Thoughts on Teaching (for Orthopaedic Graduates) *

Abstract

The house of academic medicine is supported by four pillars, which include clinical care, administration, research, and teaching. These pillars sustain the diverse missions of academic medical centers. Our subspecialty of orthopaedic surgery is also supported by these pillars. Clinical care is the largest and strongest pillar of academic medicine and orthopaedics. All value in health care begins with service to patients, and providing high-quality, safe health care is critical to the success of all medical centers and all orthopaedic practices. Administration is a necessary pillar. Competent, knowledgeable, and diligent administrators are very important for medical centers and orthopaedic practices, as they manage the complex processes associated with the clinical and academic missions. Research is an essential pillar of academic medicine and orthopaedic surgery. Besides providing new knowledge, new services, new products, and innovations that improve the care we offer to our patients, research can generate additional revenue for medical centers. During my career, research in orthopaedics has led to subspecialization in orthopaedic surgery, which, in general, has improved patient care. Specific clinical advances that I have observed include arthroscopic surgery, microsurgery for neurovascular reconstruction, cartilage restoration, cementless hip replacement, instruments and navigation for total knee arthroplasty, advances in spine surgery, and techniques and products for orthopaedic trauma care. These innovations have succeeded because they relieve pain and improve function for orthopaedic patients. Orthopaedic research improves the lives of our patients, and research is an essential pillar in the house of orthopaedics. Teaching is the fourth pillar of academic medicine and orthopaedics, although teaching can be an undervalued and overlooked pillar. Teaching generates less revenue than clinical care and research, generates administrative costs, and takes time to do well. Despite the critically important fact that teaching programs train the next generation of physicians and orthopaedic surgeons, the importance of the …