Nova DPM/DO Program

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Does anyone know what is the purpose and benefit in completing this program? Would you be able to compete for a residency in dermatology and specialize in podiatric dermatology with this program?

I can think of few things more retarded.

Originally Posted by CHOPSTIX

Does anyone know what is the purpose and benefit in completing this program? Would you be able to compete for a residency in dermatology and specialize in podiatric dermatology with this program?

I think the point of this dual degree program was to create more primary care physicians who can also provide sound foot care in poor socio-economic communities. You could kill two pretty important birds with one stone in areas where people don't have a lot of access to quality healthcare. This dual degree program would take forever to complete because you have to probably complete 4 years of traditional med school followed by a Family med residency and podiatric medicine residency. That's a ton of years to work in disadvantaged areas of the US (if you were to properly utilize this dual degree). If you are not going to work in these areas then there is really no point to pursue this option.

Also, why the hell would you want to go through a derm residency only to provide dermatological care to the foot and ankle when you could simply provide skin care to the entire body and make 300-500K a year?

http://forums.studentdoctor.net/showthread.php?t=492448

Nova does quite a few of these seemingly pointless dual programs, but, like someone else pointed out, the school places a huge emphasis on primary care, and the goal of these programs is to train one-stop-shop practitioners for rural/underserved communities. Same thing with their DO/DMD program. Unless you are planning on practicing as kind of like the "town doctor" who can literally do it all in an underserved community ... I don't think I'd recommend it. That's a LOT of school (and money).

Originally Posted by JaggerPlate

Nova does quite a few of these seemingly pointless dual programs, but, like someone else pointed out, the school places a huge emphasis on primary care, and the goal of these programs is to train one-stop-shop practitioners for rural/underserved communities. Same thing with their DO/DMD program. Unless you are planning on practicing as kind of like the "town doctor" who can literally do it all in an underserved community ... I don't think I'd recommend it. That's a LOT of school (and money).

No, it's a lie. This primary care emphasis is a lie. No one becomes a physician and a dentist to serve both medical and dental needs in a community. It's a ****ing joke and a lie. The school is fabricating these programs for selfish reasons.

Originally Posted by sideways

No, it's a lie. This primary care emphasis is a lie. No one becomes a physician and a dentist to serve both medical and dental needs in a community. It's a ****ing joke and a lie. The school is fabricating these programs for selfish reasons.

Shrug? I don't attend the school, nor have I gone through any of their programs. I'm just stating what I was told on the day I interviewed for the DO program. You could very easily be right.

Originally Posted by JaggerPlate

Shrug? I don't attend the school, nor have I gone through any of their programs. I'm just stating what I was told on the day I interviewed for the DO program. You could very easily be right.

My point wasn't to call you out. Just the programs.

if you do that program good luck actually using that extra D.O. degree because no insurance company will accept you with completing a 1 year internship only. Insurance will require you to at least be board qualified to get reimbursement to function as a family physician and you can't be board qualified without completing 3 years of residency. There is no added value to a podiatric practice with this degree you aren't going to be credentialed at a hospital any differently unless you are board qualified and you're not getting more money without being board qualified...it's a bust

Originally Posted by sideways

My point wasn't to call you out. Just the programs.

For sure. Are you at an osteo program (just curious).

Originally Posted by JaggerPlate

For sure. Are you at an osteo program (just curious).

Yeah, I'm osteo.

As a NSU BS/DO student I agree that some joint programs don't have a point. Most people invariably wind up doing one thing or the other most DO/JDs and DO/MBAs either do law or business or medicine but not usually a combination. The DPM to DO program is a good fit for someone who wants to go use it as a segue to ortho or who wants to expand their scope of practice. The DO/DMD program seems to be for those who want to do primary care and dentistry, Case Western has a similar program. For someone wanting to do OMS or do dental anesthesia it makes sense for most others, they wind up doing one of these and their skills in the other atrophy.

...

An alumnus from our school and who teaches pathology and dermatology did a DPM degree then a DO degree. He has a company that is doing quite well and who has helped further the research of pathology and dermatology in podiatry. You will have to research where he did his residencies and fellowship. He donates back generously and is a great leader in our profession. Dr. Bakotic has been successful doing the DPM/DO route. I don't know anyone else who has done that route, but 100% of the people I know have benefited greatly.

The only benefit I see from this is it allows DPMs to harvest tissue that would be outside the normal scope of podiatrists such as bone grafts from the hip and skin grafts from the upper leg. Is it worth the 4 extra years??? I don't think so.

Originally Posted by janV88

The only benefit I see from this is it allows DPMs to harvest tissue that would be outside the normal scope of podiatrists such as bone grafts from the hip and skin grafts from the upper leg. Is it worth the 4 extra years??? I don't think so.

That is not true actually - how are you going to harvest the graft if you have no training in that procedure? We practice in a very litigious medical system so even if you have the DO degree, without any formal training in harvesting iliac grafts then you have no business attempting that procedure - which is far from "benign" for the record. The DPM-DO degree discussion has been opened up before and most of us agree that it really serves no purpose to your podiatric practice, but more so a direction to pursue primary care medicine (or other specialties) with a podiatric background - no more and no less.

Originally Posted by PMSIII

That is not true actually - how are you going to harvest the graft if you have no training in that procedure? We practice in a very litigious medical system so even if you have the DO degree, without any formal training in harvesting iliac grafts then you have no business attempting that procedure - which is far from "benign" for the record.

I'm curious, how does it work in the real world if DPMs can't harvest from these places? Does the General Surgeon do it then leaves as the DPM applies the graft? Would it be possible for a DPM-DO to assist the General Surgeon and train in this procedure? Would a hospital still not allow a DPM-DO to get these privileges?

Originally Posted by janV88

I'm curious, how does it work in the real world if DPMs can't harvest from these places? Does the General Surgeon do it then leaves as the DPM applies the graft? Would it be possible for a DPM-DO to assist the General Surgeon and train in this procedure? Would a hospital still not allow a DPM-DO to get these privileges?

Typically, you can ask an Orthopedic Surgeon colleague to harvest the graft for you if you insist on using Iliac crest autograft for your procedure - Foot and Ankle Surgeons can also use fresh-frozen femoral head allograft as an alternative - since you avoid donor site morbidity and decrease the Anesthesia time for the patient but this all depends on the indications and the procedure of course - as supported by literature - but this is getting beyond the scope of this question. Nonetheless, A DPM-DO is a DO with a DPM - Usually these guys are different specialists outside of podiatry. If a General Surgeon trains a DPM-DO to do the procedure like you hypothetically presented, then would that hold up as formal training? Absolutely not. If complications present from this procedure - which as I mentioned earlier, is far from benign - would your crash course with the General Surgeon hold up? Absolutely not. Don't get me wrong it is a fun procedure to do as a resident (harvesting iliac graft) under the supervision of the Orthopedic Surgeon attending but unless I have formal training to do this procedure consistently, then neither myself (a DPM) nor our DPM-DO colleagues have any business performing that procedure

Originally Posted by PMSIII

If a General Surgeon trains a DPM-DO to do the procedure like you hypothetically presented, then would that hold up as formal training? Absolutely not. If complications present from this procedure - which as I mentioned earlier, is far from benign - would your crash course with the General Surgeon hold up? Absolutely not.

So you are basically saying that it probably won't hold up in court...if it came to that. That makes a lot of sense.

Thanks for the detailed response.

The DPM to DO program at NOVA will not allow you to become any specialty. It is a set program with a med school to 1 year internship program. To then change specialties and match an ortho, derm etc... residency you would have to take the USMLE for an allopathic residency or the COMLEX for an osteopathic residency. The last I heard the 1st 3 years of the DO program included a 2 year podiatry residency. It is clearly meant for 1st, the university to make money, 2nd, the practitioner created to then practice primary med/primary podiatry. It is not meant to expand your scope of practice for harvesting grafts... Hospitals do not just give out surgical priviledges. You have to have proof of formal training. Just because you have an unlimited scope due to the DO degree with out formal residency training in general surgery, plastic surgery, orthopedic surgery you will not be given priviledges to do procedures outside the podiatry scope.

As for the orthopedist harvesting iliac crest graft and treating complications - last I checked, the majority of orthopedists in the country do not treat pelvic fractures, lacerated organs, venous plexus injuries, pelvic abscesses... they will most likely refer almost all complications to a general surgeon anyway so that is not really a good excuse for why pods should not harvest their own crest. We put screws and half pins and wires up to the tibial tuberosity in some places even when scope of practice precludes treatment of tibial shaft fractures which can clearly be a complication. The tibial shaft fracture gets refered to ortho for treatment.

When ortho ORIF's a tibial shaft fracture that cannot be fixated with an IM nail and the wound won't close due to intra-operative swelling even though it has been 7-14 days post injury, does ortho do the muscle flap/free flap, skin graft to close the wound? No, they refer to plastics.

Complications happen with all procedures and just because it may still be in the foot does not mean that you learned how to handle it in your 3 short years of residency. If it is out of scope obvioulsy refer. If it is in your scope but you don't know what to do, go put your ego back in the closet and start calling for help either from other podiatrists or specialists in your area that may know how to help. This is not about you being able to do it all, it is about you helping the patient even if that means sending the patient somewhere else.

Originally Posted by Paulywog

An alumnus from our school and who teaches pathology and dermatology did a DPM degree then a DO degree. He has a company that is doing quite well and who has helped further the research of pathology and dermatology in podiatry. You will have to research where he did his residencies and fellowship. He donates back generously and is a great leader in our profession. Dr. Bakotic has been successful doing the DPM/DO route. I don't know anyone else who has done that route, but 100% of the people I know have benefited greatly.

Bradley Bakotic completed the expidited BS/DPM program at Barry. Developed an interest in dermatology, then went to DO school at University of New England. After completing a composite residency in anatomic and clinical pathology at Tufts Medical School and Miami Mount Sinai, he traveled to Manhattan where he gained fellowship training in oncologic surgical pathology and dermatopathology at Memorial Sloan-Kettering Cancer Center and the Ackerman Academy of Dermatopathology/Columbia University, respectively. He is currently board-certified in anatomic pathology and clinical pathology, and is the only podiatrist in the nation to hold specialty board certification in dermatopathology. (mostly copied from his company website)

His younger brother Wayne Bakotic followed a very similar path but did not complete the DPM before transfering to U of New England for DO school. After completing his Doctor of Osteopathy, he studied anatomic and clinical pathology at Emory University, where he remained for fellowship training in cytopathology and dermatopathology. (mostly copied from company website)

Notice that Bradley Bakotic is not board certified in podiatry. Most dual degree holders choose one or the other to become board certified with. It typically does not make financial sense for both.

if one were to do the DPM to DO at Nova. that would be 3 years to get the DO degree. then a 1 year internship.

After that would they be about to enter a residency say in psychiatry

Does anyone know someone who has done this program?

Originally Posted by captaindargo

Does anyone know someone who has done this program?

EDIT: I thought Dr. Brad Bakotic had done the Barry/NOVA DPM-DO program but in fact he received his DPM from Barry but then did his DO overseas. Which is interesting because a DO outside the US has a very different scope then in the states if I recall correctly.

Originally Posted by Ankle Breaker

EDIT: I thought Dr. Brad Bakotic had done the Barry/NOVA DPM-DO program but in fact he received his DPM from Barry but then did his DO overseas. Which is interesting because a DO outside the US has a very different scope then in the states if I recall correctly.

I think he completed his D.O. at UNECOM in Maine

http://www.bakopathology.com/about-us/our-pathologists

Originally Posted by shenanigans327

I think he completed his D.O. at UNECOM in Maine

http://www.bakopathology.com/about-us/our-pathologists

His facebook profile says University of New England in Armidale, New South Wales

http://www.facebook.com/people/Bradl...tic/1570716341

It really doesn't matter. He is board certified and having been taught by him for our dermatology class the guy def knows his stuff.

Originally Posted by Ankle Breaker

His facebook profile says University of New England in Armidale, New South Wales

http://www.facebook.com/people/Bradl...tic/1570716341

It really doesn't matter. He is board certified and having been taught by him for our dermatology class the guy def knows his stuff.

FB is wrong... Anyway, I was just wondering if the DPMs who did the Nova program actually stayed in podiatry after getting their DOs.