Trauma Fellowship, Department of Orthopaedics

ROMAN HAYDA: Welcome to the
orthopedic trauma fellowship at Rhode Island Hospital
and Brown University. I’m Dr. Roman Hayda, the
chief of orthopedic trauma. For over 20 years graduating
over a hundred fellows, we have developed the unique
opportunity for our residents at Brown to complete an
orthopedic trauma surgery fellowship. The extra year spent at
Brown allows our surgeons in training to mature to
fully independent, highly skilled surgeons. During any residency,
the resident can never experience the full
responsibility of a surgeon. But as a Brown trauma fellow,
this crucial transition takes place in a
familiar setting with the ever ready supervision
and backup of the faculty. Dr. Andrew Evans, Christopher
Born, and I, along with the rest of
the Brown faculty, are dedicated to this process. Our trauma fellows cover one
of the busiest level one trauma centers and see a
full range of injuries and orthopedic conditions. They learn how to approach
polytrauma patients, fix complex
periarticular fractures, and manage nonunions
and infections. They also learn how to recognize
and manage associated medical, social, and psychological issues
that impact patient recovery. Teaching takes place through
daily trauma service patient review conference, weekly trauma
fellow meetings, journal club, and frequent case
discussions to address patient management, Prue-op
planning, and post-op critique. The majority of our fellows
are well-versed in addressing these complex orthopedic
problems after completing their residency at Brown,
but the trauma fellowship allows them to think and
operate independently. They are the primary
surgeon for the case, fully planning and
executing the surgery with guidance from myself
and Dr. Evans as needed. Just as important
is the experience the fellows gain managing
the intricacies of a practice to include personnel
management and billing while caring for the patients
from start to finish. These are skills that are not
taught in orthopedic residency but are essential for
success once in practice. The fellows also
work very closely with the residents on the trauma
service and learn how to teach. In order to teach
surgery you not only have to be able to
perform surgery. The teacher needs to
be able to understand what the trainee knows and does
not know while safely guiding them through the operation. Our fellows learn
these key elements of the teaching process. At the end of the fellowship,
Brown orthopedic trauma s are experts in the
management of patients with significant skeletal
injuries in isolation and in polytrauma situations. They are leaders of an
orthopedic trauma team and experienced
surgical educators with the ability to teach
residents and students. Most of our graduates go on
to do additional fellowships where they are highly valued
because of their added experience. The maturity and self-confidence
gained during the fellowship also allows them to focus
on the finer details of any subsequent fellowship. The strong foundation in
complex fracture care developed during our fellowship
forms a key aspect of their professional careers. A vast majority of our
fellows over the last 20 years are active in teaching
in trauma care. So is the Brown trauma
fellowship worth it? We certainly think so. Here are some thoughts
from our recent graduates. MARY MULCAHEY: For me
it was an absolutely phenomenal experience. And I would 100% do it again. I learned so much
during that year. It was a year of
certainly growth in terms of surgical skills. It certainly brought
our classmates, myself and my classmates
close together. You work together
every single day and still have the sort of
supervision and oversight of the senior trauma attendings. I had a lot of personal growth
certainly during that year and found it to be incredibly
beneficial and prepared me very well for going
out into practice. Really when I started
in practice here, which is a level one trauma center,
I had absolutely no fears about anything that I would
encounter while being on call. And I think that
was a huge advantage and really put me off to
a good start in practice. And to be honest, you know,
I was even more confident doing the trauma
cases when I started then doing my own sports
medicine cases, because I hadn’t had the same
level of autonomy coming out of sports fellowship
as I had during that trauma year at Brown. I found that trauma fellowship
year to be the most beneficial of all the six years, and I
would without any reservations do that again. PETER KAVEH MANSURIPUR:
I learned the most, gained a ton of confidence. Moving forward, I think
it really set me up for the fellowship that I wanted
and the jobs that I was looking for, which I’ll get into. But bottom line, absolutely yes. Definitely got me the
fellowship that I wanted. I felt like on the
fellowship trail I was in a different pool
from the other applicants. If you’re choosing between
an applicant fresh out of residency and
someone who’s had a year of independent
operating under their belt, you know they’re going
to be more confident, they’re going to
be more competent. You can kind of
skip ahead and focus on what makes each subspecialty
different– in my case, microsurgery, soft tissue
stuff, things like that. And the same applies to
every other subspecialty. Definitely helped me get
my first choice here. And now that I’m
interviewing for jobs, similarly makes me a very
attractive candidate. I think every job
you get, most jobs are going to come with an
aspect of general call. And having done a
year of trauma call at a level one
trauma center helps put everyone’s mind at
ease that you will in fact be incredibly competent. They don’t have
to hold your hand. ALAN DANIELS: It’s an
excellent opportunity to learn how to build and
code for the procedures you’re doing, which is not something
that most residents or even fellowship programs
will teach you, which we do teach you here. It gives you a lot of
also autonomy in terms of learning how to talk
to patients about surgery, counsel them preoperatively,
and then probably most importantly take care of
the complications that occur. Unfortunately trauma patients
do have a lot of complications and very difficult problems. And the year really provides
you a great opportunity to talk to the families
beforehand, talk to these patients about
very difficult problems, and then manage the
complications when they arise, deal with some very complex
soft tissue trauma issues and infections and
things like that that are very helpful in your career
when you do run into them. When you’re early in
your career and you have a bad
postoperative infection, you’re going to have
seen many of these during your trauma fellowship,
largely because we get them shipped in from the community. We get them from
other hospitals. And you have a
lot of opportunity to take care of them.

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