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krabmas, are you at inova? If not, where are you? How happy are you so far?
krabmas, are you at inova? If not, where are you? How happy are you so far?
I enter the OR, and the patient is being prepped for a circumcision (non-infant)...
The one of the surgeons asks the anesthesiologist, "you have an apprentice today?"
I respond and tell them I'm a 3rd year podiatry student doing the anesthesia rotation. The surgeon responds, "podiatry? Hmmm, I know they are doing more and more, but you guys don't operate on dicks, do ya?"
The other surgeon chimes in, "well, it depends. What if the dick is 12 inches long? That's a foot."
JW,
What kind of procedures are doing on your general surgery rotation?
wow that sounds pretty cool! how long was that rotation for JW?
One month rotation (February). I don't know if it is cool as much as it is painful! No, I have learned a lot but this isn't for me.
I enter the OR, and the patient is being prepped for a circumcision (non-infant)...
The one of the surgeons asks the anesthesiologist, "you have an apprentice today?"
I respond and tell them I'm a 3rd year podiatry student doing the anesthesia rotation. The surgeon responds, "podiatry? Hmmm, I know they are doing more and more, but you guys don't operate on dicks, do ya?"
The other surgeon chimes in, "well, it depends. What if the dick is 12 inches long? That's a foot."
I am just finishing up Vascular surgery and thinking the same thing that q3 and q4 30 hour shifts are just not fun or exciting anymore. The first night it was sort of exciting but that was 2 months ago on Medicine. Next is Gen surg. I think I want another month of vascular. The stuff in the abdomen is pretty gross - and people ask why feet?
I was just thinking about this 30 hour thing. I keep telling people that we take home call for podiatry but for at least 6 months of the 3 years we are doing q3 or q4 30 hour shifts. Still better than doing it for 5 years though.
As for exciting stories - I was sewing a dehissence of a fem-pop bypass bedside w/ a subcutanious reverse GSV graft. And the patient decided to become nauseous and drop his O2 sats and gasp for air - real fun times.
You probably thought I was gonna say that I pierced the graft and the patient exsanguanated.
When you guys are on rotations like gen/vascular/ortho surgery/anesthesia, are the attendings aware you are PM and S residents? Just curious if you guys are treated any differently than non-pod residents....meaning if you doing everything they are allowed to do.
Yea, they are aware but it doesn't matter. At least where I am, I am treated as a regular intern. I take care of my own patients and see my own consults. On floor call, I'm often called to manage blood sugar, blood pressure, electrolyte imbalances, nausea, isomnia, pain, etc. And of course, if I'm not sure what to do, there is always a chief to bounce ideas off of. It is a great learning experience but sometimes doesn't make for much sleep! It was the same on medicine. On ID, I was actually the only resident on service that month so I ran the service and worked directly with the attendings.
All of these off rotations are great for general knowledge but really make me thankful for the profession that I have chosen.
When you guys are on rotations like gen/vascular/ortho surgery/anesthesia, are the attendings aware you are PM and S residents? Just curious if you guys are treated any differently than non-pod residents....meaning if you doing everything they are allowed to do.
When you guys are on rotations like gen/vascular/ortho surgery/anesthesia, are the attendings aware you are PM and S residents? Just curious if you guys are treated any differently than non-pod residents....meaning if you doing everything they are allowed to do.
Yes, it does make you appreciate podiatry that much more, but I enjoyed those months that I was on other services. It allows me to relate to my patients about the procedures/surgeries that they've had or about to have or talk to them about their medical issues.
Just like Jonwill, I to am just another intern. Our surgery residency is set up with 5 teams: Trauma, Vascular, Colorectal, Gen surg run by resident, gen surg kaiser. Each team has an intern and some other residents including a team chief. Vascular this month has me as the intern and the chief resident as our team chief. That is the team. The Chief went away this weekend. So the team is me. There is no "I" in "team" but there is a "me".
And just like jonwill, as the intern on the team, the floor is my responsibility. We are expected to know all of the patients on the team (meds, labs, results, plan...)
Tomorrow I get to scrub on an open AAA! It was supposed to go today but it got posponed until tomorrow. It is not dissected yet.
To answer the question - are we treated differently? The expectations are the same. We are asked the same questions as any other intern. And there is always someone else to call if something happens but we don't know what to do.
Words of wisdom for when you become a resident.
1. better to risk looking like an idiot and ask for advice than to do the wrong thing.
2. no one will think you are an idiot. the junior and senior residents are there for a reason and they know that.
When you guys are on rotations like gen/vascular/ortho surgery/anesthesia, are the attendings aware you are PM and S residents? Just curious if you guys are treated any differently than non-pod residents....meaning if you doing everything they are allowed to do.
I always say that it will definitely make me a better podiatrist and that if nothing else it teaches me when to say no to surgery. I think it is very important to know when to not opperate.
When the attendings meet you they can read on our white coats and badges "podiatry" or "podiatric surgery".
There are times that we talk to the attendings on the phone before we meet them. In those cases they do not know. If you introduce yourself on the phone as "so and so the podiatry resident" and not just "so and so team intern" it is sort of saying that you are different.
Personally, as a first year student I think it is great to read about all of the experiences throughout residency. Makes it much easier to keep working through Micro when you know there are great things a head!
It has got to be pretty neat as a podiatry resident to get the opportunity to rotate with different specialties. I can imagine that the rotations with specialties such as plastics, vascular, etc are very important when it comes to podiatry and the things podiatric surgeons are doing today and into the future.
Thanks again for all the great tidbits and keep them coming!
Exactly^ This is even how I feel about some of my 3rd year clinic rotations. There are many days and experiences that make me very glad that my future specialty is foot and ankle....All of these off rotations are great for general knowledge but really make me thankful for the profession that I have chosen.
Exactly^ This is even how I feel about some of my 3rd year clinic rotations. There are many days and experiences that make me very glad that my future specialty is foot and ankle.
I also agree with your and others' statements about how pod residents need to make sure the attendings and other residents know they are DPMs in order to increase the awareness of our level of training and competence.
today I got to do an extravisation of a hematoma from the popliteal fossa.
The patient had a ruptured SFA/pop pseudoaneurysm that was stented endovascularly. Then the patient had a neuropraxia of the common peroneal nerve/possibly entire sciatic nerve at the level of the bifurcation.
So tonight we removed the hematoma. After the surgery the patient said he could feel his foot but he could not move it yet.
We will see how he does tomorrow.
Got to scrub a DRIL procedure today in Vasc Sx. Then we did a AV graft for dialysis access in the groin.
Last night one of my patients had an angio of the R leg. She then had belly pain. We followed the H/H for a few hours - it dropped. She became hypo tensive. The attending was called - she went back to the OR w/ a retroperoteneal bleed. SFA was ligated and drains placed. She woke up in the ICU and was extubated in the AM.
To Feelgood: I know you want to do lots of surgeries and get real good at being a surgeon, but with out inpatient care it is hard to learn what is normal post-op and what needs to either go back to the OR or the ER.
When you are out in provate practice and the patient calls you the night of surgery with a complication or that they cannot pee - what are you going to do if you've never seen a post-op patient before.
For my first few months of residency I wondered why we needed to round all the time. After medicine and vascular surgery I understand - we know our patients and what we are looking for as complications. we know what happened in the OR (good and bad). The nurses just know in general to call with outlying limits of vitals. Sometimes things happen during the day that the nurses wait to tell you until later when they see you for rounds. If you do not round again you won't find out. Better to find out before it is an emergency.
I agree - Feelgood - that when we are attendings we will not round 2-3 times a day. But for now we are residents (you will be) and this is what we do.
I've got vascular next month. It should be interesting.
Rehab Med... (to self: "at least it's a top 10 program")... ugh.... rehab
So what kind of moonlighting options do podiatric residents have? Are you able to cover the ER or anything when you aren't on duty to make a little cash on the side? How about working with nursing homes or something of that sort? I know that none of us could ever become rich while being a resident (minus winning the Powerball or World Series of Poker) but I am just curious what you all do to make a little on the side?
There is not a lot of time on the side for moonlighting.
Many programs prohibit it.
I've only really seen higher level MD residents moonlight.
We actually do some moonlighting for ortho and some other pods as well. We don't have time to do a lot of it though.
300+ pound middle aged man comes into the ER around 3am huffing and puffing after falling in the shower. BP is nearly 300 systolic.
"Any meds?" Nope. "Allergies?" Nope. "Major medical problems in the past?" He states that he gets SOB like this sometimes, but usually it's not so bad.
I decide it might be ACS, so I start him on O2 and notify my attending that he needs to see the patient and get him a BP med right away. With obvious fluid in the lungs on physical exam, my attending knows right away that it's acute CHF but tells me with a smile "at least you realized it was a pretty serious problem."
Labs come back with blood glucose of almost 300, and CXR shows and the most worst cardiomegaly I'd seen so far. My attending tells him he's diabetic with acute CHF and asks him if he has a primary doc who would like to admit him. The patient replies that he doesn't have a primary and doesn't really like going to hospitals or doctors. "Nope.... can't imagine you do."
I wonder if he will start going to doctors in the future?
feelgood wants to take care of his htn and dm
Ahh, the life of a DMC first year resident. I just recieved the call schedule for my first year of residency and it looks like I will be spending the week of Thanksgiving and the week of Christmas taking first call at the hospital. This is going to be a long year.
Ask for a good tote bag loaded up with toothpaste, deodorant, eye drops, and a razor as a graduation present...Ahh, the life of a DMC first year resident. I just recieved the call schedule for my first year of residency and it looks like I will be spending the week of Thanksgiving and the week of Christmas taking first call at the hospital. This is going to be a long year.
Ask for a good tote bag loaded up with toothpaste, deodorant, eye drops, and a razor as a graduation present...
...always good to avoid lookin like a derilict on morning rounds after a night of in-house call