What’s New at VCU
Jonathan Isaacs, MD
Department of Orthopaedic Surgery
Virginia Commonwealth University Health System
Richmond, VA
As we finish our second of two resident interview days at VCU, I’ve had a chance to reflect on how much the interview process has changed in the last six years since I joined the faculty at VCU. Undoubtedly, the main change has been the incorporation of electronic applications. When I was a medical student, I filled out a different application for each place that I was interested in. While a bit of a pain in the you know what, I only applied to programs that I was at least a little interested in. Now, one “universal application” can be sent to as many programs as you want-- all at a push of a button. As a consequence, we received 518 applications for 5 spots (up from around 300 applicants a few years ago). Unfortunately, the only way to deal with these huge numbers is by filtering. Using a score of 90 or above on Step I & II as a cut off, the number was narrowed down to 364. Our program director, Wil Zuelzer, MD, then had the unenviable task of reviewing these applications. Academic records, letters of recommendation, and the personal statements were dissected apart, interpreted, and carefully evaluated as this number was trimmed down to 183 applicants. These were scrambled into a random order and invited to interview. The applicants, based on first come, first served, can pick which of two dates they want to interview.
The interview process took place on one Saturday in December and one Saturday in January. The residents took out any applicants available the night before for an informal, “attending-free” dinner. In general, the applicants have really appreciated the chance to interact with the residents in this more relaxed atmosphere though I’m not convinced that we learn as much about them. Bright and early Saturday morning, the applicants gather for the formal interviews. Drs. Zuelzer and Adelaar (our chairman), give an overview of the program and each applicant has several 15 to 30 minute interviews. We are blinded to board scores, academic records, or letters of recommendation during this part of the process and must try to get a feel for the applicants based only on our interactions with them. Final rankings are generated based on our impressions from the interview process and their academic accomplishments which are then reconsidered. Applicants from VCU (this year there were nine!), came in on a separate evening for a more intimate interview session. Each applicant interviews for a total of about 1 hour and five minutes spread out amongst 5 different faculty and senior residents. Each applicant meets with the chair or program director for 15 minutes and then 20 minutes with a faculty member team and 30 minutes with a faculty/senior resident team. Behavioral questions that the applicant has never heard are emphasized and the evaluation is based on a comparison of responses between the various applicants. This portion of the process emphasizes a more subjective assessment and highlights the relationships between faculty members and faculty and residents (definitely one of the strengths of our program). Thus about 65 of the applicants will be ranked by mid February based on the ERAS site. Based on the applicant’s rank list, the ERAS system will then notify our program about the top 5 “matches” in mid March.
Every year we try to improve the process to keep it as fair and balanced as possible. This remains a challenge, and innovative approaches including small group dinners, standardized questions, and “skills” stations are considered every year. The truth is that many of the applicants would do well in our program, and despite our efforts, “superstar” residents usually come in unexpected packages.
What's New at UVA
New Orthopaedics Chair at UVA
Mark Abel, MD, Plans to Improve Access and Expand Programs
Residency Program Director
Associate Professor of Orthopaedic Surgery
University of Virginia Health System
Charlottesville, VA
A pilot program launching this year to enable referring physicians to have their patients seen in the orthopaedic department clinics within one week is among the initiatives planned by Mark Abel, MD, the new Chair of the University of Virginia Health System’s Department of Orthopaedic Surgery. “We have an expanding faculty of board certified and highly specialized orthopaedic surgeons, and if physicians feel their patients need our expertise, then we want to be available,” says Abel.
“We’re committed to making sure we’re accessible to the entire state as well as the region,” says Abel, a board-certified orthopaedic surgeon whose specialties include pediatric orthopaedics, pediatric spinal surgery, hip dysplasia and cerebral palsy.
The department plans to add three new orthopaedic surgeons this year – one specializing in hand and upper extremity procedures, one specializing in spine procedures and one specializing in sports medicine to complement a recently added non-surgical faculty member with expertise in Pediatric Musculoskeletal Medicine. A fourth new surgeon, specializing in trauma procedures, is scheduled to be added next year, Abel adds. Additional support staff, such as physician assistants and nurses, will also be hired to make it easier for referred patients to access UVA’s comprehensive orthopaedics services.
“I believe that we need to have a robust clinical program to drive our education and research,” Abel says. “You have to understand the medical needs and priorities of patients to generate the research ideas.”
Growing Programs
Abel also envisions expanding the department’s outreach and offerings. In Culpeper – where UVA has established a partnership with Culpeper Regional Hospital – Abel hopes to partner with those regional orthopaedic doctors to provide highly specialized orthopaedic care to the locality. UVA expects to begin by offering ambulatory surgery, Abel says, with plans to eventually offer inpatient surgery such as, spine and joint arthroplasty procedures.
Abel also wants to expand and strengthen the multidisciplinary collaboration with other departments at UVA. For instance, Abel says that a freestanding Spine Center is due to open in December 2009, building on the collaboration with UVA’s Department of Neurosurgery. Surgeons from the two departments now perform about 1,400 procedures annually. Similarly, Abel also says that the Orthopaedic Hand Center which currently partners with the Department of Plastic Surgery will be in a new location in December 2009. Finally, he is working with his sports medicine faculty, who currently see patients in the McCue Center, to establish a Sports Medicine Center in collaboration with members of the Department of Physical Medicine and Rehabilitation and the University’s physical therapy department. UVA’s team of sports medicine specialists provides care for the athletics teams at both UVA and James Madison University.
“An integral part of the care we provide is through interdepartmental collaboration so that we have an ideal complement of non-operative and operative treatments,” he says.
Comprehensive Orthopaedic Care
Services available through UVA’s Department of Orthopaedic Surgery include:
- Adult Reconstruction
- Trauma Surgery
- Hand and Microvascular Surgery
- Sports Medicine
- Spinal Surgery
- Pediatric Orthopaedics
- Orthopaedic Oncology
- Ambulatory Orthopaedics
- Foot and Ankle Surgery
- Prosthetics and Orthotics
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Better or Different?
Thomas Brown, MDAssociate Residency Program Director
Associate Professor of Orthopaedic Surgery
University of Virginia Health System
Charlottesville, VA
Bobby Chhabra, MD
Residency Program Director
Associate Professor of Orthopaedic Surgery
University of Virginia Health System
Charlottesville, VA
In a response to negative survey feedback from resident applicants concerning the interview process and the difficulty of gathering useful information about applicants using conventional interview techniques, the
UVA Orthopaedic residency program has developed a new "theme-specific" interview process to assess prospective residents. Post -interview surveys identified that applicants previously felt that they had inadequate time to represent themselves effectively, and they were repeatedly asked the same
questions and gave the same answers. The new format assigned specific themes to each interview room for the interviewers to focus on a particular area. The themes included: radiologic interpretation, ethics, personal interests & hobbies, "back to the Future", Chairman's room, Resident's room and Bioskills assessment.
The University of Virginia Orthopaedic Surgery residency program received 678 applications for five positions this year. After an extremely challenging review process by a committee comprised of faculty and residents, 80 applicants were invited for interviews.
Post-interview surveys from the new interview format were extremely positive from both resident applicants and faculty participants. Although each room was limited in scope, it provided the opportunity to delve deeply into a particular area with each applicant. Following the interviews, faculty met as a group to compile their information and impressions which was more effective in developing a composite assessment of each applicant. The Department plans on collecting data next year and for years to come in order to better answer the question: is this interview and selection process better at identifying outstanding residents, or is it merely different...time will tell.
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