the residents: Dr. Vinogradov

Resident: Dr. Aleks Vinogradov

Year: PGY 1

1)What residency program are you at, and what year are you?

University of Pittsburgh Medical Center (UPMC), PGY 1

2)What are your thoughts on completing a fellowship versus going straight into practice after residency graduation?

Not sure at this point. I feel like I will have excellent training that will hopefully prepare me for pretty much everything that may come through my doors, but at the same time, I almost feel like not having a fellowship will put me “behind” in some way since it has become extremely popular and “the thing to do” as of the last few years

3)What is the best part of residency, in your opinion?

First, the training itself. Being exposed to such a great number of different pathologies, trauma, or really anything that the patient comes to you for. Furthermore, having the privilege to treat this person, knowing well that if there is anything you do not know, the attending will step in and show you the way or a better way.

Second, having great attendings who love teaching and dedicate themselves to making you a better doctor when you graduate.

Finally, I usually tell the externs: “Remember as a student rotating through the program, you got stuff out and ready for the attendings and the residents, whether it is for a procedure or surgery, and watch them do it? Well, now you get to stay and actually do the fun stuff!”

4)What is your surgical case volume and type in a typical week at your program

That really depends on the rotation you are on. As a first-year, you are essential “on-service” or associated with some surgery for 8.5 out of 12 months in your first year. Perhaps even as much as 10 out of 12 if you factor in “call” and the add-on cases that stem from it. So, you tend to find your way to the OR frequently. Official “non-office” podiatry rotations during the first year tend to have 2 surgery days per week, which may have as many as 5 cases per day. During those rotations, you may see something as straightforward as a bunion correction or as complex as a Charcot recon with the external fixator/intermedullary nail or a total ankle replacement.

Our program also has the privilege to rotate through the local VA, where as a first-year you get to take charge on most of the forefoot surgeries and assist the 2nd year resident with their cases (ankle fusions, ankle fractures, ligament repairs, etc). The VA tends to be a very busy rotation, sometimes as many as 3 surgical days per week. It is a wonderful opportunity for a first-year resident to grow in their surgical skills. During your first year, you also get to rotate 1 month through the “Podiatric Surgery” rotation where you get to scrub in on the elective cases with the local podiatrists who are eager to show off their technique. I feel like the program has a great balance between surgeries and clinics. It is not uncommon for the residents to be done with their forefoot numbers during their first year. There is also no hierarchy as far as the surgeries go. Some first-year residents have found themselves doing an Achilles tendon repair as their very first surgery!

5)If you had to pick again, would you pick podiatry and your program?

I am privileged to be where I am and learn from and with who, I believe, are some of the greatest doctors the world has to offer.

Yes and yes! Podiatry isn’t something I grew up dreaming of doing. I didn’t even plan on being a doctor, but I am very happy to have found myself where I am now. It is an amazing career that will teach you a rather diverse set of skills. From treating an ingrown toenail to trying to save somebody’s limb and everything in between. There is absolutely no excuse for ever being bored or stuck in a monotony! As far as the program goes, I am privileged to be where I am and learn from and with who, I believe, are some of the greatest doctors the world has to offer.

6)What advice do you have for a (4th year) podiatry student?

Assuming we are talking about those who are yet to embark on their externships, I would say learn classifications (trauma section of pocket podiatry is ideal), work hard, be humble, and do not complain.

For the 4th years who are getting ready to start their residency – congratulations on the match! Relax, sleep in, spend time with the family, and get ready for an amazing ride! 

7)What is your favorite surgery?

TibioTalarCalcaneal (or TibioCalcaneal) fusion with an intramedullary nail. When I saw it during my externship, I was simply speechless. I’m still amazed every time I see it.

8)What has been your favorite outside rotation?

It was a real eye-opener to see just how well versed the doctors, NPs, and PAs are. First, they are treating a patient with chest pain, followed by a foreign body evaluation in the eye with a slit lamp, and then pulling teeth or draining a dental abscess. Very humble people and eager to share their knowledge.

9)What do you see for your future practice setting/case type? Has this changed since you were a student?

I still do not know. Each one has its own appeals. I can’t say that my opinion has changed since I was a student, but I have definitely become more informed.

10) Finally, everyone is constantly learning, and new information is more available now than ever before. When you’re finding that things you’ve done or learned in the past are not correct, how do you respond to this? 

Accept the criticism, thank the person for their input, and try to grow from it.

The Residents - Special EditionAs a student, in my opinion, there will be plenty that you will see out on externships that conflicts with what you may have learned in the textbook or in a classroom. Like the questions mentions, things change rapidly, and I think the textbooks can’t keep up with it all. Take a note-to-self when you see something new and remember it. If you feel compelled to ask a certain doctor why he or she is doing something different from what you’ve learned. However, be careful with how you phrase it. Something along the lines of “Excuse me doctor, I’m just a student and do not have much real-life experience like you do. I’ve noticed that you do ____ this way. Would you mind teaching me why? I’d like to learn.”

As a young resident, I think you still have to be careful with how you ask things, but at least very often a discussion could be sparked based on a recent article that has been published and the two parties would benefit from it. If somebody is mentioning to you that you are doing something wrong, ask them why and how to improve. Accept the criticism, thank the person for their input, and try to grow from it.

I think the young resident’s response would suffice. It is critical to stay humble regardless of what stage of learning you are in. There is always someone who knows more or has done more than you have and there will always be room for improvement. Pride has no place in this profession.

Interview by  Elizabeth Ansert, St. Vincent Hospital

 

the residents

Special Edition


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