Medical Student Rotations

karch-speaking

Accrediting

The Mammoth Orthopedic Institute primary physicians are all accredited clinical faculty members of the University of Nevada School of Medicine for clinical third and fourth year medical students interested in an elective general orthopedics, orthopedic trauma, and sports medicine rotation.

Medical students of the University of Nevada Reno may arrange clinical rotations through the University office for clinical rotations.

Students outside the University of Nevada may contact the MOI office at [javascript protected email address] or 760-924-4084 for more information and to make arrangements with your specific accrediting institution.

Scheduling

While 2 or 4 week rotations are the most common, we can tailor the duration and timing of your rotation to meet your scheduling needs so long as your dates do not overlap with other visiting students. In some circumstances, there is adequate clinical exposure to permit two visiting students at one time.

Sample Clinical Schedule

Surgical Orthopedics Track

Monday - Dr. Crall, Sports Medicine Clinic

Tuesday – Dr. Gilmer, Operating Room

Wednesday – Dr. Crall, Operating Room

Thursday – Dr. Gilmer, Sports Medicine Clinic vs Dr. Crall and Dr. Gilmer Operating Room

Friday – Academic Day with Didactics vs Orthopedic Subspecialty (Hand, Spine, Foot and Ankle, Adult Reconstruction)

Non-Operative Outpatient Sports Medicine Track

Monday – Dr. Crall, Sports Medicine Clinic

Tuesday – Academic Day with Didactics versus optional Operating Room Experience

Wednesday – Dr. Gilmer, Sports Medicine Clinic

Thursday – Dr. Gilmer Sports Medicine Clinic

Friday – Dr. Crall, Sports Medicine Clinic vs Dr. Clark Sports Medicine Clinic

Goals and Objectives

Students receive an intensive immersion experience which spans general orthopedics with an emphasis on arthroscopy, sports medicine, and trauma. Students can tailor the experience to emphasize a surgical or non-surgical sports medicine track. Students are invited to take call with the attending physicians at their discretion or as dictated by their clinical requirements.

A general overview of goals and objectives is provided below:

Surgical Orthopedics Track

  • Medical care of the orthopedic patient:
    • obtain necessary but not excessive preoperative studies according to published guidelines
    • obtain appropriate consultations
    • triage patients who should be admitted to a medical service or intensive care unit
    • operioperative care and discharge of orthopedic patients.
  • Evaluation of patients in the emergency department
  • Outpatient orthopedics: basic exam for each joint and spine
    • indications for appropriate radiographic and laboratory studies
    • appropriate period of follow-up, when to discharge patient from care
    • Manual and other basic skills:
      • dressings/casts
      • patient positioning, prepping and draping
      • Fracture biomechanics and AO principles
  • Musculoskeletal trauma, including:
    • fractures and dislocations as treated in the Emergency Department
    • interpretation of basic radiographs and descriptive fracture terminology
    • injuries managed in the outpatient setting
    • casting and splinting
    • indications for surgical management of fractures
  • Sports Medicine, including:
    • Perform and present a history and directed physical exam of patients presenting with sports-related musculoskeletal complaints.
    • Formulate a meaningful differential diagnosis of patients’ musculoskeletal conditions for each joint.
    • Become familiar with indications for and principles of operative treatment of common sports injuries: ACL reconstruction, rotator cuff repair, meniscal and labral repair, etc.
    • Understand unique aspects of orthopaedic surgical procedures, including meticulous sterile technique.

Non-Operative Outpatient Sports Medicine Track

  • Musculoskeletal knowledge base, including:
    • normal alignment and joint range of motion
    • basic biomechanics
    • basic bone pathophysiology
  • General musculoskeletal diseases, including:
    • bone and joint infections
    • hip conditions, such as osteoarthritis, rheumatoid arthritis, avascular necrosis
    • spine conditions, such as spinal stenosis, disc disease, adult scoliosis, back pain
    • foot conditions, such as bunions, flatfoot or cavus deformities, tendonitis
    • hand conditions, such as carpal tunnel syndrome, osteoarthritis and rheumatoid arthritis
    • shoulder diseases, such as recurrent dislocations, osteoarthritis, frozen shoulder
    • sports injury in the athlete
    • tumors of bone and soft tissue
  • Musculoskeletal trauma, including:
    • fractures and dislocations as treated in the Emergency Department
    • interpretation of basic radiographs and descriptive fracture terminology
    • injuries managed in the outpatient setting
    • casting and splinting
  • Sports Medicine, including:
    • Perform and present a history and directed physical exam of patients presenting with sports-related musculoskeletal complaints.
    • Formulate a meaningful differential diagnosis of patients’ complaints, considering non-orthopaedic conditions as well as musculoskeletal conditions.
    • Become familiar with basic orthopaedic diagnostic and treatment strategies.
    • Become familiar with operative and non-operative treatment of common sports injuries.
    • Learn and understand principles of sports rehabilitation.

What you will be able to do for musculoskeletal problems in adult outpatient setting, or what we expect at the end:

  • Make a correct diagnosis - know what you’re dealing with, and don’t miss anything important.
  • Perform an acceptable work-up – perform a basic but thorough evaluation, including physical examination, imaging studies, laboratories.
  • Provide the standard of care in the community – treat what you’re comfortable treating.
  • Seek an appropriate referral – ask for help when it is necessary and warranted

Recommended Textbooks

The recommended texts below provide a basic introduction to core principles in general orthopedics and sports medicine

Netter’s Concise Orthopaedic Anatomy by Jon C. Thompson

Handbook of Fractures by Joseph Zuckerman and Kenneth Koval

Brukner’s and Khan’s Clinical Sports Medicine

Copies of these texts are available for students to borrow from Mammoth Orthopedic Institute for your use during your clinical rotation.

Additional online resources specific to surgical procedures performed are available at:

Sports Medicine -- www.arthrex.com

Orthopedic Trauma – www.aosurgery.org

Electronic access is available to relevant journals during the clinical rotation:

Arthroscopy: the Journal of Arthroscopy and Related Research

American Journal of Sports Medicine

Journal of Bone and Joint Surgery: American

Housing

Temporary housing in Mammoth Lakes can be difficult to secure at times. For assistance in securing housing during your rotation please contact us at [javascript protected email address] or 760-924-4084.

Medical Student Testimony

My 4 week observership at Mammoth Hospital was one of the most rewarding and enriching experiences of my life. I learned so much, not just about orthopedics and sports medicine, but also the joys of living and working in a tight-knit community. I was very impressed with just how much access I was given to the hospital and the patients, allowing me to really get as much out of the rotation as I wanted. Dr. Gilmer, Dr. Crall, Dr. Karch and the rest of the team were more than happy to take time out of their busy schedules to explain things to me and continuously encouraged my active involvement. I was able to freely ask questions and assist when appropriate. If you are looking for a great opportunity to work with a fantastic team, see extremely interesting cases and visit one of the most beautiful places in the world, I would highly recommend a rotation with Mammoth Orthopedic Institute.

Mammoth is one of the most naturally beautiful places I have ever been. With world-class skiing, hiking, rock climbing and mountain biking, take the opportunity in your downtime to make the most of what this beautiful town has to offer.

-Matthew Peters, BSc Med student, The University of Queensland Brisbane, Australia

In January 2018 I was given the opportunity to spend 8 days observing various orthopedic cases with Dr. Karch. Upon arriving in Mammoth, I was immediately welcomed by Dr. Karch and his team who were very accommodating and eager to answer any questions I had.

Mammoth Hospital was not what I was expecting by any means—it exceeded my expectations. Mammoth is not just a hospital, rather it is a welcoming community of health care providers who seek to care for the whole patient instead of simply repairing a broken bone or degenerative joint. Dr. Karch’s philosophy of cura personalis, as taught by Georgetown, is apparent in his implementation of a multidisciplinary committee to review and acknowledge modifiable risk factors so that each patient has the best possible outcome. Through this, I learned how numerous factors contribute to a patient’s post-surgical outcomes and the importance of evaluating these to promote a successful recovery. The multidisciplinary committee’s objective of caring for the whole patient is not a philosophy emphasized by all physicians, thereby setting the Mammoth orthopedic team apart from others.

During the 9 days I spent in Mammoth, Dr. Karch challenged me to think critically, understand the processes involved in each operation, and to contribute to discussions where appropriate. I had the opportunity to meet patients before their operations, immediately after surgery, at follow-up several months later, and post-operatively in physical therapy. Seeing patients in all stages of the recovery process provided me with a more comprehensive understanding of post-surgical outcomes and the recovery timeline for total hip and knee arthroplasties.

The experiences and opportunities that came from my time at Mammoth Hospital are countless. I left with a greater understanding of all components involved in orthopedic surgery and a deepened passion for the field. Dr. Karch is an inspirational orthopedic surgeon who promotes positivity and asks for 100% from his team every time, creating a healthy and motivational environment for his team and patients.

Kayla Smith, BS, ATS Moravian University

-Kayla Smith, BS, ATS Moravian University