On-Boarding for New England Podiatry Residents

By John T. Marcoux
ABFAS Board Member
Residency Director, St. Elizabeth's Medical Center 

On-boarding is an annual rite of passage for all residents starting their post graduate training program.  In most institutions where there are many post-graduate residency or fellowship programs, podiatry residents are often integrated into an institutional wide orientation.  The general on-boarding presentation usually covers the basics of functioning within the facility with training on the electronic medical record system, and proper documentation, in addition to presentations regarding proper code of conduct, hospital compliance, and risk management. Other components of the general hospital on-boarding orientation typically include BLS/ACLS training, human resource presentations on house staff benefits, and wellness discussions on sleep deprivation and stress mitigation.

Although the integration of first-year podiatry residents into the general on-boarding orientation with other house officers provides an excellent overview, it does not prepare them for the specific expectations and issues that a podiatry resident may encounter on day one of their residency training program.  The task of getting the first-year resident up to speed in a rapid fashion is the responsibility of the program director, with the assistance of teaching faculty and senior podiatry residents at the institution.  The residency training programs in the Boston area have had a long history of collaboration with didactic activities, journal clubs and workshops, and recently developed the Boston Area Foot and Ankle Council on Teaching (BAFACT).  BAFACT’s charter definition is - adding to post graduate medical education value by a collaboration of institutions. Therefore, in an attempt to augment the resident’s preparation, several of the Boston based residency training programs who are charter members of BAFACT trialed a focused on-boarding program last June. 

The on-boarding agenda was developed by several of the residency directors and teaching staff with the assistance of senior residents.  A series of presentations were delivered over 4 hours on the Saturday morning prior to the formal start of the academic year.  The agenda was structured around the basic tenets that all of the programs needed to instill in the first-years residents.   It also provided pearls from the senior residents on items that they wished they had known when they started their residency training.

The presentations included: 
-Appropriate Opioid Prescribing /Prescription Monitoring Program
-Handling Post-operative Phone Calls
-Dealing With the Difficult Patient
-Journal Club
-PRR Logging
-General Expectations – From the Attending Perspective
-General Expectations – From the Senior Resident Perspective
-Hospital Protocol/Professionalism
-Appropriate Behavior in the Workplace
-OR Protocol, From the Surgical Tech Perspective
-Living in Boston

And the workshops included:
-Basic Suturing Skills

The multi-institutional on-boarding program for first-year podiatry residents was a resounding success due to the collaboration of the faculty and staff of many different institutions.  Not only did it help lay the necessary foundation for these residents as they began their post graduate training but it also allowed them to meet, socialize, and network with the other residents from neighboring institutions.  The premise of this on-boarding program was to continue the collaboration amongst the institutions and provide a value added educational experience for all the first year residents without having each institution duplicating the same work.  The residency programs in the area look forward to continuing the on-boarding orientation as well as the continued collaboration on didactic lectures, workshops and journal clubs under the umbrella of BAFACT. 

Residency Programs involved in this on-boarding event are:
-Beth Israel Deaconess Medical Center
-Boston Medical Center
-Cambridge Health Alliance
-MetroWest Medical Center
-Mount Auburn Hospital
-St. Elizabeth's Medical Center
-St. Vincent Hospital Southwestern
-Vermont Medical Center