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Adult & Pediatric Tumor Rotations About the rotation The musculoskeletal oncology service is organized as an adult orthopaedic tumor service at the University of Washington Medical Center and as a pediatric orthopaedic tumor service at Children's Hospital. The service is directed under the guidance of board certified and fellowship trained orthopaedic oncologists Ernest U. 'Chappie' Conrad III, MD, FACS and Jason Weisstein, MD, MPH. The second-year resident rotates on the tumor service for two six-week blocks, spending an equal amount of time on the adult and pediatric services. As this is a high-volume service, the resident will encounter a broad spectrum of differential diagnoses, including: benign and malignant bony and soft-tissue lesions, metastatic disease, pseudotumors, and dysplasias. Working with the orthopaedic oncology ACE and a dedicated physician assistant on the adult rotation, residents care for outpatients and inpatients at the University. Not only do the residents evaluate patients with high-grade tumors in the chemotherapy clinic but also lower-grade tumors at the Bone and Joint Surgery Center. In addition, residents actively participate in surgical cases with attendings and/or the orthopaedic oncology ACE on dedicated surgical days at the University. The pediatric tumor service allows the R2 to evaluate and manage tumor patients who are sent to the Children's Hospital from our large referral area. A central aspect of the rotation revolves around a weekly multidisciplinary clinic with the attending, the orthopaedic tumor ACE, a dedicated pediatric oncologist, and a hematology/oncology nurse practitioner. The R2's are responsible for the care of the inpatients, assist in the operating room, and take trauma call at Children's. Goals & Objectives The goal of these services is to teach the salient aspects of evaluation and management of bony and soft-tissue lesions that are relevant to a general orthopaedic practice, as well as provide a foundation for fellowship training. Residents for both the pediatric and adult service are expected to master the differential diagnosis of musculoskeletal oncology during their rotation. The educational goals of the orthopaedic oncology service are partially met by attending multidisciplinary oncology conferences and clinics. Residents are not only expected to understand the principles of evaluation and the differential diagnoses of tumor patients, but also to learn the techniques of biopsy, the indications for radiation and chemotherapy, and the overall prognosis for different tumor categories. Developing a foundation in perioperative management and surgical planning for orthopaedic oncology patients is emphasized. Clinical projects are encouraged for both the adult and pediatric services. Basic science programs revolve around the molecular or genetic basis of sarcomas, while other projects involve metabolic imaging with PET scan and prospective protocols for the assessment of clinical outcomes. |
