Orthopaedic Surgery Training at the University of Pittsburgh - Alumni Profiles: C. Benjamin Ma, MD; Antonia Chen, MD, MBA; Robin V. West, MD

We train orthopaedic surgeons at the University of Pittsburgh and UPMC to take ownership early and to carry it forward into patient care, research, and whatever roles our trainees choose to build for themselves and their career. The goal of our residency program and advanced fellowship training is not to produce one type of orthopaedic surgeon for one type of career. Our goal, since Albert Ferguson, MD, assumed the position of department chair in 1953, through the leadership of James Herndon, MD, Freddie Fu, MD, and current chair, MaCalus Hogan, MD, MBA, is to ensure that every trainee leaves here prepared to operate at a level where they can make a meaningful, lasting mark on the field, whether that happens through leadership, program building, scientific discovery, or exceptional clinical practice.

This article looks at our training approach and dynamics through the paths of three alumni who came through the Department at different points in time and in different ways. Two trained as residents and now lead major academic orthopaedic surgery departments as chairs. One came to Pittsburgh as a fellow, remained on faculty for a dozen years developing programs, and then went on to establish and grow an entire service line.

The Department of Orthopaedic Surgery at the University of Pittsburgh has changed over time as the field and medicine as a whole have changed. The resources here now are very different than they were in 1953, 1993, or 2023. The structure and scope of our training programs have grown exponentially. What has remained consistent is what is expected of the people who train here, and what they will carry with them after they leave. From the beginning, our trainees are asked to take responsibility for patients, to develop judgment through experience, and to engage in the work of advancing orthopaedic surgery as part of their training, not as something separate from it.

What these three alumni did with the foundation from their training here, plus their own innate skills and abilities - what they have accomplished so far, and what they still are working toward reflect their own goals, interests, and opportunities. We are in the business of creating foundations that last. Our orthopaedic surgery trainees have the responsibility for everything that comes after.

Benjamin Ma, MD

Benjamin Ma, MD, is professor and chair, Department of Orthopaedic Surgery, University of California, San Francisco. Dr. Ma was named chair at the beginning of 2024. He also serves as vice chair of adult clinical operations in the Department, holds the Dr. Peter and Sophie Pappas Endowed Chair, and has been the V-Nee Yeh Endowed Professor since 2021. He completed his orthopaedic surgery residency at the University of Pittsburgh School of Medicine from 1996 to 2002 on the six-year academic track, with his research year between his second and third clinical years working in the laboratories of Savio Woo, PhD, Christopher Harner, MD, and Freddie Fu, MD. After residency he completed a fellowship in shoulder and knee surgery and sports medicine at the Hospital for Special Surgery in New York. He joined the UCSF faculty in 2003 and was chief of the Division of Sports Medicine and Shoulder Surgery from 2007 to 2019, growing the faculty fourfold during that tenure.

Dr. Ma's clinical practice is in sports medicine, shoulder surgery and replacement, knee ligament reconstruction, and the treatment of meniscus and cartilage injuries. His translational research focuses on cartilage imaging and dynamic MRI assessment of ACL-injured knees, with the goal of earlier detection of cartilage injury following ACL reconstruction and improved long-term reconstruction outcomes.

He has published extensively on outcomes following rotator cuff surgery and shoulder replacement. His research has been funded by the American Orthopaedic Society for Sports Medicine (AOSSM) Cartilage Initiative and by P30 and P50 program grants from the National Institutes of Health, and he serves as a standing member of the NIH AMSC Study Section, which reviews proposed clinical trials in the care of musculoskeletal injuries. He is a founding member of the Multicenter Orthopaedic Outcomes Network (MOON) Shoulder Group, whose research has received the Charles S. Neer Award from the American Shoulder and Elbow Surgeons, the top research award in shoulder and elbow surgery, three times.

His division at UCSF also participates in the Multicenter ACL Revision Surgery (MARS) Group. In 2022, Dr. Ma was appointed Research Chair of the AOSSM, and he serves on the AOSSM board and the editorial board of the American Journal of Sports Medicine. His individual research has been recognized with the O'Donoghue Award from the AOSSM, the Patellofemoral Research Excellence Award from the International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine, and the New Investigator Recognition Award from the Orthopaedic Research Society.

Dr. Ma matched at the University of Pittsburgh in an era of orthopaedic training that bears little resemblance to the present one. There were no program websites, no current-resident testimonials posted online, and no rankings beyond a handful of magazine lists that residency applicants generally understood to be flawed. Program selection ran through faculty roster, mentor recommendations, and the in-person interview.

“In 1996, applicants to programs outside their home institutions had access to limited information about other programs. There was no internet resource to consult, and no platform through which current trainees could share their experiences with applicants. The available information consisted of the names of the faculty and the recommendations of mentors at one’s medical school. That was nearly the entirety of it,” Dr. Ma says.

The strength of the faculty roster, particularly in sports medicine and biomechanics, drew Dr. Ma to the University of Pittsburgh, along with the recommendations of his mentors at Johns Hopkins School of Medicine.

The progression of the residency, from intern to super chief, is what Dr. Ma identifies as the foundation for his as a department chair. By his sixth year of residency, he was credentialed as a staff physician with admitting privileges, and he took trauma call as the attending of record at a Level I trauma center, directing teams managing open fractures and multiple-extremity injuries without faculty present. The arc from clinical novice to attending-level responsibility, all within the structure of the residency, is a hallmark of how the residency program in the Department of Orthopaedic surgery functions.

“The University of Pittsburgh program develops a trainee from a position of essentially no operational knowledge to the capacity to direct, for example, a Level I trauma team as the attending of record. That progression, with that level of responsibility built into the structure of the residency, is what prepares trainees to lead in whatever direction they choose,” Dr. Ma says.

Dr. Ma did not enter medical school thinking about a future chair role or an academic leadership track. His career goals were to be a strong clinical orthopaedic surgeon and a productive academic researcher. The example that opened the chair role to him as a career possibility came during his research year, when Dr. Fu became chair of the Department in 1997. Dr. Fu had joined the University of Pittsburgh faculty in 1980 and went on to lead the Department through one of its most productive periods.

“Watching Dr. Fu lead the Department made the idea of a position of leadership in the field visible to me as a viable career path. Without that example before me during training, I am not certain the position would have come into view as a real possibility,” Dr. Ma says.

The mentorship Dr. Ma received from Dr. Fu and the entire Department continued throughout his career and shapes how he now talks to the trainees at UCSF about the residency relationship. A conventional view treats orthopaedic residency as a five-year program that ends at graduation. Dr. Ma argues for a much longer view of the process. A surgeon’s residency training is the beginning of a career-long professional relationship between a program, its faculty, and its trainees.

“Residency is not a five-year program. It is really just the beginning of a relationship that should continue across a career. To treat residency as a transaction that concludes at graduation is to relinquish that relationship prematurely. The mentorship I received at the University of Pittsburgh is something I continue to rely on more than 20 years after completing the program,” Dr. Ma says.

The same principle informs how Dr. Ma describes the obligations of the trainee. Patients trust attending physicians to direct their care, and they extend that trust to the residents and fellows brought into that care because the program has vouched for them. Faculty, in turn, must extend the same trust to the trainees so that they grow into the work.

“The position of a learner in a training program carries privilege and substantive responsibility. Patients consent to involvement in their care by trainees because the program has vouched for those trainees. The faculty must extend the same confidence. The trainees who internalize that responsibility early are the ones who succeed,” Dr. Ma says.

Antonia F. Chen, MD, MBA

Antonia F. Chen, MD, MBA, is professor and chair, Department of Orthopaedic Surgery, UT Southwestern Medical Center, where she holds the Dr. Charles F. Gregory Distinguished Chair in Orthopaedic Surgery. She completed her undergraduate work at Yale University, her medical degree at Rutger’s University Robert Wood Johnson Medical School, and her MBA at Rutgers Business School during medical school. Dr. Chen completed her orthopaedic surgery residency at the University of Pittsburgh School of Medicine from 2008 to 2013, followed by an adult reconstruction fellowship at the Rothman Institute in Philadelphia. She first joined the faculty at Rothman Institute as associate director of research, then joined the faculty at Brigham and Women’s Hospital in Boston, where she was chief of arthroplasty and joint reconstruction and director of research for arthroplasty services. She joined UT Southwestern as chair on September 1, 2024.

When Dr. Chen applied to residency in 2008, the application landscape had expanded considerably from the pre-internet era Dr. Ma had navigated. She applied broadly. The University of Pittsburgh was on her list more for its East Coast geography than for any specific draw, but her interview at what is now the UPMC Freddie Fu Sports Medicine Center changed that quickly. The clinical and academic profile of the program was strong, and meeting Dr. Fu in the building he had constructed around a comprehensive sports medicine model was an experience she had not encountered at other programs.

“Dr. Fu had built a recognized national presence in academic orthopaedics through clinical excellence, research output, and the comprehensive sports medicine model he established at the University of Pittsburgh. That was a model of what was possible in the field that I had not seen at other programs, and it was a substantial factor in my decision to pursue residency at the University of Pittsburgh,” Dr. Chen says.

The residency was high-volume and high-autonomy, structured around long hours, sustained patient continuity, and surgical responsibility that came from being trusted by attendings to operate. Dr. Chen completed her residency training and was comfortable with trauma, spine, and her eventual subspecialty in adult reconstruction. Her mentors during training included James Kang, MD, Brian Klatt, MD, William Donaldson, MD, Joon Lee, MD, and Adolph “Chick” Yates, MD. Dr. Klatt taught her arthroplasty as a resident. Dr. Kang, who left the University of Pittsburgh for Brigham and Women’s during her training, recruited her after her time at Rothman.

The research environment at the University of Pittsburgh during Dr. Chen’s residency set the direction for the rest of her academic career. Sports medicine research under Dr. Fu was a built-out, internationally recognized academic enterprise. The joint reconstruction faculty were in earlier stages of building a comparable research program for adult reconstruction, drawing on the operational model Dr. Fu had established in sports. Working inside a research program in active development, rather than a fully mature one, taught Dr. Chen how research operations are built.

“The opportunity to learn how a research operation is built, while it is being built, shaped my academic trajectory. The research record I developed during my residency at the University of Pittsburgh is likely the reason Dr. Kang recruited me to Brigham,” Dr. Chen says.

Dr. Chen heard during her training that the University of Pittsburgh program had produced one of the highest counts of orthopaedic surgery chairs in the country, going back to Dr. Ferguson. She was not, at the time, planning to add to the number. Her path to the chair role at UT Southwestern came earlier than she had expected. Two factors shaped that path. The first was watching Dr. Kang lead, both at the University of Pittsburgh and in Boston, and seeing what was possible from that role. The second was her own MBA, which gave her vocabulary and frameworks for the operational and financial side of running an academic department that physicians without that training generally must acquire on the job.

That dual preparation defines the work Dr. Chen is doing as chair. Her department-level priorities at UT Southwestern are clinical excellence, education, and research, in that order, with active recruitment underway to build a faculty of clinically excellent surgeons whose practice in turn supports both resident education and research output. In her national society work with the American Association of Hip and Knee Surgeons and the American Academy of Orthopaedic Surgeons, she is focused on increasing the representation of women and underrepresented minorities in orthopaedic surgery, with particular attention to arthroplasty, where the numbers remain among the lowest in the field. She is also using the chair role to address a national gap she sees in orthopaedic training. Surgeons are taught to operate, but the operational, financial, and team-leadership competencies that determine how well a department or a practice run are not generally explicitly taught to trainees.

“Residency trains exceptional clinicians and surgeons. It does not, as currently structured, train leaders, and it generally does not address the practical competencies of running a practice or a department. The skills required to reach a chair role are distinct from the skills required to succeed in one. I think our field needs to teach both during training more rigorously and in a more formalized way,” Dr. Chen says.

What Dr. Chen returns to when she thinks back on the years, she spent at the University of Pittsburgh is not the case volume or the research output, both of which were considerable, but the relationships the program produced, and the relationships that have endured. The residents she trained alongside and the attendings she trained under remain part of her professional life.

“The University of Pittsburgh established a culture of long-term professional relationship. Attendings functioned as mentors and friends as well as teachers, and residents formed a working team that did not dissolve at graduation. Those relationships are among the most formative aspects of the program,” Dr. Chen says.

Robin V. West, MD

Robin V. West, MD, is the current chief of Inova Sports Medicine and previously served as president of the Inova Musculoskeletal Service Line for eight years. She joined Inova in 2014 to build the orthopaedic and sports medicine program from a starting group of seven surgeons in one office. The multidisciplinary program now includes 38 physicians who work across five hospitals, five ambulatory surgery centers and 10 ambulatory offices. Dr. West has served as a team physician in the National Football League for 16 years, and she has served or 10 years in Major League Baseball with the Washington Nationals, the first eight of which were as head team physician.

Dr. West completed here general surgery internship and orthopaedic surgery residency at George Washington University Medical Center from 1997 to 2002. She then completed her sports medicine and shoulder fellowship at the University of Pittsburgh School of Medicine from 2002 to 2003 under the mentorship of Dr. Fu and James Bradley, MD, and Christopher Harner, MD. Dr. West remained at the University of Pittsburgh and UPMC for 11 years after her fellowship and was part of the orthopaedic surgery residency program and the orthopaedic sports medicine fellowship program. for more than a decade after her fellowship.

The University of Pittsburgh fellowship program was widely recognized as one of the strongest in the country when Dr. West applied, and the comprehensive sports medicine model Dr. Fu had built was the specific draw. At a time when sports medicine as a discipline still varied considerably from program to program, the University of Pittsburgh had integrated orthopaedic surgery, primary care sports medicine, physical therapy, and concussion care into a single team-based program. Fellows took care of athletes across the full range, from high school to collegiate to professional, as part of a fully integrated team rather than as orthopaedic surgeons collaborating loosely with other disciplines.

“Dr. Fu was one of the architects of modern sports medicine and of the contemporary definition of the team physician role. The discipline is not exclusively orthopaedic surgery. Rather, it is comprehensive care of the whole athlete. The program he established at the University of Pittsburgh is the model on which sports medicine programs across the country are now constructed,” Dr. West says.

A second feature of the fellowship program shaped how Dr. West now thinks about hiring at Inova. The attendings she worked with during her fellowship and her time as faculty in the department had largely completed their residency or fellowship training somewhere other than the University of Pittsburgh and then come back. The faculty brought genuinely different perspectives and approaches to the same clinical problems.

“An inbred fellowship, in which trainees and faculty come exclusively from one institution, loses the perspective that comes from people who have trained elsewhere. At the University of Pittsburgh, most of the faculty had completed their residency or fellowship at other institutions before returning, which meant fellows learned multiple approaches to the same clinical problem from different attendings. That structure made the fellowship stronger,” Dr. West says.

The leadership lessons Dr. West applies daily at Inova came out of her relationships with Drs. Fu and Dr. Bradley during her years as Department faculty. The lessons were less about clinical practice and more about how a leader treats the people around them. Dr. Fu’s lesson was about communication, particularly after a complication, for example, and about being available without delay.

“Dr. Fu taught me that following a complication, the surgeon must increase communication with the patient and family rather than reduce it, and that the communication must be direct rather than mediated through staff or written correspondence. That principle of direct, immediate communication is a substantial component of effective leadership,” Dr. West says.

Dr. Bradley’s lesson came from observing how he built and retained a clinical team. The staff who work with him have, in many cases, been with him for decades.

“Dr. Bradley demonstrated how a surgeon can build and maintain a cohesive clinical team across a career. The members of his staff have worked with him many years, which is uncommon in medicine, where burnout and turnover are persistent challenges. That retention is indicative how he treats the people who work with him - with respect, with reliance, and with the recognition that they are members of the team rather than support personnel to it,” Dr. West says.

Dr. West served as a team physician for the Pittsburgh Steelers alongside Dr. Bradley during her years in the Department. When she started in the National Football League, two women were working as team physicians in the league: Dr. West and Leigh Ann Curl, MD, who covered the Baltimore Ravens. The orthopaedic surgery field overall was approximately four percent women when Dr. West was in training and is now approximately six percent. Sports medicine as a subspecialty is a smaller fraction still.

The opportunity to build the orthopaedic and sports medicine program at Inova arrived in 2014. Dr. West was not seeking to leave the University of Pittsburgh, and Dr. Fu and Dr. Bradley both made the case for her to stay. She accepted the Inova role because the chance to build a program at that scale, at the point in her career when she had the experience to do it well, was unlikely to come around again.

“Opportunities arrive at the intersection of preparation and chance. The capacity to take an opportunity when it presents itself is built over years of preparation that precede it. The Inova role was the opportunity. The preparation came from twelve years on the University of Pittsburgh faculty,” Dr. West says.

When residents reach out to Dr. West about choosing a fellowship, the advice she offers is based on what her own University of Pittsburgh fellowship gave her. The Inova program now runs its own accredited sports medicine fellowship, which Dr. West helped establish. Her Inova fellows continue to call her with questions years after training, and the fellows she trained at the University of Pittsburgh do the same.

“I think the principal value of fellowship is the mentorship it produces. Surgical technique can be acquired throughout a career through skills laboratories, video resources, and continuing education. The mentors a surgeon trains under in fellowship are the people that surgeon will call ten years into practice when a case is complex or the right approach is uncertain. That is the criterion that should guide a fellowship decision,” Dr. West says.

Dr. West remained on the University of Pittsburgh and UPMC faculty for more than a decade after her fellowship ended in 2003, and the breadth of what was available to her there is part of what kept her in Pittsburgh that long. The combination of an academic medical center, a major research university, and a comprehensive sports medicine enterprise built specifically for cross-disciplinary work produced opportunities in any direction she wanted to go.

“The University of Pittsburgh offered an extraordinary breadth of opportunity. Surgeons could work with the athletic teams, conduct research in the laboratories, or pursue formal training in the business school. The range of available work was the principal reason I remained on faculty as long as I did,” Dr. West says. “It was not an easy decision to leave and have the task of building an entire program. It was daunting, but what I learned in Pittsburgh helped to make it a reality.