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Rushing CJ, Rathnayake V, Amin T, Pham A, Spinner SM, Ramaswamy II. Intraoperative Radiation Exposure to U.S. Podiatric and Medicine Surgery Residents Annually: How Much Are We Really Getting? J Am Podiatr Med Assoc 2022; 112:19-177. [PMID: 36115034 DOI: 10.7547/19-177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
As the number and complexity of operative techniques taught at U.S. podiatric medicine and surgical residencies (PMSR) with the added credential in reconstructive rearfoot and ankle (RRA) surgery has continued to increase, so to has the use of intraoperative fluoroscopy. The purpose of the present prospective observational pilot study was to quantify and compare the shallow dose equivalent (SDE), deep dose equivalent (DDE), and lens of the eye dose equivalent (LDE) exposures for podiatric medicine and surgery residents at a single PMSR-RRA over 12 consecutive months. Shallow-dose equivalent, DDE, and LDE exposures (in millirems) were measured using Landauer Luxel dosimeters from July of 2018 to July of 2019. Dosimeters were exchanged monthly, and mean monthly/annual SDE, DDE, and LDE exposures were calculated and compared. Overall, residents averaged 19 operative cases per month and 222 per year. More than half (53%) required intraoperative fluoroscopy, for which a mini C-arm was used in most cases. Monthly SDE, DDE, and LDE exposures averaged 7.3, 9.3, and 7.0 mrem, respectively; whereas annual SDE, DDE, and LDE exposures averaged 87.3, 112, and 84 mrem, respectively. No significant monthly (P = 1.0, P = .70, and P = .74) or annual (P = .67, P = .67, and P = .33) differences were identified between residents. The annual SDE, DDE, and LDE for residents at a single PMSR-RRA were well below the recommended dose limits of 50,000 mrem/year (SDE), 5,000 mrem/year (DDE), and 15,000 mrem/year (LDE) set by the National Council on Radiation Protection. However, given that the stochastic effects from low levels of ionizing radiation are cumulative, not well studied long-term, and relate both to the degree and duration of exposure, mini-C arm fluoroscopy, radiation tracking, and use of personal protective equipment provide simple means for residents to reduce any long-term potential for risk.
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Affiliation(s)
| | | | - Tarak Amin
- †Westside Regional Medical Center, Plantation, FL
| | - Alyssa Pham
- †Westside Regional Medical Center, Plantation, FL
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Factors associated with burnout amongst medical students, residents, and attendings in Orthopaedics. NORTH AMERICAN SPINE SOCIETY JOURNAL (NASSJ) 2021; 7:100074. [PMID: 35141639 PMCID: PMC8819969 DOI: 10.1016/j.xnsj.2021.100074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 07/12/2021] [Accepted: 08/17/2021] [Indexed: 11/20/2022]
Abstract
Background Methods Results Conclusion
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Rushing CJ, Casciato DJ, Ead JK, Spinner SM. Perceptions of Burnout, Personal Achievement, and Anxiety Among US Podiatric Medicine and Surgery Residents: A Cross-Sectional Pilot Study. J Foot Ankle Surg 2021; 59:953-956. [PMID: 32487454 DOI: 10.1053/j.jfas.2019.12.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Accepted: 12/21/2019] [Indexed: 02/03/2023]
Abstract
The prevalence of physician burnout among doctors of podiatric medicine (DPM) in the United States remains unknown. The purpose of the present pilot study was to assess perceptions of burnout, personal accomplishment, anxiety, and experiences of shame among DPMs training at Podiatric Medicine and Surgery Residency programs accredited by the Council on Podiatric Medical Education. An anonymous 35-question cross-sectional online survey was developed using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and the Hospital Anxiety and Depression Scale-Anxiety (HADS-A). Demographic data (sex, age, marital status, postgraduate year) and experiences of shame were also recorded. On December 31, 2018, the survey was distributed for completion. Univariate and bivariate analyses were conducted to obtain summary measures of the predictors and outcomes. Multinomial logistic regression models were obtained to evaluate the associations, and a 2-sided p < .05 was considered statistically significant. A total of 155 responses were eligible for inclusion. Forty-six percent of respondents reported high burnout, and nearly half (54%) reported low personal achievement and moderate to severe anxiety. Most had experienced ≥1 shame event during residency, which was associated with a greater level of anxiety (p < .001). Overall, lower burnout and higher personal achievement scores using the MBI-HSS were associated with lower anxiety scores using the HADS-A questionnaire (p < .001) and the absence of an experienced shame event (p = .039). Given that a potential relationship appears to exist between anxiety/experiences of shame and burnout/personal achievement in the present pilot study, additional longitudinal studies are warranted to discern any causal relationships.
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Affiliation(s)
- Calvin J Rushing
- Foot and Ankle Surgeon, Westside Regional Medical Center, Plantation, FL; Board Member, Foot and Ankle Research Foundation of South Florida Inc., Plantation, FL.
| | - Dominick J Casciato
- Doctor of Podiatric Medicine Candidate, Barry University School of Podiatric Medicine & Surgery, Miami Shores, FL
| | - Joey K Ead
- Doctor of Podiatric Medicine Candidate, Barry University School of Podiatric Medicine & Surgery, Miami Shores, FL
| | - Steven M Spinner
- Board Member, Foot and Ankle Research Foundation of South Florida Inc., Plantation, FL; Residency Director, Westside Regional Medical Center, Plantation, FL
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Casciato DJ, Ead JK, Rushing CJ, Law RWY, Calaj PM, Mosseri AV, Singh BN. Podiatric Medicine and Surgery Resident-Authored Publications in The Journal of Foot and Ankle Surgery: A Systematic Review. J Foot Ankle Surg 2021; 59:541-545. [PMID: 32354510 DOI: 10.1053/j.jfas.2019.09.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Revised: 08/06/2019] [Accepted: 09/25/2019] [Indexed: 02/03/2023]
Abstract
Since its introduction into the medical community, the Podiatric Medicine and Surgery residency has strived to graduate the most advanced and learned foot and ankle surgeons. From increasing length of training, to assuring didactics and education are sufficiently incorporated into the residency, the Council on Podiatric Medical Education has overseen this transition. One area of interest, podiatric medicine and research, remains central to this training and contributes to the field of foot and ankle surgery through journal publications. The purpose of this review was to identify Podiatric Medicine and Surgery resident-authored publication rates, trends, and geographic distribution. All published case reports, original research articles, review articles, and tips, quips, and pearls in The Journal of Foot and Ankle Surgery from January 2009 to December 2018 were reviewed. Podiatric Medicine and Surgery residents comprised 8% of all authors. Residents contributed to and published as first authors in 22% and 11% of all manuscripts, respectively. An increasing trend in resident authors, resident-authored manuscripts, and resident-first-authored manuscripts was observed. From before the mandated 3-year residency to after, the proportion of resident-authored manuscripts to all manuscripts declined from 9.99% to 7.21%; however, among these resident-authored publications, the rate of first-authorship increased from 45.32% to 51.36%. To the best of our knowledge, this is the first and only study to examine publication rates among foot and ankle surgery residents.
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Affiliation(s)
| | - Joey K Ead
- Resident, Graduate Medical Education, Westside Regional Medical Center, Plantation, FL
| | | | - Rona W Y Law
- Resident, Medical Education Department, Grant Medical Center, Columbus, OH
| | - Phillip M Calaj
- Student, Barry University School of Podiatric Medicine, Miami, FL
| | - Ashley V Mosseri
- Student, Barry University School of Podiatric Medicine, Miami, FL
| | - Bibi N Singh
- Assistant Professor, Barry University School of Podiatric Medicine, Miami, FL
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Rushing CJ, Goransson M, Spinner SM. Publication Barriers of Oral Abstracts From the American College of Foot and Ankle Surgeons: 2010-2014. J Foot Ankle Surg 2019; 58:852-854. [PMID: 31155468 DOI: 10.1053/j.jfas.2018.12.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Indexed: 02/03/2023]
Abstract
Despite possessing the highest oral abstract publication incidence for any national foot and ankle society conference to date (76.9%), it remains unclear why almost a quarter of the oral abstracts accepted to the annual American College of Foot and Ankle Surgeons (ACFAS) conference fail to achieve journal publication. The purpose of the present study was to assess the publication barriers of oral abstracts from the ACFAS conference: 2010 to 2014. Unpublished oral abstracts from the temporal period were procured from a database. A questionnaire was then distributed to the primary authors to determine the current status of the abstract, as well as the reasons for the failure to pursue or achieve journal publication. Of the 25 oral abstracts that failed to achieve journal publication before July 1, 2017, a total of 11 questionnaires were completed. At the time of the survey, 4 oral abstracts had since been published in a journal, 1 had been published outside of a journal, and 6 had never been submitted for publication consideration. An insufficient amount of time for manuscript preparation (42%), difficulties with co-authors (30%), and a low perceived priority (17%) were the 3 primary reasons authors cited for the failure to publish. Based on the principal barriers identified, a series of recommendations have been proposed to improve the future publication incidence of oral abstracts from the ACFAS conference and research productivity amongst foot and ankle surgeons.
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Affiliation(s)
- Calvin J Rushing
- Resident, Westside Regional Medical Center, Plantation, FL; Board Member, Foot and Ankle Research Foundation of South Florida, Plantation, FL.
| | - Miranda Goransson
- Doctor of Podiatric Medicine Candidate, Barry University School of Podiatric Medicine, Miami, FL
| | - Steven M Spinner
- Residency Director, Westside Regional Medical Center, Plantation, FL; Board Member, Foot and Ankle Research Foundation of South Florida, Plantation, FL
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Rushing CJ, Rushing DC, Spinner SM, Hardigan P. Factors Associated With the Journal Publication of Oral Abstracts From the American College of Foot and Ankle Surgeons: 2010 to 2014. J Foot Ankle Surg 2019; 58:692-695. [PMID: 31079986 DOI: 10.1053/j.jfas.2018.11.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Indexed: 02/03/2023]
Abstract
The oral abstract publication incidence (76.9%) of the American College of Foot and Ankle Surgeons (ACFAS) is currently the highest reported for any national foot and ankle society conference to date. However, factors associated with the conversion of an abstract to a journal publication (JP) remain undetermined. The purpose of the present study was to identify the factors associated with the JP and time to publication for oral abstracts from the ACFAS conference from 2010 to 2014. Databases containing information on the abstracts were procured, and predictor variables were categorized as abstract or author specific. Bivariate analysis was conducted using the Mann-Whitney U test, Fisher's exact test, chi-square test of independence, or Spearman's rank correlation. Multivariable logistic regression and generalized linear regression models were utilized to analyze predictor variables. Oral abstracts by authors without a formal research degree were >12 times (95% confidence interval 2.25 to 71.67) more likely to achieve JP compared to abstracts by authors with a research degree. The author-specific variable was the only significant predictor of future JP (p = .002); however, trends with respect to other variables (funding, prior publications, and ACFAS regional division) were also identified. Abstracts originating from academic institutions (p = .042) and those involving fewer centers (p = .03) were associated with a significantly shorter time to publication. Although the present study broadens our understanding on the publication incidence and time to publication for oral abstracts from the ACFAS from 2010 to 2014, it remains unclear why almost a quarter of the abstracts accepted ultimately failed to achieve JP. Identifying the publication barriers of those abstracts remains a necessary first step in helping to form recommendations aimed at improving the future publication incidence for oral abstracts presented at the ACFAS conference.
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Affiliation(s)
- Calvin J Rushing
- Resident, Westside Regional Medical Center, Plantation, FL; Board Member, Foot and Ankle Research Foundation of South Florida, Inc., Plantation, FL.
| | - Denae C Rushing
- Doctor of Medical Dentistry Candidate, Nova Southeastern College of Dental Medicine, Plantation, FL
| | - Steven M Spinner
- Board Member, Foot and Ankle Research Foundation of South Florida, Inc., Plantation, FL; Residency Director, Westside Regional Medical Center, Plantation, FL
| | - Patrick Hardigan
- Director of the Statistical Consulting Center, Nova Southeastern University, Fort Lauderdale, FL
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Rushing CJ, Merritt G, Amin T, Spinner SM. Publication Rates for Oral and Poster Abstracts from the American Podiatric Medical Association: 2010-2014. J Am Podiatr Med Assoc 2019; 109:226-230. [PMID: 31268791 DOI: 10.7547/18-016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The quality of national society conferences is often assessed indirectly by analyzing the journal publication rates for the abstracts presented. Studies have reported rates from 67.5% to 76.7% for oral abstracts and 23.2% to 55.8% for poster abstracts presented at national foot and ankle society conferences. However, no study has evaluated the abstract to journal publication rate for the American Podiatric Medical Association's (APMA's) annual conference. METHODS All presented abstracts from the 2010 to 2014 conferences were compiled. PubMed and Google Scholar searches were performed, and the number of abstracts presented, publication rate, mean time to publication, and most common journals of publication were determined. These results were then compared with those for the 2010 to 2014 American College of Foot and Ankle Surgeons' conferences. RESULTS Of 380 abstracts presented, 142 (37.4%) achieved publication, most often in the Journal of the American Podiatric Medical Association. The oral abstract publication rate was 45.2% (14 of 31), with a mean time to publication of 24.2 months (range, 0-47 months). The poster publication rate was 36.7% (128 of 349), with a mean time to publication of 16.3 months (range, 0-56 months). Significant differences were identified between the two societies. CONCLUSIONS The overall abstract to journal publication rate for the 2010 to 2014 APMA conferences was 37.4%, and, expectedly, oral abstracts achieved publication more often than posters. Moving forward, a concerted effort between competing societies seems necessary to increase research interest, institutional support, and formal mentorship for future generations of foot and ankle specialists.
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Affiliation(s)
| | | | - Tarak Amin
- Westside Regional Medical Center, Plantation, FL
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