Podiatric Surgery at Hayward
Podiatric Surgery Hayward - Curriculum
PGY-1
Medical Imaging:
At the end of this rotation the podiatric resident should understand
the basic physics, indication and capabilities of various medical
imaging modalities. Additionally a basic functional ability to read
extremity x-ray and chest x-ray are expected.
Pathology:
Residents should expect to understand the need for microscopic examination
of human tissue, recognize the features of normal and abnormal tissue.
Internal Medicine Santa Clara:
At the conclusion of this rotation the resident should have a functional
understanding and ability to manage inpatients in a safe fashion.
The resident should understand the indication for specialist referral
as well as the need for communicating with the attending physician.
Internal Medicine Hayward:
and ability to manage both healthy and medically ill podiatric inpatients
in a safe fashion. The resident should understand the indication
for specialist referral as well as the need for communicating with
the attending physician.
Anesthesia:
This is a 4 week rotation for first year PSR residents under the
direction of Dr. Richard Cummings the Hayward hospital. The goal
is to educate the resident in the application of general, spinal
and local anesthesia. The level of education should allow a podiatric
resident or practitioner to functionally interact with anesthesia
services. This level of knowledge requires that familiarity with
risk stratification, with all aspects of anesthesia application
and pre and post anesthesia care.
Infectious Disease:
A functional understanding of infectious disease in the setting
of a suburban hospital is expected. The resident should understand
the indication for an infectious disease consult in both the medical
and orthopedic setting.
General/Vascular Surgery:
The resident should understand the nature of the general and vascular
surgeon and the indications for referral to this service. The resident
should have a functional understanding of the common surgical disorders
and their management in the medical milieu. A functional understanding
of vascular reconstruction gained from surgical assisting or observation
is expected.
Sports Medicine:
The goal of this rotation is to educate the resident in the diagnosis
and management of musculoskeletal disorders in the athletic patient.
Understanding of appropriate sports medicine and orthopedic surgery
referral is also expected.
Dermatology:
The goal of this rotation is to functionally orient the podiatric
resident to skin disorders and their management. The resident will
understand the indication for dermatology referral, and be able
to manage common dermatologic disorders of the foot.
Emergency Department:
Goals include a functional understanding of triaging, and treating
urgent/emergent disorders in the suburban setting. The podiatric
resident should develop a functional understanding of the relationship
of lower extremity trauma, infection and other disorders to other
medical conditions commonly encountered in the suburban setting.
Behavioral Science
Description and Goals
This is a one week rotation in the Department of Psychiatry in Union
City. This rotation is under the supervision of Michael Sands, MD.,
Assistant Chief. This rotation exposes the podiatric resident to
behavioral science in a multi-specialty group practice. The podiatric
resident may function in any capacity that the psychiatrist in charge
directs, provided that the resident is supervised. Goals include
a functional understanding of behavioral science as it relates to
podiatric medicine and surgical patients, as well as general medicine
and surgery patients.
PGY-2
Orthopedic Surgery:
The orthopedic surgery rotation is a 5 week rotation based in the
Fremont Orthopedic Surgery Department and is under the direction
of Dr. Omar Bayne. The podiatric surgery resident will spend time
with various members of the orthopedic department in the clinic
as well as the operating room. They are expected to do morning rounds
with the orthopedists, assist in surgery, and see clinic patients.
The resident should have a functional understanding of general orthopedic
surgery and trauma, and their medical management.
Podiatric
Clinic and Surgery:
This is a focused rotation in foot and ankle surgery and podiatric
foot and ankle clinic under the supervision of the attending staff
at Fremont and Union City MOBs. The day to day management of residents
in this rotation is the responsibility of the podiatric attendings
assigned to the resident.
The goals of this training is to provide a skill development in clinical practice and patient management occurs in the outpatient clinic setting. Co-management of patients with attending podiatric physicians in all aspects of patient care (medical and surgical) is encouraged and expected.
Plastic Surgery and Wound Care:
This rotation takes place for 2 weeks at the end of the PGY-2 year,
and will be located at Georgetown University Hospital with Dr. John
Steinberg.
PGY-2 Objectives:
- Diagnose, manage and treat common foot and ankle disorders presenting to the out patient clinics of the foot and ankle clinic.
- Manage an outpatient podiatric clinic schedule.
- Develop and demonstrate competence in "routine foot care".
- Develop and demonstrate competence in routine strapping, and padding.
- Develop and demonstrate competence in a biomechanical examination.
- Develop and demonstrate competence in casting and application of other immobilization devices.
- Develop and demonstrate competence in a gait analysis.
- Gain skills in supervision and interaction with support staff and dysvascular nurse.
- Demonstrate and maintain competence in an appropriate orthotic prescription.
- Develop and demonstrate competence in routine office surgery (onychoplasty, biopsy, skin excision etc.)
- Recognize patients that are at risk for morbid change of life or limb and deal with them appropriately.
- Instruct patients appropriately in strategies of managing their disorder(s)
- Develop and demonstrate competence in complete preoperative work-up including H&P, admitting orders, rationale for admission and treatment plan.
- Order and assess appropriate admitting labs, radiographs, and physical condition of the patient.
- Understand the fundamental surgical considerations in reconstructive surgery of the foot and ankle.
- Develop and demonstrate competence in management of the post operative patient including analgesia, wound management and supportive care.
- Develop and demonstrate competence in as an able assistant in foot and ankle surgery.
- Understand all aspects of sterile technique, instrumentation, and OR protocol.
- Develop and demonstrate competence in all aspects of wound closure including layered closure, suturing, staples, tapes and related devices.
- Develops and demonstrates competence in communication and presentation skills.
- Understands and actively participates in the academic environment: Stimulates case discussion, engage cohorts and students in academic discussion, understands scientific inquiry and method, understands the goals and participates effectively in journal club.
- Gain understanding of trauma management, including splinting, casting and immobilization techniques.
- Understand orthopedic surgical principles including open and closed fracture reduction, and internal fixation principles.
- Affectively assist in orthopedic surgery.
- Participate and gain an understanding of peri-operative management of the orthopedic patient.
PGY-3
Podiatric Surgery and Clinic:
This is a focused 2nd year rotation in foot and ankle surgery and
podiatric foot and ankle clinic under the supervision of the attending
staff at Fremont and Union City MOBs. As chief resident this resident
is assigned the primarily the hospital OR and to the larger cases
that are scheduled at the surgical center. This allows the resident
to focus on collecting category V. The day to day management of
residents in this rotation is the responsibility of the residency
director.
Podiatric Surgery and hospital admissions take place in the operating rooms of Kaiser Foundation Hospital-Hayward and the Surgical Center at Fremont. Residents in this rotation are assigned to clinic in a regular rotation based on staffing needs. The residents activities are supervised by attending staff located at the respective facilities. Senior resident may be responsible for performance and behavior of junior residents, and students in patient care at the discretion of the attendings at that facility.
The goals of this training is to provide a mature podiatric surgeon with skills enabling him/her to perform most types of forefoot and simple adult hindfoot surgery. Additionally it is expected that at completion of training that this individual will have substantial experience and training in management of all phases of diabetic foot care including prevention, risk identification, incision and drainage, reconstruction, pedorthia and prosthetics. Exposure to pediatric foot surgery, complex reconstructive surgery of the ankle and hindfoot, arthroscopy and endoscopy should be expected. Podiatric residents should not necessarily expect to become sufficiently skilled to perform advanced surgical procedures based only upon completion of this residency. Competence in any kind of surgical practice is based on many variables including but not limited to knowledge, motor skills, execution, common sense and patient management skills.
3rd year elective rotations: Plastic surgery, Rheumatology and private office rotations are available as electives during the PGY-3 year.
PGY-3 Objectives:
- Diagnose, manage and treat common foot and ankle disorders presenting to the out patient clinics of the foot and ankle clinic.
- Manage an outpatient podiatric clinic schedule.
- Become competent and maintain competence in "routine foot care".
- Become competent and maintain competence in routine strapping, and padding.
- Become competent and maintain competence in casting and application of other immobilization devices.
- Become competent and maintain competence in a biomechanical examination.
- Become competent and maintain competence in a gait analysis.
- Gain skills in supervision and interaction with support staff and dysvascular nurse.
- Demonstrate and maintain competence in an appropriate orthotic prescription.
- Become competent and maintains competence in complete preoperative work-up including H&P, admitting orders, rationale for admission and treatment plan.
- Order and assess appropriate admitting labs, radiographs, and physical condition of the patient.
- Understand the fundamental surgical considerations in reconstructive surgery of the forefoot hind foot and ankle.
- Become competent and maintains competence in post operative patient care including analgesia, wound management and supportive care.
- Become competent and maintains competence as an able assistant in foot and ankle surgery.
- Understand all aspects of sterile technique, instrumentation, and OR protocol.
- Become competent and maintains competence in all aspects of wound closure including layered closure, suturing, staples, tapes and related devices.
- Become competent and maintains competence in all aspects of application of drains, dressings and casts.
- Become competent and maintains competence in hammer toe repair, simple bunionectomies, metatarsal osteotomy, heels spur procedures, soft tissue excision, simple lump and bump procedures of the hind foot, osteotomies of the first ray segment, forefoot joint implants.
- Become competent and maintains competence in bone stabilization techniques (wire suture, kirschner wire, screw, staple).
- Become competent and maintains competence in simple osteoplastic maneuvers (exostectomy, arthroplasty, simple osteotomy).
- Become competent and maintains competence in communication and presentation skills.
- Understand the fundamental surgical considerations in reconstructive surgery of the forefoot, hind foot and ankle.
- Maintains competence in patient management aspects of the perioperative period.
- Maintains competence in as an able assistant in foot and ankle surgery.
- Become competent and maintains competence in closed reduction of fracture dislocations of the ankle and foot.
- Become competent and maintains competence in infection management including complex incision and drainage, amputation of the foot and ankle, and antibiotic selection.
- Become aware regarding the principles and application of transfer of major muscle - tendon units if the foot and ankle.
- Become aware regarding the principles and application of surgical repairs of complex acquired and congenital foot and ankle deformities (flatfoot, cavus foot, TEV, etc.).
- Become familiar with the principles and application of basic skills of small joint arthroscopy.
- Develops management skills: assigns and manages student assignment, reports to the director. Manages residents schedule, assigns cases, identifies and manages discipline problems, in cooperation with the director.
Developing Rotations:
- Rheumatology – One week during the third year.
- Plastic Surgery – One week during the third year.