Questions to Ask

By what point in residency do residents typically hit their CPME case minimums — first year, second, third?

By graduation, how far beyond the minimums do most residents end up — 2×, 3×, more? What's a typical total case count?

Is the surgical volume stable year to year, or has a key attending leaving or a hospital contract changing recently shaken it up?

When a case is double-scrubbed, who logs first assistant — and how close are the case totals residents quote to real first-assist numbers?

At what point do residents start doing major reconstructive and trauma cases skin-to-skin? Are cases usually single- or double-scrubbed?

By third year, who's actually making the intraoperative decisions — does the resident plan and drive the case, or execute the attending's plan?

What's the patient population — VA, county, privately insured, or a mix — and does it tilt the caseload toward wounds and limb salvage or toward elective reconstruction and trauma?

What are the most common elective procedures residents perform? The most common non-elective?

How much rearfoot and ankle reconstruction do residents get, versus a forefoot-heavy caseload?

How much exposure is there to total ankle replacement (TAR), and how many do residents do skin-to-skin?

How much Charcot reconstruction, external fixation, and limb-salvage work (including flap coverage) do residents see?

Is the flagship hospital a Level I trauma center? Does the ED consult podiatry for ankle fractures and lower-extremity trauma, or does a separate trauma team handle them?

Do podiatry residents perform closed reductions of ankle fractures in the ED?

Roughly how many pilon, calcaneal, and Lisfranc cases does the average resident graduate with skin-to-skin?

What's the exposure to minimally invasive (MIS) forefoot and rearfoot techniques?

What does the medicine side look like here — biomechanics and orthotics, pediatrics, dermatology, sports medicine — or is it box-checking between surgical cases?

Who does the amputations — podiatry, vascular, or ortho — and how many do residents actually do?

How many attendings are affiliated with the program, and who are the core attendings? What's the academic-vs-private-practice mix?

What is the call schedule like — weekday and weekend structure, holidays, and how does it change by PGY year?

How many hospitals and surgery centers do residents cover, and how many do they take call at?

How does a typical week split between the OR, clinic, and inpatient work — consults, rounding, wound care?

How much of the week is scut — notes and H&Ps on attendings' patients, discharge paperwork, chasing transport and consults — versus work you actually learn from?

How is the chief resident chosen, and what does the chief actually control — the OR schedule, call, and who scrubs which cases?

How structured are the didactics — lectures, journal club, cadaver and sawbones labs, surgical-skills sessions?

Is there a research requirement, and is there real support for presenting and publishing?

How have recent residents done on the ABFAS in-training exams and the ABFAS and ABPM boards, and is there protected prep time?

What's the relationship between residents and attendings — are they actively teaching, or just supervising?

Is mentorship real and built-in, or something you have to find on your own?

How does podiatry work with orthopedics, vascular, ID, and plastics — is there a true multidisciplinary limb-salvage team?

Is there a fellowship at the institution (limb salvage, RRA, or similar)? Does it compete with residents for cases, or strengthen the training environment?

How does the externship actually run day to day — scrubbing, clinic, presenting — and does an extern get into major cases or mostly observe?

How does the program use the externship to evaluate candidates — what makes an extern stand out?

Roughly how many of the current residents externed here first? Is externing here essentially a requirement to match?

Beyond the externship month, what actually moves the rank list here — the CRIP interview, APMLE scores, letters, class rank?

How does the program run its interview — academic questions, case workups, hands-on skills — and do residents sit on the panel?

Is there a journal-club article or case presentation externs are expected to give?

Where have recent graduates gone — fellowship (reconstruction and trauma, RRA, sports medicine, wound care and limb preservation) or straight into practice?

Do graduates feel prepared for independent rearfoot and ankle surgery, or do most need a fellowship to feel confident?

Does the program actively support fellowship applications — letters, time, connections?

For those who went straight to practice, did they land the jobs and locations they wanted — hospital-employed, private practice, or a mix?

What's the relationship like among the residents — collegial or competitive?

How supportive is the program when a resident struggles, clinically or personally?

Has any resident left, transferred, or been let go — and why?

If a resident runs into academic or professional trouble, what does remediation actually look like — is it a documented plan with a real path back, and what happened to residents who went through it?

Has the program director changed in the last few years — and why?

Is the hospital itself financially stable — any mergers, closures, or service-line cuts coming?

If CPME has found areas of noncompliance, or the program has been on probation or provisional accreditation, what was behind it — and what changed?

Does the program genuinely feel welcoming to residents who don't look like the attendings — and if a mistreatment or harassment concern has come up, what actually happened?

Honestly, how many hours a week are residents working?

How is vacation handled — how much, and do residents actually get to use it?

When a resident is out — sick, on leave, at a conference — who covers, and how hard does it land on everyone else?

Is burnout acknowledged, and is there real, confidential mental-health support residents actually use?

What's the pay and benefits package, and are there moonlighting opportunities?

Who actually employs and pays the residents — the hospital, a university, or a private group — and do loan payments during residency count toward PSLF?

What's the living situation — housing cost, the city, and whether it's workable for a partner or family?

What's parental and family leave actually like here for residents who've taken it — did it push anyone past their case minimums or extend their training?