Practice Perfect - PRESENT Podiatry
Practice Perfect
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Advice to New Clinicians

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Jarrod Shapiro
medical students

It’s that time of the year: the academic transition. Our third year residents and fellows are about to graduate from their respective programs and move into practice. Our recent podiatry school graduates are about to enter residency, and our youngest colleagues, the third year podiatry school students, are just now entering their clinical years. It’s an exciting time for all of our colleagues, and I find I’m in the unusual and privileged position to watch all of these events occur simultaneously.

As a classroom and clinical teacher at one of our nine colleges and a residency program director, I work with every level of trainee (minus the fellowship – we don’t have that yet!). Having lived through each of these positions in the past, I’d like to give a bit of advice to each level of our young colleagues. To that end, here are my top five pieces of advice for each level of our burgeoning podiatric future.

Top 5 Pieces of Advice for New Practitioners

  1. Don’t Stop Learning - During your busy life starting practice it’s easy to stop reading and keeping on top of the medicine. But the pace of knowledge is very rapid, and it’s easy to get behind.  
  2. Learn Practice Management - Unfortunately, medical practice today is all about business. If you don’t know how to code and bill, as well as the most efficient methods to run your practice, you stand to lose a lot of money. 
  3. Market Yourself - Whether you’re opening a new practice or starting in someone else’s, you must make yourself known in the community. It’s not fun, but you have to knock on referring doctors’ doors and explain why they should send their patients to you. Build your practice volume. This is the time to be gregarious and be aggressive. 
  4. Get Certified - Remember there are two boards with which most people certify, ABPM and ABFAS. ABPM consists of written tests that allow you to certify in the first year of practice. ABFAS requires a larger amount of work. Start logging your surgeries immediately and continue as you move forward. This is just like residency. If you wait for the last minute to log cases, it will create torturous difficulties and you will be kicking yourself. Try running a practice, having a life, and preparing for certification at the same time. Not fun. 
  5. Remember Balance - It’s difficult to balance the demands of a new job with a personal life, and your personal life usually suffers. Don’t forget to take enough good quality time out for yourself and your family.  

Top 5 Pieces of Advice for First Year Residents

  1. Read, Read, Read - Read about everything you see and do. Then read more. When you’re done, read more again. Think you’ve read enough? Probably not. Read more. Read about upcoming cases, about cases you just finished, and patients you’ve seen in clinic and the hospital. Did I say “read”?  
  2. Be There - The only way to gain experience is to be in the clinic, hospital, and operating room. Stay late. Take extra call. You’ll never see that rare pathology or experience the unusual surgery if you sleep in late or go home early. Three years is a remarkably short period of time, so take advantage of your opportunities by being mentally and physically present.  
  3. Teach Others - One of the best ways to learn something is to teach it to others. If your program has clerks, take the time to teach them. You’ll be surprised; you might even enjoy it.  
  4. Do Research or at Least Write - Many if not most programs have requirements to complete some sort of research. If your program does not then take the initiative and start a project on your own.  
  5. Learn Practice Management (at Some Point During Residency) - Among all the skills we learn in residency, practice management is one of least common, but most important. Understanding coding and how to run a successful practice will give you a competitive edge and another skill with which to negotiate a higher initial pay with that first job out of residency. 

Top 5 Pieces of Advice for Clinical Students

  1. Read Even More than Residents - If it’s at all possible to read more than a resident, then students should be doing it. There’s a lot to learn, and you’ll only become a good physician if you know stuff. Don’t just read textbooks and handy little manuals that fit in your white coat. It’s time to read journal articles. Learn the research and understand why your attendings make the decisions they do. 
  2. Start Early; Stay Late - Residency programs want students who work hard and are willing to put in the time. Ask residents if you can round with them on the weekends. NEVER show up late. Ever. Create a good impression by showing how hard working and willing you are to help. 
  3. Get Involved - If you haven’t previously been involved with your podiatry school, now is the time. Do something. If you have blanks in your residency application, you’ll be less competitive for those good positions everyone’s competing for. Show that your time at podiatry school wasn’t just studying for tests.  
  4. Practice Suturing - There are a few skills that attendings and residents can see you do that will tell them you’re ready for more advanced activities. Suturing is one of them. Want to show you should scrub in to that next case? Demonstrate your suturing skills.  
  5. Take Notes - As an attending it annoys me when I’m teaching something and my students aren’t taking notes. “Do they already know this?” I ask. “Do they know so much they don’t need to take notes?” You can’t remember all the topics to read about if you don’t take notes.  

One last piece of advice for all levels: Listen carefully to those older and more experienced than you. They have been through it and made lots of mistakes along the way. If you truly listen and absorb what they have to teach, then just maybe you and your patients will be spared the pain of their mistakes.

Best wishes and good look with all your endeavors.
Jarrod Shapiro Signature
Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
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