Residency Program

Dr. Henry Broekhuyse

Dr. Henry Broekhuyse, Director of Postgraduate Education

The Orthopaedic Residency Program at the University of British Columbia is one of the leading orthopaedic training programs in Canada. The residency is a five year program, organized along Royal College of Physicians and Surgeons guidelines. Five residents are accepted into the first year of training every year.

The philosophy of the training program is to provide our residents with the best possible orthopaedic education and to facilitate their career development.

Residents from our program go on to a diverse number of careers in orthopaedics. Some elect to enter a general community orthopaedic practice and others select an academic career including Masters and PhD training. The training is a preceptor based adult learning model, allowing residents to have a close relationship with the attending surgeon they are working with and graduated levels of responsibility.

At the University of British Columbia, orthopaedic surgical education is based on participation in clinical rotations. The first two years of the program include “core” rotations in a variety of subspecialties including: plastic surgery, vascular surgery, general surgery, ICU, and general medicine. After completing the “core” training years residents complete the "Principles of Surgery" Exam administered by the Royal College of Surgeons. The residents then rotate through orthopaedic subspecialty rotations for the remaining three years of the program. The rotations include: general orthopaedics, orthopaedic trauma, reconstructive orthopedics, paediatric orthopaedics, orthopaedic oncology, hand surgery, foot and ankle surgery, athletic injuries, upper extremity orthopaedics and an elective experience. The final year of the program is tailored to the resident’s career desires and their academic needs.

A number of physical sites participate in the orthopaedic training program. Vancouver Acute serves as the home base for the residents. The academic offices are situated at Vancouver Acute and the resident half day seminar and lecture series occurs at that location. Daily morning teaching rounds take place in the orthopaedic conference room. Key trauma, reconstructive and orthopaedic oncology rotations take place at this site. Paediatric rotations are completed at British Columbia’s Children’s Hospital located a short distance away. Athletic injury rotations and upper extremity rotations take place at the UBC Hospital. The residents complete a foot and ankle rotation at St Paul’s Hospital. The Royal Columbian Hospital, situated in New Westminster, is a busy general hospital that manages a large volume of orthopaedic trauma. Residents complete a general orthopaedic rotation at that site. Subspecialty hand, foot & ankle, and athletic injury training are also available at the RCH site.

The UBC Orthopaedic Residency Program is the only residency training program in the province of British Columbia. As a result the residents have access to a high volume of orthopaedic cases and the program is able to provide complete training. By the time of their graduation our residents are competent surgeons who have participated in a large volume of surgical procedures. Managing orthopaedic emergencies is a key component of orthopaedic training and the residents see a large volume of orthopaedic trauma cases. Call requirements are typically 1/4 for in house call and 1/3 for at home call.

The University of British Columbia has a strong academic record and very strong leadership. Within the Department of Orthopaedics there are 7 faculty members with masters level clinical epidemiology training. The Department has an orthopaedic engineering division with 2 full time bioengineers as members of the Faculty. Throughout the 5 year program residents participate in a structured academic half day. A portion of that time is self directed learning or research participation. The second half of the afternoon includes a resident led interactive seminar and a faculty lecture.

The summer academic program includes a weekly anatomy session with cadaveric dissection. This focused anatomy program greatly facilitates the residents understanding of musculoskeletal anatomy and surgical approaches. Throughout the year there are different academic events that the residents participate in. Each spring the Department hosts its “Orthopaedic Update”, with local, national and international guests participating. A variety of local courses provide the residents with experience in arthroscopy, arthroplasty, fracture fixation and many other techniques and procedures. These local events are supplemented by national and international courses and meetings that the residents attend.

Morning rounds are a key component of interactive problem based learning within the Department. Each academic site has its own schedule of teaching rounds based on the subspecialty focus of the surgeons at that location. These rounds provide the residents with an excellent small group learning environment.

Ongoing learning is a key component of successful modern orthopaedic practice because of the rapid pace of technological advancement. Orthopaedic surgery by its nature is greatly affected by advances in surgical techniques, engineering, biomaterials, pharmacology, genetics and human biology. An understanding of orthopaedic research and critical appraisal skills are mandatory for successful practice and Royal College Certification. These skills are taught through a combination of scheduled didactic lectures, interactive group seminars, journal review meetings, and participation in orthopaedic research projects. The residents participate in two research projects during the 5 year program. They work directly with a research supervisor on a project of their selection. The residents present their work in progress annually at an Orthopaedic Grand Round and during their 3rd and 5th years they present their completed work at the annual Orthopaedic Research Day. Residents also present their work at national and international meetings.

Residents graduating from our program have diverse career paths, ranging from direct entry into community practice to advanced clinical fellowships and PhD training. The reputation of the training program and the orthopaedic faculty provide our residents with a great deal of opportunity outside Canada for fellowship training or career development. A large number of our graduates have gone on to successful academic careers and are among the leaders in orthopaedic surgery in Canada.

By their nature, surgical training programs are demanding. Residents are challenged to learn a large amount of new information. Also, they must develop surgical skills and surgical experience. Call requirements are in agreement with the Professional Association of Residents Guidelines. Organization skills, desire and commitment greatly assist residents in achieving success in the residency. Clearly, students will need to be dedicated and have an excellent work ethic to achieve success in a surgical residency and career.

Positions in Postgraduate training in British Columbia are funded and allocated by the Provincial Government. The UBC program accepts 5 orthopaedic residents to begin the training program each year. Applications are open only to Canadian citizens who have graduated from a medical school in Canada or the United States. There are no positions available to graduates of medical schools outside Canada or the United States. All residents are selected through the Canadian Residents Matching Service in an annual match. Detailed information can be obtained at the CARMS website at www.carms.ca. Orthopaedic positions are competitive. Applications are received from across Canada and Internationally. Applicants need to have demonstrated strong academic performance, keen interest, integrity and commitment in their undergraduate training. Potential candidates are interviewed by members of the Residency Selection Committee.

Do residents ever leave the program?
Occasionally a resident will request to leave the program, usually to transfer to another residency training program. Because of the competitive nature of orthopaedics, most residents have clearly thought out their career goals and have carefully evaluated their residency choice. However, because of the structure of undergraduate medical education in Canada, and the resident selection process, medical students must select the residency early in their education and occasionally someone makes an incorrect career choice and is more suited to another discipline. There is a specific process directed by the Postgraduate Dean’s Office for resident transfers.

Is there any time for electives in the residency program?
Residents are provided with a two month elective rotation during their fourth year. Many residents elect to work in a rural community or in another centre for that experience. Residents interested in subspecialty training may use the time to explore fellowship opportunities. The final year of the program also offers residents with the ability to structure their year according to their academic needs.

How much holiday time is provided?
Residents are given 4 weeks holiday each year.

Is there maternity leave within the residency program?
Maternity leave is protected within the PAR-BC contract structure and by legislation. Up to a year of leave is available and is at the discretion of the resident.

Is it beneficial to do an elective if you are interested in obtaining a residency position?
Certainly elective experiences can be very valuable for both the orthopaedic program and the medical student. The student is provided with an opportunity to evaluate the program, staff and residents. The residency program is provided with an opportunity to showcase its educational program and also to evaluate the student. However, the orthopaedic community in Canada is relatively small and the surgeons at UBC have close contact with other surgeons throughout Canada, and in many international centres. Reference letters from other locations are very useful tools for the selection committee and allow us to evaluate students who have not performed an elective at UBC.

Does the UBC Orthopaedic Surgery Residency Program accept applications from IMGs?
No. Applicants to the UBC Orthopaedic Surgery Residency Program must be Canadian citizens who have graduated from a medical school in Canada or the United States.

For more information email: elizabeth.denton@vch.ca