Building the Foundation
A practical roadmap for first-year residents learning how to prepare, communicate, stay engaged, take ownership, and earn trust during a foot and ankle rotation.
Your job is not to become a foot and ankle surgeon yet.
Your job during PGY1 is to build the foundation that future surgical excellence will be built upon. The expectation is not perfection. The expectation is growth.
Prepare Well
Learn how to review charts, imaging, anatomy, and operative plans before entering clinic or the OR.
Earn Trust
Understand the behaviors that make attendings more comfortable giving responsibility early in training.
Build Fundamentals
Focus on splinting, closure, positioning, OR setup, basic anatomy, and early ankle fracture exposure.
What the PGY1 Playbook covers.
This guide is designed to help residents understand exactly where they stand and what behaviors move them from observer to contributor, owner, and multiplier.
Trust & Professionalism
- Integrity
- Reading the room
- Patient ownership
- Communication
- Anticipation
PGY1 Technical Foundations
- Clinic preparation
- Surgical preparation
- Basic foot and ankle anatomy
- Room setup and positioning
- Closure and splinting
Evaluation Tools
- Observer to Multiplier framework
- Trust Score
- Technical Score
- Faculty evaluation
- Development plan
Success Benchmarks
- Efficiently apply common lower extremity splints
- Close surgical incisions appropriately
- Present patients concisely
- Expose common ankle fracture approaches with guidance
- Take ownership of assigned responsibilities
Residents can honestly identify where they stand.
The PGY1 Playbook gives clear behaviors for each stage so feedback becomes more specific and actionable.
Observer
Requires frequent direction and is still learning basic workflow, preparation, and expectations.
Contributor
Performs expected responsibilities, participates actively, and begins to function reliably.
Owner
Takes responsibility, follows through, communicates proactively, and anticipates basic needs.
Multiplier
Elevates the team, helps other learners, improves efficiency, and models PGY1 excellence.
Trust Score and Technical Score are separated.
This matters because technical skill alone does not determine autonomy. A resident can have strong hands and still lose opportunity if trust has not been earned.
Trust Score: 30 Points
- Integrity
- Preparation
- Ownership
- Communication
- Clinic Performance
- Anticipation
Technical Score: 20 Points
- Clinical Synthesis
- Anatomy Knowledge
- OR Fundamentals
- Surgical Skills
Start with PGY1 or get the full pathway.
The PGY1 Playbook works as a standalone guide, but the bundle gives residents the full progression through PGY5.
Want the full resident development system?
Get The Strasser Standard plus PGY1 through PGY5 in the Complete Resident Bundle.
Common questions before purchase.
Who is the PGY1 Playbook for?
First-year orthopedic residents, medical students entering orthopedic rotations, and trainees who want to understand early expectations in foot and ankle surgery.
Is this a surgical textbook?
No. This is a development and evaluation playbook focused on preparation, ownership, trust, autonomy, clinic performance, and OR fundamentals.
Does it include technical expectations?
Yes. PGY1 expectations include splinting, closure, basic anatomy, positioning, OR setup, and guided exposure for common ankle fracture approaches.
Should I buy the bundle instead?
The PGY1 Playbook is best if you only need the first-year guide. The bundle is better if you want the full roadmap from PGY1 through PGY5.
Build the foundation early.
PGY1 is where trust, preparation, ownership, and surgical habits begin. Start with the playbook built for that stage.