Fellowships, Residencies & CME

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Adult Reconstructive Surgery Fellowship Program

The Massachusetts General Hospital Fellowship in Adult Reconstructive Surgery provides a broad-based clinically oriented experience with emphasis on diagnostic, surgical, and patient management skills for total hip and total knee replacement.

Fellows participate in an educational program based at Massachusetts General Hospital and work with seven different surgeons both in the outpatient and inpatient setting. Fellows work very closely with different attending surgeons during operative treatment.

Highlights of the educational program include a daily 7am Conference where we review surgical indications, techniques, complications, and new technologies. There are also lectures from various faculty members including our diverse research staff. In addition to these conferences, Fellows participate in the CORE Lecture Series for the Harvard Combined Residency Program. Research activities are reviewed on a weekly basis and there is dedicated time during the Fellowship for work in our Laboratories and also time to prepare presentations and manuscripts. One of the unique features of our Fellowship includes our daily and ongoing links between clinical work and research activities. Fellows are able to be involved in all aspects of our clinical care and scientific research and development activities.

Potential Fellows must be graduates of a US Residency Programs and be Board Eligible. Fellows must have outstanding recommendations and history of clinical and educational excellence and a keen interest in participating in the research program we have ongoing at the Massachusetts General Hospital.

This fellowship participates in the national matching program.

Fellows participate in our daily 7 AM conference series where there are presentations and didactic lectures from experts in basic science, anatomy, biomechanics, and healing. We also review basic science topics in our Journal Club.

Required Conferences

  Week 1 Week 2 Week 3 Week 4 Week 5
Monday 7am: (WHT 10)
Pre-op Planning Conference
7am: (WHT 10)
Pre-op Planning Conference
7am: (WHT 10)
Pre-op Planning Conference
7am: (WHT 10)
Pre-op Planning Conference
7am: (WHT 10)
Pre-op Planning Conference
Tuesday 7am: (WHT 10)
Pre-op Planning Conference
7am: (WHT 10)
Pre-op Planning Conference
7am: (WHT 10)
Pre-op Planning Conference
7am: (WHT 10)
Pre-op Planning Conference
7am: (WHT 10)
Pre-op Planning Conference
Wednesday     7am:
Core Lecture
Grand Rounds
   
Thursday 7am: (WHT 10)
No conference/Staff meeting
7am: (WHT 10)
Senior resident presentation
7am: (WHT 10)
M&M Conference
7am: (WHT 6)
Service Chief Walk on Ward Rounds
7am: (WHT 10)
Case presentation
Friday 7am: (WHT 10)
OR Case presentation
7am: (WHT 10)
OR Case presentation
7am: (WHT 10)
OR Case presentation
7am: (WHT 10)
OR Case presentation
7am: (WHT 10)
OR Case presentation

Thursday Morning Teaching Conferences

Thursday morning is our time dedicated to specific presentations from the residents. The presentations are prepared with the assistance of fellows and attending staff. Usually we have a short computer slide presentation and then discuss 1 or 2 recent journal articles related to the topic.

Week 1: No conference MGH Orthopaedic Staff Meeting.

Week 2: Senior resident (PGY 5) will give presentation. Didactic lecture on a common topic in reconstructive surgery. Topics will rotate and include complications of total joint arthroplasty, biomechanics, osteolysis, loosening of components, peri-prosthetic fractures, Avascular necrosis, developmental dysplasia of the hip, SCFE and alternatives to total joint arthroplasty including osteotomies of the hip and knee. These lectures should compliment the lectures given during Core conferences.

Week 3: Monthly M&M report. Morbidity and Mortality Conference.

Service Chief Walk on Ward Rounds: This is to occur on the 3rd Thursday of every month we will meet as a service (residents, fellows and attendings) on White 6 at 7AM and round on the in-house patients. We will discuss three or four patient cases, physical findings and peri-operative management.

Week 4: Journal club: the PGY-5 resident will be responsible for selecting and distributing 4-5 articles for discussion. This should be reviewed with one of the fellows. The articles should be given to faculty, residents and fellows as soon as possible during the month. Each resident and fellow will be responsible for reading all articles to be discussed and be prepared to summarize and critique one article in detail. The PGY-2 resident will discuss one article as well. A sign up sheet will be posted by the PGY-5 resident by the end of the second week of the rotation. There will be a presentation by the fellows.

Week 5: Case presentation given by senior resident and fellow.

A preoperative planning/indications conference occurs each day except Thursday. Selected cases on the arthroplasty service will be discussed in concise reports and templated at this time. This will involve all members of the team, resident, attendings and fellows. The attendings, residents, and fellows will be responsible for organizing the X-rays needed for this conference.

Topic Schedule for the PGY-5 lectures

July: The focused history, physical exam, and the differential diagnosis of hip and knee pain, both pre-operative and post-operative considerations.

August: Osteonecrosis, Part I. The etiology, natural history, pathology, clinical presentation, and diagnosis.

September: Osteonecrosis, Part II. The classification, treatment, complications, and long term outcome.

October: The Differential Diagnosis of Arthritis: Differences in presentation, radiographic findings, and treatment of the causes of arthritis. This should include osteoarthritis, inflammatory arthritis, traumatic, etc.

November: Prosthetic Infections, Part I. The causes, risk factors, diagnosis, and prevention of peri-prosthetic infections. Antibiotic prophylaxis.

December: Prosthetic Infections, Part II. Treatment Options including delayed and immediate exchange, role of antibiotic therapy, temporary implants, resection arthroplasty techniques, antibiotic cement.

January: Preoperative Planning. The thought processes and treatment algorithms used to perform joint arthroplasties. This should include templating, leg length determinations, pre-operative laboratories, pre-operative x-rays, etc., for both primary and revision arthroplasty.

February: Hip fusions and techniques of conversion to total hip arthroplasty.

March: Knee fusions and conversion to total knee arthroplasty. This should include extensor mechanism reconstruction.

April: Non-operative treatment of osteoarthritis of the hip and knee. This should include medical management as well as injections and bracing.

May: Total Knee Arthroplasty: Outcomes and Complications. Should include discussion on CR versus PS.

June: Total Knee Arthroplasty: Treatment of Complications.

**Wednesday morning, the residents have no clinical duties and are required to attend Core lectures and Grand Rounds. The fellows and attending staff will be responsible for all clinical duties during this time. The other two mornings per week will be working discussions augmented by the teaching file.**

Fellows must complete twelve months of clinical work that includes surgical care and outpatient activity. Our Fellows are expected to participate in a number of clinical research projects and produce abstracts for national meetings and manuscripts for peer-reviewed journals as part of their graduation requirements.

Current research interests include biomechanics and robotics, biomaterials for implants, pharmacological therapies, and prevention of thromboembolic disease, outcome studies and minimally invasive knee surgery. Although there is emphasis on skills useful for today’s challenges in reconstructive surgery, a critical component of the fellowship is development of future techniques and clinical practices.

Please mail inquiries and letters of support to:

Young-Min Kwon, MD, PhD
Director, Adult Reconstructive Surgery Fellowship Program
Department of Orthopaedic Surgery
Massachusetts General Hospital
55 Fruit Street, YAW 3700
Massachusetts General Hospital
Boston, MA 02114
Telephone: (617) 643-7436
Fax: (617) 724-0718

This fellowship participates in the national matching program.

Young-Min Kwon, MD, PhD

Director, Adult Reconstructive Surgery Fellowship
Department of Orthopaedic Surgery
55 Fruit Street, YAW 3700
Boston, MA 02114

Phone: 617-643-7436
Fax: 617-724-0718

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