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Residency Rap

Conferences - The Good, The Bad and the Ugly

by Jarrod Shapiro, DPM
PRESENT Resident Editor
Botsford General Hospital
Farmington Hills, MI

Recently in Michigan, we’ve had a couple of smaller local conferences, and with the ACFAS Scientific Conference in Las Vegas coming up soon, I thought this would be a good time to have the resident community weigh in on conferences. What do you think about them? Waste of time? Can’t stand to sit through another lecture? Best thing since sliced bread? I’m a little torn on the issue. Here’s my take on this.

The Great

Overall, I think conferences are an important and integral part of not only resident education but continuing education of practitioners around the country. For some people this is the only way they learn anything new. I enjoy winding my way around the lanes of vendors, seeing new products that I can try to convince my attendings to use. I enjoy seeing friends and colleagues I may have lost touch with. I’m a hound for an interesting lecture from a new point of view or that teaches me something I didn’t know before. And I LOVE the workshops. I think I can speak for just about every resident in the country when I say I enjoy learning new techniques and technologies, and what better way than through hands-on workshops? I’d go to every workshop at every conference if I could, just to try stuff out.

The Not So Great

So then you’re wondering if conferences are so good, what’s the problem? Shapiro always has to have a problem! OK, here’s why I’m torn. First, not all conferences are created equal. The ACFAS Scientific Conference and the APMA conference are in my opinion the best two conferences of the year. They’re standouts. I’ve been to a few conferences in the past that were a complete waste of my time (poorly organized, presenters that clearly didn’t know anything about their topics, and no darn workshops). They usually sound pretty good on paper, but when I arrive I realize I could have learned more podiatry by staring at my own feet for three days!

Residents Can't Afford these Programs

Second, the expense for residents is ridiculous. I’m going to the ACFAS conference, and I’m truly excited about it. The topics are interesting, the “big guns” of podiatry will be speaking, and there’ll be a ton of vendors (and free stuff of course). But between airfare, hotel, and the workshops I’m spending over $1000. This doesn’t even include the fee for the conference. Here’s the crux of the problem. Why do residents have to pay to attend the conference? Did the organizers forget most of us live on a fixed (and pretty small) budget? I’m not saying we should necessarily get in to the workshops free of charge—cadavers and such cost money—but why not support resident education and cut us a break? I’m not talking about a discount—I mean free admission to the conference. Are you not more likely to increase resident attendance (the future of podiatry I might add) by making the conference free of charge?
One of my attendings that speaks at some national conferences told me he’s given a small honorarium for lecturing, which he donates to the local podiatry college. That’s the kind of support I’m talking about. He could reasonably pocket that money, arguing it would pay his time preparing the lecture. But he doesn’t, and I respect that.

The PRESENT Courseware folks are bringing their practice management seminars to six of the podiatry colleges again this year. How much is their attendance fee? A steep zero dollars – it’s free! Again, that’s support for residents that we really appreciate.

Register to Attend for FREE
Come one, come all. All podiatrists welcomed to attend.

I urge the organizers of these large conferences to think the same way when they’re deciding on fees for residents. And if they want to give us discounts for the workshops, who am I to argue?

I look forward to seeing all of you at the ACFAS Conference. Please feel free to introduce yourselves and let me know of any topics you’d like to discuss on our Residency Rap.

As with all PRESENT publications, all issues of Residency Rap will be stored on the PRESENT website, so if you miss an issue or you want to refer back to a prior issue, it'll be at:

http://www.podiatricresidency.com/residencyrap/

Talk to me,

Jarrod Shapiro, DPM
PRESENT Resident Editor
jarrod@podiatry.com

From:         Robert D. Phillips, D.P.M.
                     Residency Director
                     Coatesville VAMC
Subject:    Confidence vs Competence

Some interesting comments you made about confidence. After 26 years I have come to realize that confidence is a result of both experience and knowledge and also self-worth. My observations of many students and residents is that there is an inverse relationship between knowledge/capability and confidence. It seems that some of the most confident residents are some of the most uninformed, misguided, and even incompetent. Some seem to make brash decisions and statements with the smallest of knowledge bases and understanding of the long-term results of their actions.

I believe that there’s real need for more honesty in residents. After those 26 years of practice, I realize that the book of things I don't know keeps growing faster than the book of things I do know. Confidence comes when one can honestly state that there are so many things they don't know, without losing their self-worth. It comes with being able to ask others' opinions without feeling humiliated. I believe that residency directors can do much to boost self confidence by giving honest praise publicly and honest criticism privately. It also comes from resident teachers setting an example of true honesty with their patients and with their colleagues. It comes from teachers not bluffing their own way through tricky and touchy situations. It comes from being able to humbly admit that all doctors make mistakes and misjudgements and no doctor knows it all. I know the law profession would like the public to believe otherwise, but such is not reality.

I believe that a director can best build confidence by helping the resident be honest with himself/herself about what they do know and also about what they do not know. When a person can do this without judging themselves superior or inferior, then true confidence will shine through in a natural way.

Robert D. Phillips, D.P.M.
Residency Director
Coatesville VAMC
Robert.Phillips2@va.gov

From:         Brad Fine, DPM
                    3rd year, Chief Resident
                    Hollywood Medical Center
Subject:    Confidence vs Competence

I agree with you. You don't want to appear too confident, because that also aggravates attendings. There was a certain point--at least for me-- during my residency, that I felt capable of doing just about every procedure that we can do. Once you get there, there is no appearing confident, your experience, comfort-level, and confidence shines through

Editor's Response

Wise words as usual from Dr Phillips. I wish more of your directors and attendings would participate in our online Residency Raps. (Hint Hint Nudge) It’s nice to hear an honest viewpoint from an experienced attending. Too often, I interact with attendings that have no explanation for their actions and can’t come up with a reasonable rationale for what they’re doing besides “this works in my hands.” I’ve also had excellent experiences with attendings that welcome my input with interest and respect. If you find an attending like that, hang on to them; they’re a true asset to your education!

Dr. Fine brings up the excellent point of the delicate balance we have to follow as residents. I think the hardest point in achieving this balance is during the second year of training, when we’ve received a good bit of training but still have a relatively small store of experience to draw from. It’s often hard not to appear cocky. On the other hand, some people just come across that way no matter how hard they try not to.

- Jarrod

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