Podiatric Foot and Ankle
PGY-1 residents will spend half of the year on the
podiatric surgery service. They will perform history and physical
examinations and perform and assist on all levels of foot and ankle
surgery. They will take foot and ankle call at both the DMC's level
I and level II trauma centers. Surgical cases include elective forefoot
and rearfoot surgeries, diabetic foot/ankle infections, and reconstructive
surgeries of the foot and ankle with and without external fixations
including pediatric and adult congenital and acquired deformities, and Charcot
reconstruction. Trauma cases will include tibial Pilon fractures,
malleolar ankle fractures, calcaneal fractures, LisFranc fractures, gunshot
wounds and fractures, tendon ruptures, etc.
Management and surgery of complex diabetic foot and ankle infections are
regularly performed. PGY-1 surgical volumes have typically been high
enough to qualify them to sit for the ABPS Foot Board which normally takes two
years to complete.
Anesthesia (2 weeks)
Residents will assist and perform in administration and
monitoring of patients with general anesthesia. They will perform
intubations, extubations, and help manage pain consults on the floor. The
resident will become comfortable with airway management.
Behavioral Medicine (2 weeks)
alongside a Psychiatrist in an out-patient clinic and learn to manage
psychological disorders and depression in a diverse patient population.
General Surgery (4 weeks)
Podiatric surgical residents assume full responsibility of
floor patients and consultations from both the floor and ED on this
service. They take primary in-house call with the senior resident.
Placement of central lines, Quinton catheters, bedside procedures (I&D's,
Chest tubes, etc)
performing and assisting on general surgical procedures in the operating room
are included. Residents are part of the team on all trauma resuscitations
and are part of all floor codes. They participate fully as a PGY-1
Infectious Disease (4 weeks)
Residents take the same pre- and post-rotation examination like
all other specialties that rotate on this service. They will consult and
work-up patients completely including: history and physical, labs, cultures,
and will complete treatment plans to review with the supervising fellow.
During this rotation they will see all patients that are admitted to or
consulted by the infectious disease service, prescribe and monitor antibiosis
for patients, and clinically re-evaluate as needed.
Internal Medicine (4 weeks)
Podiatric residents will assume the responsibilities of all
other PGY-1 interns or residents. Duties include: work-up of patients
including full history and physical examination, develop differential diagnoses
and treatment plans. They will admit, treat, and follow patients as part
of the academic teaching team with senior resident/fellow/attending
supervision. Podiatric residents are trained and treated equally
with other residents and interns on this service. They will participate on
floor codes while on in-house call.
Radiology (2 weeks)
Instruction in interpretation of
all types of radiologic imaging is included: chest films, MRI, CT, PET scans,
bone scans, and angiograms. Academic meetings and rounds are also
integrated. The residents will rotate as all PGY-1 rotators from other
Pathology (2 weeks)
Review of surgical pathology specimens from preparation to
Our service provides hospital based clinics at both Detroit
Receiving and Sinai-Grace Hospitals. Community based patients, follow-up
after discharge from the hospital and emergency room, and operating
room follow-ups are seen in the clinics. Residents will spend two
half-days per week when on service. In addition, residents will rotate
at private offices with some of the attendings.
Radiology (2 weeks)
Instruction in interpretation of all types of radiologic
imaging is included: chest films, MRI, CT, PET scans, bone scans, and
angiograms. Academic meetings and rounds are also integrated. The
residents will rotate as all PGY-1 rotators from other services.
Vascular Surgery (4 weeks)
Residents will participate as PGY-1 resident on the
vascular surgery service. Resident responsibility include work-ups and
management pre- and post-operatively. They will perform and assist in
vascular analysis both invasively and non-invasively. Residents will
perform and assist on reconstructive vascular procedures and on lower extremity
amputations at all levels.
Podiatric Foot and Ankle
As a PGY-2 resident, a more active role is taken in
surgery. Residents are frequently the primary assistant in trauma and
reconstructive cases such as LisFranc, calcaneal, ankle, and Pilon fractures,
compartment syndromes, gunshot wounds, crush injuries, degloving injuries, and
injuries involving the neurovascular compromise of the foot and ankle. A
significant volume of elective foot surgical cases will be provided through the
hospital system and surgical centers. PGY-2 residents also take call at
the level I and II trauma centers, but no longer cover holidays. Near the
end of the PGY-2 year, residents have almost satisfied the minimal numbers
needed to sit for the ABPS Foot and Rearfoot/Reconstructive Ankle qualifying
Emergency Medicine (4 weeks)
Residents will rotate at our level II trauma center which
is the busiest emergency department in the state. All emergency
department admissions from coughs and colds, to congestive heart
failure and asthmatic attacks, myocardial infarctions, and
cerebrovascular accidents to gunshot wounds, blunt trauma, and closed head
injuries will be included. Resuscitations, line placements, intubations,
and all aspects of advanced life support are part of the resident's responsibilities.
They will complete ACLS prior to this rotation, and are again given the same
responsibilities as all other emergency medicine PGY-2 residents.
Microsurgery (1 week)
Every PGY-2 resident will complete a micro-vascular course
locally and become familiar with nerve and vascular repair utilizing the surgical
microscope and loops.
Orthopedic Trauma Surgery (12 weeks)
On this rotation at Detroit Receiving Hospital, the
first level I trauma center in southeast Michigan, residents will take
8-10 primary in-house call per month. This includes reduction and
management of all fractures of the body with the exception of acute cervical
fractures. Included are bedside pin placement for traction and long
running traction. Residents will perform and assist attendings in all
aspects of orthopedic procedures and additionally get preference for lower
extremity trauma. Cases are followed up on the floor and in
clinic. Podiatric residents are treated as junior orthopedic resident on
this service and expected to function as a member of the team.
Plastic and Reconstructive Surgery (4 weeks)
During this rotation, residents are an integral part of the
team and treated as plastic surgery PGY-2 residents. During
this rotation, podiatric residents do all pre- and post-operative
management. They also assist and perform procedures with fellows and
attendings. They take primary plastics call with the attending and
work-up and participate in surgery in all aspects of trauma including but not
limited to: oromaxillofacial, hand, burns, and all facets of reconstructive
plastics. Residents are exposed to rotational and free flaps for coverage
of soft tissue deficits of the lower extremities.
This rotation builds on the training from PGY-1 where the
resident now takes a more active role in the decision-making process and
treatment of each patient. Assistance and guidance are also given to the
junior residents and students.
Residents are able to take an elective month for additional
training outside of the program. Previous fellowships have included the
Ponsetti clinic in Iowa City and rotations with Drs. Dror Paley, Sigvard
Hansen, and Mark Myerson. Residents have gone to Germany and Russia for
advanced training opportunities. Residents are free to design a training
elective of their choosing either domestically or internationally.
Corporate sponsorships are available to help fund an elective rotation.
All residents are required to fulfill at least one research
project and submit if for publication by the time of graduation.
Residents have the full access of Wayne State University Medical School
facilities and have opportunity to work with faculty. Often
collaborations with other services at the Detroit Medical Center are
undertaken. Residents are expected to present at the Michigan Podiatric
Medical Association annual conference. In addition, residents are
encouraged to present at the Midwest Podiatry and American College of Foot and
Ankle Surgeons Annual Conferences.
Pain Management (2 weeks)
will include in-patient and out-patient management to teach pain management
principles. Upon completion of this
rotation, the resident is expected to be able to manage acute and chronic pain.
Foot and Ankle Surgery
PGY-3 residents build on previous surgical experiences and
take on more challenging cases of the foot and ankle. They have more
responsibilities to help with the teaching of the junior residents and assist
them in their educational experience. Although call is not taken, they
are involved in overseeing the junior residents' work-up of cases and
the decision-making process of patients seen in the emergency
room prior to presenting them to the attendings. This allows
development of patient management skills. They become proficient in all
aspects of internal and external fixation. The latter half of the year is
focused on fine-tuning the surgical skills. Upon completion of the
residency, the surgical volume far exceeds what is needed to sit for the ABPS
Foot and Reconstructive Rearfoot/Ankle qualifying examinations.
Pediatric Orthopedic Surgery (8 weeks)
During this rotation, residents take call and work-up all
in-patient and emergency room consults. This includes closed reductions
and management of acute trauma of all body fractures. This rotation has a
high clinic volume where scoliosis, club foot, vertical talus, and limb length
discrepancies as well as all other acute and congenital deformities.
Again, residents are given the same responsibilities as orthopedic PGY-3
residents and treated as an equal member of the orthopedic pediatric team.
This rotation builds on the training from PGY-2.
Assistance and guidance are also given to the junior residents and
students. PGY-3 residents will spend more time in the private offices to
learn practice management and hone their clinical skills.
Residents spend with office managers and understand the business side of
running a private practice.
See description under PGY-2 Rotations.
Residents are expected to submit their project for
publication and present their abstracts at ACFAS, Midwest Podiatry, and MPMA
Wound Care (2
This rotation will provide the resident with the
specialty of wound care to the entire body with an emphasis on lower extremity wounds
and to understand the etiology, work-up, and management of these wounds in the
outpatient wound clinic setting.