Educating Leaders Through Clinical Practice

Published in Orthopaedic Surgery - Spring 2017

A leadership program that houses the "best” is how hip and knee surgeon Daniel Valaik describes the orthopaedic surgery residency program at the Johns Hopkins University School of Medicine. The faculty consists of highly experienced orthopaedic surgeons like Valaik who have a passion for sharing their knowledge with the next generation.

Valaik has long been connected with Johns Hopkins, where he completed his fellowship in adult reconstruction. After serving for 26 years in the U.S. Navy, Valaik recently returned to Johns Hopkins to join the Department of Orthopaedic Surgery faculty.

Valaik’s expertise is highly valued by the Johns Hopkins orthopaedic surgery residency program, which admits six applicants each year. The program’s emphasis on clinical training is supported by a didactic curriculum for basic and clinical sciences. In addition to Grand Rounds and subspecialty teaching conferences, teaching sessions are held at Johns Hopkins Bayview Medical Center’s International Center for Orthopaedic Advancement, which houses an orthopaedic skills laboratory.

Privately owned by Johns Hopkins, the facility allows experts like Valaik to impart their surgical skills to residents, preparing them for the difficult surgeries they will face. “We model some of the most complex patients in the laboratory,” says Valaik.

In addition to an instrument development laboratory, the facility has high-tech biomechanical testing capabilities and a surgical dissection laboratory with six surgical stations fully equipped to allow residents to perform mock procedures. Here, residents become familiar with orthopaedic implants, devices and instruments, and receive hands-on experience with orthopaedic models and fresh-frozen cadavers.

“We bring in all the instruments and implants that you would have in an actual case,” says Valaik. “We go through practice cases of the most complex variety, and the residents learn through hands-on experience.”

A tibial tubercle osteotomy in revision knee surgery is one challenging surgical approach that the residents can perform in the laboratory. This “tough revision approach,” as described by Valaik, is done step by step on a cadaver. “The tibial tubercle osteotomy requires you to precisely cut the tibial tubercle and reflect it over to obtain enhanced exposure to the knee. Meticulous repair and/or fixation of the osteotomy are also practiced by the residents.”

Teaching residents is an inspiring aspect of Valaik’s work. “These are smart young people, and they ask very good questions,” says Valaik. “I find that it keeps me on my toes. Every once in a while, they ask something that I had never thought of. This leads us to innovate and improve what we do.”

Valaik believes that when you teach, you must not only have a mastery of the subject, but also an open mind. You must allow the residents to explore all of the possible solutions to complex problems. This is the philosophy behind developing orthopaedic expertise at Johns Hopkins: educating leaders and preparing residents to face the biggest challenges of their professional lives.