What Third-Year Residents Would Recommend To First-Year Residents

These third-year residents advise their younger peers on how to navigate and maximize their first year of residency.

Q:

What did you do in your first year of residency to improve your knowledge level? In retrospect, what would you have done differently?

A:

Alaa Mansour, DPM, emphasizes reviewing anatomy consistently and prior to each case.

“Develop a habit to prepare studiously for all surgical cases,” recommends Dr. Mansour. “Read a recent journal article on each topic or surgical procedure as part of your preparation.”

Similarly, Michael Reed, DPM, encourages plentiful reading and looking up topics that you don’t have a strong understanding of. Dr. Mansour and Alexandra Scrimalli, DPM, both cite the benefits of participating in a journal/book club with fellow residents in order to discuss the latest journal articles and surgical textbooks. Dr. Scrimalli also praises the online surgical videos available with Present Podiatry and mobile apps such as AO Surgery Reference.

Hands-on learning is critical. Dr. Scrimalli cites the availability of simulation labs with cadaveric specimens in her residency program at the Bryn Mawr Hospital in Bryn Mawr, Pa.

“When we are planning a bigger case, we are able to practice the techniques and dissections with our attendings instead of just reading about the case,” explains Dr. Scrimalli.

Similarly, Dr. Mansour encourages first-year residents to attend as many cadaver labs or surgical workshops as possible. He also suggests participating in monthly radiology review and analyzing postoperative outcomes of recent surgeries. Dr. Mansour also says first-year residents should attempt to get involved with presenting surgical plans and X-rays to fellow residents and attendings.

He advocates strong familiarity with the major hardware sets in the operating room and improving first assist skills by anticipating what the surgeon will do or ask for next.

“Participate in as many surgical cases as possible, even in a first assist or second assist capacity,” emphasizes Dr. Mansour. “The more experiences you have, the easier the transition will be when it comes time to perform complex cases in your third year of residency.”

First-year residents should be open to criticism and seek out feedback, according to Dr. Mansour. He also says it is important to have the appropriate perspective when assisting on surgical cases.

“You will learn at least one thing from every patient encounter, no matter how trivial or minute you may think the surgical case is,” maintains Dr. Mansour. “Always be eager to be involved in every type of surgical case.”

He also notes that learning how to deal with surgical complications comes with time and experience.

Looking back on his first year of residency, Dr. Reed notes that in retrospect, if a topic was brought up that he didn’t know, he would have focused on that topic for the day and looked up everything he could on it.

“That way, I look like a boss the next time,” notes Dr. Reed.

In her first year of residency, Dr. Scrimalli says she initially had the propensity to try to look things up herself but she quickly realized that her best resources were “my senior residents.”

“It is important to recognize that those before you have gone through the struggle and their trials and tribulations are your keys to success,” notes Dr. Scrimalli.

Q:

How did you interact and network with other first-year residents during your first year of residency? What advice would you give to first-year residents on this?

A:

“When I was a first-year resident, my chief residents had great relationships with other residents in other specialties and I was encouraged to emulate this rapport,” points out Dr. Scrimalli. “The relationships I’ve made are extremely helpful when trying to coordinate patient care and create continuity with different specialties.”

Dr. Mansour emphasizes keeping in touch with fellow classmates from podiatry school and rotations.

“Compare the different ways that fellow residents approach different pathologies and treatments across the country,” recommends Dr. Mansour.

When it comes to networking, Dr. Mansour also advocates attendance at state and national meetings, and participating in networking functions at these meetings, not only with residents but attendings and DPMs currently in practice as well.

Drs. Reed and Scrimalli convey the benefits of good relationships with the interns in your residency program. Dr. Reed says there was a comfort level in exchanging basic questions of each other’s specialty throughout the year. Dr. Scrimalli encourages building a team environment with co-residents, especially co-interns.

“It is essential to recognize as residents that we are on a journey together to create a positive experience for our patients and ourselves in the residency learning process,” notes Dr. Scrimalli. “I constantly tell my residents this advice: ‘Look around. These people are your second family. You will argue with them and get on each other’s nerves, but you will create a bond that could never be broken. Encourage each other, help each other, challenge each other and always be honest with each other. Most importantly, you need to remember you are stuck with your co-interns the next three years and you wake up every day with the choice to make it amazing.’”

Q:

In your first year of residency, did you spend time after hours or at the end of the day with podiatry and non-podiatry attendings? How was this beneficial for you? Can you recall any specific examples?

A:

Dr. Scrimalli says this is commonplace in her residency program, noting a multitude of academic events and workshops as well as casual educational dinners with her attendings and those from other specialties.

Dr. Mansour encourages first-year residents to make the most out of their residency and work extra hours in an effort to learn more. “Residency comes once in a lifetime,” notes Dr. Mansour. “The variety of pathology and volume of surgical cases should be appreciated.”

He says residents should never let a surgical case that may be beneficial to them go uncovered and advocates watching the surgical board constantly for new podiatric, orthopedic and plastic surgery cases.

“By working with orthopedic surgeons, you will be exposed to different schools of thought and will advance your knowledge in the AO principles and fixation techniques,” points out Dr. Mansour. “Furthermore, by working with plastic and hand surgeons, you will gain experience in the art of complex closure and microvascular techniques. This is also a great way to develop inter-professional relationships with attendings and residents from other departments at your hospital.”

Dr. Reed recalls rounding with one of his attendings and afterward talking for an hour about a variety of podiatry and non-podiatry topics. He remembers the attending physician giving him good advice about balancing career and family life.

“Interacting with my podiatric and multidisciplinary attendings outside of the hospital has allowed me to create relationships that are outside of the realm of patient care,” adds Dr. Scrimalli. “They speak with us more freely and this environment creates candid conversations regarding just about everything and anything, from podiatry to personal matters.”

Recalling a specific example from her first year of residency, Dr. Scrimalli remembers driving over an hour away, after hours, with other residents in her chief resident’s Tahoe in order to attend a cadaver lab to help prepare for an upcoming Charcot reconstruction case.

“This wasn’t only educationally beneficial but an indelible memory to have with my attending and co-residents,” notes Dr. Scrimalli. “This was also an attestation of my attending’s dedication to our education. To this day, I know he did not set up the lab for himself but he went out of his way to provide his residents with an experience so they would feel comfortable in the OR. How could I not appreciate that?”

Dr. Scrimalli offers a last piece of advice for first-year residents.

“It is now the time to learn and hone your skill with the luxury of having an attending supporting you,” says Dr. Scrimalli. “Make the most of your residency experience and help lay the foundation to become a successful physician and surgeon.”

Dr. Mansour is the Chief Resident at the Podiatric Foot and Ankle Surgical Residency at Beaumont Hospital-Wayne in Wayne, Mich.

Dr. Reed is Chief Resident with the Reconstructive Rearfoot and Ankle Surgical Fellowship and Residency Training program at Northside Hospital in Youngstown, Ohio.

Dr. Scrimalli is Chief Resident with the Bryn Mawr Hospital/Main Line Podiatry Residency Program in Bryn Mawr, Pa.

Dr. Bernstein is the Director of the Podiatric Residency Program at Bryn Mawr Hospital in Wayne, Pa. He is a Fellow of the American College of Foot and Ankle Surgeons.