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Abstract
Background: The COVID-19 pandemic impacted all facets of health care in the United States, including the disruption of professional training for podiatry residents and students. In March 2020, the Association of American Medical Colleges (AAMC) recommended pausing then modifying all clinical rotations. The podiatric community followed suit. In-person restrictions, cancellations of clerkships, limited clinical experiences, virtual didactic programs and reduced surgical cases for students and residency programs occurred for many months during the ongoing pandemic. These adaptations impacted the ability of podiatric students to complete clinical rotations and clerkships, which are pivotal to their academic curriculum and residency program application and selection.
Methods: A survey was conducted by the Council of Teaching Hospitals (COTH) and sent out by the American Association of Colleges of Podiatric Medicine (AACPM). The 2021 post-interview surveys were sent out to all participants in the 2021 CASPR application and match cycle, both programs and candidates.
Results: The COTH presents results and comments from the 2021 virtual interview experience and residency match. Data and anecdotal comments from the 2021 post-interview survey conducted by COTH, sent out by AACPM, are presented here.
Conclusions: Results from the surveys of program directors and candidates show a preference by both groups for in-person interviews despite the personal time demands and increased costs associated with travel.
Residency education has an interesting history in the US that speaks clearly about some of the cherished beliefs still perpetuated in today's residency training programs. The history also provides a foundation for considering how the current knowledge of adult education theory and practice can be incorporated into residency education programs. The author presents a brief overview of the history of residency education in the US followed by a recommendation for applying a conception of adult learning to residency education.
Background
The objective of this study was to investigate the rate of attrition within podiatric medicine and surgery residency training programs.
Methods
Between the academic years 2006–2007 and 2015–2016, the Temple University School of Podiatric Medicine matched 780 graduates into 163 different residency training programs. Program directors from these sites were individually contacted by e-mail and asked whether the specific Temple University School of Podiatric Medicine graduates who originally matched with their program 1) completed the program, 2) transferred to another program, 3) quit the program, or 4) were fired from the program.
Results
Results were returned with respect to 614 (78.7%) of the 780 graduates, representing 103 (63.2%) of the 163 training programs. Program directors reported that 573 (93.3%) of the 614 graduates completed the program, 17 (2.8%) transferred from the program, six (1.0%) quit the program, five (0.8%) were fired by the program, and 13 (2.1%) matched but never started the program. This equates to an annual attrition rate of 0.46% for residents who started the podiatric residency training program that they matched with.
Conclusions
We conclude that the rate of attrition in podiatric medicine and surgery residency training appears to be relatively low or at least in line with other medical specialties, and hope that this information leads to other investigations examining attrition, specifically as it relates to physician-specific and program-specific risk factors for attrition.
Background:
The fourth year of podiatric medical school is an important period in the education of the podiatric medical student, a period that consists largely of month-long clerkships. Nonetheless, there has been limited formal study of the quality of learning experiences during this period. Furthermore, there is limited knowledge of how podiatric medical students evaluate residency programs during clerkships.
Methods:
An online survey was developed and distributed electronically to fourth-year podiatric medical school students. The focus of the survey was the quality of learning experiences during externships, and decision making in ranking residency programs.
Results:
The most valuable learning experiences during clerkships were interactions with attending physicians, interactions with residents, and general feedback in surgery. Students self-identified that they most improved in the following areas during clerkships: forefoot surgery, clinical podiatry skills, and rearfoot surgery. The areas in which students improved the least were research, pediatrics, and practice management. The three most important factors students considered as they created their rank list were hands-on resident participation in surgical training, the attitude and personality of the residents, and the attitude and personality of the attending physicians. A range of surgical interest was identified among students, and students lacking in surgical interest self-reported less improvement in various surgical topics.
Conclusions:
The perspectives of fourth-year podiatric medical students are currently an underused resource. Improved understanding can help residency programs improve the quality of associated learning experiences and can make their programs more appealing to potential residency candidates.
Background: Resident-run clinics provide autonomy and skill development for resident physicians. Many residency programs have such a clinic. No study has been performed investigating the effectiveness of these clinics in podiatric medical residency training. The purpose of this study was to gauge the resident physician–perceived benefit of such a clinic.
Methods: A survey examining aspects of a resident-run clinic and resident clinical performance was distributed to all Doctor of Podiatric Medicine residency programs recognized by the Council on Podiatric Medical Education. To be included, a program must have had a contact e-mail listed in the Central Application Service for Podiatric Residencies residency contact directory; 208 residency programs met the criteria. Statistical analysis was performed using independent-samples t tests or Mann-Whitney U tests and χ2 tests. Significance was set a priori at P < .05.
Results: Of 97 residents included, 58 (59.79%) had a resident-run clinic. Of those, 89.66% of residents stated they liked having such a clinic, and 53.85% of those without a resident-run clinic stated they would like to have one. No statistically significant differences were noted between groups in how many patients each resident felt they could manage per hour or regarding their level of confidence in the following clinical scenarios: billing, coding, writing a note, placing orders, conversing with a patient, working with staff, diagnosing and treating basic pathology, and diagnosing and treating unique pathology.
Conclusions: Resident-run clinics provide autonomy and skill development for podiatric medical residents. This preliminary study found there was no difference in resident-perceived benefit of such a clinic. Further research is needed to understand the utility of a resident-run clinic in podiatric medical residency training.
Background:
A patient “handoff,” or the “sign-out” process, is an episode during which the responsibility of a patient transitions from one health-care provider to another. These are important events that affect patient safety, particularly because a significant proportion of adverse events have been associated with a relative lack of physician communication. The objective of this investigation was to survey podiatric surgical residency programs with respect to patient care handoff and sign-out practices.
Methods:
A survey was initially developed and subsequently administered to the chief residents of 40 Council on Podiatric Medical Education–approved podiatric surgical residency programs attempting to elucidate patient care handoff protocols and procedures and on-call practices.
Results:
Although it was most common for patient care handoffs to occur in person (60.0%), programs also reported that handoffs regularly occurred by telephone (52.5%) and with no direct personal communication whatsoever other than the electronic passing of information (50.0%). In fact, 27.5% of programs reported that their most common means of patient care handoff was without direct resident communication and was instead purely electronic. We observed that few residents reported receiving formal education or assessment/feedback (17.5%) regarding their handoff proficiency, and only 5.0% of programs reported that attending physicians regularly took part in the handoff/sign-out process. Although most programs felt that their sign-out practices were safe and effective, 67.5% also believed that their process could be improved.
Conclusions:
These results provide unique information on a potentially underappreciated aspect of podiatric medical education and might point to some common deficiencies regarding the development of interprofessional communication within our profession during residency training.
The author discusses the establishment of the Nursing Home Care Unit at the Tampa Veterans Hospital. The role of the podiatric resident and the residency program in the care of the patients in the facility is presented.
The author presents information related to the structures of medical and podiatric residency training and statistical information regarding entry level residency positions in approved podiatric residency programs. The results of surveys of residency directors (1989 and 1990) and the residency community of interest (1990) conducted by the Council on Podiatric Medical Education are reported. Specific findings from the surveys indicated the desirability of establishing training sequences consisting of rotating podiatric residencies followed by specialty training programs but identified significant difficulties related to implementation.
