Dr. Christopher Hyer
Orthopedic Foot and Ankle Center Fellowship – Westerville, OH
Q1. What podiatry school did you go to? The Ohio College of Podiatric Medicine (OCPM), now the Kent State University program.
Q2. Why did you choose podiatry? I actually kind of stumbled into finding podiatry/foot and ankle as an area of opportunity. I grew up in a medical family. My grandfather was a general practitioner and my father a rheumatologist. I always liked the idea of the medical field but saw the stress that my father had running a solo practice and dealing with chronically ill people. In college, I knew I liked the sciences and I liked working with my hands. I asked my father what he thought about me entering medicine. He was actually pessimistic about the future of medicine, seeing the changes in healthcare in his 40 years of practice. He advised me if I was going to look to a medical field, he suggested I check out 3 different options: 1) interventional radiology, 2) oral and maxillofacial surgery (OMFS) and 3) podiatric surgery. I really had limited knowledge of any of these specialties so I set forth in shadowing each of them while I was in my 3rd year of college.
Drs. Eugene Pascarella and Robert Hoover of Foot and Ankle Associates of Florida had a thriving practice just down the hall from my father’s office at Florida Hospital in Orlando. My father had great respect for the care they provided his patients and the variety of what they did from medicine to surgery. It was really my father’s recommendation to go and shadow Drs. Pascarella and Hoover that opened my eyes to podiatry and sparked my interest to follow that path. So, I really owe both my father and Drs. Pascarella and Hoover for helping me find my way to becoming a foot and ankle surgeon.
Q3. How many years have you been a podiatrist? What kind of setting are you currently practicing? I graduated from OCPM in 2000, from The Ohio State University Medical Center Residency Program in 2003 and from the Orthopedic Foot and Ankle Center Fellowship in 2005. During my fellowship years, I was given the opportunity to run my own clinic and manage my own patients, so I consider my practice starting in 2003—so, long answer, I’ve been practicing for 16 years. I practice in a multi-disciplinary Foot and Ankle clinic, which is really unique in the country. The group focuses only on below-the-knee/foot and ankle pathology and our providers include MD, DO and DPM fellowship-trained surgeons, surgically trained podiatrists, and physician assistants.
We are highly involved in research and education with numerous publications and presentations each year, train 2-3 fellows each year and are all active faculty members of both DPM surgical and DO orthopedic residencies.
Q4. Outside of podiatry, what occupies your spare time? I have a pretty busy life but I like it that way. I am the Residency Director at Grant Medical Center and the co-director of our fellowship at the Orthopedic Foot and Ankle Center in Columbus, OH. I am fortunate to have a great family and we like to travel together as much as possible. Both my wife and I are Florida natives, so we are usually trying to find time to get to sunshine and warmth when we can. I stay very active in the education world and have been lucky to work with world-renowned physicians from all around the country and the world, both at academic meetings and teaching courses as well as working as an orthopedic implant and device design surgeon.
Q5. Do you have any interesting stories that you would like to share? I have always liked to ask questions and try to understand the ‘why’ of things, instead of just simply accepting them as fact, or “the way it’s done”. I can remember a case I was assisting during my 1st year of residency. One of the orthopedic foot and ankle surgeons were performing a lateral column lengthening procedure for correction of transverse plane flatfoot deformity. As he was teaching me, he stated that you measure back from the calcaneal-cuboid joint 1cm and that’s where you make the osteotomy and place the graft. I wondered, “why 1cm?” So, I asked him—and in a classic teaching faculty response, he said, “I don’t know, you tell me.” So, as I went to the library (yeah, we actually had to go and physically find magazines to read the articles) and read up on the procedure, I found authors saying to make the osteotomy at 6mm, 8mm, 1cm, and 1.5cm. I wondered, “how could these all be right?” So, this is what got me started on my first research project and I was fortunate to present it at the ACFAS annual scientific meeting during residency and later get published in the Journal of Foot and Ankle Surgery in 2002. That experience was really impactful to me and showed me another side of medicine that allowed me to ask why and to seek and find answers—and I’m still asking questions to this day.
About the Program
Q1. Why did you go into a fellowship? What were you looking for in a fellowship?
This is a good question, especially because in 2003, this really was very rare in podiatry. Both growing up in a medical household and then doing residency training at a university medical center, I understood the role of fellowship training for the specialist physician. My father did a rheumatology fellowship after his internal medicine residency. Many of the other allopathic residents I was training with at OSUMC were going to go on to a plastics or endovascular fellowship for example, and many of the orthopedic residents were going to sub-specialize as well. I saw the surgical evolution of podiatry accelerating and I wanted to make sure I had the most complete training possible. I was lucky as a resident to have some opportunity to train alongside the orthopedic foot and ankle fellows. What I saw with the fellowship was a higher concentration of complex cases, a more focused approach to research and education, and just a further fine-tuning of skillset that the fellow was able to achieve. So, when the opportunity to do the fellowship training came along, I jumped at it. Interestingly, I had classmates (who already thought I wasted time doing a 3-year residency, while most of them were 2 years) tell me I was wasting even more time and that they were already out and practicing and starting to make money. I’m glad I was mature enough to realize you can never have too much training or too much experience. My fellowship experience is irreplaceable and is one of the best professional decisions I have ever made.
Q2. What does a typical day look like in the office? My office hours are from 7am-3pm. I run 3 clinical rooms and 3 cast room spaces. I also have a physician assistant who runs in 2 clinical rooms and shares the cast room spaces. I’ll typically see about 45 patients and the PA will see another 25-30, mostly routine follow-ups and some post-operative check-ups. I really have mostly a surgical practice but also treat many non-operative conditions. I don’t really do any procedures in the office, other than injections, due to time constraints and patient flow. We have a limb salvage/wound specialist podiatrist in our group who handles all the in-office procedures like ingrown nails and wound debridement, which is a big help. Our fellows come to the clinic with the attendings as they have desire and availability. They also have their own clinic a half day a week to really learn how to work up and manage patients on their own—but there’s always one of us in the next hall for a ‘phone a friend’ consultation when needed.
Q3. What are the biggest challenges that someone in this position would face? I’m a partner in our group and we are a private practice, so I think the biggest challenge is putting enough time and effort into business management. Obviously, you can’t do it all, so finding good people who share the vision and can help you get it done can be a challenge.
Q4. What is your favorite part about working here? My favorite part is having the professional camaraderie with other like-minded individuals. We have many activities we do as a group including weekly case planning conference, monthly research committee meeting, monthly journal club and usually several business meetings. We are all always looking to do what we do better and that dynamic environment is really energizing for me.
Q5. Any research was done at this fellowship? Yes, a lot. We always have ongoing projects and research. It is one of our core principles to continually evaluate what we do and find ways to improve outcomes for our patients. We present research at most of the major foot and ankle meetings nationally each year and generally, 5-8 get published as well. Research takes a real commitment of time, resources and perseverance. Our practice employs a full-time research coordinator to help us get it all done and the fellows are very involved as well.
Q6. What facilities do you cover? As our group has added some younger physicians over the past couple years, I have been evolving my practice to be as much of an elective, outpatient foot and ankle practice as possible. Our group covers several locations around Columbus including Grant Medical Center, Dublin Methodist Hospital, Grove City Methodist Hospital, and New Albany Surgical Hospital. I spend most of my operative time at Polaris Surgery Center.
Q7. How is the patient population? I’m fortunate and see a diverse patient population from all over the state and sometimes from adjacent states. I limit my practice mostly to adults but will see and treat children older than 12. Our group will see urgent care and ER referrals for routine traumatic injuries but I would say we are mostly a reconstructive and elective surgical group.
Q8. Is fellowship similar to residency? I see fellowship as very different than residency. First off, you choose to do a fellowship and you have to do a residency. That simple fact really is a difference maker in the level of involvement and dedication for many. Fellowship really builds on what you have already learned, refines what is there and hopefully exposes you to new skills and techniques that you didn’t learn in residency. If you visit or consider fellowships and they seem to like it’s just another year of residency for you, I would say that program isn’t a good fit. Most fellowships also add in a large amount of practice management and business exposure that we usually don’t get while in residency.
Q9. How many surgeries are expected in a year? Our fellows typically graduate the year with about 700-800 cases each.
Q10. How is the fellowship application process? What advice do you have when applying? There is information on our website http://www.orthofootankle.com and also on the ACFAS website fellowship page. We usually take applications until about mid-September each year and do a one-day interview in late September to early October. My advice on finding and applying to the right fellowship is to do your homework. Read up on the programs that interest you. Find out what that program excels in and what their faculty is doing. Find out where their past fellows have gone after fellowship and perhaps reach out and talk to current and past fellows if possible. I think the most valuable information is to really talk to the people who have trained at that program and see what they have done with that training afterward on their own.
Q11. What was the most impactful advice a podiatrist gave you? Never think you know it all and realize you always can get better.
Q12. Any advice to current residents who are thinking of applying or general advice for current podiatry students? Be open to possibilities and make the most out of all the opportunities that come your way. Believe it or not, your time in medical school and residency really goes by quickly and there is a small window of opportunity to make the most of. Once you are done with formal training, unless you stay active in a teaching program somewhere, it is very easy to become frozen in time with your medical knowledge and skills. Every residency and fellowship you consider has some great opportunities to be experienced, but you have to be active in your own learning and take the initiative. Many learners really struggle with the change from medical student, where the information is pushed to you constantly with lectures and labs by your instructors, to the role of the resident. where it’s on you to become active in your own education. This is really how your education will be for the rest of your career as well.
By Josephine Wu
Kent State University College of Podiatric Medicine
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