How Does One Become an Exceptional Foot and Ankle Surgeon?

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Master Surgeon: How Does One Become an Exceptional Foot and Ankle Surgeon?
Thomas S. Roukis
Foot & Ankle Specialist 2008 1: 58-60

 

Can I add two to Dr. Roukis' list of three?

>>"1) a sound understanding of the science of surgery,
2) mastery of the art of surgery,
and 3) life-long discipline."<<

4. Great manual dexterity
5. A HUGE EGO!

Steve

 

Another addition on how to become an exceptional foot surgeon:

Take the time and effort to understand the biomechanics of the foot and lower extremity so that the surgical decisions made will not cause mechanically-based pathologies for the patient in the future.

 

LOL! Nice one Steve!

6) Use the word "I" a lot.

So does "life-long discipline" mean that some day this profession is going to kill me?

 

1. Be a reflective surgeon, not merely an automaton. The greatest advances in my work came about when I started to analyze and evaluate the effects of surgical maneuvers intra-operatively. And keep going until you can be sure the objectives are met. Surgery is as much art & craft, as science.

2. Know when not to operate.

3. Appreciate the strengths and limitations of foot surgery.

4. Guide and help your patient (especially in elective cases) to make the best possible decision (surgery, conservative or other). i.e. don't be a salesman

5. Practice, practice and more practice

6. Don't be afraid to refer to a colleague with more experience, if that is what is required.

 

1. I began right out of residency by attending the AO-ASIF Basic [all things] Fixation Course. If you have NOT attended either part I or part II, then by all means, GO. It is balls to the wall-- INTENSE, bones, cadaver feet, & those casted sawdust bonez ALL 3 dayz with tools, drills, & fixation plates & screws in your hands, alternating between .PPT screenshots & HANDS-ON!! / 2. Next, I set a goal to read every book published on Foot & Ankle Surgery; in this endeavor, it was difficult to catch up as in the late 1990's & early 2000's, there was an explosion of published texts in this OUR field... AND every one of them ADDS something to the 'mix' -e.g., a new angle, new ways of 'looking' at the problem, of how to approach the problem, and MORE importantly--of HOW TO get BETTER at performing surgery technique-wise; I mean, one cannot help but glean & pick up pearls with every source you read--TRUTH! However, here's the rub: Pod & Ortho Ft & A books are expensive, upwards of $200 to $400 per book or 2-book set... But, I was lucky, very fortunate indeed: practicing in the Army, the library helped by buying the books I couldn't afford, then put them on permanent loan to me (till I was discharged several yrs later). Anyhoo, IF YOU PERFORM A LOT OF SURGERY, then, YES, by all means, it becomes incumbent upon you to absolutely read every book, it helps - a lot! Bottom Line: One becomes GREAT by standing upon the shoulders of those who've gone before you!! --FACT. / 3. Attend ALL the Workshop courses you possibly can; or rather, after a few key GOOD ones, namely the ACFAS Cadaver Course(s) at the Ortho Learning Center (OLC) in Chicago (Rosemont, to be exact), IL are worth every penny. You are taught by the Pod experts, learn the exact appropriate Indications, precise Incisional Approaches, and no fail Techniques for accomplishing ALL of the surgeries that can possibly be performed on a foot--from the 5th toe to 1st ray, Midfoot, Rearfoot, & the Ankle. You get a video disc to take home, a manual, and the expertise to take home, do some supervised cases, up your priveleges, and rock on. AND - if you have a tremendous chair & bed side manner that people love, everyone from kids, teens, adults, & the elderly, then you TRULY will be exceptional; with a positive attitude, a deeply spiritual philosophy, (and you never eat the young - a problem in our profession, at least it was 10-15 yrs ago as far I knew), THEN YOU CAN'T HELP BUT BE EXCEPTIONAL BY DEFAULT... AND THE SUCCESS (& $$$) WILL FOLLOW. 4th - Be Board Certified: the mother of all Pod boards, of course, is ABPS; but, if you couldn't get all the mix of cases, then another board will have to do. People, there are just too many NON- Brd Cert Pods around, TOO MANY Pods who don't AND simply CANNOT take call at the local hospitals, step-down care, & nursing homes... and if you ask me: that HOLDS US BACK, keeps us 'out of the proverbial loop' and I've talked to too many other PCPs in too many places who would be ALL too welcoming to have us on board, available, taking call, coming, & assisting in the care of their patients. EXCEPTIONAL. THAT'S HOW I DID IT. AND GOT A STELLAR REP FOR EXCELLENCE IN ALL OF MY RESULTS IN A PT POP'N OF 40K THAT GREW TO 60K OVER 7 YRS in the surrounding military base community of Ft Polk, LA; and my rep became well-known about the military community when my patients got transferred and others, Pods & Orthopods saw my work. 5th - one last thing: become familiar with ALL fixation systems, the latest plate systems- namely the Acumed Foot set; you won't believe how fast a FF or midfoot fusion heals, how low profile these plates, and how rarely the titanium needs be removed. Exceptional. Be the Pod. {One last thing: if u wanna MAX your ABPS oral exam, then buy the Podiatry Present Board Review online lecture plus free accompanying board review manual -which includes many, many oral oral board questions from previous yrs!!! And study it every waking minute for one full year; do all the lectures; and once again- memorize the manual! You will score high on the written, AND 'max' the oral exam... that's how I did it (2nd time--I was sick the 1st time, but it was good practice & didn't have THAT manual--others, BUT NOT that ONE; and I do NOT have a photographic memory!} Be the Exceptional Pod. Read every book, take every key course, & be Board Certified. Stay current. And do NOT be afraid to contact the experts in the sub-specialties with questions about difficult cases; they are flattered when you do... I did that my whole time I was in the Army: Gumann, Dockery, & other authors & experts; I even flashed Rads at them at conferences & workshops; they didn't mind. They helped me become the exceptional & CONFIDENT Pod, and patients love it when you tell them you asked the TOP guy!!! It makes them feel special, even - exceptional!

 

Master the "enter" key?

That's a good one

 

Got to "INTENSE" and had to stop. (2nd line)

It's like reading the Doomsday book!

 

That's "too" (not 'to'), dude. Nope, no girls checking anything out over here, mate. Cheerio. And yes, it's a serious question, so I gave it a serious answer. Did you read the protocols for "posting replies" ?

 

It was definately "to"

I'm sure. I just couldn't read it due to an inability to follow the text. I have just tried rereading it and got to line 4. It looks like the "matrix".

No

EDIT: And another thing, why so much usage of capital letters? It looks like you are giving the readers a bo!!ocking

 

Got to "INTENSE" and had to stop. (2nd line)

That's "too" (not 'to'), dude. Nope, no girls checking anything out over here, mate.


The first step in becoming a master surgeon is mastering grammar so you can do not lose (or is it loose?) your credibility. Robin P is indeed correct.

http://www.grammar-monster.com/easily_confused_words.htm

Preaching is also always distasteful and master surgeons that I know are actually quite confident but humble as they are more likely to know what they do not know. When you're ego is huge, your glass is full and your less likely to seek advice from others. When your humble, your glass is half full and you're always willing to add knowledge to your glass.

Steven





Steven

 

WOW. In reference to WillTrekker's post......please get off your high horse. Some of your "advice" is certainly reasonable regarding continuing education, but you really need to learn a little humility.

First and foremost is to not be ashamed of, or look down on your colleagues who provide palliative care for nursing home patients, etc, or for all those "non board certified" docs.

Yes, I am ABPS board certified and I served as an oral examiner for the ABPS for about 10 years. But that does not make me any better than anyone else, nor does it give me the right to judge other docs who have chosen not to perform surgery.

In my opinion, a master surgeon has to have two key traits, in addition to many already mentioned;

1) Humility

2) The ability to refrain from performing surgery to boost his/her own ego, and to only perform surgery when absolutely indicated.

It's great to hear that you're very impressed with yourself.

 

WillTRekker,

That wall of text hurt my brain. Could you possibly make it a bit more readable by breaking the text up a bit please?

 

Couldn't have said it any better, so I'm quoting it for emphasis.