Guest Contributor
Megan Lawton, DPM
Discusses A Unique International Learning Experience
Jarrod Shapiro, DPM
PRESENT Resident Editor
Botsford General Hospital
Farmington
Hills, MI
| Many residents throughout the country have the opportunity to
participate in international programs, which broaden our collective
understanding of medicine. It’s my pleasure to have another enlightening
guest contributor to our Residency Rap,
Megan Lawton, DPM who participated in the AO Fellowship in
Germany. Many of you may know Megan from her columns in a number of our
journals, including the APMA News, APMA Young Members Newsletter, and
Podiatry Management Magazine. Megan is currently a third year resident
at the Grant Medical Center Podiatry Program in Columbus, Ohio. Megan’s
experience demonstrates one facet of the many opportunities available to
us as podiatric residents. -Jarrod |
As residents, we are offered numerous
opportunities to attend lectures, seminars, and workshops. Another great
experience, which I just attended, was an AO International rotation in Dresden,
Germany.
For one month, I was able to participate in offices and surgeries and learn
different, and sometimes unique, approaches to foot and ankle pathologies.
I believe this kind of exposure to international patient care was invaluable.
Not only was I able to see how things are handled in the Eastern Hemisphere, but
they were able to ask what Americans would do in certain cases and question some
of the practices we utilize in giving patient care.
For example, after surgery (cases we consider outpatient), patients would
stay in the hospital for weeks. They asked why we send them home so soon,
worrying about the increase in risk of infection.
An interesting case I was able to observe was a patient that was to undergo
an amputation, similar to a Symes. The difference in this was the calcaneus was
preserved and was actually rotated so that the posterior aspect was in the ankle
joint (talus was removed) and fused in that position. The theory behind this was
that this would preserve length of the limb and provide a sturdy bone block.
I was also able to participate in revisional surgeries of malunited pilon,
talar, and calcaneal fractures. The pictures listed below are of a surgery that
was originally going to be an ankle joint revision s/p pilon fracture, but there
was a large block of necrotic bone discovered intraoperatively. An antibiotic
block was placed in the area and the patient was later taken back for ankle
joint fusion. With such a large deficit of bone, an iliac crest bone graft was
harvested and placed in the area with plate and screw fixation.
Even with some differences, it was exciting to be involved with a program to
discuss issues in the world that pertain to our field. If the chance presents
itself to do a rotation or attend a meeting overseas during your career, I would
highly recommend it. This once-in-a-lifetime opportunity allows you to observe
various techniques and appreciate just how small the podiatry world really is.
Respectfully Submitted
Megan Lawton, DPM
PGY 3 Grant Medical Center
lawtonmegan@hotmail.com
