07/02/2019    Peter Bellezza, DPM

Preventing Suicides of Pediatric Residents(Patrick DeHeer, DPM)

If there are podiatry residents out there
thinking of committing suicide, then they
probably should NOT have been accepted to
podiatry school and pushed through, by school
administration, to graduate in the first place.
There is nothing stressful about podiatry
residency training when you compare it to being
an internal medicine resident, general surgery
resident, orthopedic resident, etc.

The stakes are higher in those training programs.
They just are. Intern residents from these
specialty tracks are dealing with patients with
more diverse pathology. Intern residents in these
specialty tracks are actually medically managing
these patients, dealing with complications during
inpatient care. Things that most podiatry
residents don't have to deal with every day and
night. The only time podiatry residents are
medically managing patients is under the auspices
of an MD/DO attending and senior MD/DO residents
on an off service rotation which lasts anywhere
from 30-60 days.

Podiatry residency training is highly variable.
Some programs are based out of Veteran Affairs
hospitals, some are based out of community
hospitals and then there are programs based out
of level 1 trauma centers/ university hospitals.
Some residency programs just have their residents
driving around from surgery center to hospital to
surgery center covering their attendings surgical
cases and then going home. Not stressful. Some
residency programs have residents manning high
volume resident clinics clipping toenails and
doing wound care. Not stressful.

The months a podiatry resident is "on service"
should not be stressful because they are training
to do what they signed up for. This is the fun
stuff. Another variable that complicates ANY data
that could be produced from a survey is that
podiatry residency programs have variable amounts
of off service (ER, ortho, gen surg, etc.) vs
podiatry rotations. There is a bare minimum
amount of off service rotations that every
residency program must have. BUT not all
residency programs do the bare minimum. In fact
some programs may have their residents spend
18/36 training months doing off service
rotations. Maybe more.

When a podiatry resident is spending more than
50% of their training months on off service
rotations (such as ER. ortho trauma, Internal
medicine, general surgery, etc) I can bet those
residents are experiencing higher levels of
stress compared to their resident colleagues who
spent 75% training months doing "on service"
podiatry rotations doing surgery and covering
podiatry residency clinic. On top of all of this,
you must consider that the quality of these off
service rotations are highly variable depending
on the hospital the podiatry residency program is
based out of. ER rotations at the Veterans
affairs hospital are not as stressful as an ER
rotation at the level 1 trauma center. Same goes
for IM, ortho, general surgery, etc. Way too many
obvious variables in the podiatry residency
training paradigm to produce any legitimate data
that applies to all podiatry residents.

Peter Bellezza, DPM, Bristol, CT

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