Podiatry Res Manual

Resident Manual
Podiatry Medicine & Surgery Residency

Carilion Clinic
Roanoke, VA
Rev. 7.11.2011
Contents
Introduction ..............................................................................................................................3
Administrative staff ..............................................................................................................................3
Curriculum ..............................................................................................................................4
Competencies - CPME ............................................................................................................................5
General Program .......................................................................................................................8
Rotation Specific .................................................................................................................9-16
Resident Duties General ....................................................................................................................17
On Call Responsibilities .........................................................................................................18
Maintaining Surgical Log .......................................................................................................18
Medical Records ...............................................................................................................18-20
Levels of Competency ............................................................................................................................21
Educational Experience ...........................................................................................................................21
Conferences .......................................................................................................................21-24
Research Requirements ..........................................................................................................24
Meetings & Vacations ..............................................................................................................26
Disaster Codes ......................................................................................................................26
Miscellaneous Departmental information .................................................................................................27
GME and Select Policies of interest.................................................................................................32-128
Emergency Codes ..........................................................................................................................127
Resident Meal Allowance .......................................................................................................................128
CRMH Departmental Phone Listing ......................................................................................................129
Appendix 1 : Sample Resident Contract ..............................................................................................130
Appendix 2: Evaluations..............................................................................................................133-180
2
Introduction
Welcome to the Podiatric Medicine & Surgery Residency program. This manual is to provide a general overview of
the expectations and requirements of the podiatry program and is supplemental to the Graduate Medical Education
Resident Handbook which may be found online at
http://chsweb.carilion.com/meded/ResidentManual2011WOTOCdph[1].doc. A complete listing of GME policies and
procedures may be found online at http://chsweb.carilion.com/meded/GMEPolicies.html .
Organization, program content, responsibilities and procedures will be defined in this manual. Specific questions
regarding matters addressed herein should be directed to Dr. J. Randy Clements, Director of Podiatric Education.
This manual is not intended to state and does not state or reflect the standard of care with respect to any specific
patient or category of patients. The Podiatry Residents render patient care, regardless of point of service (ER, OR,
inpatient, outpatient, clinic), under the supervision of the Attending. The Attending Surgeon is directly responsible for
care of all patients.
Podiatry Education- Administrative staff
Program Director: Dr. J. Randolph (Randy) Clements [email protected]
Program Assistant: Rhea Jordan

Point person for all residents. Responsible for managing the podiatry residency program. Rhea Jordan can be
reached via e-mail [email protected] or O - 540-981-8345 C 540-397-5812
3
Curriculum
Block rotations 2012-2013 (2012-2013 calendar has not yet been set by GME, dates are approximate) All rotations
are at Carilion Roanoke Memorial Hospital unless marked.
Abbreviations used: SVAMC Salem Veterans Administration Medical Center

PGY1a PGY1b PGY2a PGY2b PGY3a PGY3b
6-15-12 / 7- Orientation Orientation
1-12
July Podiatry SVAMC Podiatry Podiatry Radiology Podiatry Ortho-Foot &

7/2-7/31 SVAMC Ankle
August Podiatry Podiatry-SVAMC Orthopaedic Vascular Podiatry Ortho-Foot &
8/1 8/31 surgery Surgery Ankle
September Emergency Infectious Orthopaedic Anesthesia Podiatry Ortho-Foot &
9/3-9/28 Medicine Disease surgery Ankle
October Emergency Behavioral Health Podiatry Orthopaedic Podiatry Pathology
10/1 10/31 Medicine SVAMC surgery
November Internal Medicine Emergency Podiatry Orthopaedic Ortho-Foot & Podiatry
11/1-11/30 Medicine SVAMC surgery Ankle
December Internal Medicine Emergency Vascular Podiatry Ortho-Foot & Podiatry
12/3 12/31 Medicine Surgery SVAMC Ankle
January Wound Care 2 Internal Anesthesia Podiatry Pathology Podiatry
1/1 -1/31 weeks// Pain Medicine SVAMC
Management 2
weeks
February General Surgery Internal Ortho-Foot & Podiatry Podiatry Orthopaedic
2/1-2/28 Medicine Ankle SVAMC surgery
March General Surgery Wound Care 2 Ortho-Foot & Podiatry Podiatry Orthopaedic
3/1-3/29 wks// Pain Ankle SVAMC surgery
Management 2
weeks
April Infectious Disease General Surgery Ortho-Foot & Podiatry Orthopaedic Podiatry
4/1 4/30 Ankle surgery SVAMC
May Behavioral Health General Surgery Podiatry Ortho-Foot & Orthopaedic Podiatry
5/1-5/31 Ankle surgery SVAMC
June Radiology Podiatry Podiatry Ortho-Foot & Podiatry Podiatry
6/3-6/28 SVAMC Ankle
4
Competencies
CPME Competency requirements (CPME document 320, 6.1)
A. Prevent, diagnose, and medically and surgically manage diseases, disorders, and injuries of the
pediatric and adult lower extremity.
1. Perform and interpret the findings of a thorough problem-focused history and physical ex, including
problem-focused history, neurologic examination, vascular examination, dermatologic
examination, musculoskeletal examination, biomechanical examination, and gait analysis.
2. Formulate an appropriate diagnosis and/or differential diagnosis.
3. Perform (and/or order) and interpret appropriate diagnostic studies, including:
-Medical imaging, including plain radiography, stress radiography, fluoroscopy, nuclear medicine
imaging, MRI, CT, diagnostic ultrasound, vascular imaging,
-Laboratory tests in hematology, serology/immunology, toxicology, and microbiology, to include
blood chemistries, drug screens, coagulation studies, blood gases, synovial fluid analysis,
urinalysis.
-Pathology, including anatomic and cellular pathology.
-Other diagnostic studies, including electrodiagnostic studies, non-invasive vascular studies, bone
mineral densitometry studies, compartment pressure studies.
4. Formulate and implement an appropriate plan of management, including:
-Direct participation of the resident in the evaluation and management of patients in a clinic/office
setting.
- perform biomechanical cases and manage patients with lower extremity disorders utilizing a
variety of prosthetics, orthotics, and footwear.
-Management when indicated, including - dermatologic conditions.
- manipulation/mobilization of foot/ankle joint to increase range of motion/reduce associated pain
and of congenital foot deformity.
- closed fractures and dislocations including pedal fractures and dislocations and ankle
fracture/dislocation.
- cast management.
- tape immobilization.
- orthotic, brace, prosthetic, and custom shoe management.
- footwear and padding.
- injections and aspirations.
- physical therapy.
- pharmacologic management, including the use of NSAIDs, antibiotics, antifungals, narcotic
analgesics, muscle relaxants, medications for neuropathy, sedative/hypnotics, peripheral vascular
agents, anticoagulants, antihyperuricemic/uricosuric agents, tetanus toxoid/immune globulin,
laxatives/cathartics, fluid and electrolyte management, corticosteroids, anti-rheumatic medications.
-Surgical management when indicated, including - evaluating, diagnosing, selecting appropriate
treatment and avoiding complications.
5
- progressive development of knowledge, attitudes, and skills in preoperative, intraoperative, and
postoperative assessment and management in surgical areas including, but not limited to, the
following: Digital Surgery, First Ray Surgery, Other Soft Tissue Foot Surgery, Other Osseous Foot
Surgery, Reconstructive Rearfoot/Ankle Surgery (added credential only), Other Procedures (see
Appendix A regarding the volume and diversity of cases and procedures to be performed by the
resident).
-Anesthesia management when indicated, including local and general, spinal, epidural, regional,
and conscious sedation anesthesia.
-Consultation and/or referrals.
-Lower extremity health promotion and education.
5. Assess the treatment plan and revise it as necessary.
-Direct participation of the resident in urgent and emergent evaluation and management of
podiatric and non-podiatric patients.
B. Assess and manage the patients general medical and surgical status.
1. Perform and interpret the findings of comprehensive medical history and physical examinations
(including pre-operative history and physical examination), including:
-Comprehensive medical history.
-Comprehensive physical examination.
- vital signs.
- physical examination including head, eyes, ears, nose, and throat, neck, chest/breast, heart,
lungs, abdomen, genitourinary, rectal, upper extremities, neurologic examination.
2. Formulate an appropriate differential diagnosis of the patients general medical problem(s).
3. Recognize the need for (and/or order) additional diagnostic studies, when indicated, including (see
also section A.3 for diagnostic studies not repeated in this section).
-EKG.
-Medical imaging including plain radiography, nuclear medicine imaging, MRI, CT, diagnostic
ultrasound.
-Laboratory studies including hematology, serology/immunology, blood chemistries,
toxicology/drug screens, coagulation studies, blood gases, microbiology, synovial fluid analysis,
urinalysis.
-Other diagnostic studies.
4. Formulate and implement an appropriate plan of management, when indicated, including
appropriate therapeutic intervention, appropriate consultations and/or referrals, and appropriate
general medical health promotion and education.
5. Participate actively in medicine and medical subspecialties rotations that include medical
evaluation and management of patients from diverse populations, including variations in age, sex,
psychosocial status, and socioeconomic status.
6. Participate actively in general surgery and surgical subspecialties rotations that include surgical
evaluation and management of non-podiatric patients including, but not limited, to:
6
-Understanding management of preoperative and postoperative surgical patients with emphasis on
complications.
-Enhancing surgical skills, such as suturing, retracting, and performing surgical procedures under
appropriate supervision.
-Understanding surgical procedures and principles applicable to non-podiatric surgical specialties.
7. Participate actively in an anesthesiology rotation that includes pre-anesthetic and post-anesthetic
evaluation and care, as well as the opportunity to observe and/or assist in the administration of
anesthetics. Training experiences must include, but not be limited to:
-Local anesthesia.
-General, spinal, epidural, regional, and conscious sedation anesthesia.
8. Participate actively in an emergency medicine rotation that includes emergent evaluation and
management of podiatric and non-podiatric patients.
9. Participate actively in an infectious disease rotation that includes, but is not limited to, the following
training experiences:
-Recognizing and diagnosing common infective organisms.
-Using appropriate antimicrobial therapy.
-Interpreting laboratory data including blood cultures, gram stains, microbiological studies, and
antibiosis monitoring.
-Exposure to local and systemic infected wound care.
10. Participate actively in a behavioral science rotation that includes, but is not limited to:
-Understanding of psychosocial aspects of health care delivery.
-Knowledge of and experience in effective patient-physician communication skills.
-Understanding cultural, ethnic and socioeconomic diversity of patients.
-Knowledge of the implications of prevention and wellness.
C. Practice with professionalism, compassion, and concern in a legal, ethical, and moral fashion.
1. Abide by state and federal laws, including the Health Insurance Portability and Accountability Act
(HIPAA), governing the practice of podiatric medicine and surgery.
2. Practice and abide by the principles of informed consent.
3. Understand and respect the ethical boundaries of interactions with patients, colleagues, and
employees.
4. Demonstrate professional humanistic qualities.
5. Demonstrate ability to formulate a methodical and comprehensive treatment plan with appreciation
of healthcare costs.
D. Communicate effectively and function in a multi-disciplinary setting.
1. Communicate in oral and written form with patients, colleagues, payors, and the public.
2. Maintain appropriate medical records.
E. Manage individuals and populations in a variety of socioeconomic and healthcare settings.
1. Demonstrate an understanding of the psychosocial and healthcare needs for patients in all life
stages: pediatric through geriatric.
7
2. Demonstrate sensitivity and responsiveness to cultural values, behaviors, and preferences of ones
patients when providing care to persons whose race, ethnicity, nation of origin, religion, gender,
and/or sexual orientation is/are different from ones own.
3. Demonstrate an understanding of public health concepts, health promotion, and disease
prevention.
F. Understand podiatric practice management in a multitude of healthcare delivery settings.
1. Demonstrate filiarity with utilization management and quality improvement.
2. Understand healthcare reimbursement.
3. Understand insurance issues including professional and general liability, disability, and Workers
Compensation.
4. Understand medical-legal considerations involving healthcare delivery.
5. Demonstrate understanding of common business practices.
G. Be professionally inquisitive, life-long learners and teachers utilizing research, scholarly activity, and
information technologies to enhance professional knowledge and clinical practice.
1. Read, interpret, and critically examine and present medical and scientific literature.
2. Collect and interpret data and present the findings in a formal study related to podiatric medicine
and surgery.
3. Demonstrate information technology skills in learning, teaching, and clinical practice.
4. Participate in continuing education activities.
Competencies by Rotation
Podiatry Program General

Competencies
The following are competencies identified by the Council on Podiatric Medical Education {CPME} in document 320,
6.1 for clinical and didactic experiences within the curriculum developed by the Residency Director of Podiatry at
Carilion Clinic. This curriculum is designed to provide the resident with appropriate training experiences in the
management of patients with a variety of diseases, disorders, and injuries through achievements of various
competencies.
The overall Goals and Objectives of this Program are directly linked to help facilitate the residents sequential and
progressive achievement of specific competencies. The following general competencies are to be evaluated for each
resident while on clinical rotations or in didactic course work. Each rotation and educational experience for the
residents has more specific competencies to be achieved:
The following represent required competencies:

Prevent, diagnose and manage diseases, disorders, and injuries of the lower extremities in both
pediatric and adult patients
Assess and manage the patients general medical status
Practice with professionalism, compassion and concern in a legal, ethical, and moral fashion
8
Communicate and function in a multi-disciplinary setting
Practice and abide by the principles of informed consent
Practice and abide by state and the local laws including Health Insurance Portability &
Accountability Act (HIPAA) as it pertains to the practice of podiatric medicine and surgery
Provide sensitive and responsive care to all patient's
Provide superior care to all patient's despite cultural values, patient behavior, race, ethnicity,
patient origin, religion, gender and /or sexual orientation.
Demonstrate filiarity with utilization management and quality improvement
Manage individuals and populations in a variety of socioeconomic and healthcare settings
Understand podiatric practice management in a multitude of healthcare delivery settings
Be professionally inquisitive, life-long learners and teachers utilizing research, scholarly activity,
and information technologies to enhance professional knowledge and clinical practice
Communicate in oral and written form with all patient's, colleagues, payors, family's and public.
Demonstrate interpersonal skills of superior professionalism and communication
Accept criticism constructively and make appropriate changes based on attending and colleagues
recommendation
Maintain medical records
Demonstrate an understanding of the psychosocial and healthcare needs of all patient's and all
lives stages: Pediatric to death
Podiatric Medicine and Surgery

Carilion Roanoke Memorial Hospital and Salem Veterans Affairs Medical Center
The following represents clinical competencies for Podiatric Medicine and Surgery rotations:
The resident should understand and utilize appropriate hospital protocols including appropriate
admission and discharge procedures.
The resident should maintain appropriate medical records and documentation in both inpatient and
outpatient settings.
Perform and interpret the findings of a thorough problem focused physical ex for all podiatric
patients that include vascular, dermatologic, musculoskeletal examination.
The resident must demonstrate competency and perioperative assessment in management of
podiatric surgical cases. The resident must demonstrate basic principles of podiatric surgery to
include suturing techniques aseptic technique universal precautions fixation techniques basic
instrumentation nomenclature proper tissue handling hemostasis and appropriate operating room
behavior.
The resident must also identify and diagnose diseases, disorders, and injuries of the pediatric and
adult foot and ankle by nonsurgical and surgical means.
The resident should understand appropriate consultation protocols to either hospital specialties
9
The resident should understand professionalism and demonstrate the ability to communicate
effectively and function and a multidisciplinary academic setting
Perform and interpret findings of a comprehensive medical examination to include vital signs head,
chest and thorax, heart, lung, abdomen, neurologic and a problem focused lower extremity ex.
Resident should demonstrate competency in interpretation of appropriate diagnostic medical
imaging studies to include nuclear medicine scans MRI, plain film radiography, bone scintigraphy
and CT scan.
The resident should understand and interpret noninvasive arterial studies
The resident should perform an adequate lower extremity mechanical ex
The resident should safely provide palliative care to include nail and callus debridement.
The resident should understand basic shoe gear management, orthosis and foot and ankle
specific
bracing techniques
Demonstrate appropriate management of local anesthetics for podiatric specific office and
hospital-based procedures
Should demonstrate appropriate closed management of foot fractures and dislocations
Should demonstrate adequate knowledge in open and closed management of all foot and ankle
fractures and dislocations
Should understand
o digital surgical techniques,
o first ray surgery
o soft tissue surgery
o tarsometatarsal surgery and foot surgery
o tendon surgery
o major rearfoot reconstructive and ankle surgery
o simple laceration repair
o foreign body retrieval.
Foot and Ankle Orthopaedics

Carilion Roanoke Memorial Hospital
During the foot and ankle orthopaedic rotation the resident should demonstrate the following competencies:
Perform and interpret appropriate diagnostic studies.
Perform and interpret appropriate hematological pathological serological microbiological and
synovial analysis of patients as they pertain to the chief complaint.
Understand and recognize the management of foot and ankle fractures including splinting casting
and immobilization techniques
Understand closed management of fractures of the foot, ankle
Understanding and management of all foot and ankle fractures
Demonstrate knowledge in treatment of infections of soft tissue and bend of the foot and ankle
10
Formulate and implement appropriate surgical management for digital surgery, first ray surgery,
and foot surgery, ankle surgery.
Perform a problem focused foot and ankle ex to include vascular, neurologic, musculoskeletal,
radiographical.
Wound Care
During the wound care rotation the resident should demonstrate the following core competencies:
Understand wound care patient and various treatment options available both surgical and
nonsurgical
Utilized various wound care products and understand the differences in various wound care
products. For example: Alginates, collagen, sore base dressings.
Understand and interpret appropriate laboratory testing
Understand appropriate grading of diabetic foot ulcerations
Perform and interpret noninvasive vascular studies to include Doppler, ABI, TC pO2.
Understand indication and benefits of hyperbaric oxygen therapy
Understand biomechanical explanations to increase peek plantar pressures resulting in recurrent
ulceration
Understand the role of tendon Achilles lengthening in wound management
Understand the differences in skin substitutes
Demonstrate competency and wound debridement
Demonstrate competency in the application of a total contact cast
Demonstrate competency and application of Unna boot or other compression wrap
Understand appropriate antibiotic management of a diabetic foot infection
Demonstrate competency in the management of a negative pressure wound closure device.
Vascular Surgery
During the vascular surgery rotation the resident should be competent in the following:
Perform and interpret basic vascular studies

Understand and interpret noninvasive vascular studies
Understand and interpret angiography as it pertains to the lower extremity
Understand and formulate revascularization plans based on noninvasive and invasive arterial
testing
Recognized and managed superficial and deep vein thromboses
Practice in an ethical, legal and moral fashion, understand indications and functional differences
and various putation levels
11
Understand management of dialysis access grafts
Understand various options for indwelling catheter access
Radiology
During the radiology rotation, the resident should demonstrate the following core competencies:
Interpret plain radiography

Interpret chest x-ray
Interpret contrasted imaging studies
Understand foot and ankle MRI
Understand diagnostic ultrasound
Recognize and become familiar with various bone and soft tissue tumors in masses
Recognize the need for additional diagnostic studies when necessary
Pain Management
During the pain management rotation, the resident will demonstrate the following core competencies:
Understand the importance of response and all narcotic prescribing
Understand management of chronic pain syndromes
Demonstrate competency and management of acute post injury and post surgical pain
Identifying and differentiate drug seeking behavior from legitimate chronic pain conditions
Understand alternatives to narcotic prescribing in patient's with chronic pain conditions
Understand the role of pill counting, monitoring patient's urine drug screens, understanding the
use of the prescription monitoring program, implementation of narcotic contracts
Understanding the role of sympathetic nerve blocks and epidural spinal injections
Emergency Medicine
The following core competencies should be met resident during the emergency medicine rotation.
The resident should:
Understand and appreciate the principles of emergency medicine and emergency room protocol
Recognize and assist in acute systemic emergencies
Handle common emergencies with lower extremity emphasis
Handle noticed orthopedic emergency with emphasis in lower extremity
Perform and interpret appropriate diagnostic laboratory tests to include hematology toxicology
microbiology and serology
12
Formulate inappropriate differential diagnosis and definitive diagnosis prior to discharge from the
emergency department
Formulate an implement an appropriate discharge management planned to include appropriate
disposition
Formulate appropriate inpatient management plan and appropriate consultation to the admitting
physician
Recognized the need for diagnostic modalities
Understand appropriate fluid and electrolyte management
Maintain appropriate medical records
Effectively communicate with consultants
Understand and respect apical boundaries and interactions with patient's, colleagues and
employees.
Assess and manage the patient's general medical status an implement an appropriate plan of
management
He able to interpret a chief complaint and appropriately performed a history and physical ex
directed towards the patient's chief complaint. This workup should include appropriate diagnostic,
imaging, laboratory studies to arrive a provisional diagnosis.
Internal Medicine
During the internal medicine rotation the resident should demonstrate the following competencies:
The resident should perform and interpret a comprehensive medical history and physical ex to
include chief complaint review of systems history of present illness social history family history.
The physical ex should include vital signs HEENT, neck, chest, lung, heart, abdomen,
genitourinary, rectal, extremity, neurological.
The resident should motor and interpret appropriate laboratory tests based on the chief complaint
and medical history
Pharmacologic management of patients including the proper ordering of medications dosages
interactions and side effects
Interpret and evaluate EKGs
Understand fluid management and blood transfusion management
Understand perioperative surgical optimization
Formulate appropriate differential diagnoses and patients with general medical problems
Formulate an admission diagnosis and inpatient treatment protocol and appropriate discharge
planning
Demonstrate the ability to communicate effectively and function and a multidisciplinary setting.
Recognized the need for diagnostic studies and have basic understanding and relevant findings on
EKG, chest x-ray, nuclear scans, plain radiography.
13
Understand pharmacologic management to include nonsteroidal anti-inflammatories, antibiotics,
analgesics, muscle relaxers, peripheral vascular agents, anticoagulants, medication, tetanus
toxoid, cardiovascular disease medications, laxatives, steroids.
Understand and demonstrate compassion towards family and patient during end of life situations
General Surgery
During the General Surgery rotation, the resident should meet the following competencies:
Understand perioperative management of fluid and electrolytes.
Understand perioperative management of blood products
Understand operative room protocol and appropriate surgical and sterile technique
Understand surgical emergencies
Understand and successfully performed a primary and secondary survey on a trauma patient
Understand indications and contraindications and functional discrepancies and various putation
levels
Understand and respect the apical boundaries and interaction with patient's, colleagues, and
employees
Interpret necessary imaging and at laboratory data pertaining to general surgical conditions
Admit, formulate an inpatient treatment plan, and appropriate discharge planning for a general
surgical
Understand medical legal considerations when delivering healthcare
The compassion and towards patient's and patient family's bearing end of life situations
Infectious Disease
During the Infectious Disease rotation the resident should be competent in the following:
Perform and interpret basic culture and sensitivies results
Understands appropriate antibiotic selection based on culture results and MIC
Understands the process and procedure for appropriate tissue biopsy
Understands appropriate antibiotic therapy and duration for bone and skin infections
Understands post mortem management and autopsy process.
Understands bacteriological testing, ( i.e. gram stains, cultures), in the bacteriology laboratory
Understand drug pharmacology, potential interactions with other medications, side effects, and
cost factors
14
Pathology
During the pathology rotation the resident should be competent in the following:
Perform and interpret basic culture and sensitivies results in microbiology lab
Understand and interpret cellular pathology, with emphasis on the lower extremity
Understands the process and procedure for appropriate tissue biopsy
Understands and can interpret basic gross pathology and cellular pathology
Understands post mortem management and autopsy process.
Behavioral Health
During the behavioral health rotation, the resident should demonstrate the following core competencies:
In understanding of psychiatric management of any patient's
Demonstrate familiarity with psychiatric conditions and established a differential diagnosis and the
treatment of patient's mental illness
Demonstrate familiarity with various medications used in the treatment of patients with mental
illness and potential interactions and side effects
Assess and manage the patient's general medical status.
Perform effective communication in an interdisciplinary setting
Communicate and oral and written form with patient's colleagues and family's regarding the
patient's condition
Understand informed consent protocols based on state statutes it in patient's who are mentally
impaired
Understand substance abuse and drug abuse tendencies with particular focus in narcotics and
alcohol
Understand the process of temporary detention order (TDO)
Orthopaedic Surgery
During the orthopedic surgery and trauma rotation the resident should demonstrate the following competencies:
Understand management of poly-traumatized patient
Formulate and implement appropriate surgical management when indicated
Understand management of open fracture and open fracture antibiotic protocols
Understand closed and open management of all orthopedic injuries including foot and ankle
Understand basic physeal fracture management and management of pediatric fractures
Demonstrate proficiency and surgical principles including suturing techniques atraumatic tissue
handling and instrumentation as it applies to orthopedic surgery
15
Knowledge of orthopedic techniques and instrumentation
Understand AO/ASIS technique fixation techniques
Understand external fixation and internal and orthopedic care
Understand total joint arthroplasty and management of infection and complicated total joint
arthroplasty
Understand various bone grafting options and when bone graft is most appropriate
Understand management of joint and bone infections
Understand various fixation techniques and options for skeletal stabilization in all fractures
Understand various fixation techniques for high risk patient's including: Diabetes, obesity, tobacco
abusers, noncompliant patient's, osteoporosis.
Understand fracture classification and open fracture classification
Demonstrate ability in communicating successfully with other orthopaedic colleagues
Anesthesiology
During the resident's anesthesia rotation, the resident should demonstrate the following core competencies:
Understand ASA classification
Understand pertinent perioperative laboratory and imaging studies
Maintaining appropriate medical records
Understand regional anesthesia
Understand various anesthesia options and the value and risks associated with each. For expel,
understand the indications for general versus LMA versus spinal
Understand pharmacologic agents used in general anesthetic cases
Understand mechanisms of action of anesthesia gases, induction agents, paralytics, muscle
relaxers.
Understand reversal agents and mechanisms of action
Understand indications and contraindications to various anesthesia techniques
Understand anatomy and be able to successfully perform a distal sciatic (popliteal) nerve block
The residency director will conduct quarterly meetings with each resident to review resident performance in an
attempt to assure resident is achieving competencies. These will be written and submitted electronically per CPME
requirements. Standard hospital and CPME documents will be utilized.
16
Resident Duties General :
A. General Responsibilities
The residents are directly responsible to the attendings on each of the services. Their duties, in part,
are as follows:
1. Participate in patient care, operating room procedures, and post-op care including post-op checks
on all patients.
2. Take night call in rotation with other residents. Responsibility includes all ED trauma each day and
night. On weekend call days, the resident should call into the operating room early at 7:00 7:30
a.m. to find out if any cases have been posted so they can read up for that case and be available.
The expectation is that one resident will be on call each weekend and will remain in Roanoke. It is
also expected that when the resident is on service at SVC, that resident , depending on the
schedule, will also cover the CRMH floor and ED Calls from 5pm -7. That se resident will also
cover the CRMH inpatient service on the weekends. The residents not on call can be out of town.
3. Evaluate, formulate and carry out a treatment plan for patients from the Emergency Room and
discuss consultations along with a specific attending.
4. Provide prompt service with minimal delay to patients in the Emergency Department.
5. Attend emergency or semi-emergency operative procedures and all cases of when on call.
6. Attend assigned out-patient clinics. For CRMH responsibilities when resident staff is out of town or
unavailable the Chief Resident or Dr Clements should be notified and the resident resources will
be dispensed at the discretion of the Chief or Dr Clements to cover the priorities of trauma and
CRMH clinics. Elective surgery takes a secondary role. The resident should take the responsible
step of notifying the attending physician on any elective cases where resident coverage may not
be available.
7. Attend all Roanoke conferences and as directed on the appropriate schedule ( i.e. Journal Club,
Fracture Conference, and any rotation specific conference) For expel, if you are on your
Emergency Medicine rotation, the resident is expected to attend the Emergency Medicine
conferences
8. Participate in the clinical education of podiatric resident colleagues, other house staff, medical
students, and other Allied Health professionals (PAs, etc.).
9. Complete all medical records before leaving each service. Should medical records become
delinquent during a rotation, OR privileges will be revoked until records are completed. This
information will be included in the residents evaluation should OR privileges have to be revoked.
10.Complete rounds by 11:00 a.m.
11.The resident should be in contact with the attending physician to determine his/her protocol for
discharge planning and patient management on a day to day basis. (Patients staying past 12:00
midnight are charged for the prior day. For example, if you came in Monday at 7:00 p.m. and left
Tuesday at 3:00 p.m., you would only be charged for Monday.)
12.Sign out. All patients must be signed out to another resident, and attendings must be notified
regarding time out of town. Sign out should include a written sign out on the charts of all patients
17
the resident is following indicating the dates they will be out and the responsible resident covering
his/her patients. All patients should be covered on every day.
13. All vacations must be approved through the Program Director or Program Assistant (Dr.
Clements /Rhea Jordan).
14.Sign out to the resident on night call and provide complete information about existing or
anticipating problems on his or her particular service should occur before 10 each day.
15.Participate in and facilitate ongoing faculty and resident research protocols. See later description
B. On Call Responsibilities
The on-call schedule is a combined orthopaedic call schedule. Orthopaedic trauma call, unassigned
patient call, hand, and foot and ankle call. The podiatry resident will be on Foot and Ankle call when
the resident is on Podiatry RMH or SVC(only from 5pm-7). When the podiatry resident is on
orthopedic specific services, the podiatry resident will function in the call schedule with the UVA
orthopedic residents. Orthopaedic trauma call is for all patients who are Gold Alert and Trauma Alert
patients. If the Gold Alert or Trauma Alert patient is awake and alert and expresses a physician
preference, every effort should be made to honor that preference. However, the attending physician
on call for orthopaedic trauma is in charge and should be notified of this situation. Consults from the
General Surgical Trauma Service to Orthopaedics will go to the orthopaedic trauma call roster, and all
in-house consults directly from the Trauma Service should go to the Orthopaedic Trauma Call roster.
An unassigned patient is a patient that has no preference for an orthopaedic attending or group. A
patient that comes in initially as an unassigned patient and sees an orthopaedic physician and then
the orthopaedic physician obtains a trauma consult does not automatically make that patient an
Orthopaedic Trauma patient. However, should the unassigned orthopedist want to consult the
Orthopaedic Trauma attending that is always an option for that attending.
Assigned patients are patients with a specific preference for an orthopaedic surgeon/group or who
are current patients of that group practice. Taking a few moments to sort out these logistics will be
helpful in preventing confusion. If there are any questions, please do not hesitate to discuss further
with Dr. Shuler for orthopedic service or Dr Clements for Podiatry service related questions.
C. Maintaining a Surgical Log
Each resident must maintain a log of all surgical cases in Residency Resource. The importance of
accurate records cannot be overemphasized. This is important for the residents personal case list
and for viability of the residency program according to CPME standards. This log must be kept
current at all times. The residents must log all clinic and surgical activity within one week of the date
on the service was rendered
D. Medical Records
Electronic Medical Record - EPIC
1. It is your responsibility to keep your charts up to date at all times.
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2. You need to leave a footprint note every time you see a patient. Pay particular attention to this in
the ED-our trouble spot for missing notes. If you consult on a patient, even if you never see the
patient, put in a short note. Nurses like to leave ortho consulted notes that cause us grief. Do this
prior to end of shift.
3. You must have a brief procedure note on the chart immediately after a procedure has been
performed.
4. Never let deficiencies stay in your in-basket. Clear these daily. If you have trouble clearing an
item, call HIM at 981-7842 for assistance. A weekly report is generated by HIM indicating
residents who have deficiencies. You will be emailed to notify you that you are on the deficiencies
list and you will be requested to clear them immediately. If you make the red list it means you
are two weeks delinquent and subject to being pulled from duty until the deficiencies are cleared.
5. Check your staff messages often (in your in-basket). This is how HIM communicates with you.
6. If using smart text or free text to do reports in EPIC, you must check the co-sign required button.
This ensures the attending will be able to co-sign effectively in a timely manner
7. When in EPIC, if you are renewing orders and use the renew all function, it will literally renew
EVERY old order on the patients chart that has ever been entered. DO NOT USE this function.
8. Therapies requests that physicians provide information related to orders in the Answer field and
not in the Comment field when entering orders. Ex: Pt awaiting PT eval then ready to go home
This allows them to prioritize the case load.
Dictations
The Carilion Roanoke Memorial Hospital dictation numbers are as follows:
Inpatient: 981-8200 (7-8200 using a system phone) or 1-877-496-1161
ambulatory: 866-311-5739
These numbers should be used for inpatient history and physicals, operative notes and discharge
summaries.
Delinquent Charts effective February 15, 2011

Feedback from residents have suggested can they be notified of delinquent charts before they are
placed on the Delinquent Resident List on Tuesday. Suggestion to give the Residents a chance to
complete their charts before the Program Director is notified.
Every Tuesday:
HIM will e-mail residents that have delinquent charts.
The Residency Program Chiefs will be ccd on the e-mail.
The Program Administrator/Assistants will also be ccd on the e-mail.
The residents will have one week to complete their delinquent chart.
The following Tuesday they will be Red Lined if delinquent charts are not completed from the
previous week.
The Delinquent Resident List will be e-mailed to the Program Directors and Program
Administrator/Assistants.
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Residents that have Red Lined will be notified via their in-basket in EPIC of delinquent charts the
previous week. (A letter is sent to their in-basket.)
FYI:
It is the resident responsibility to notify HIM if they are having an issue with EPIC or their charts.
(Do not ignore this-Please call HIM at 981-7842.)
Residents need to notify HIM before they go on vacation.
When a resident is notified and he/she only works the delinquent charts and ignore the others then
they take a chance of getting another e-mail the next week. Encourage residents to complete all
charts in their in-basket.
Any dictations are delinquent 15 days after discharge. (Ex: Patient is discharged on the 1st of the
month. The 16th day of the month this chart is delinquent.)
Signatures are delinquent 30 days after discharge. (Ex: Patient is discharge on the 1st. The 30th
day after discharge the chart is delinquent.)
Failure to complete dictations can result in the attending of the chart to be held accountable for the
dictation. This can put the attending in jeopardy of being suspended.(HIM does not like to take
this route.)
Sometimes dictations are passed around from one resident to another. When this happens we
end having to get the attending involved. The attending will advise who should do the dictation.
(Some attendings do not like when this happens.)
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Levels of Competency in Podiatry Residency
The following competency list is authorized for each podiatry resident and the procedures listed may be performed
without supervision at the PGY level indicated.
Procedures that are not listed below should be supervised by a credentialed provider (Faculty or Resident)
PGY
Mandatory Procedure
Level
1 Arthrocentesis (adult and pediatric)
Wound debridement
Primary and delayed wound closure
Arthrotomy for irrigation or debridement
Open and closed reduction/internal fixation of ankle fractures
Closed reduction/internal fixation of all foot fractures
Closed reduction/casting of extremity all foot and ankle fractures
Tendon repairs
Tenotomy
2 Arthroscopy of the ankle
Open reduction and internal fixation of major fractures
Ligament repair or reconstruction
Osteotomy or ostectomy
Bone grafting (including harvest of autogenous graft)
Soft tissue procedures
Small joint arthroplasty or fusion
3 Major Hindfood fusion: Triple and Ankle
Tendon transfers
Nerve Surgery
Practice Clinical Management
Educational Experience
Conferences- Mandatory attendance.
1. Orthopaedic Fracture Conference is held weekly, Wednesdays, 6:30- 8 a.m. in the Medical
Education Conference Room Classroom 1 at CRMH. This conference focuses on presentation of
fracture cases and presents two topics per week. Preoperative, operative, and postoperative care,
surgical indications and complications are discussed in a case study format. The resident is
expected to attend this conference unless the resident is off service.. Residents will be assigned
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presentation topics during the year. A PowerPoint, reference article(s) and case summary are
required for these presentations.
A sample of the topics covered in the preceding two year period include:
AC/SC Distal Humerus Fractures
AC/SC Dislocations Distal Humerus Fractures in ORIF
Acetabular Fx Distal Radius Fractures
Acetabular Revisions in THA DVT Prophyaxus
ACL Injuries Elbow Arthroscopy
ACL Reconstruction Graft choice & Tunnel Placement Elbow Fractures-Distal Humerus
Adult Acquired Flatfoot EPIC OP notes
Adult Forearm Fractures Extra-articular Angular Deformity and Alignment in Total
Alternative Bearing Surfaces in THA Knee Replacement
amputations Femoral Neck Fractures
Ankle Arthritis femoral neck/intertrochanteric femur fx
Ankle Fractures Femoral Shaft Fractures
Anterior Approach in THA Flexion-Extension Gap Balancing in TKR
Articular Cartilage & OCD Forearm Fractures
Articular Cartilage Repair & OCD Forefoot Fractures
Athletes of a "Certain Age" - Care of the Mature Athlete Forefoot Fx: Includes 5th Metatarsum
Bearing Surfaces in THA Forefoot Injuries & Metatarsal Fractures
Bennet Fractures and GameKeepers Thumb Fracture dislocation of Elbow
Bio Mechanics of Hip Fractures due to GSW
Biomaterial & Biologic Response to Implants Fractures of the Distal Femur
Biomechanics of the Knee Fractures of the Talus
Calcaneous Fractures Glenhumeral (Shoulder ) Instability
Clavicle Fractures Hallux Valgus
Clavicle Fx/ AC Halux Valgus & Bunion Management
Clavicle/Scapula/Glenoid Fractures Hammer Toe
Clubfoot Evaluation & Management Hand- Metacarpal and Phalangeal Fx
Comprehensive Review Clavicle Fractures Head Injuries
Comprehensive Review in Adult Reconstruction Head Injury Evaluation
Computer navigation in TKR surgery Heel Pain
Concussion Heel Pain - Plantar Fasciitis
Concussions/MTBI Hip
Constraint in TKA Hip Dislocation & Femoral Head Fx
C-spine Fractures C1 & C2 Hip Injuries in Athletes
Current Fractures - multiple case study Hip Osteotomies
Deformity Correction in TKR History of THR & Mechanisms of Failure
Diabetic Foot History of Total Knee Replacement
Dislocations in Total Hip Arthroplasty History of Total Hip Arthroplasty
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Humeral Shaft Fractures Patellofemoral Complications in TKR
Infections in TKA Pathalogic Fractures
Infections in Total Joint Prevention and Management PCL Injuries
Intertrochanteric Hip Fx Pediatric Ankle Fractures
Intertrochanteric/ Subtrochanteric Fractures Pediatric Elbow Injuries
Knee Dislocation Pediatric Femur Fractures
Labral and Slap Injuries Pediatric Femur Fx
Labral and Slap lesions Pediatric Forearm & Distal Radius Fx. In Children
Labrum Tears / SLAP Injuries Pediatric Forearm fx
Leg Length vs. Stability in Total Hip Replacement Pediatric Growth Plate Fractures
Lesser Toe Deformity Pediatric Hip
Limb Salvage & Bone Transport Pediatric Scoliosis Overview
Limb Salvage vs. putation Pediatric Scoliosis Treatment Options
Lisfranc Fractures Pediatric Supracondylar Humerus Fractures
Lisfranc Injuries Pediatric Tibia Fx
LisFranc Injuries of the Foot- ORIF vs. fusion Pediatric Tibial and Ankle
Lower C-spine Fractures-Sub axial Cervical Spine Pediatric Forearm Fractures
injuries. Peds Physeal Fractures
Management of AC Sprains & Shoulder Dislocations Peds Physeal Injuries
Management of Labral Tears in the Shoulder Peds: Elbow R & G
Management of the Diabetic Foot Peds: Humeral Shaft & Proximal Humerus
Meniscus Peds: Radial Head/Monteggia
Metacarpal Fx & Phalanges Pelvic & Hip Disorders
Metacarpals/Phalanges Pelvic Fx
Metal on Metal Hips Pelvic Ring Disruptions
Mgt. of Open Fractures Pelvic Ring Disruptions/Fractures
Midfoot and LisFranc Pelvis, Sacrum, Acetabulum
Mobile vs Fixed Bearing in TKR Perilunate and Carpal Instability
Multiligament Knee Injuries Periprossthetic Fractures
Multiple Ligament Injury Periprosthetic Fractures
Olecranon fracture Periprosthetic Fractures in THR
Olecranon, Radial Head, Elbow Dislocations Periprosthetic Infection in THR & TKR
Open Fractures/Compartment Syndrome Periprothetic Fractures TKR
Open tibial shaft fx peritrochanteric femur fractures
Ortho Infections Pilon Fractures
Osteotomies about the Knee for Osteoarthritis Pilon Fractures & Syndesmosis
Patella Fractures Pilon/Syndesmosis
Patellar Pain & Instability Polyethylene Wear in THA
Patellofemoral Polyethylene Wear in THR
Patellofemoral Complications in TKA Posterior Cruciate Ligament
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Posterior Tibial Tendonitis Spine Infections
Practice Mgt Update of EMTALA and CMS Regulations Subtrochanteric & Intertrochanteric Femur Fx
re call(VOS 2009 lecture) Subtrochanteric Femur Fx
Proximal Femoral Fractures: Gamma Nail - Supracondylar/ Floating Knee
Intramedullary Nail Technique Surgical Approaches to the Hip
Proximal Humerus Fractures Surgical Approaches to the Knee
Proximal Humerus Fractures Prosthetic Replacement Talus Fractures
Proximal Tibial Shaft Fx & the use of Blocking Screws Tarsal Fractures
PRP - Platelet Rich Plasma Templating in THR
Reconstructive Pelvic Osteotomy for DDH THA Dislocation: Etiology and Treatment
Revision TKR Throwing Injuries in Athletes
Rotator Cuff Tibia Fractures
Rotator Cuff Syndrome & Repair Tibia Shaft Fractures
Rotator Cuff Tears & Tx Options Tibial Pilon Fx
Scaphoid Fractures Tibial Plateau Fx
Scaphoid/Carpal Bones Tibial Shaft Fractures
Shoulder Dislocations Tibial Tendon Dysfunction
Shoulder Instability TKR Revision Surgery
Shoulder Instability Total Hip Revision: uncemented femoral component
Sizing & Balancing in TKR Treatment of Open Fractures
SLAP/Labral Repair Unicondylar Knee Replacement
2. Noon Lecture Series Monday Friday, 12 1 pm
3. Grand Rounds Every Friday 8-9
4. Podiatric Residency Evening Lecture Series (Journal Club ) - 6-9 pm First Monday evening of
each month.
5. VPMA Monthly Lectures
Research Requirements
Original research topic to be submitted for publication in a peer review journal prior to graduation.
1. Identify original research topic by January 1 of first year.
2. Will meet with residency director every 3 months to review research project status ( first week of
January, March, July and October)
3. CITI online training (www.citiprogr.org ) as well as OSP online Investigator Training Modules
(located on Cornerstone (Carilions in-house online training resource ) are mandatory . The OSP
training modules include:
Introduction to Clinical Trials
Introduction to Clinical Research (ITC100E)
Submitting a New Study at Carilion Clinic (ICT101E)
Study Startup and Project Management (ICT102E)
Research Protocol Resources
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Tips for Using the Health Sciences Library(RPR100E)
Developing and Writing Research Protocol (RPR101E)
Data Management in Research (RPR102E)
Research Te Responsibilities
Clinical Researchers Roles and Responsibilities (RTR100E)
Record Keeping and Regulatory Documentation (RTR101E)
Reporting Adverse Events, Unanticipated Problems and Protocol Violations (RTR102E)
Project Management
Pre-Award Procedures for Grants and Contracts (PM100E)
Administrative Management of Grants and Contracts (PM101E)
Financial Management of Grants and Contracts (PM 102E)
Informed Consent
Recruitment of Study Subjects (IC100E)
Informed Consent Process for Clinical Research (IC101E)
Tips for Writing Better Research Consents (IC102E)
4. Will work closely with the Institutional Review Board and Office of Sponsored Projects to meet system
requirements.
6.. Attendance is strongly encouraged at all research oriented classes offered by Carilion. Most of the classes are
presented from 12:00 1:00 pm. The following classes are offered yearly based on the current schedule.
Titles are followed by the month in which they are generally offered:
Introduction to Medical Research - July
Quality Improvement: Common Tools & Project Designs
Knowledge-Based Resources- September
Turning Ideas into Research - September
Research Design and Methods, Part 1- October
Identifying Funding Sources for Research Projects- November
Research Design and Methods, Part 2- December
Introduction to Office of Sponsored Projects (OSP)- January
Grant Proposal Writing- February
Overview of Statistical Applications- March
Clinical Research: A Statistical Perspective- April
IRB and Research Ethics- April
Publishing and Presenting Research Findings- May
7. Participation/attendance is required in the Carilion Research Days. An annual poster presentation

conference. This poster may be one of the residents case reports or the resident may present his/her
original research work.
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8. Publication of a case report/study is required each year. This will total 1 original research project and 2
case study reports during the residency program.
Meetings and Vacations
1. Scheduling will be coordinated with the Department of Orthopaedics.

2. All vacations must be approved by Dr. Clements, Program Director or Rhea Jordan, Program Assistant.
3. No more than one resident should be away at any one time for the work week.
4. The Podiatry residency adheres to the Carilion GME Resident Vacation Policy noted in the Resident
Handbook and your resident contract. Currently that policy reads A minimum of two calendar weeks of
vacation and seven additional days off usually during winter holiday (total twenty-one days).
5. The winter holiday schedule will be carried out as per the rest of the house staff on the Carilion schedule. This
varies on a year-to-year basis depending on the date of Christmas and New Years. The Graduate Medical
Education Manager and Carilion Medical Education can provide the Carilion policy for the resident staff for each
particular year.
6. To comply with 80-hour workweek regulations, the resident on call will be off the following day. The resident
staff will also have two full weekends off every month. Modification in coverage will be arranged as needed by
the Administrative office.
Disaster Code Green
A disaster is described as any situation that results in an unusually large number of casualties and/or significant
number of critically injured (internal/external) brought to a Carilion hospital for medical treatment and/or admission. It
is an expectation that all contract services and personnel meet the needs of the institution during a disaster.
Notification within each facility will take place simultaneously by the Switchboard Operator as follows:
Code Green - (A disaster situation is reported and patients are either expected or may have
already arrived.) An overhead announcement Code Green will be paged three times.
Disaster Drills - An overhead announcement Code Green Drill will be paged three times.
What to Do
In the event of a disaster real or drill - all Podiatry residents are to call Rhea Jordan, Residency
Program Assistant and give their location and availability, then return to regular duties. The
program assistant will report your information to the command center. You will be called /
paged if needed. DO NOT report to ED unless called upon by coordination staff.
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Miscellaneous Departmental Information
Radiology
The X-Ray Department, located on 2 west, is staffed on a 24-hour basis; however, after 5:00 p.m., staffing is limited.
Films are available in the x-ray file room for you to review at any time. In order to take these films out of the
department, you must sign for them at the file room. Films taken out of the department should be returned promptly.
Develop the habit of reviewing all of the films on your patients and of using the radiologists as consultants in selecting
the type/sequence of imaging procedures for clinical situations.
Laboratory
Carilion has a full-service laboratory serving Carilion Clinic. With a core laboratory located at Carilion Roanoke
Memorial Hospital, Carilion operates rapid response laboratories at key hospital sites, a central pathology and
cytology lab, and several patient service centers. Although the Carilion-owned hospitals anchor their client list,
services are also provided to many physician offices, nursing homes, home health agencies and other healthcare
providers in southwest Virginia.
The hospital computer system EPIC is the gateway for placing orders and accessing test results. Tests are ordered
on a STAT, routine or timed basis so that resources can be effectively used to give physicians the information they
need, when they need it, in a cost-effective manner. Requests for service are typically very heavy at 6:00 a.m., 11:00
a.m., and 4:00 p.m., so physicians are urged to consider alternatives to these traditional order times.
The 300 technical and support personnel of labs at Carilion are directed by pathologists with specialty training in many
areas of laboratory and surgical pathology. Clinicians are encouraged to call upon members of the CCL professional
team for help in utilizing available resources to serve patients. Key phone numbers are:
Client Services 77157
Pathology, Carilion Roanoke Memorial 77271
Pathology, Carilion Roanoke Community 88020
Rapid Response lab, Carilion 88400
Administration 77878
Paychecks
Payday is every other Friday. Direct Deposit may be set up through Human Resources. An automatic teller machine is
located in the Lobby of Carilion Roanoke Memorial Hospital. Program Offices distribute paychecks or pay stub copies
if the check is Direct Deposited.
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Pharmacy
The central pharmacy is located on the 14th Floor of Carilion Roanoke Memorial Hospital. The Rehab Pharmacy is
located on the 1st floor of the Rehabilitation Center. Personnel in the Pharmacy are available to answer any questions
you might have regarding medications, dosages, etc. Questions regarding specific situations such as hyper
alimentation, home IV therapy, etc. can also be directed to the Pharmacy Department at Carilion Roanoke Memorial
Hospital or the Rehabilitation Center. Carilion Employees may obtain personal prescriptions from the Medical Center
Pharmacy, Monday-Friday, 8:30 a.m. to 5:30 p.m., and on Saturdays 9:00 a.m. - 12 p.m. Refills may be called in on
the refill line (853-0912) or sent bye-mail [email protected].
Pastoral Care Service
The Pastoral Care Service is staffed by ordained clergy of their respective religious affiliations who also have
education and training as counselors and chaplains. They are available from 7:00 a.m. - 4:30 p.m. Monday through
Friday and are on call after regular working hours.
The ministry provides support and counsel primarily to patients and their families. Much of the attention is focused on
critical and serious situations. The Pastoral Care Department assists patients and family members in clarifying their
anxieties, accepting the reality of their situations and helping them to utilize constructively the resources of their
religious traditions.
Liaison and interpretation is possible between physicians and families. The Pastoral Care Service will be happy to as-
sist physicians, patients or families when you feel that this ministry would be appropriate.
Home Health Service
The Home Health Service operates on a 24-hour basis. Office hours are Monday-Friday from 8:00-4:30 (981-7482).
After office hours or on weekends or holidays, a registered nurse is on call 24 hours per day and can be reached
through the hospital switchboard. The following services are offered by the Home Health Service: skilled nursing care,
physical therapy, speech therapy, IV therapy, occupational therapy, medical social services and home health aides.
These services are covered under most private insurance plans, Medicare and Medicaid.
Employee Health
Employee Health (981-7206 or 77206) is located on 5 South. In addition to the department's responsibility for onsite
emergencies and illnesses of employees of Carilion Roanoke Memorial Hospital, Employee Health supervises PPDs,
makes available flu and hepatitis B vaccine and investigates exposure to various contagious diseases.
All residents and faculty on CRMH payrolls will be required to complete an annual health assessment. The
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assessment is performed annually during your birth month. At that time you will be given a PPD if appropriate and will
be required to return in 48-72 hours for reading.
In the month prior to your birth month, you will receive a notice that your health assessment is due. Please call
Employee Health at 77206 to schedule an appointment.
Parking
Residents are issued master access cards that will allow you to enter the designated Rooftop Resident parking at
CRMH and the Libraries at CRMH and CRCH..
Please do not park in the Attending Physicians' area on the First level of the CRMH garage.
It is permissible for Residents to enter the CRMH Parking Garage and park on levels 4, 5, and 6
when there is snow or ice on the rooftop area.
Residents parking inside the main garage during normal conditions will be ticketed. Vehicles are
towed after three offenses.
Residents may also park in the Riverwalk Garage.
Safety and Security
Residents may contact Carilion Campus Police (981-7140 or 77140) and request an escort when returning to either
hospital late at night or at other times if there is a safety concern. The emergency number is 981-7911 or 7-7911)
Health Sciences Library
The librarians will provide reference work and literature searches upon request. Articles and books not available can
be ordered on an inter-library loan from other libraries. Limited copying is available, and information regarding this can
be obtained from the librarians.
Hours: Monday-Thursday 8:00a.m.-8:00p.m.
Friday 8:00a.m.-4:30p.m.
Saturday 1:00p.m.-5:00p.m.
Sunday 5:00p.m.-8:00p.m.
Access: 24-hour by key card
Event Reports (ED)
ER reports provide documented, comprehensive information on any occurrence considered contrary to established
hospital or departmental policy. Medication errors, procedure variances, therapeutic questions and patient complaints
are examples of occurrences that can be identified through ER reports. ER reports pertaining to the professional
performance of residents are reported to the appropriate program director, who investigates the reported variance and
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discusses the report with the involved resident. If you think an ER report should be generated, tell the charge nurse
yourself. Do not write an order on the chart for an ER.
Paging/Telephone Calls
A. Employee Internal Calls

Internal calls may be placed from any extension in the hospital system by dialing the appropriate extension after
receiving a dial tone. Internal telephone directories are available in each department, at nursing stations and on the
Intranet.
B. Employee Outside Calls

Local calls for hospital business may be made from any extension in the hospital system by dialing "9" and the 7-digit
telephone number after receiving a dial tone (does not include patient rooms).
C. Long Distance
Long-distance calls are restricted to hospital-related business and should be placed from the nursing station if at all
possible. Long-distance calls cannot be processed from courtesy telephones or patient rooms. Most nursing
stations/departments have at least one telephone with long-distance access, and use of these is encouraged. If using
a long-distance-approved telephone, dial 9, 1, area code and number. If you are not utilizing a telephone with long-
distance access, dial "0" and the Operator will place the call for you. The Hospital Director/designee monitors long-
distance calls. Any employee or student found misusing long-distance will be subject to disciplinary action and
payment for calls.
D. Personal Calls
Personal calls and paging requests should not be routed through the hospital operator. Personal long-distance calls,
should they be necessary in an emergency, must be made Collect or charged to a personal credit card. Use of pay
telephones for all personal calls is encouraged.
E. Paging
You have two internal paging options. You can page through WebXchange which allows text messaging (if
applicable) or you can page via phone which only accepts numeric messages.
Internally Paging through WebXchange from any Carilion terminal with Carilion Intranet access. All nursing stations
have Intranet Access.
Instructions for Accessing WebXchange (the CHS Phone/Pager Listing)

Go to the Carilion Intranet http://chsweb.carilion.com
Look under the Links column located on the left-hand side.
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Click on the CHS Phone/Pager Listing hyperlink.
Look under the Quick Links section located on the right-hand side.
Select Access the CHS Phone/Pager Listing.
WebXchange with our Staff Directory will appear. WebXchange is designed with various access
levels. Logging in will give you access to view the Staff Directory and On-Call Schedules. You will
also be able to page anyone on staff that is marked as pageable (marked with a green dot beside
their pager ID number). You will only have Directory Access (not able to quick page, page from a
profile or page from the on-call schedule) if you do not log in.
Log In
User ID: (The first letter in you first name, plus your last name example: JDoe)
Password: (your badge number omitting the first zero)
Enter the last name of the person that you want to page in the box under Search by Category.
Click on Name
A list of people with that last name will appear. Select the correct person by clicking on their name.
Their profile should open.
Enter your numeric or text message in the box at the bottom of their profile and then click on yellow
Page button beside the message box.
You should receive a confirmation that your page was sent.
We strongly encourage the use of WebXchange verses telephone paging. It is more reliable and better enables us to
track paging volumes and information related to patient care.
Internally - dial 78900. A voice prompt informs you that you have entered the system for a digital pager. The prompt
indicates it is time to enter the four digits of the pager you wish to dial. You must wait for the tone. You are instructed
to enter the telephone number you wish the carrier of the pager to call using the telephone keypad. Hang up after
entering your number. (As you become familiar with the system, you may disregard the voice prompts by dialing a *
on the telephone keypad as soon as the voice prompts begin. Then you will hear the tone for the dialing of the pager
number. As the voice prompts begin again, press * and wait for the tone to put in the number you wish the carrier to
call.) The carrier of the pager will receive readout of the number to call and should return your call promptly.
Externally - dial 981-8900. Listen for voice prompts and follow the procedure described above. Pager listings are
mailed to departments/nursing stations monthly.
Employees should exercise care in the use of telephone equipment. Telephone repair problems should be reported
to the Network Services Help Desk at Extension 71599. Transmission problems should be reported to the CRMH
Switchboard.
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GME Policies:
A full list of Carilion GME Policies may be accessed at:

http://carilionclinic.org/Carilion/Residency_Forms_and_Policies
Selected Policies:
Benefits Disability for Residents
Benefits Employee Assistance Program
Compliance Plan
Discipline Academic Remediation
Discipline Administrative Sanction
Discipline Appeal Process
Discipline Dismissal by the DIO
Discipline Institutional Probation
Discipline Institutional Suspension
Discipline Non Renewal of Contract
Drug Free Workplace
Duty Hours
Impaired Physician
Leave of Absence
Moonlighting
Program Closure and Reduction
Reappointment of Residents
Redress of Grievances
Resident Responsibilities
Resident Supervision and Job Description
Supervision--Institution
Vacation Request
Workplace Harassment
Additional Policies:
Surgical Attire
Do Not Use Abbreviations
Emergency Codes
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Surgical Attire (Carilion Policy rev 04/09)
GENERAL STANDARDS
Street clothes are worn to and from duty
O.R. personnel should wear a hospital identification badge on the upper left half of their clothing when
outside the surgical suite. When inside of the surgical suite your badge may be tucked for patient safety
Fragrances are not worn while on duty
Fingernails are kept short, clean, and undecorated, i.e., no artificial nails are permitted
SURGICAL ATTIRE
All individuals entering the semi-restricted or and restricted areas should wear freshly hospital laundered
surgical attire, intended for use only within the surgical suite
Facility approved, clean and freshly laundered surgical attire should be donned in a designated dressing
area of the facility upon entry or re-entry to the facility
Surgical attire should be changed daily or whenever visibly soiled, contaminated, or wet
Other garments should be contained completely within or covered by the surgical attire
Clothing that cannot be covered by the surgical attire should not be worn
Loose-fitting tops are tucked into the trousers
Non-scrubbed personnel should wear jackets with long sleeves. The jackets are buttoned or snapped
closed during use to prevent contamination of a sterile field
Jackets are not to be worn around the waist. Wearing of disposable or non-disposable gowns, as a cover,
is not considered appropriate
Surgical attire, which becomes visibly soiled or wet, is changed as soon as possible
HEAD COVERING
Hair including sideburns and neckline, must be covered when in the surgical suite and in the restricted
and semi-restricted areas of OR Services
Facial hair must be covered when in the restricted areas of the surgical suite
New head coverings are donned daily and replaced when visibly soiled or wet.
Reusable cloth head coverings may be worn and must be home laundered after each use
MASKS
All individuals entering restricted areas of the OR suite will wear a mask when open sterile items or
equipment are present
Masks cover both mouth and nose and are secured in a manner that prevents venting
124
Masks are either on or off. They are not worn hanging around the neck
Face shields or approved eyewear is required when performing a task at risk for a splash to the face or
eyes
JEWLERY
All scrubbed personnel will remove ALL jewelry prior to scrubbing
Non-scrubbed personnel may wear a wedding band, all other rings/jewlery should be removed. Post
earrings may be worn. However, hoop and dangling earrings must be confined inside the hat or removed.
Necklaces are not recommended and must be covered if worn in the non-scrub role.
125
Do Not Use Abbreviations
Drug names:
ARA A Do not use for Vidarabine
CPZ Do not use for Compazine
DPT Do not use for Demerol-Phenergan-Thorazine (outdated)
FOLINIC ACID Do not use for Folinic Acid. Use Leucovorin.
HCT Do not use for Hydrocortisone
MSO4 Do not use for Morphine Sulfate
MS Do not use for morphine sulfate
MgSO4 Do not use for magnesium sulfate. Write magnesium sulfate
TAC Do not use for tricinolone
ZnSO4 Do not use for zinc sulfate
nitro Use nitroglycerine
Norflox use norfloxacin
Abbreviations, Dose Expressions:
Apothecary Symbols use metric system
AU can be mistaken for OU (each eye)
cc do not use for milliliter or cubic centimeter. Use ml for milliliter
mg use mcg
TIW or tiw/BIW use times per week
Q.D or QD use daily
QOD or Q.O.D. use every other day
Per os use PO, by mouth: or orally
qn use nightly or qhs
U or u use unit. May be misread as 0resulting in 10-fold overdose.
IU use units
X3d use for three days or for three doses
BT use hs
Zero after a decimal point Do not use zero after a decimal for doses expressed in whole numbers.
No zero before decimal dose Always use zero before a decimal when the dose is less than a whole unit.
126
Emergency Codes (rev 01/05)
You may frequently hear the operator make announcements over the public address system. The following codes
and their meaning are for your information only and should not be shared with patients, family members or visitors
unless they ask.
General Codes
Code Red Fire situation that requires a facility-wide response

Code Grey Bomb threat situation that requires a facility-wide response
Code Orange Hazardous materials or contamination (internal/external)
Code Green Disaster situation (internal/external)
Code EVAC (CMC only) Partial or total evacuation of an area, department, or the facility
Code Siege Hostage situation within the facility
Code Secure Aggressive, psychological, abusive situation within the facility that requires police/security response
Cold Weather Alert Designation by the National Weather Service that severe weather may be affecting the area
Cold Weather Warning Designation by the National Weather Service that severe weather is approaching the area
Patient Care Codes
Code Blue Cardiac arrest in an adult

Code Kinder Cardiac/respiratory arrest in a child
Code Lindbergh
Newborn- Actual or attempted infant abduction within the facility
Pediatric- Actual or attempted abduction of a pediatric patient (ages 0-18 years)
within the facility
Emergency Department Alerts
Gold Alert Patient in the Emergency Department with unstable multi-system injuries
Trauma Alert Patient in the Emergency Department with stable multi-system injuries
Code Yellow (CMC only) Extreme increase in Emergency Department patient volume and requires additional staff
Code Silver (CMC only) Increase security measures in the Emergency Department
127
Eligible Call Groups for Meal Allowances:
Resident Call Group Meal Allowance Mon Fri Meal Allowance Sat, Sun, and
Holidays
Faculty Medicine Short Call Lunch
7 12 pm
Thursdays 7 5 pm Lunch, Dinner Lunch Dinner
Faculty Medicine Long Call Dinner Lunch, Dinner
12 pm 9 pm
Thursdays 5 pm 7 Lunch, Dinner Lunch, Dinner
Faculty Medicine Float Breakfast (Friday Wednesday) Breakfast (Friday Wednesday
9 pm 7 Holidays)
Faculty Medicine Cross Cover Dinner and Breakfast Dinner and Breakfast
5 pm 7 a.m.
Family Practice 1st Call (night) Dinner and Breakfast Dinner and Breakfast
5pm -7 (if required to be in-house)
1st Call Surgery Dinner and Breakfast Breakfast, Lunch, Dinner

2nd Call Surgery Dinner and Breakfast Breakfast, Lunch, Dinner
Sr. Surgery Resident In-House Dinner and Breakfast Breakfast, Lunch, Dinner
Ortho / Podiatry Dinner and Breakfast Breakfast, Lunch, Dinner
Residents will use their badge for on-call meals with the allotted amount for that block. Maximum allowable amount is
$7.50 per meal. If you go over the maximum allowable amount, you will be expected to pay out of pocket at the time
of purchase. amounts do NOT carry over to the next month if not used.
Mountain View Caf Hours (3rd floor)

Monday Friday (Closed on Weekends & Holidays)
Breakfast 7:00a.m. -9:45a.m.
Lunch 11:00a.m. -1:45p.m.
Dinner 3:00p.m. -6:30p.m.
128
CARILION ROANOKE MEMORIAL HOSPITAL
Main Number: 981-7000
TELEPHONE NUMBERS
DIAL 981 UNLESS OTHERWISE NOTED:
ADMINISTRATION (UNTIL 5PM) ..................7798 POLICE DISPATCH .................................... 7911 BULATORY CARE
ADMISSION UNIT .........................................7660 POST ANESTHESIA RM.(Recovery)............ 7173 CARILION BRBLETON CENTER
ADMITTING OFFICE (PATIENT ACCESS) PSYCHIATRIC SERVICES........................... 7097 (BULATORY SURGERY) .................... 772-7440
(BED PLACEMENT)....................................7108 PULMONARY FUNCTION LAB .................... 7661 (RADIOLOGY DEPT) .......................... 772-7401
(EMERGENCY DEPT).................................8249 RADIOLOGY NORTHWEST ....................................... 224-3870
(LOBBY/CASHIERS OFFICE) ....................7119 (CT SCAN) ................................................. 7093 ROANOKE/SALEM................................ 562-5700
ANESTHESIA................................................7268 (DIAGNOSTIC)........................................... 7122 SOUTHEAST......................................... 427-9200
(SURGERY CALL ROOM)...........................7216 (FILE ROOM) ............................................. 7126 SCREENING MMOGRAPHY N.RKE 265-
BLOOD BANK ...............................................7877 (INTERVENTIONAL) .................................. 7083 5545
CANCER CENTER (MRI) .......................................................... 7576 MISCELLANEOUS
ONCOLOGY/HEMATOLOGY...............982-0237 RESPIRATORY CARE SERVICES .............. 7218 ARCHIVE CENTER ............................... 224-4778
RADIATION ONCOLOGY ...........................7377 SLEEP LAB ........................................... 985-8526 CARILION BIOMEDICAL INST.............. 581-0123
CARDIAC CATH LAB (6 S PAV) ...................7085 SOCIAL SERVICES ..................................... 7678 CARILION EAP . . . . . ........................... 981-8950
CARDIAC REHAB ................................7619,7620 SURGERY/OR (4 S PAV)............................. 7244 CARILION HOME CARE/DME ......... 224 (8) 4700
CARDIAC SURGERY OR (6 S PAV).............8912 TRANSCRIPTION ................................. 224-6838 CARILION HOME CARE PV.DUTY 224-4875
CARES/PRESURG TESTING ................853-0924 ULTRASOUND............................................. 7088 CARILION OCCUP.HEALTH. ............... 985-8529
CASE MGMT ................................................8360 UTILIZATION MANAGEMENT ..................... 7503 CARILION DIRECT ............................... 981-7641
CONNECT ..8181 VASCULAR LAB .......................................... 7544 CARILION TRANSPORTATION. . . 345-7628
CYTOLOGY ...........................................985-9046 WAREHOUSE....................................... 224-3050 CRYSTAL SPRING IMAGING
DENTISTRY..................................................7128 NURSING STATIONS RECEPTION............................................... 7600
DIABETES CLINIC .................................224-4360 12 WEST (1200 1228) ............................... 7386 DIAGNOSTIC AREA................................... 7203
ECHOCARDIOGRAPHY LAB........................7618 11 WEST (1100 1127) ............................... 7166 PROCESSING AREA ................................. 7535
EEG ............................................................. 7102 10 WEST (1000 1027) ...................... 7240,8620 ULTRASOUND........................................... 7202
EKG ............................................................. 7285 10 MTN (SPCU 1080 - 1099)........................ 2940 FILEROOM................................................. 7250
EMERGENCY DEPT.................................... 7337 10 MTN (SICU 1068 - 1079) ......................... 2950 MRI ..................................................... 7109
EMPLOYEE HEALTH................................... 7206 9 WEST (900 928) ........................ .7394,7395 CT ..................................................... 7153
ENDOSCOPY .............................................. 7170 9 SOUTH (CARD. PCU 931 950) ........... .8250 FOOD SVCS(FRANKLIN RD). 344-0399
GIFT SHOP.................................................. 7980 9 MTN (NTPCU 980 - 999) .......................... 2939 HOME HEALTH................................ 224 (8) 4800
HEALTH INFO MGMT .................................. 7145 9 MTN (NTICU 968 - 979) ........................... 2949 HOSPICE ......................................... 224 (8) 4753
HEARTNET.................................................. 7910 8 WEST (801 828) .................................... 8362 INFORMATION SERVICES . . . . . . 224-1400
HELP DESK .......................................... 224-1599 8 SOUTH (CARD PCU 831 850) .............. 7189 LIFE-GUARD 10
HEMODIALYSIS .......................................... 7662 8 MTN (MSPCU 880 - 899).......................... 2938 (OFFICE) ............................................ 342-7637
HUMAN RESOURCES................................. 7305 8 MTN (MSICU 868 - 879) ........................... 2948 (EMERGENCY) .................................. 344-4357
INFECTION CONTROL................................ 7813 7 EAST (752 776) ..................................... 7986 MEDICAL CTR PHARMACY 853(7)0905
LABORATORY ............................................ 7157 7 SOUTH (CCU CC01 CC12) .................. 7316 PAYROLL........................................... 224(5)5039
LIBRARY...................................................... 8039 7 SOUTH (MCPCU 731 - 750)............ 7286,7287 RONALD MCDONALD HOUSE............. 857-0770
LOGISTICS 224-3040 7 MTN (VASCULAR PCU 779 - 790) ........... 2947
MEDICAL EDUCATION 6 WEST (CCDU 600 - 627) ......................... 7236
BILLING
DIRECTOR............................................... 78385 6 SOUTH (CSICU CS01 - 12)............. 7631,7632
GME ADM DIR ......................................... 78385 6 MTN (VASCULAR ICU 630 639)............ 2946 C.CONSOLIDATED LAB BILLING 342-2772
FILY PRACTICE.................................. 562-5702 5 WEST (501 526) .................................... 7498 ELIGIBILITY ASST. ............................... 224-2020
INTERNAL MEDICINE ............................... 7120 4 WEST (OP SURG 401 417)................... 7178 (OR 1-800-365-2445)
OB/GYN ............................................... 985-9977 WAITING ROOMS PATIENT ACCOUNTING....................... 224-5500
ORTHOPEDICS. ..981-8345 2 SOUTH EMERGENCY ROOM .................. 8751 (HOSPITAL BILLS)
PEDIATRIC .......................................... 985-8230 4 WEST ....................................................... 8934 PROFESSIONAL BILLING .................... 224-5688
PSYCHIATRY Residency Program. 7695 5 CENTRO ................................................... 7355 (PHYSICIAN SERVICES) ........... 1-800-540-1487
Outpatient Program.8025 6 SOUTH ..................................................... 8850 ___________________________________
SURGERY .7244 6 MTN ......................................................... 2924 STREET ADDRESS:
TRANSITIONAL .......................................... 7776 7 SOUTH ................................................... 70846 BELLEVIEW AT JEFFERSON STS.
TRAUMA 7441 7 MTN ......................................................... 2925 ROANOKE, VA. 24014
NUCLEAR MEDICINE.................................. 7274 8 SOUTH .................................................... 7820
O.R. POSTING............................................. 7494 8 MTN ........................................................ 2926 MAILING ADDRESS:
PAGING SYSTEM........................................ 8900 9 SOUTH .................................................... 7794 P.O. BOX 13367
PASTORAL CARE ...................................... 7255 9 MTN.2927 ROANOKE, VA. 24033
PATHOLOGY 7271
PATIENT ACCOUNTING ...................... 224-5500 REHAB
PATIENT INFORMATION ....................7118,7143 1ST FLOOR (DAY REHAB) 853-0656,0657
PHARMACY ................................................ 7275 2 ND FLOOR....................................... 7425,7426
PHYSICAL/OCCUPATIONAL/SPEECH 3RD FLOOR........................................ 7433,7434
THERAPY (MAIN) ...................................... 7284 4TH FLOOR ........................................ 7448,7449
(REHAB) OUTPATIENT PT/OT ................. 7443 5TH FLOOR ........................................ 7417,7418
129
Appendix 1 Resident Contract Sample
CARILION CLINIC
RESIDENT CONTRACTUAL AGREEMENT
Podiatric Medicine and Surgery Residency (PMSR)
July 1, 2011 through June 30, 2012.
I. I, ____________________, accept appointment as a _______ Year Resident in Podiatric Medicine and

Surgery Residency (PMSR) with reconstructive rearfoot/ankle credential option with Carilion Clinic from
July 1, 2012 through June 30, 2013.
II. I will conscientiously fulfill my responsibilities and obey all applicable rules, regulations, and policies of
Medical Education and the hospitals, medical staff and educational affiliates of my program. I will not
prematurely resign my appointment except for reasons of health or circumstances over which I have no
control; or by mutual agreement with Carilion Clinic. I will adhere to all policies attached to this
agreement. I understand and agree that my appointment is contingent upon my ability to begin it on a
timely basis and that if I am unable to begin it within sixty (60) days of the start date, I will be deemed to
have resigned my appointment.
I further understand that a criminal background check will be conducted before my arrival at Carilion
Clinic. A successful background check is needed for acceptance into the residency program.
III. I accept the following responsibilities:
A. Develop a program for professional growth with guidance from the teaching staff
B. Participate in safe, effective, and compassionate care under supervision, commensurate with my
level of advancement and responsibility
C. Participate fully in the educational activities of the program and assume responsibility for teaching
and supervising other residents and students
D. Participate in committees, institutional programs and activities involving the Medical Staff
E. Adhere to established practices, procedures, and policies of the institution and participate in
committees as requested
F. Utilize cost containment measures in the provision of patient care where medically appropriate
G. Participate in the required documentation and compliance with duty hours regulations.
I understand that failure to meet these responsibilities may result in sanctions, suspension, probation or
dismissal.
IV. Carilion Clinic agrees to provide:

A. Annual salary of: $48,054 payable bi-weekly.
A. Health insurance as set forth in the applicable Summary Plan Description (SPD) choice of HMO or
PPO coverage (effective on the first official day of employment). The HMO and PPO premiums are
subsidized in part by Carilion Clinic, but residents will be responsible for the payment of partial
premiums in an amount determined by the particular plans(s) and coverage(s) offered and selected.
B. Dental insurance as set forth in the applicable SPD basic coverage for the Resident and, if married,
for the Residents spouse and dependent children paid by Carilion Clinic. Comprehensive coverage
requires premium to be paid by the resident.
C. Salary continuation for up to 150 days per rolling contract year for covered illness and/or injury, as per
Carilion Clinic policy.
D. Eligibility for long-term disability as set forth in the SPD.
E. Group life insurance of one and one-half times annual salary and payable as set forth in the
applicable SPD.
F. Carilion provides, under its corporate medical professional and general liability insurance program,
claims-made insurance coverage of a continuous nature with respect to all clinical activities and
employment activities undertaken by residents under the aegis of the educational program. This
claims-made coverage is applicable, with respect to specific dates of employment, beyond the dates
of employment of any resident so employed by Carilion. It is of a continuous nature and unlimited in
duration.
130
G. A minimum of two calendar weeks of vacation and seven additional days off usually during winter
holiday (total twenty-one days), in accordance with the department-specific Resident Vacation Policy.
(See policy).
H. Parking in designated areas without charge.
I. Call rooms along with meals, subject to specified dollar limits, for designated resident call groups.
J. Uniform jackets
K. Documented moving expenses for new residents, reimbursed up to $850.00
V. Call and duty hours are consistent with Carilion Duty Hour Standards, as applicable.
Program Offices will provide residents with Program appropriate duty hours policies and procedures.
VI. Individual programs provide a description of the educational program, educational leave for upper level
residents, rotations, call responsibilities, and policies concerning leave, evaluation, reappointment, and
advancement.
A. First year residents may not engage in extramural clinical activities (moonlighting). After successful
completion of the first year, moonlighting may be permitted at a frequency and at locations approved
by the Program Director and Carilion Clinic. All moonlighting hours must be reporting in weekly duty
hours reporting. Residents are required to disclose moonlighting activities to their Program Director.
Carilion Clinics professional liability insurance does not cover such professional activities by
residents. The DEA number for Carilion Medical Center is to be used for approved program activities
and cannot be used for moonlighting. A resident must apply for a federal DEA license in order to
practice outside the educational program.
VII. Carilion Clinic has formal policies for Academic Behavioral Discipline and Redress of Grievances.
Oversight is the responsibility of the Graduate Medical Education Committee. The Academic Behavioral
Discipline policy covers such things as administrative sanction, probation, suspension, dismissal, appeal
of dismissal, and conduct of hearings.
VIII. Carilion Clinic has a formal policy on workplace harassment, including sexual harassment.
IX. Carilion Clinic has a formal policy on Compliance.
X. Carilion Clinic has Employee Use of Tobacco and Drug-Free Workplace Policies. Residents undergo a
post-offer health assessment, including a test for illegal drugs. A positive result is sufficient cause for
revocation of this appointment and immediate termination of this agreement.
XI. Carilion Clinic recognizes the need for residents in Medical Education to occasionally request an
extended period of time away from work during the course of employment. Carilion Clinic has a Leave of
Absence Policy, including Family Medical Leave benefits applicable to residents.
XII. Carilion Clinic provides residents and their families with an Employee Assistance Program (EAP). EAP
offers a variety of counseling services, including family and personal counseling, stress management, and
substance abuse. Carilion Clinic has a formal policy on the Employee Assistance Program for Residents
XIII. Carilion Clinic has a formal policy on physician impairment.
XIV. In the event that Carilion Clinic would need to reduce the size or close a residency program, residents
would be informed as soon as possible. For residents already in the program, Carilion Clinic will make
every reasonable effort to allow the resident to complete their education or be assisted in enrolling in a
PMSR accredited program in which they can continue their education. (See policy).
XV. Carilion Clinic does not request or require residents to sign a Restrictive Covenant, guaranteeing non-
competition.
XVI. I have read, understand and agree to adhere to the attached policies and procedures.
RESIDENT:
131
Signature: __________________________________
Date: ______________________________________
Address: ___________________________________
__________________________________
Phone (s):__________________________________
__________________________________________________
John Randolph Clements, D.P.M.
Director of Podiatric Medicine and Surgery Residency
Carilion Clinic
__________________________________________________
Daniel P. Harrington, M.D.
Vice President for Academic Affairs, DIO
Carilion Clinic
__________________________________________________
Nancy Agee, R.N.
Chief Administrative Officer
President and CEO
Carilion Clinic
The following policies can be accessed on the internet at:
http://www.carilionclinic.org/Carilion/Residency_Forms_and_Policies
Benefits Disability for Residents

Benefits Employee Assistance Program
Compliance Plan
DisciplineAcademic Remediation
Discipline Administrative Sanction
Discipline Appeal Process
Discipline Dismissal by the DIO
Discipline Institutional Probation
Discipline-Institutional Suspension
Discipline Non Renewal of Contract
Drug Free Workplace
Duty Hours
Impaired Physician
Leave of Absence
Moonlighting
Program Closure and Reduction
Reappointment of Residents
Redress of Grievances
Resident Responsibilities
Resident Supervision and Job Descriptions
Supervision Institution
Vacation Request
Workplace Harassment
List of Specialty Boards is located at:

http://www.abpoppm.org/
http://www.abps.org/
132
Appendix 2 Evaluations
Resident evaluations will be sent electronically via Med Hub at the appropriate intervals. Copies of the evaluations
follow for faculty evaluation of resident, resident evaluation of faculty and resident evaluation of rotation.
133
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136
137
138
139
140
141
142
143
144
145
146
147
148
149
150
151
152
153
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155
156
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159
160
161
162
163
164
165
166
167
168
169
170
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172
173
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177
178
179
Carilion Clinic: Podiatric Surgery and Medicine Residency Program
House Staff Inpatient Evaluation
Name of Resident ______________________________________________Evaluation Date__________________
Site CRMH SVC

Block Dates: __________________________________________
Evaluators Name _____________________________________________ (RN, SW, D/C Coord, Mgr. PA)
1 2 3 4 5
POOR MARGINAL AVERAGE GOOD EXCELLENT
Keeps Nursing Staff informed of patients
progress and plan(s) of care
Maintains appropriate interaction with patient
and patient's family
Appears to appreciate and react to social,
ethical, and/or cultural differences in patients
that may interfere with health care
Answers pages in a timely fashion
Treats RNs Social Workers and allied health
professionals with respect and
professionalism.
Responds quickly to emergency situations
Completes records/orders in a timely fashion
Please comment on the residents overall performance:
Please fax your completed evaluation to: Rhea Jordan

Program Assistant, Podiatry Residency
F 540-344-3812
Thank you.
180

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Resident Manual

Podiatry Medicine & Surgery Residency

Podiatry Education- Administrative staff

Program Director: Dr. J. Randolph (Randy) Clements [email protected]

Program Assistant: Rhea Jordan

Abbreviations used: SVAMC Salem Veterans Administration Medical Center

July Podiatry SVAMC Podiatry Podiatry Radiology Podiatry Ortho-Foot &

CPME Competency requirements (CPME document 320, 6.1)

Podiatry Program General

The following represent required competencies:

Podiatric Medicine and Surgery

Foot and Ankle Orthopaedics

Perform and interpret basic vascular studies

Interpret plain radiography

C. Maintaining a Surgical Log

Delinquent Charts effective February 15, 2011

Conferences- Mandatory attendance.

7. Participation/attendance is required in the Carilion Research Days. An annual poster presentation

Meetings and Vacations

1. Scheduling will be coordinated with the Department of Orthopaedics.

Disaster Code Green

Pastoral Care Service

Home Health Service

Safety and Security

Health Sciences Library

Event Reports (ED)

A. Employee Internal Calls

B. Employee Outside Calls

Instructions for Accessing WebXchange (the CHS Phone/Pager Listing)

A full list of Carilion GME Policies may be accessed at:

Street clothes are worn to and from duty

Fragrances are not worn while on duty

Loose-fitting tops are tucked into the trousers

All scrubbed personnel will remove ALL jewelry prior to scrubbing

Code Red Fire situation that requires a facility-wide response

Patient Care Codes

Code Blue Cardiac arrest in an adult

Emergency Department Alerts

1st Call Surgery Dinner and Breakfast Breakfast, Lunch, Dinner

Mountain View Caf Hours (3rd floor)

I. I, ____________________, accept appointment as a _______ Year Resident in Podiatric Medicine and

III. I accept the following responsibilities:

IV. Carilion Clinic agrees to provide:

IX. Carilion Clinic has a formal policy on Compliance.

XIII. Carilion Clinic has a formal policy on physician impairment.

The following policies can be accessed on the internet at:

Benefits Disability for Residents

List of Specialty Boards is located at:

Name of Resident ______________________________________________Evaluation Date__________________

Site CRMH SVC

Evaluators Name _____________________________________________ (RN, SW, D/C Coord, Mgr. PA)

Please comment on the residents overall performance:

Please fax your completed evaluation to: Rhea Jordan

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I. I, ______________, accept appointment as a _ Year Resident in Podiatric Medicine and

Name of Resident ____________________________Evaluation Date