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A 36 month surgical residency program IS A HIGH POWERED PROGRAM. Seriously? Whoever is fortunate enough to get into a residency program...don't take it for granted. If you want to do cases, do them. If you want to do research, do it. Please, try to help the other pods out there whether they are in practice or residents or students. Share new techniques, interesting cases, surgical and medical pearls, and try always to make our profession better.
I'm going to interject with a thought. It's just to put it out there and is by no means a criticism or a poke at anyone.
These "High Power Programs". Do you find they teach only the most up to date techniques?
It's obvious that most will teach TAR, but I find through talking to some residents that some programs still encourage their residents to use "old school" techniques that are somewhat antiquated (imo only, so don't jump all over me). Some even shelter their residents from procedures that are really state of the art (Arthroscopic repair of the ATFL with thermocapsular shrinkage for example, Callus Distraction techniques, pediatric surgery exposure), in place of "old school".
So, is "High Power Program" just mean academics and busy? Or is there an expectation that the latest and greatest techniques and hardware is implemented as well (other than TAR which EVERYONE is learning in residency now)?
In my rotations, I would agree that I didn't see many programs doing a lot of TAR's if at all. I think of the 5 or so programs I visited, less than half did TAR's. Even the programs that did them didn't give residents that much exposure to them - I don't think I would want any of the graduating residents at those programs doing a TAR on me or my family. I know that there are other programs that have much more exposure though. I don't anticipate training to do TAR's in residency, nor do I really prefer to. If I did do them, I don't think it would be often, and with the steep learning curve plus relatively high failure/complication rate, I would rather leave them to someone who does them more often.I rotated at 7 different programs and only 1 of those did any ankle replacements. From what I have seen and heard, that training may be primarily obtained through a fellowship (although I hope not). Many cite the high failure and complication rates in the literature as well as the good success and predictability of a fusion.
I think HPPs often have a doc or two who might do these latest and greatest techniques, but I don't think that's it a prerequisite. To me, a HPP should focus on teaching surgical principles and fundamentals. Specific procedures come and go, but a resident who has a rock solid foundation can easily adapt and perform these procedures as she/he deems them indicated and not just use them because they are novel or "that's what I was trained to do".
I don't think that a high power program has to teach "the latest and greatest." I don't think Dekalb (Podiatry Institute) has any attendings that do TAR's - they didn't when I visited at least. They do use some newer techniques and hardware, but that is not the focus. They teach the basics very well.So, is "High Power Program" just mean academics and busy? Or is there an expectation that the latest and greatest techniques and hardware is implemented as well (other than TAR which EVERYONE is learning in residency now)?