By Troy Watson, MD
Program Director
Founder, Foot and Ankle Institute
Director, Las Vegas Orthopaedic Foot and Ankle Fellowship
Desert Orthopaedic Center
Las Vegas, NV
In a city defined by rapid growth, a diverse patient population, and a high demand for musculoskeletal care, the OPTI–West Valley Hospital Medical Center Orthopaedic Surgery Residency Program has emerged as a rigorous, high-volume training environment designed to graduate practice-ready orthopaedic surgeons with durable academic habits. Based in Las Vegas, the program offers a five-year, progressive surgical curriculum with continued accreditation through ACGME and American Osteopathic Association. With two residents matched per year—maintaining a full complement of ten trainees—the program emphasizes deliberate repetition, close faculty mentorship, and graded autonomy anchored in patient-centered outcomes.
At the core of the program is an apprenticeship model: residents train directly with a broad, fellowship-trained faculty representing sports medicine, spine surgery, hand surgery, foot and ankle surgery, pediatric surgery and adult reconstruction. The clinical base at Valley Hospital Medical Center provides a high-throughput operative experience and a case mix that reflects the realities of modern orthopaedics, particularly the evaluation and management of complex sports and spine pathology, degenerative conditions, and urgent musculoskeletal presentations. Daily operative exposure is paired with structured expectations for preoperative planning, intraoperative execution, and postoperative decision-making, with increasing responsibility as competency milestones are met.
The residency’s off-site trauma and pediatric experiences are intentionally designed to broaden residents’ procedural repertoire and clinical judgment. Residents complete six months of pediatric orthopaedic surgery at Phoenix Children’s Hospital and six months of adult orthopaedic trauma at University Medical Center in Las Vegas, sharing the workload with the UNLV Orthopaedic Surgery Program. The trauma rotation provides a high-yield exposure to fracture care, periarticular injuries, polytrauma coordination, and the urgent decision-making that shapes safe surgical practice. By integrating pediatric and adult trauma into the five-year continuum, the program ensures graduates are comfortable managing acute pathology while maintaining a disciplined approach to indications, timing, fixation strategy, and complication avoidance.
Academic rigor is supported through a minimum of four hours of protected weekly didactics with active faculty participation and a consistent emphasis on exam preparation, clinical reasoning, and evidence-based practice. The program’s academic structure is built to translate directly to improved performance on the Orthopaedic In-Training Examination and board preparation—without sacrificing operative development. Monthly cadaveric and technical skills laboratories further strengthen procedural confidence, providing a controlled environment to refine fundamentals, rehearse approaches, and improve efficiency before translating techniques to the operating room.
A distinguishing strength of the program is its early operative integration. Residents are introduced to meaningful intraoperative responsibility early in training (appropriate to their level) reinforced by close supervision and targeted feedback. This “early exposure, high repetition” philosophy is designed to build comfort with surgical flow, instrumentation, tissue handling, and real-time problem solving, while preserving safety and educational accountability. Over time, residents develop the ability to lead cases in a structured manner: preparing and presenting the plan, anticipating pitfalls, and executing key steps with progressive independence.
Beyond the operating room, the program prioritizes scholarship that matters to patients and practices. Residents are encouraged to participate in outcomes research, quality improvement, and clinically relevant investigations throughout training. By embedding research into the educational culture, the program aims to graduate surgeons who not only apply evidence but also contribute to it—particularly in areas where pragmatic, real-world data can improve decision-making and reduce variability in care.
Under the leadership of Program Director Troy Watson, MD, the program’s mission is clear: to train highly skilled, board-eligible orthopaedic surgeons prepared for success in community practice with sustained academic engagement. In an era where healthcare systems increasingly demand value-driven care, the program’s educational strategy remains consistent—pair high-volume clinical experience with a disciplined academic framework, a strong trauma foundation, and a culture of mentorship. The result is a residency experience built to develop surgeons who can deliver exceptional musculoskeletal care to the diverse urban population of Nevada—and to carry forward the habits of lifelong learning, clinical leadership, and measurable improvement.
