Congratulations to Rebecca Burmeister, DPM, MPH who is an upcoming graduate of the Michigan Medicine Podiatry Fellowship Training Program. Before joining the program in July 2019, Dr. Burmeister earned her Doctor of Podiatric Medicine (DPM) at the Scholl College of Podiatric Medicine in Illinois and then completed her residency at the William S. Middleton Memorial Veterans Hospital in Wisconsin.

When Dr. Burmeister isn't caring for patients, she is working on research projects in her area of interest - improving diabetic limb salvage with a special interest in patient education - and has an article in press in the International Wound Journal. Dr. Burmeister was also an active presenter at the Michigan Podiatric Medical Association (MPMA) Great Lakes Conference in February 2021, where she won first prize in the MPMA abstract competition. In addition to her MPMA presentations, Dr. Burmeister has presented at the Endocarditis conference, the Michigan Diabetes Research Conference, many internal conferences, and she is presenting at the American Diabetes Association (ADA) 81st Scientific Sessions this summer.

Dr. Burmeister graduates on June 9, 2021 and then will join the Michigan Medicine Podiatry team as a faculty member. Below she shares her experience in the program and what she's learned.

What is the most important thing you’ve learned while doing your fellowship?

My fellowship has been an incredible opportunity and I seriously have learned new things each day. I think the most important lesson I learned from my fellowship is the importance of a multi-disciplinary approach for improving limb salvage in patients with diabetes.

What aspects of the fellowship do you enjoy the most?

The part of the fellowship I enjoyed the most is the support and mentorship from my podiatry attendings to ensure I am improving and reaching the goals I have set for myself. They have helped me grow professionally more in two years than I could have imagined prior to starting this fellowship.

How do you think the fellowship has prepared you for the future?

The fellowship has truly prepared me to be an expert in limb salvage in patients with diabetes. I have learned how to care for patients with complex foot wounds and most importantly, I have learned how to design various research projects that can hopefully contribute to improving diabetic limb salvage outcomes and foot ulcer prevention.

What research projects did you work on, what were the goals, and why were you interested in these topics?

I have worked on and led multiple research projects during my fellowship. One of my projects that I was able to design from the ground up was exploring what impacted healing outcomes after an inpatient diabetic limb salvage surgery. I reviewed the outcomes of all the podiatry inpatient referrals that required an inpatient limb salvage surgery for an acutely infected diabetic foot infection. The study found that patients discharged to a short-term nursing facility had poorer post-operative outcomes compared to patients discharged home.

I was interested in this topic because it is clear that despite some of our patients having similar arterial flow to their foot and similar comorbidities, we still find that some patients heal much easier than others after limb salvage surgery. I wanted to see if we could identify any modifiable factors that could improve post-operative outcomes for our patients.

I am also still working on a research project that explores patients' understanding of the importance of taking pressure off their diabetic foot ulcer while it heals. This topic has always been of interest to me because healing a diabetic foot ulcer is very difficult for many of our patients. As providers, I think we have a lot to learn about how we can help our patients heal their ulcers faster.

Previous research has indicated that taking pressure off the diabetic foot ulcer all the time, with every step our patient takes, is critical for better healing outcomes. However, it is a lot of responsibility on our patients to stay off the foot with the ulcer completely and/or to use the often cumbersome shoe gear we ask them to wear all the time when ambulating. What this study is revealing is despite our best efforts and time explaining the importance of diabetic foot ulcer offloading in clinic, our patients do not truly understand why it is important for them to follow the restrictions we give them to promote healing.

I am passionate about this project because I greatly enjoy promoting proper patient education and learning more about effective health communication between the health care provider and patient. I will be presenting the final results of this study at the ADA Scientific Sessions in June 2021.

How do you spend your day when you’re in the clinic?

When I am in clinic, I am seeing patients and presenting to attendings directly. I am collaborating and relying on the nursing staff to keep the clinic flowing smoothly. It is also common for me to reach out to other providers to ensure the patient is getting all aspects of their health care properly served related to the concerns I am seeing them for that day.

I am also managing the inpatient podiatry referrals and ensuring all studies, recommendations, and orders are in place for our inpatients.

What accomplishment are you most proud of?

I am most proud of the rapport I have made with multiple patients and I hope this has improved their pedal outcomes.

In terms of non-clinical accomplishments, I am proud of being selected as the first place presenter at the 2021 Michigan Podiatric Medical Association conference where I discussed my research project that looked at outcomes of all the podiatry inpatient referrals that required an inpatient limb salvage surgery.

What gives you the most satisfaction in your job?

I typically am caring for patients with diabetes and they often have many diabetic complications in addition to other severe health comorbidities. The part of my job I get the most satisfaction from is when I see a patient on an urgent basis who is presenting with early signs of a diabetic foot ulcer or pre-ulcerative callus. This tells me the patient is taking the simple, yet extremely important action of looking at their feet often and catching concerning changes early in the process as opposed to me meeting them in the ED when it is a major problem. Often they tell me they called the clinic because I had informed them to do that if they had concerns. I know when patients take this simple advice, we are going to have better outcomes.

Learn More About the Podiatry Fellowship Training Program

The Podiatry Fellowship Training Program in the Division of Metabolism, Endocrinology & Diabetes is a two-year program that involves all areas of clinical medicine, with an emphasis on research and patient populations at risk for limb loss. Fellows in the program rotate in the Podiatry Clinic, Wound Care Clinic, and other specialty clinics throughout the two years. When they’re not in the clinic, they work on developing their research project and gain exposure to various components of the research process.