The fellows assist and contribute to inpatient care by:
- Performing a hand/upper extremity exam on patients admitted through the emergency room when on call or on patients admitted from the outpatient or private offices in which the fellows participate in their surgical management
- Making daily rounds on hand/upper extremity patients
- Serving as a resource of experience and knowledge to the resident staff
- Writing orders as appropriate
- Evaluating consults and aiding the resident and attending staff with patient care
The presence of the fellows will augment, not supplant, resident responsibility. The clinical care of inpatients is the primary responsibility of the attending and resident staff.
Inpatients on the orthopaedic service are assigned to one of 4 teams. Each team is comprised of 3 attendings, a chief resident (PGY-5), a PGY-3 or PGY-4 resident, a junior resident (PGY-2), and one or 2 PGY-1, -2, or -3 residents from General Surgery, Emergency Medicine, Family Practice, or Pediatrics.
Fellows participate in rounds, provide information regarding patient care, and advise the resident staff.
Team administration is directed by the chief resident who utilizes the fellows as a clinical resource.
Final decisions regarding patient care are at the attending level.
Supervision is by direct observation during daily ward rounds. The fellows and one or more residents are expected to round with an attending on all patients.
Inpatient consults are assigned by the administrative chief to an appropriate attending.
Emergent upper extremity consults are seen by the first available physician, resident, fellow, or attending.
Semi-emergent upper extremity consults will be assigned by the chief resident to one member of the resident staff and the fellow will be notified by the secretary as to the name and location of the patient. The resident and fellow, unless unavoidable conflicts exist, will evaluate the patient, establish a diagnosis and differential diagnosis, and outline a treatment plan. The patient will then be presented on rounds to the attending staff who will evaluate this patient and discuss diagnostic alternatives and management options.