Foot and ankle surgery-The Achilles heel of medical students and doctors

Background: Numerous studies have shown that deficiencies exist in orthopaedic and musculoskeletal medical training resulting in students and doctors regularly failing basic orthopaedic exams. However, there have not been any studies addressing the attitudes of medical students towards the orthopaedic subspecialties. Objectives: This study aimed (i) to determine if foot and ankle surgery was the orthopaedic specialty with which students and doctors have the most difficulty, (ii) to appraise attitudes towards teaching of foot and ankle surgery, and (iii) to suggest ways teaching might be improved. Methods: A questionnaire on orthopaedic teaching was given to 238 medical students in Ireland. Perceived difficulties with foot and ankle surgery were compared to seven other orthopaedic subspecialties and the results were analysed. Other aspects of teaching were assessed including why foot and ankle surgery is perceived as difficult and ways teaching could be improved. Results: Foot and ankle surgery is the orthopaedic subspecialty with which medical students and doctors have the most difficulty, least confidence and poorest knowledge in. This was due to: perceived complexity; insufficient exposure; and a lack of teaching. Conclusion: Foot and ankle surgery is the least popular of the orthopaedic subspecialties and considerable deficiencies exist in its education.