OrthoBuzz occasionally receives posts from guest bloggers. The following contribution comes from Rob Christian, MD and Maddy Lyons, MD.
Editor’s Note: The application deadline for the 2019-2020 JBJS Robert Bucholz Resident Journal Club Grant Program has been extended to November 1, 2019.
Junior residents often hear attendings, fellows, and senior residents quote landmark studies, but few find the time to track down and read these important papers on their own. So, when the Northwestern University Orthopaedic Residency Program was awarded one of the JBJS Robert Bucholz Resident Journal Club Grants, Haley Smith, MD (PGY-2) and I used the funding to pilot an Intern Journal Club, inviting all the interns in orthopaedic surgery residency programs across Chicago to read and discuss landmark studies.
Over the last decade, several hospitals in Chicago, such as John H. Stroger, Jr. Hospital of Cook County and Ann & Robert H. Lurie Children’s Hospital of Chicago, have trained teams of orthopaedic residents from multiple programs. Working in the hospital with residents from different programs is a great educational experience, and we thought these resident teams could be even more effective if they interacted with one another prior to working together in the hospital.
Our Intern Journal Club met quarterly, and had impressive attendance, especially considering the busy intern work schedule. Each journal club session featured 4 to 5 landmark studies (suitable for PGY-1s), and discussions were led by senior residents selected across the programs. Articles discussed came from all orthopaedic subspecialties. In addition to literature-based discussions, the get-togethers fostered collegial relationships among the different programs.
For me, the most rewarding part of the Intern Journal Club has been meeting the interns as they begin their residencies and guiding discussion to help them think critically about orthopaedic literature. With the continued support of the JBJS Robert Bucholz Resident Journal Club Grant, we look forward to continuing to host the Intern Journal Club for this year’s intern class.
Rob Christian, MD (PGY-5)
McGaw Medical Center of Northwestern University
* * * *
Initially, the JBJS Chicago Intern Journal Club felt like it was adding articles to an endless intern reading list. However, it turned out to be one of the more valuable and fun educational experiences of my intern year.
The meetings provided the unique opportunity to meet residents from the other Chicago programs. Exchanging stories of intern-year trials and tribulations quickly bonded our group. It was interesting to discover the differences and similarities in our programs, our rotations, and even in the ways in which we manage injuries. In addition to building relationships with peers across programs, the journal clubs allowed me to connect with senior residents who have similar career interests and build several new mentorships.
The articles that we read and discussed were landmark studies that shape the practice of orthopaedics on a daily basis. Through morning conferences, OITE practice questions, and clinical care, interns are exposed repeatedly to fundamentals of orthopaedics, such as open fracture management and functional bracing of humeral shaft fractures. However, without our Intern Journal Club, I may not have explored the studies on which these practice-shaping principles are built. An open, discussion-based format with senior residents helped me understand the “whys” of what we are taught.
We are fortunate to have so many great orthopaedic residency programs in Chicago, each with unique strengths. I hope that our Intern Journal Club continues in the years to come to inspire future collaboration in educational, social, and networking events among the local residency programs.
Maddy Lyons, MD (PGY-2)
Loyola University Medical Center
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
Medical education is a constant need, but how it’s delivered is always changing. When my grandfather was a surgeon, medical trainees brought their dusty textbooks and print journals to “fireside chats” at an attending’s home. Today, we have online journals, tablets and smartphones, podcasts, and “virtual” discussions on social media platforms. Although the technologies evolve, the need to discuss present and past literature remains constant.
These discussions often taken place nowadays through journal clubs. Medical residents across the continent routinely get together in formal or informal settings to discuss journal articles, not only to acquire the knowledge contained in the articles themselves, but also to learn how to properly read, critique, and digest the information.
JBJS provides medical education across multiple platforms, several of which I participate in. I strongly encourage residency programs to submit an application for the 2019-2020 JBJS Robert Bucholz Resident Journal Club Grant Program before the deadline of September 30, 2019. The grant allows medical educators to support their journal clubs in many ways:
- Investigating new and innovative alternatives to the traditional journal club.
- Bringing an author to your institution to discuss his or her articles.
- Hosting a virtual journal club with multiple authors via teleconference or social media.
- Purchasing food and refreshments within the “old school” method of a fireside chat at an attending’s home.
No matter the platform or methodology, journal clubs are a vital part of orthopaedic education, not only for interpreting literature, but also for incorporating knowledge into future clinical practice and for the joy and excitement of lifelong learning.
Matthew R. Schmitz, MD, FAOA is an orthopaedic surgeon specializing in adolescent sports and young adult hip preservation at the San Antonio Military Medical Center in San Antonio, TX. He is also a member of the JBJS Social Media Advisory Board.