Department of Orthopedics - Spring 2024 issue

EDUCATION

Residency program listens to learners to better support their well-being.

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RESEARCH

Researchers seek to improve patient outcomes with potentially revolutionary treatments.

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DEPARTMENT OF

PHILANTHROPY

Donor establishes memorial fund to remember his father and support residents’ education.

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A Message from Our Chair

Welcome, alumni, faculty, residents, and friends of the Department of Orthopaedics. I am proud to share with you our first newsletter detailing the many clinical, scholarly, and philanthropic activities happening in our department.

In Sports Medicine, we have recently welcomed a new physician, Scott Klass, MD, MS. He brings a wide array of new diagnostic tools and treatments to provide our patients with more options as we work together in their care.

We also said farewell to Charlie Carr, D ’79, MED ’81, RES ’87, who has served our department—and hundreds of Dartmouth student-athletes—for more than three decades. Charlie stood on the sidelines at nearly every Dartmouth football, hockey, rugby, and lacrosse game, no matter whether they were at home or away. He will be sorely missed by athletes and coaches alike. A new group of sports medicine doctors have stepped up to fill his impressive shoes.

The department’s research portfolio is growing, both in number of studies and in funding. Among the many studies, our clinical researchers are investigating new ways to use photodynamic therapy to prevent and treat infections. Another team in our department is studying the use of a fluorescent drug to diagnose necrotizing soft-tissue infections and remove as little tissue as possible to treat this life-threatening condition.

For the past two years, we have partnered with Nth Dimension, a program that’s providing early exposure for

women and minorities in medical school. We hope this partnership will increase the diversity of our specialty.

The residency program has undergone a number of changes to improve our learners’ experience and wellbeing. And, of course, the success of our residency program relies heavily on generous donors. We’ll introduce you to one of them, and we invite you to join him in supporting our learners.

I hope you enjoy these departmental highlights, and I look forward to sharing more with you in the future. Thank you for your continued support of everything we’re doing in orthopaedics.

Kevin J. McGuire, MD, MS

Interim chair, Department of Orthopaedics, Dartmouth Health Section chief, Center for Pain and Spine Associate Professor of Orthopaedics, Geisel School of Medicine

Save the Date!

Senior Resident Research Day, Alumni Dinner and Golf Outing

Join us as our senior residents present their research projects on October 11. Grand Rounds and case presentations will be followed by the presentation of Chief Resident research projects and an alumni dinner. Alumni, residents, faculty, and friends are also invited to gather October 12 for a golf outing.

October 11-12, 2024 Lebanon, New Hampshire

It took three of us to fill the massive void he left.”

Jamie Ames, MED ’04, MS ’08, RES ’10 Co-director, Sports Medicine

Thank you, Charlie Carr

Charlie Carr, D ’79, MED ’81, RES ’87, emeritus director of sports medicine at Dartmouth College and an orthopaedic surgeon at Dartmouth Hitchcock Medical Center (DHMC) since 1989, retired from his longtime roles at the college and the medical center in 2022.

He didn’t initially intend to become so heavily involved with Dartmouth’s athletics teams, but it ended up becoming a passion, so he frequently attended football, hockey, lacrosse, and rugby games. Over time, he became more deeply ingrained in the role and became a fixture on the sidelines.

“The players and coaches got to know my name, and they welcomed me as part of the team,” says Carr, who often traveled on the team bus to cover away games. “You hang out a lot with each other when you are on the road together. I became included in all aspects of the team, including getting championship rings.”

“I thought Charlie would stand on the sidelines until he couldn’t stand anymore,” says Jamie Ames, MED ’04, MS ’08, RES ’10, who has

Over his career as an orthopaedic surgeon, Charlie Carr, D ’79, MED ’81, RES ’87 (left), pictured with the late Dartmouth football coach Buddy Teevens D’ 79, worked tirelessly with Dartmouth studentathletes, and he served on the sidelines of hundreds of Dartmouth sports events.

stepped into Carr’s shoes with the help of DHMC orthopaedists Timothy Lin, MD, MS ’14, RES ’16, and Scott Klass, MD, MS. “It took three of us to fill the massive void he left.”

“At home or away, it didn’t matter—he was always there covering Dartmouth games,” says Kristine Karlson, MD, the section chief of Family Medicine, a member of the Orthopaedics sports medicine team, and head team physician for Dartmouth College. She worked alongside Carr for more than 10 years and continues to care for Dartmouth athletes. “He made efforts to get to know the student athletes he treated, and he was genuinely interested in their lives.”

“I probably overdid it as a one-man show covering games alongside an orthopaedic resident for all those years,” Carr says. “The way the sports division is doing it now is more sustainable, by having a group of doctors using a team approach for coverage. I truly enjoyed watching sports and standing on the sidelines. However, retirement has been great so far. I’m happy to have made it to my finish line.”

Updates help improve training experience

Education has always been a priority in the Department of Orthopaedics, and the residency program has recently undergone several changes to improve learners’ experience at Dartmouth Hitchcock Medical Center (DHMC).

“We have an incredible training experience, and you aren’t awash in other residents and fellows like at bigger institutions,” says Marcus Coe, MD, D ’00, MS ’09, RES ’12, the orthopaedic surgery residency director, noting that there are only four residents per year in the five-year program. “And there are no other Level 1 trauma centers in rural areas like this. Our alumni have hands-on experience with the sickest of the sick patients. That makes this place unique, and our residents continue to be courted by the most prestigious fellowships in the country.”

Read more about the recent changes to the residency program to better support learners.

Academic Half Day

The department recently transitioned to an academic half day for didactic teaching every Friday. In the past, residents sat together every day for a morning conference, but as the residency broadened to more locations, it became impossible to get everyone in the same room on a daily basis.

“A hallmark of this program was the cohesiveness of the group,” Coe says. “So now instead of every day, we do a half day Friday dedicated to resident education. No matter where they are stationed, we can come together in one physical space.”

New London Hospital Rotation

Many residents went through their orthopaedic training at the White River Junction VA Medical Center, but the program recently discontinued those rotations. Two years ago, however, a community hospital called New London Hospital joined the program, allowing orthopaedic residents to gain a community practice rotation with numerous subspecialties—hip and knee arthroplasty, sports medicine, shoulder and elbow, foot and ankle, hand and community trauma. Chief residents have the opportunity to run the orthopaedic service, coordinating with other residents and attendings at Dartmouth Hitchcock Medical Center. The New London Hospital rotation has allowed orthopaedic residents to receive extra exposure in their area of interest.

Formalized Research Block

To improve residents’ research experience, the department has instituted a formal research block—three months set aside for fourth-year residents to dedicate all their attention to their research project. For many years, residents have been expected to produce a publishable paper to present at Senior Research Day in the fall. But residents found that completing their research while also doing rotations was extremely challenging.

“Now they have a devoted block of time to get their project to the finish line,” Coe says. “They’re in the bullpen for cases as needed, but the majority of their time is spent on research.”

Marcus Coe, MD, D ’00, MS ’09, RES ’12, Orthopaedic surgery residency director

Fran Faro, MD, Orthopaedic surgery associate residency director

Administrative Chief Residents

In 2020, the residency program established a new role: administrative chief resident. Each year, by a vote of their peers and attendings, two fifth-year residents are chosen for the position, which includes clerical work, such as creating call schedules, as well as experience leading department-wide initiatives. The administrative chief resident also acts as a sounding board for the residency program directors and as a source of inspiration for the other residents.

“The administrative chief resident provides structure for the more junior residents,” says Fran Faro, MD, the associate residency director. “If someone has a problem, they go talk to the admin chief to see what they can do among themselves to create a better pattern.”

The administrative chief resident helps not only the residents but also the other learners in the department, such as thirdyear medical students, get a broad experience of different orthopaedic services.

Taylor Yong, MD, MS ’19, RES ’21, an orthopaedic trauma surgeon at Texas Tech University Health Sciences Center, was the first administrative chief resident in the department. “I helped mitigate conflict and served as an intermediary between the residents and faculty. I felt more involved behind the scenes, and it was helpful to see more of what I now see at my first attending job. I approached the position like, ‘This is our program, and we should all work together to make it better.’”

Recent graduates

The goal of the Department of Orthopaedics is to prepare residents for their future and help them achieve their career goals, whether it involves fellowship training, academic practice, or private practice. We would like to celebrate our recent alumni by sharing the medical schools they attended prior to residency and their post-graduate fellowship or immediate employment.

2023

Steven P. Baltic, MD, MS

University of South Florida Health Morsani College of Medicine, Tampa, Florida

Spine Fellowship at OrthoCarolina, Charlotte, North Carolina

Timothy McManus, MD

Ohio State University College of Medicine, Columbus, Ohio

Sports Medicine Fellowship at the Steadman Hawkins Clinic, Denver, Colorado

Cody Ramirez, MD

UT Health San Antonio Long School of Medicine, San Antonio, Texas

Sports Medicine Fellowship at the Steadman Hawkins Clinic, Denver, Colorado

Corey Resnick, MD

George Washington University School of Medicine and Health Sciences, Washington, D.C.

Adult Reconstructive Surgery Fellowship at Virginia Commonwealth University, Richmond, Virginia

Travis Wright, MD

Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo, Buffalo, New York

Hand Fellowship at Cleveland Clinic, Cleveland, Ohio

2022

Tracy M. Borsinger, MD

Georgetown University School of Medicine, Washington, D.C.

Adult Reconstructive Surgery Fellowship at the Hospital for Special Surgery, New York City

Thomas M. Hanson, MD

UT Health San Antonio Long School of Medicine, San Antonio, Texas

Adult Reconstructive Surgery Fellowship at the University of Virginia, Charlottesville, Virginia

Kelly C. Mead, MD

Uniformed Services University of the Health Sciences F. Edward Hebert School of Medicine, Bethesda, Maryland

Hand Surgery Fellowship at Brown University, Providence, Rhode Island

Ilda Molloy, MED ’16, MS ’19

Geisel School of Medicine at Dartmouth, Hanover, New Hampshire

Adult Reconstructive Surgery Fellowship at the Rothman Orthopaedic Institute, Philadelphia, Pennsylvania

The faces of sports medicine at Dartmouth

The sports medicine group takes a team approach to caring for their patients.

Over the past year, the sports medicine team at Dartmouth Hitchcock Medical Center (DHMC) has said goodbye to a familiar face and welcomed a new one, and the group continues to collaborate to serve their patients, including many athletes at Dartmouth College.

Orthopaedic sports medicine surgeons Jamie Ames, MED ’04, MS ’08, RES ’10, the co-section chief of Orthopaedics, and Timothy Lin, MD, MS ’14, RES ’16, have taken on roles as co-heads of the Dartmouth College sports medicine surgical team.

They work alongside primary care sports medicine specialists Kristine Karlson, MD, the section chief of the Department of Family Medicine at DHMC and head team physician for Dartmouth College, and Scott Klass, MD, MS, who is new to the Department of Orthopaedics. Together, the group takes a team approach to caring for Dartmouth studentathletes on the sidelines and in clinic, helping to ensure there’s no gap in coverage.

In addition to the sports medicine physicians, Ames emphasizes the crucial role athletic trainers play in sports medicine.

“Our sports medicine program doesn’t work without ATCs (certified athletic trainers),” he says. “One of the ATCs, Hannah LaRoche, works with me in both the clinic and in the operating room. That’s a unique feature of our sports medicine group.”

And with the addition of Klass to the department, the sports medicine team has started offering new services and procedures.

DARTMOUTH HEALTH Sports Medicine

Clinic Locations

8,000

Dartmouth Hitchcock Medical Center (Lebanon, NH)

Davis Varsity House at Dartmouth College (Hanover, NH)

Alice Peck Day Memorial Hospital (Lebanon, NH) New London Hospital (New London, NH)

Members of the sports medicine team (from left to right) Sarah Trainor, MSHS, PA-C; Hannah LaRoche, ATC; Scott Klass, MD, MS; and Brianna Thorburn, ATC.

Meet Scott Klass, MD, MS,

WHO OFFERS NON-SURGICAL THERAPIES

IN SEPTEMBER 2022, Scott Klass, MD, MS, joined Dartmouth Hitchcock Medical Center (DHMC) as the first non-operative, sports-medicine-trained faculty member within the Department of Orthopaedics. His expertise in non-operative musculoskeletal care has brought new depth to the department’s clinical offerings.

What’s your background?

My specialty before sports medicine was physical medicine and rehabilitation. Physiatrists are experts of biomechanics and rehab. I evaluated people clinically for things contributing to their pain and helped them develop an individualized therapy program to target those conditions and

be successful. Before medicine, I was a certified athletic trainer, and I worked as a strength and conditioning coach. So I draw on my background to help my patients get back to sports and be even better than they were before.

What special equipment do you use?

In addition to gathering medical history and doing a physical exam, I perform diagnostic ultrasound to help understand and characterize various injuries. Then I use that information to target the therapy directly into the area that needs treatment. With better accuracy comes better outcomes. For example, I often do ultrasound on patients with various

OPERATIVE SPORTS MEDICINE SERVICES

SHOULDER:

• Rotator cuff repair

• Bankart repair

• Latarjet procedure

KNEE:

• ACL (anterior cruciate ligament) reconstruction

• Meniscus repair and debridement

• Multiligamous knee repair

• Cartilage procedures

HIP:

• Labral repair

• Femoroacetabular impingement (FAI)

• Complex hip arthroscopy

OTHER SERVICES:

• Distal biceps rupture repair

• Proximal hamstring rupture repair

• Elbow ligament reconstruction

musculoskeletal issues that aren’t good surgical candidates. I can use percutaneous image-guided minimally invasive procedures to remove necrotic tissue in chronic tendinopathies that have failed other conservative measures.

What types of injections do you provide?

I do regenerative therapies, like PRP (platelet-rich plasma) injections on parts of the body that have limited healing capability. For people who haven’t had a good response to steroid or hyaluronic acid injections, we take their blood and spin it in a centrifuge to separate the platelets, which contain proteins and growth factors to help stimulate the body’s healing response. I inject it back into their joint or tendon to promote healing. We’ve done this for more than 30 patients, and we’ve had some really positive outcomes.

What’s your philosophy of patient care?

I love educating. I spend time talking my patients through their condition and what they should expect. I show them the ultrasound while I’m talking to them so they can understand what’s going on. As humans, we gather information with our eyes, so I use the ultrasound to enhance their education about what’s going on and how to alleviate their problems.

NATIONAL AND

INTERNATIONAL ATHLETIC TEAM COVERAGE

• U.S. ski and snowboard team

• U.S. soccer team

• U.S. rowing team

RESEARCH BRIEF

Finding a better way to treat ‘flesh-eating bacteria’

RESEARCH TITLE:

“Detection of superficial vascular thrombosis associated with necrotizing fasciitis using a vascular perfusion fluorophore: A pilot study”

CURRENT FUNDING:

Approximately $200,000

FUNDING AGENCIES:

Hitchcock Foundation; Orthopaedic Research and Education Foundation

With a 30% mortality rate, necrotizing soft-tissue infections—‘flesheating’ bacterial diseases—create a significant hurdle for surgeons who need to provide emergent treatment. They face two challenges: The first is the difficulty of making the correct diagnosis, because patients usually present with nonspecific symptoms and signs. Second, after the physician diagnoses the condition, it’s hard to surgically extract all infected tissue without removing normal tissue.

Eric Henderson, MD, is investigating whether using a fluorescent drug administered intravenously can make those decisions easier.

“We have shown that giving patients the fluorophore indocyanine green reveals sharp demarcations of where the infection is and where it is not,” says Henderson, an orthopaedic oncology surgeon in the Department of Orthopaedics at Dartmouth Hitchcock Medical Center. “The purpose is to have a better way of diagnosing these infections and also to provide guidance for surgeons to know where to start and stop debridement. Many patients end up with amputations, but with clearer definition of the extent of infection, we may be able to spare more patients’ limbs.”

RESEARCH BRIEF

Future of infection prevention might lie in antimicrobial photodynamic therapy

RESEARCH TITLE:

“Applying antimicrobial photodynamic therapy to prevent infection in contaminated open fracture and osseointegrated prosthesis”

CURRENT FUNDING: $3.5 million

FUNDING AGENCIES:

National Institutes of Health; U.S. Department of Defense

Antimicrobial photodynamic therapy has historically been used to treat cancer, but orthopaedic trauma surgeon Leah Gitajn, MD, MS ’20, and her team at Dartmouth Hitchcock Medical Center (DHMC) have another purpose in mind: preventing infection.

The clinical investigators are studying the use of this FDA-approved therapy as a way to destroy the bacterial biofilm that adheres to bone and prosthetic implants.

Biofilm is resistant to treatment modalities such as systemic and local antibiotics as well as irrigation solutions, making it difficult to treat. However, applying the topical antimicrobial photodynamic therapy to an open wound causes the bacteria to absorb the medicine and convert it to a photosensitive molecule. The researchers can then shine an optimized light on the bacteria, which results in cell death.

“Biofilm is a major cause of persistent infection because it’s highly protected from normal treatment,” says Gitajn, co-section chief of the Department of Orthopaedics at DHMC. “In vitro models show that

Henderson began the study two years ago, and the results so far have been encouraging. He has submitted a grant application to the National Institutes of Health to fund a nationwide clinical study, partnering with the academic medical centers at Vanderbilt University, the University of Michigan, the University of Pennsylvania, and the University of California, Los Angeles, among others.

“If we can enroll a large cohort of patients and demonstrate that these trends hold up across the country with various bacteria, then we’ll be in a position to pursue an FDA-sanctioned trial,” Henderson says. “My hope is to use this technology as a more definitive diagnostic test—and later to guide surgery—for these life-threatening infections and remove diagnostic uncertainty from the situation.”

My hope is to use this technology as a more definitive diagnostic test—and later to guide surgery—for these life-threatening infections and remove diagnostic uncertainty from the situation.”

Eric

Henderson, MD Orthopaedic oncology surgeon

In vitro models show that antimicrobial photodynamic therapy kills up to 98% of bacteria. This intervention could revolutionize our field and improve patient outcomes in truly profound ways.”

Leah Gitajn, MD, MS ’20 Orthopaedic trauma surgeon, co-section chief of Orthopaedics

antimicrobial photodynamic therapy kills up to 98% of bacteria. This intervention could revolutionize our field and improve patient outcomes in truly profound ways.”

She says antimicrobial photodynamic therapy could eventually become a standard treatment for contaminated open fractures, and it may be applied in a field-forward manner, such as during emergency transport before arrival at the definitive hospital. This creates an opportunity to positively impact patients who are most at risk of experiencing longer transport times to the tertiary care trauma center, such as those who are injured in a rural area or military members fighting on the front line.

The therapy may also help prevent infections for people with an osseointegrated prosthesis, which is a metal implant anchored in the bone and attached to a

prosthetic limb through a stoma. “Preventing infection in this patient population has the potential to pave the way for much broader implementation of these functionally superior prostheses,” Gitajn says.

“We believe photodynamic therapy will be a good home-based topical treatment that can be applied to the skin-metal interface to prevent infection in our patients,” Gitajn explains. “We’re working on optimizing treatment frequency (daily versus less frequent) in this patient population.”

Early results for using antimicrobial photodynamic therapy to treat infections in animal models have been encouraging. Gitajn has applied for a new grant from the National Institutes of Health and hopes to begin human trials within a year.

Patients with necrotizing soft-tissue infections often undergo amputations as a life-saving treatment. Eric Henderson, MD, is researching whether indocyanine green fluorescence can reveal more clearly where infected tissue is, which can assist surgeons with debridement. This research was recently featured in BioPhotonics Magazine (Laurin Publishing Co., Inc.).

ENDOWMENT FUND Family’s gift honors father, assists students

William Abdu, MD, RES ’90, MS ’01, (right) a retired orthopaedist at Dartmouth Hitchcock Medical Center, and his family established an endowment fund to honor his father, a primary care physician who inspired Abdu to become a physician.

William Abdu, MD, RES ’90, MS ’01, and his five siblings wanted to honor their father, a primary care physician for more than 40 years, in a way that also benefited orthopaedic residents at Dartmouth Hitchcock Medical Center (DHMC). With their gift, the family established the Louis Abdu MD Memorial Research and Education Fund in 2005.

“This fund is a way to support the surgical education of orthopaedic residents and to advance orthopaedic research and the science of health care,” says Abdu, a retired orthopaedic spine surgeon and former medical director of the Center for Pain and Spine at Dartmouth Hitchcock Medical Center. “We wanted to continue the memory of a physician who was dedicated to the care of his patients and who set a great example of giving back to the community he served. All who donate will know that this fund serves a great purpose.”

Louis Abdu was the son of immigrants and the youngest of seven children. He was the only one in his family to go to college and then to medical school. He served in the Army as a physician in World War II, and he was captured in the Battle of the Bulge,

becoming a prisoner of war. After the war, he returned home and began a long career in solo practice in Brockton, Massachusetts, caring for an ethnically and economically diverse community for more than four decades.

with him on rounds at the hospital. Sometimes the path to becoming a doctor begins long before going to medical school.”

Currently the endowment funds the purchase of surgical loupes for all orthopaedic residents. These are used in spine and hand surgeries and for other micro-procedures that require magnification—an indispensable gift for an orthopaedic resident. With additional donations, Abdu wants the fund to support other educational and research opportunities, and he emphasizes the need for alumni to contribute to this effort by generously giving back to the department.

Orthopaedic residents spend five years training at Dartmouth, and this memorial fund is one way for alumni to recognize the institution that trained them.”

William Abdu, MD, RES ’90, MS ’01

Retired orthopaedic spine surgeon and former medical director of the Center for Pain and Spine at Dartmouth Hitchcock Medical Center

“His example inspired me to become a physician,” says Abdu, who started at DHMC as an intern in June 1985 and retired in June 2021. “As a child, I frequently went with my father on house calls and

“Orthopaedic residents spend five years training at Dartmouth, and this memorial fund is one way for alumni to recognize the institution that trained them,” says Abdu, who has seen the fund grow over the years with contributions from family, friends, faculty, residents, and grateful patients. “To show their appreciation, alumni can make

contributions to support their training program, or they can make a financial contribution in memory of someone in their own family to help advance the science in orthopaedic surgery and to enhance the surgical education of orthopaedic residents.”

Abdu adds: “I know that alumni want to give back, but they are perhaps uncertain of the best mechanism to do so. I also know that they want their contributions to be meaningful and purposeful and aligned with their good intentions. This endowment fund serves that purpose, so I encourage alumni to make substantial contributions to the Research and Education endowment fund, whose sole purpose is to support the residency training program. Alumni know where their contributions are going, and they know what they’re doing.”

For more information, please contact Matthew Hall, senior associate director of patient and family giving, at (603) 667-6309 or matthew.r.hall@hitchcock.org

What is a CLINICAL RESEARCH COORDINATOR?

Clinical research coordinators are indispensable to the successful research portfolio in the Department of Orthopaedics. With so much to do, it takes a team of coordinators to manage all the research studies orthopaedics investigators are involved in.

Meet Devin Mullin, a clinical research coordinator who has been part of the research study team since 2019.

What are some of your responsibilities?

Among many things, we recruit and follow patients; create protocol summaries and amendments; communicate with physicians, sponsors, institution review boards, and internal teams; and collect and organize data.

What are some of your current research studies?

Some of our current studies explore the effects of early weight-bearing after fracture, fluorescent-based measurement of bone profusion in open fractures and infections, and new ways of identifying periprosthetic joint infections. We also have many new projects coming up that we are really excited about.

How are you making a difference in the field of orthopaedics?

We’re making a difference by supporting investigators to help innovate and improve current practices. By conducting research, we are able to gather valuable information to help our investigators find the best way to care for our patients.

What are the biggest challenges of your job?

One of the biggest challenges is following up with patients at nine- and 12-months post-fracture or surgery, since they can be hard to reach. Another challenge is asking a patient who has experienced a severe trauma to participate in a research study when they are stressed and in extreme pain.

What do you like best about your job?

One of the best parts of the job is following patients through their fracture recovery. We love seeing our patients in high spirits at one year post-fracture who are weight-bearing without assistive devices. We see our patients during one of the most challenging times of their lives, and witnessing them regain their mobility and independence brings us joy.

We must deconstruct the view that you have to be a certain way to be in orthopaedics. You don’t have to be a sports enthusiast, an extrovert, white, or male to be an orthopaedic surgeon.”

Fran Faro, MD an orthopaedic surgeon and the associate residency director in the Department of Orthopaedics

Nth Dimensions program aims to improve diversity in orthopaedics

Orthopaedics is the least diverse of all medical specialties, with the fewest women and underrepresented minorities working as surgeons in this field. The Department of Orthopaedics began a partnership with Nth Dimensions two years ago in an effort to change that reality.

Nth Dimensions is a program that helps women and minorities get earlier exposure to several medical specialties, including orthopaedic surgery, before their second year of medical school. For each of the past two years, a female medical student has joined the department for an eight-week summer internship. The interns shadow attendings in clinics, conduct exams, write notes, and assist in the operating room.

“Both of these young women got the message somewhere that orthopaedics isn’t for them. We must actively combat that sentiment,” says Marcus Coe, MD, D ’00, MS ’09, RES ’12, the orthopaedic surgery residency director. “You can say ‘you belong’ as much as you want, but if no one looks like you, it’s hard to believe that. We must truthfully reinforce that these folks can do this.”

Produced by:

Fran Faro, MD, an orthopaedic surgeon and the associate residency director, says she encountered these stereotypes in her personal experience as a woman in orthopaedics.

“When I first applied to orthopaedics 20 years ago, a lot of people told me I couldn’t be a good mom or do what the guys could do in the operating room,” Faro says. “If you made a mistake, they said it’s because you’re a woman, not because you’re human. I had to let go of what other people thought of me.”

Faro adds: “We must deconstruct the view that you have to be a certain way to be in orthopaedics. You don’t have to be a sports enthusiast, an extrovert, white, or male to be an orthopaedic surgeon.”

From left: Nth Dimensions scholar Travette Daniels, from Rosalind Franklin University of Medicine and Science; Fran Faro, MD; and subintern Natalya McNamara, a fourth-year student from Spencer Fox Eccles School of Medicine at the University of Utah who is doing a four-week elective in orthopaedics. McNamara recently matched to Dartmouth Hitchcock Medical Center’s orthopaedic surgery residency program.