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Resident Schedule

PGY-1 ROTATIONS

 

Podiatric Foot and Ankle Surgery

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)

Residents work 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 resident.


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 services.


Pathology (2 weeks)

Review of surgical pathology specimens from preparation to interpretation performed


Podiatric Clinic

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.

 

PGY-2 ROTATIONS

 

Podiatric Foot and Ankle Surgery

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 examinations.


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.


Podiatric Clinic

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.


Elective Training 

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.


Research Project

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.

 

PGY-3 ROTATIONS

 

Pain Management (2 weeks)

The experiences 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.


Podiatric 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.


Podiatric Clinic

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.


Elective Training

See description under PGY-2 Rotations.


Research Project

Residents are expected to submit their project for publication and present their abstracts at ACFAS, Midwest Podiatry, and MPMA Conferences.


Wound Care (2 weeks)

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.

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