I was pleasantly surprised and excited when I first heard about the citywide Chicago PGY1 journal club. This journal club was funded by the Robert Bucholz Resident Journal Club Grant through The Journal of Bone and Joint Surgery. The premise of this program was for all of the orthopedic surgery PGY1s from around the city to meet and discuss landmark articles specific to a certain orthopedic topic. The event that I attended was the first meeting of the program, and the focus of our discussion revolved around four orthopedic trauma articles. I recognized all of the articles as the guidelines established from these papers are still used in our trauma practice every day.
Although I knew the general principles derived from this literature, I found reading the full text beneficial as it helped provide a more thorough background into the reasoning behind the decisions we make in the management of various fracture patterns. What I found most educational however was the discussions we had with residents at various programs, specifically in regards to our institutions’ management of common orthopedic fractures. We each went around the table and discussed our ED management of injuries including humeral shaft fractures, femoral shaft fractures, open fractures, and our intraoperative technique for intramedullary nailing of tibial shaft fractures.
While there were small differences in our management of these injuries, we all seemed to abide by the general guidelines that were set into motion after the publication of these landmark articles. It brought into focus how influential this literature has been, and also gave me additional insight into possible alternative management algorithms that could produce similar outcomes. When working at one institution throughout your residency, that institutions protocols often become the “normal” for you. I now better recognize that it is important to keep an open mind and that there can be many methods to achieve a desired result.
Our meeting allowed for a low stress environment to both appreciate and constructively criticize how we think about orthopedic trauma. At our specific institution the discussion of articles occurs in a large group setting with attendings and senior residents, and usually focuses on more recent literature. I think it is essential to understand where we came from, and this citywide journal club provides that history while also encouraging open critical discussion. I think any junior resident would benefit from this type of educational open forum with their colleagues.
You can apply for your own Robert Bucholz Resident Journal Club Grant by clicking this link.
Orthopaedic Surgery, PGY-2
University of Chicago