Can The Present Help Shape The Future?

By Jeff Hall, Editor-in-Chief

There are significant disparities between the various podiatric residency programs across the country. For example, at the University of Texas, residents get “five hours per week of lectures and topic discussions,” according to one of the professors. Yet another educator who was accustomed to hearing four or five lectures a week during his residency concedes that the current crop of residents at his facility “are lucky to get one or two a week.” In order to help address some of these issues, Alan Sherman, DPM, Michael Shore, DPM, and Jay Lieberman, DPM, have teamed up to create PRESENT (Podiatric Residency Education Services Network) Residency Courseware, which will provide weekly online lectures from top educators in the field, starting on August 1. (See “Established DPMs To Teach Residents Online,” News And Trends, pg. 8.) The goals behind the online courseware are admirable. Organizers say PRESENT can help facilitate a higher common ground of clinical skill and expertise among residents. One lecturer for PRESENT suggests, “there are less than 10 guys in the country who can perform limb salvage with the big external frames.” Therefore, many residents won’t have access to an external fixation expert on staff. PRESENT would conceivably give those residents access to a lecture by an educator who has considerable experience in this area. The organizers have assembled an impressive list of educators lecturing on clinical topics that they have specialized in over the years. As Douglas Richie, Jr., DPM, points out in the aforementioned “News and Trends” article, didactic educational variety is another key benefit of the courseware as it will expose residents to different insights and philosophies from other programs. He says this is important as residency programs often have faculty who tend to “follow the same philosophy of practice.” The key stumbling block may be the annual subscription cost of $1,500. There are discounts available if multiple residents at a given facility subscribe. Corporate sponsorship may also defray these costs. According to PRESENT organizers, Medicis has agreed to provide scholarships to the service for 250 residents, who will be selected by lottery. However, will the hospitals pay the subscription fee for those who don’t get the scholarships? That remains to be seen. PRESENT organizers say the online courseware meets the educational requirements of the Council on Podiatric Medical Education (CPME) so the teaching facility should be able to pay for it out of the graduate medical education (GME) money that is specifically earmarked for resident education. One educator says getting the $1,500 subscription charge paid by GME dollars should be a “no-brainer” yet others say the funding isn’t there at their facilities. PRESENT organizers note that even the smallest community hospital gets at least $100,000 per resident in GME dollars, although one educator at a small community hospital says its allotment per resident is between $74,000 and $110,000. That said, the potential benefits of PRESENT certainly make it worthwhile to check out the Web site at The organizers provide residency directors with fairly convincing ammunition they can take to their hospital’s Director of Medical Education (DME). The DME may still say no, but at the very least, committed residency directors can say they did everything in their power to get additional resources for their residents.

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