission from department. MS4 students only. +
2 month application process
Compliance Notes: Variable based on site location; please contact clerkship coordinator.
Clerkship Coordinator: Christine Pallasigui, 206-744-4927, cptin5@uw.edu
Clerkship site(s): Various within WWAMI
Permission Required: Yes
Surgical Selective: No

By specific arrangement for qualified students, special assignment electives may be set up at institutions located within the WWAMI region. Special Assignment electives serve to provide students experiences that may fall outside of the boundaries of already established School of Medicine clerkships. Interested students must contact the Department, provide thorough information regarding the clerkship’s details, and obtain departmental approval at least two (2) months prior to registration.

At least two (2) months prior to the clerkship start date, students must contact the clerkship coordinator to arrange a meeting with the department’s director prior to finalizing the away clerkship rotation. Please note that students are ultimately responsible for the accuracy of the information given for evaluation and final grade submittal. The clerkship coordinator will notify the UWSOM Curriculum and Registration offices upon approval of the away clerkship rotation.

Evaluations: Departmental evaluations are required to be completed by faculty and student prior to receiving a grade.

DUTY HOUR POLICY
All rotations comply with the UW institutional duty hours policy and ACGME requirements of the “80 hour work week”. This includes work hours, time between shifts, days away from hospital activities and total work hours.

 

Clerkship Evaluations 

All clerkship evaluations are completed through E*Value. Please find examples of the evaluations below:

Student Evaluation