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Residency Rap

Our Mentors


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

Good day, colleagues. We’re getting ever closer to graduation this year. For us third years, we’re all looking forward to our next step into practice with mixed emotions. We’re joyful to finally be on our own, with no one standing behind us, telling us what to do. But we’re also nervous to finally be on our own, with no one standing behind us as a safety net. Personally, I can’t wait to have my own patients and be completely responsible for all of my own medical decisions. Some people might be worried about this new autonomy, but I’m not, and I attribute this to excellent training, specifically from two of my attending mentors during residency.

Both physicians, though different in style and approach to podiatry, are similar in many ways. First, they have an unerring dedication to resident training. Working with residents is one of their passions. They are truly excited and interested by the interactions they have with their residents, and it’s this interaction that makes them stay current and motivated. They also treat their residents with respect, rather than belittling and degrading them. We’ve all dealt with these types of people; they’re all too common in surgery and are usually ineffective teachers.

Second, and most importantly, these physicians have required me to make my own decisions. I’m expected to be ready for the cases I scrub and the patients I see in clinic. If a problem occurs during a case, I have to be able to get myself out of it. For those of you who have attendings that take the knife away at the first sign of trouble, you know this doesn’t teach you anything. These attendings let me go during a case (as long as what I’m doing has a reasonable thought process behind it). This is the reason I can look forward to practicing without any trepidation.

These two attendings have not only provided me with the didactic and clinical education to make my own decisions, they have acted as the example of what a podiatric physician should be. I have attempted to emulate this example with my coresidents and the students who rotate through our service and plan to take these lessons into practice. Physicians like these, who dedicate their experience, time, and caring, provide a long lasting service to our community, making it better one new physician at a time.

Do you have a mentor at your program, an attending who has taught you how to be an excellent podiatrist? Perhaps it’s another resident who’s a mentor. Write in and recognize that person or persons. Have a great week and good luck to those of you taking the ABPS qualification exams this week.

Speaking of mentors. Here’s a public service announcement and a chance for you to mentor July’s incoming residents:

Update Your Program's
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Enrollment

We'd like to ensure that the new residents start getting the 3 emailings that PRESENT sends each week: This Week in Podiatric Residency Education (our weekly lecture assignments), Residency Insight (John Steinberg's column on making the most of residency education) and Residency Rap.

It's also important to let PRESENT know which residents are leaving and need to be unenrolled.

There are 3 ways to do this. First, gather the NAMES and EMAIL addresses of the NEW residents. Then, you can CALL, FAX or SUBMIT the information ONLINE.

(1) CALL PRESENT at 888 802-6888.

(2) FAX the information to PRESENT at 561 869-6666.

(3) ONLINE ENROLLMENT MAINTENANCE   Follow the easy instructions at  http://www.podiatricresidency.com/support/enrollmentmaintenance.html

(You'll need your Residency Directors Access Codes)

We will add the new residents and delete the graduating ones on July 1

 

Subject:  Logging System is Simple and Logical

The logging system is quite simple and logical. Lets take the bimalleolar fracture-- this is what is: a fracture of the ankle that is complex and requires knowledge on mechanism of injury etc. and is treated as one injury not broken down into the component parts. One must know restoration of fibular length, reduction of medial clear space, and determination of a syndesmotic tear. This must be treated and evaluated as a whole, not just the repair of the fracture.

Let’s take another example-- triple arthrodesis--anyone that is performing these procedures understands that this is one procedure that involves three joints. It is difficult to get these pieces to fit back together and make a functional foot. On the other hand a TN fusion and Evans calcaneal osteotomy are two separate procedures that do not rely on each other.

Another example is a pan metatarsal head resection- when you perform this procedure you must evaluate the parabola and determine the appropriate length. Think of these as procedures that treat a condition or rely on each other and cannot be separated into its parts

Charles M Lombardi, DPM
Director, Podiatric Medical Education
Wyckoff Heights Medical Center
Brooklyn, NY
chazdpm@aol.com


Editor's Response

I don’t disagree that each of these examples represents one reconstruction which would be significant, for billing purposes.  However, as I’m sure you’re aware, resident education is not the same as billing in the real world.  I’ll refer you back to my prior editorials where I assert that the logging should be based on the educational content of the procedure.  Would you let one of your residents who’s trained to do a triple perform an isolated subtalar fusion?  Sure you would.  That’s because the complexity of a triple and its educational content (including the thought processes) are sufficient to allow that resident to perform a less complex procedure.  Hence, my argument that the triple should count for 3 experiences (or 3 procedures).  Of course, I’ll log however I’m supposed to, as soon as I have a clearly written document that tells me what to do.

- Jarrod


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

 
 

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