Mission

Our mission is to educate military orthopaedic surgeons by providing exceptional patient care, fostering lifelong learning, and promoting scholarly achievement.

Vision

The NCC Orthopaedic Residency Program is the leading joint military orthopaedic training program cultivating excellent surgeons who practice independently, conduct scholarly activity, and serve as leaders of the field both militarily and professionally.

Aims

1. Demonstrate ability to independently medically manage and surgically treat core orthopaedic conditions.
2. Master fundamental medical knowledge in orthopedic basic sciences, diagnoses, treatments, and complications to achieve board certification.
3. Acquire the skills to form a clinical question, conduct a sound research project, and complete a peer reviewed publication.
4. Establish a custom of personal reflection on orthopaedic patient outcomes through application of relevant literature and participation in quality improvement.
5. Develop communication skills to create a trusting relationship with patients, families, consultants, and ancillary staff.
6. Practice professional and ethical behavior in accordance with the expectations of military officers and competent physicians.
7. Demonstrate the ability to provide patient-centered care in the military health system while considering cost-containment, health care policy, and patient safety.

Morning Report

Morning conference is held Monday, Tuesday, Wednesday, and Friday from 6:30 - 7:15 a.m. The plan of the day is disseminated and patient hand off is completed through presentations by the off going call resident. The remainder of the conference is focused on surgical indications through resident case presentations of post operative patients.

Hand Conference

Hand conference follows patient hand off on Tuesday mornings. This conference is eligible for Continuing Medical Education credits and is organized though the Walter Reed Hand Fellowship.

Journal Club

Journal club is held monthly with orthopaedic subspecialty faculty. Classic, contemporary, and systems based orthopaedic literature is reviewed. Recent topics for Journal club include Limb Salvage, Hip-Spine Syndrome, and Scoliosis.

Academics

Weekly academics are held from 12:30 - 4 p.m. every Friday. The academic curriculum is completed over a two-year cycle. It encompasses high yield board review topics, hands on didactics, splinting and casting workshops, saw bone models, anatomy labs, and guest lecturers from relevant subspecialties.

Intern year consists of six months of orthopaedic rotations and six months of non-orthopaedic rotations. Each rotation is typically four weeks long.

The 2nd year is completed primarily at Walter Reed National Military Medical Center. Residents split in-house call equally with oversight from senior resident. Rotations are two months long.

The 3rd year is completed primarily at our participating sites. The focus is on refining surgical skills.

During the 5th year residents assume a senior resident role. The year is heavily operative, but residents also begin to teach and mentor junior trainees. Rotations are two months long.

The role of the Chief Resident is to serve as the leader and manager of the orthopaedic team while educating and mentoring the junior residents. Chief residents are expected to hone their surgical skills for independent practice while preparing for board certification. Home call is split evenly among the class. Rotations are two months long.

Elective Rotations are added to the standard curriculum on an as needed basis. 

• 1st Year: The first-year residents assist with weekend call at Shock Trauma University of Maryland Medical Center while on non-orthopaedic rotations.
• 2nd Year: In-house orthopaedic call is split evenly among the junior residents rotating at Walter Reed. It is approximately every 6th night and every third weekend.
• 3rd Year: In-house orthopaedic call on every rotation.
• 4th Year: Research year. There are no clinical responsibilities.
• 5th Year: Eight months of home call. Two months of in-house level-I trauma call. Two months of no call.
• 6th Year: Home call only, approximately every 7th day. Weekend home call every other month. No holiday call. 

Orthopaedic Surgery is a mission critical medical specialty to the Department of Defense, both within the continental United States and abroad. We have unique military curriculum not found in other orthopaedic residencies. 

Military Medical Evacuation System

Walter Reed National Military Medical Center is a Role 5 medical care center and receives many of the injured service members from overseas. As such, our residents learn the intricacies of the military medical evacuation system and are familiar with taking care of polytrauma patients who are injured abroad.

Combat Casualty Care Course (C4)

Orthopaedic interns complete the Combat Casualty Care Course (C4) in San Antonio, Texas. This course develops medical readiness though simulated combat care in the field environment.

Combat Orthopaedic Trauma Surgery Course (COTS+)

Residents are encouraged to complete COTS+. This tri-service course teaches stabilization and resuscitation of extremity trauma patients though cadaver labs and mentorship from orthopaedic trauma surgeons with deployment experience.

Orthopaedic Military Society Courses

Residents can attend the Arthroscopy Association of North America and Society of Military Orthopaedic Surgeons Shoulder Arthroscopy Course or Knee Arthroscopy course. These courses are taught by leading arthroscopic surgeons, providing residents both hands on experience and mentorship.

Annual Service-Specific Officership Lectures

Topics include Fitness Reports, Officer Evaluation Reports, Officer Record Management, and Promotion.

Captain's Career Course (Army Residents)

Army residents are offered the availability to complete Captain’s Career Course during research year if it aligns with their workload.

The resident curriculum has multiple required orthopaedic courses to supplement the bedside educational experience. 

AO Trauma – Basic Principles of Fracture Management

Completed by residents prior to the start of the research year. This course covers the fundamentals of fracture management to include instrumentation, classifications, reduction, and fixation techniques. 

USUHS Basic Microvascular Surgery

Completed during the research year. This weeklong, hands-on course covers the basic techniques of microsurgery including vein grafting, anastomosis, vessel and nerve repair.

Orthopaedic Board Review

Completed during 6th year. These courses cover high yield board review topics to prepare graduating residents for passing Part I of the orthopaedic boards.

Basic Life Support Certification

Required for all residents and faculty. 

Simulation Curriculum - the Director of Surgical Simulation has developed a curriculum to foster planned, well-curated subspecialty instruction along with enough support for senior residents to mentor junior residents through simulated surgical cases

Orthopaedic residents have multiple leadership opportunities throughout their training. Most residents will serve on a hospital committee during research year and there is representation from our program on the House Staff Council. Residents have also served on committees for national orthopaedic subspecialty societies.

Our program has a mandatory research year in-between the clinical PGY-3 and PGY-5 years. There are multiple established research tracks including biomechanics lab, peripheral nerve lab, and projects with the DOD Trauma Database. Residents are also encouraged to develop their own research projects and see the project through to publication. Residents are also given the opportunity to complete an on-line statistics course from Stanford University.

Quality Improvement Conference is held quarterly. Cases are presented to identify areas of improvement in patient safety, system bases practice, and patient care. Quality improvement is also part of resident education curriculum and residents are encouraged to complete a quality improvement project prior to graduation.

Professional development is part of the orthopaedic residency curriculum. Residents are also encouraged participate in the professional development webinars produced by the USUHS Faculty Affairs Department. Topics of study include academic leadership, teaching, allyship, and research.

• Walter Reed National Military Medical Center, Bethesda, Maryland
• United States Naval Academy, Annapolis, Maryland
• A.T. Augusta Military Medical Center, Fort Belvoir, Virginia
• MedStar Washington Hospital Center, Washington, D.C.
• Inova Fairfax Medical Campus, Fairfax, Virginia
• National Hospital, Washington, D.C.
• Shock Trauma University of Maryland Medical Center, Baltimore, Maryland
• Sibley Memorial Hospital, Washington, D.C.
• Veterans Affairs Washington, D.C. Health Center Washington, D.C.

• Third year rotations are available for USUHS medical students who complete a surgical clerkship at Walter Reed National Military Medical Center.
• Fourth-year rotations and sub-intern rotations are available for USUHS (Army, Navy, and Air Force), Health Services Collegiate Program (Navy), and Health Professions Scholarship Program (Army and Navy) medical students interested in pursuing an orthopaedic residency.

Expectations for Rotators

Clinical Responsibilities: As a rotating student, you are expected to assist your assigned team in both the operative and clinical settings. This will involve scrubbing into the OR about 2-3 days a week and seeing patients in clinic 2-3 days a week. Work closely with your resident contact to discuss OR cases for the week to ensure you are well prepared for corresponding anatomy, general operative steps, and patient specific indications. Questions are encouraged in the OR and clinic!

Call Shifts

On average, each rotating student will assist the on-call resident once a week. While on call you can expect to take an orthopaedic history and physical on new consults, assist the resident on call reductions and floor work, and present a call case at Morning Conference. Call shifts are a great way to meet other residents outside your immediate team. Call shifts will end at 2200, we discourage 24-hour shifts for rotating students.

Student Presentations for Fourth Year Medical Students

Before the end of the rotation, please prepare a 5-minute presentation on an orthopedic surgery topic of choice. Typically, the topic revolves around a case that sparks a clinical or research question. Example topics include surgical outcomes data, new techniques, and debates on indications. Senior residents are a great resource for brainstorming possible topics and reviewing the talk prior to final presentation.

• Typically, there are four interview days on Fridays throughout the summer and early fall. Phone or zoom interviews can also be scheduled.
• Please arrive in formal dress uniform (Navy Summer Whites, Army AGSU/ASU). If you have not yet received your uniforms, you may arrive in civilian business attire.
• Interview day begins at 6:15 a.m. outside the Orthopaedic Surgery department (America Building 2nd floor). At 6:30 a.m. we will begin Morning Report to go over consults and cases from the previous day. Afterwards, we will have some light breakfast and a talk from the program director. Interviews will typically end by noon.
• The remainder of the day is flexible. Attendance at our weekly academics is optional but encouraged. Finally, we will all meet up at a restaurant to socialize, get to know the residents, and answer final questions about our program.

Program graduates are eligible for board certification through the American Board of Orthopaedic Surgery. The Part I written exam is offered annually following completion of residency. Upon passing Part I, graduates are deemed Board Eligible. Graduates have five years following completion of Part I to complete Part II, an oral, in person, cased based examination. After passing Part II, graduates are considered Diplomates of the American Board of Orthopaedic Surgery.

Specially certification is available to Board-Certified orthopaedic surgeons who complete fellowship training in Hand Surgery or Orthopaedic Sports Medicine.

Residents are eligible for honorific recognition of Teaching Fellow through the USUHS School of Medicine. This is a non-tenured appointment limited to the duration of residency.

Residents directly teach and supervise 3rd and 4th-year medical students rotating on orthopaedic. Additionally, there are didactic teaching opportunity at the USUHS School of Medicine during the first-year medical student Musculoskeletal Module and Basic Anatomy.

Senior residents teach, mentor, and oversee the junior level residents on their orthopaedic team.

The NCC Orthopaedic Surgery Residency has a broad representation of board certified, fellowship trained, orthopaedic surgeons in the subspeciality fields of Arthroplasty, Foot and Ankle, Hand, Oncology, Pediatrics, Shoulder/Elbow, Spine, Sports, and Orthopaedic Trauma.

• Orthopaedic residents are encouraged to seek a staff orthopaedic surgeon as a mentor at the conclusion of the PGY-2 year.
• Orthopaedic residents serve as mentors to USUHS medical students in different ways. Residents can interact with the Orthopaedic Interest Group at the medical school and volunteer as faculty for USUHS labs such as suturing or splinting.
• The Walter Reed Orthopaedic Surgery department hosts an annual Perry Initiative Medical Student Outreach Program. This evening seminar for medical students introduces the field of orthopaedics to young women through lectures, hands on surgical skills labs, and mentorship. The goal of the program is to increase the number of women entering the field orthopaedics to help increase gender diversity within our specialty.
• The Walter Reed Orthopaedic Surgery Department hosts six Society of Military Orthopaedic Surgeons E. Anthony Rankin Scholars every June. The purpose of the program is to expose underrepresented medical students to the field of orthopaedic surgery in a military setting to advance diversity within orthopaedics.

Wellness is critical in maintaining our trainees’ physical, mental, and emotional health. Orthopaedic Wellness Day is every Thursday morning in leu of morning conference. Typical activities include team-based sports, volleyball, soccer, dodgeball, or team runs. Program wide wellness activities also include summer welcome barbeque, fall retreat, winter ski outing, and end of the academic year golf outing.