Attrition in Podiatric Medicine and Surgery Residency.

BACKGROUND: The objective of this study was to investigate the rate of attrition within podiatric medicine and surgery residency training programs. METHODS: Between the academic years 2006-2007 and 2015-2016, the Temple University School of Podiatric Medicine matched 780 graduates into 163 different residency training programs. Program directors from these sites were individually contacted by e-mail and asked whether the specific Temple University School of Podiatric Medicine graduates who originally matched with their program 1) completed the program, 2) transferred to another program, 3) quit the program, or 4) were fired from the program. RESULTS: Results were returned with respect to 614 (78.7%) of the 780 graduates, representing 103 (63.2%) of the 163 training programs. Program directors reported that 573 (93.3%) of the 614 graduates completed the program, 17 (2.8%) transferred from the program, six (1.0%) quit the program, five (0.8%) were fired by the program, and 13 (2.1%) matched but never started the program. This equates to an annual attrition rate of 0.46% for residents who started the podiatric residency training program that they matched with. CONCLUSIONS: We conclude that the rate of attrition in podiatric medicine and surgery residency training appears to be relatively low or at least in line with other medical specialties, and hope that this information leads to other investigations examining attrition, specifically as it relates to physician-specific and program-specific risk factors for attrition.

The ABCESS System for Chronic Wound Management: A New Acronym for Lower Extremity Wound Management.

The authors propose a new acronym to promote teaching and learning evidence-based care for wounds of the lower extremity, maximizing healing potential, and assuring the ability to adapt to everchanging new technologies. ABCESS is a comprehensive framework for the assessment of a patient with a lower extremity wound. Wound care clinicians benefit from a system that is broad enough to include new guidelines and technologies as they appear. The TIME/DIME model has been used for many years to assist clinicians in thorough wound bed management. In order to expand the model to be able to address all aspects of lower extremity wound healing, ABCESS was developed. TIME has recently also been expanded to TIMERS in an attempt to address this. The ABCESS acronym was originally developed at the Temple University School of Podiatric Medicine to use as a teaching tool and organizational aid for students of wound healing. Each letter was used as a framework to aid the wound care clinician in performing a complete assessment of the patient with chronic wounds of the lower extremity: All of the patient, including a complete history, physical assessment, and systemic disease overview (with nutrition) to assess the physical aspects of the patient presenting with a wound; wound Bed management to include Bioload, Biofilm, cellular assessment of Biomarkers using polymerase chain reaction/DNA analysis, and wound Biopsy; Circulation to include arterial, venous, and lymphatic circulation; Edema, Exudate, and Erythema management focusing on dressing and compression choices; Skin protection and treatment to include wound edge, periwound skin, and offloading management; Social, Societal, and Spiritual factors, including assessment of the immediate social environment, the wider societal limiting factors, and personal, spiritual, and psychological issues affecting this patient's wound care.