Podiatry
I.
Rationale
Diseases and disorders of the foot affect the quality of life and mobility of millions of Americans. Foot
ailments can be the first sign of a more serious medical problem, such as arthritis, diabetes, and nerve and
circulatory disorders. As such, it is important for family medicine physicians to be able to diagnose and
manage many of these conditions, so that timely and effective care can be delivered to these patients.
II.
Competencies
Medical Knowledge/Patient Care
Goal: Provide Evidence Based Care and medically competent care to patients with common podiatric
conditions.
Objectives:
A. Learn to diagnose and manage
1. Corns and calluses
2. Tinea Pedis
3. Hallux Valgus
4. Hallux Limitus
5. Tailor's Bunion (5th Metatarasal)
6. Subungual hematoma & contusion
7. Hammertoe
8. Bone Spurs
9. Verruca
10. Arteriosclerosis Obliterans (ASO)
11. Raynaud's Syndrome
12. Ankle Osteoarthritis
13. Ankle Sprain
14. Rupture, Tendon, Foot
15. Plantar Fasciitis
16. Tendonitis, Achilles
17. Abcess Toe
18. Abcess, Cellulitis Foot
19. Ulcer, Neurogenic
20. Ulcer, Decubitious
21. Osteomyelitis Foot
22. Onychocryptosis
23. Onychomycosis
24. Metatarsolphalangeal Jt. Deformity
25. Sesamoiditis
26. Foreign Body
27. Fracture, Phalanx
28. Fracture, Metatarsal or Tarsal
29. Fracture, Ankle
30. Ganglionic Cyst
31. Morton's Neuroma
32. Tarsal Tunnel or Sinus Tarsitis
Last Updated April 19, 2013
B. Learn a few basic podiatric procedural skills essential to the practice of family medicine.
1.
2.
3.
4.
Callus/corn removal
Toe nail removal
Digital nerve block
Cryotherapy
Learning Activities
Attending Rounds
Multidisciplinary Rounds
Grand Rounds
Sub-Specialty Conference
Morning Report
Didactics
Other
Evaluation Methods
X
Attending Evaluation
X
Program Dir
Review
X
360 ᵒ evaluation
Other
X
X
X
X
Research Conference
Ethics/Comm Conference
Specialty Conference
Noon Conference
Faculty Supervision
Procedures
X
X
Directly Supervised Procedures
In-Training Exam
X
X
Videotape Review
X
X
Outpatient Clinics
Direct Patient care
Resident Seminar
Journal Club
Readings
Morning Report
Faculty Supervision
and Feedback
Quarterly Review
Practice Based Learning and Improvement
Goal: The resident should develop skills in evaluating their own patient care, appraising and assimilation of
scientific evidence to improve patient care.
Objectives:
A.
B.
C.
D.
E.
Identify resources for personal education.
Develops a plan for ongoing education.
Identify Point of Care learning resources.
Utilize Electronic Medical Records Decision aid tools and templates for patient care.
Recognizes strengths and weaknesses of knowledge and skills in self and others.
Learning Activities
Attending Rounds
Multidisciplinary Rounds
Grand Rounds
Sub-Specialty Conference
Morning Report
Didactics
Other
Evaluation Methods
X
Attending Evaluation
X
Program Dir
Last Updated April 19, 2013
X
X
Research Conference
Ethics/Comm Conference
Specialty Conference
Noon Conference
Faculty Supervision
Procedures
Directly Supervised Procedures
In-Training Exam
X
X
X
Outpatient Clinics
Direct Patient care
Resident Seminar
Journal Club
Readings
X
Morning Report
Faculty Supervision
X
Review
360 ᵒ evaluation
Other
and Feedback
Quarterly Review
Videotape Review
Interpersonal and Communication Skills
Goal: Residents will develop and demonstrate effective information exchange and teaming with patients,
their families and other health professionals.
Objectives:
A. Develop patient sensitive skills for interviewing that allow accurate, and complete collection of
information regarding symptoms, the family and the community that affect the patient's health
and care.
B. Develop skills in communicating results to patients, their families, other health care providers.
C. Develop skills in educating patients and their families, in dealing with sensitive issues
for patients and families, and in negotiating a plan of investigation and treatment with
the patient and family.
D. Develop professional relationships with co-workers, consultants, ancillary staff and other
professionals to enable assembling of health care teams and mobilization of community
resources to optimize care of the patient.
E. Develop an understanding of the role of the family medicine consultant, and is able to support
the patient through the process of consultation, medical evaluation, treatment, rehabilitation
and long-term care.
F. Use professional language and demeanor when communicating with other residents, with
Family Medicine attending physicians, with physicians from other services, with non-physician
clinical staff, with non-physician non-clinical staff, and with patients and their families.
G. Create and sustain a therapeutic and ethically sound relationship with patients.
H. Use effective listening skills and elicit and provide information using effective nonverbal,
explanatory, questioning, and writing skills.
I. Work effectively with others as a member or leader of a health care team or other professional
group.
Learning Activities
Attending Rounds
Multidisciplinary Rounds
Grand Rounds
Sub-Specialty Conference
Morning Report
Didactics
Other
Evaluation Methods
X
Attending Evaluation
X
Program Dir
Review
X
360 ᵒ evaluation
Other
Last Updated April 19, 2013
Research Conference
Ethics/Comm Conference
Specialty Conference
Noon Conference
Faculty Supervision
Procedures
X
X
Outpatient Clinics
Direct Patient care
Resident Seminar
Journal Club
Readings
X
Directly Supervised Procedures
In-Training Exam
X
X
X
Videotape Review
X
Morning Report
Faculty Supervision
and Feedback
Quarterly Review
X
Professionalism
Goal: Residents will demonstrate a commitment to carrying out professional responsibilities, adherence to
ethical principles, and sensitivity to a diverse patient population.
Objectives:
A. Demonstrate integrity, honesty, respect and a commitment to excellence in all activities
B. Demonstrate sensitivity, respect and adapt appropriately to the social and cultural issues of each
patient.
C. Display initiative and resourcefulness in patient care and in solving problems.
D. Be timely in attendance of activities and completion of tasks.
Learning Activities
Attending Rounds
Multidisciplinary Rounds
Grand Rounds
Sub-Specialty Conference
Morning Report
Didactics
Other:
Evaluation Methods
X
Attending Evaluation
X
Program Dir
Review
X
360 ᵒ evaluation
Other
X
X
Research Conference
Ethics/Comm Conference
Specialty Conference
Noon Conference
Faculty Supervision
Procedures
X
X
Outpatient Clinics
Direct Patient care
Resident Seminar
Journal Club
Readings
Directly Supervised Procedures
In-Training Exam
X
X
Videotape Review
X
Morning Report
Faculty Supervision
and Feedback
Quarterly Review
Systems Based Practice
Goal: Demonstrate an awareness of and responsiveness to the larger context and system for health care
and the ability to effectively call on system resources to provide care that is of optimal value.
Objectives:
A. Utilize and understand the importance of appropriate referral or consultation with podiatrists.
B. Support of the individual and family through consultation, evaluation, treatment, and rehabilitation.
C. Understand the psychosocial and economic impact of podiatric conditions on the individual and
family and use of the health care system to assist as needed.
D. Learns most cost effective ways to manage patients with podiatric conditions.
Learning Activities
Attending Rounds
Multidisciplinary Rounds
Grand Rounds
Sub-Specialty Conference
Morning Report
Last Updated April 19, 2013
X
Research Conference
X
Outpatient Clinics
Ethics/Comm Conference
Specialty Conference
Noon Conference
Faculty Supervision
X
Direct Patient care
Resident Seminar
Journal Club
Readings
X
Didactics
Other
X
Evaluation Methods
X
Attending Evaluation
X
Program Dir
Review
X
360 ᵒ evaluation
Other
IV.
Procedures
Directly Supervised Procedures
In-Training Exam
Videotape Review
X
Morning Report
Faculty Supervision
and Feedback
Quarterly Review
Instructional Strategies (see above)
This is a four-week elective and should be attended by the resident for a minimum of 5-6 half days per
week. The other 4-5 half days per week will be spent in the resident’s continuity clinic and in didactics.
Readings can be obtained from Section VI and should also be solicited from the Clinic Medical Director and
team.
V.
Evaluation Strategies (see above)
A. Observation and end of rotation evaluation from the Podiatry faculty.
B. Procedure documentation by the resident
C. Conference attendance
D. In-training exam profiles
E. Resident evaluation of rotation and faculty
H. Completion of required readings and scoring >90% on open book Monograph quizzes
VI.
Implementation Methods
This medical elective consists of 6 ½ day sessions per week of Podiatry in a clinical setting of the, for a total
of 4 weeks.
Location:
Robert Schwartz, DPM
Foot & Ankle Center
1711 Mt. Vernon Road, Suite 2
Dunwoody, GA 30338
Contact:
Charlotte: 770-963-5161 office
678-638-7779 fax
Family Practice Center: 5 ½ days per week in the Family Medicine Clinic, 4 ½ days in the Podiatry
Clinic.
Call/Vacation: Call will be with the Family Medicine Service at Emory University Midtown Hospital.
Vacation is permitted.
Supervision: Residents will be supervised by Dr. Robert Schwartz.
Conferences: The resident is expected to attend Thursday morning Family Medicine Didactics Conferences.
Last Updated April 19, 2013
VII.
Suggested Readings/Resources
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13.
AFP Monograph: FP Essentials 307: Common Foot Problems
JOAN M. BEDINGHAUS, MARK W. NIEDFELDT. Over-the-Counter Foot
Remedies. Am Fam Physician. 2001 Sep 1;64(5):791-797.
JOONG MO AHN, GEORGES Y. EL-KHOURY. Radiologic Evaluation of Chronic Foot Pain. Am
Fam Physician. 2007 Oct 1;76(7):975-983.
MICHAEL R. SIMPSON, THOMAS M. HOWARD. Tendinopathies of the Foot and Ankle. Am
Fam Physician. 2009 Nov 15;80(10):1107-1114.
ROBERT G. FRYKBERG. Diabetic Foot Ulcers: Pathogenesis and Management. Am Fam
Physician. 2002 Nov 1;66(9):1655-1663.
JOEL J. HEIDELBAUGH, HOBART LEE. Management of the Ingrown Toenail. Am Fam
Physician. 2009 Feb 15;79(4):303-308.
JEFFREY D. TIEMSTRA. Update on Acute Ankle Sprains. Am Fam Physician. 2012 Jun
15;85(12):1170-1176.
Barrett M. Schroeder. American College of Foot and Ankle Surgeons: Diagnosis and
Treatment of Heel Pain. Am Fam Physician. 2002 Apr 15;65(8):1686-1688.
DENISE B. FREEMAN. Corns and Calluses Resulting from Mechanical Hyperkeratosis. Am
Fam Physician. 2002 Jun 1;65(11):2277-2280.
ROBERT G. FRYKBERG. Diabetic Foot Ulcers: Pathogenesis and Management. Am Fam
Physician. 2002 Nov 1;66(9):1655-1663
TODD C. SOMMER, THOMAS H. LEE. Charcot Foot: The Diagnostic Dilemma.
Am Fam Physician. 2001 Nov 1;64(9):1591-1598.
ALFRED F. TALLIA, DENNIS A. CARDONE. Diagnostic and Therapeutic Injection of the Ankle
and Foot. Am Fam Physician. 2003 Oct 1;68(7):1356-1363.
DANIEL B. JUDD, DAVID H. KIM. Foot Fractures Frequently Misdiagnosed as Ankle Sprains.
Am Fam Physician. 2002 Sep 1;66(5):785-795.
Last Updated April 19, 2013