Forefoot / Midfoot · Trauma · Infection & Wound · Standard
Shots Fired
Podiatric surgery residency interview case. Work through it the way you would at an interview: take the history, ask for the exam and imaging, then commit to a diagnosis and plan.
Chief complaint
"I was walking down the street and got shot at."
18-year-old African American male brought to the ED by ambulance.
History of present illness
Gunshot wound to the LEFT foot sustained 20 minutes before arrival while walking down the street. He was wearing sneakers. Brought in by ambulance.
- Single shot heard; believes it was a handgun at a distance
- Pain 8/10 in the left forefoot; unable to bear weight
- No other wounds; no head strike or LOC
- No numbness or tingling
- Last meal about 2 hours ago; last tetanus vaccine as a child (primary series completed), no booster since
Questions a strong candidate asks at this step
- Time of injury and weapon type/range (handgun vs rifle/shotgun → low vs high velocity)
- Number of shots; any other wounds (full secondary survey)
- Footwear — did the bullet pass through the shoe? (Pseudomonas, retained shoe material)
- Numbness, tingling, coldness — 6 Ps
- Tetanus status and NPO status
- Police notification / safety at discharge
Present the rest of the case
Past history, exam, imaging, assessment, plan and discussion questions, with model answers, are in the interactive trainer. The diagnosis is kept there on purpose so you can practice committing to one.