ACFAS and AOFAS announce joint partnership

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A month or so ago I was at an orthopedic hospital.

Tech in the room: So you are a podiatrist.
Me: Yes
Tech: We don't do a lot of podiatry cases. The only podiatry cases I know of are with Dr. X.
Me: Dr. X is an foot and ankle orthopedist. If he hears you refer to him as a podiatrist he's going to kill me and you.

Laughter from the top of the bed.
Anesthesia: This is going to be so much fun.
 
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heybrother said:
In 360-ish days when you sign on to SDN to find out that AOFAS is pushing for a generous national scope of practice for podiatry - just think how excited you'll be 😁
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the saddest thing in the world is that you think we should care what the AOFAS has to say
 
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We are orthopods worst enemies. They hate us as much as we hate them.
 
Pronation said:
This wont end well...
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I don't think people need to worry about this. The podiatry schools and the CPME will come up with some excuse stating why their educational standards are fine and the APMLE is a legitimate test of the podiatry student's medical knowledge. A lot of people will LOSE a lot of money if podiatry students had to take the USMLE.

The problem with podiatry students taking the USMLE is that there are courses some podiatry schools don't offer to their students that would be tested on the USMLE. The only schools offering comparable medical level education are Western and AZPOD. DMU is not 100% with the medical students. The remaining podiatry schools offer watered down courses being taught by professors who have no business teaching.

I think the AOFAS and AAOS have made a good compromise. Pass our USMLE test and you have our respect. Now it is podiatry's turn to decide. If they balk at this then I think we open the door for severe scrutiny of our profession from the MD/DO world. Podiatry education would have to CHANGE an awful lot to prepare their students for the USMLE. Also, a lot of schools would come under further scrutiny if a lot of their students could not pass the USMLE.

The AOFAS/AAOS agenda is real. They just threw down the gauntlet

And the fact that we ALL KNOW THIS really shows the internal issues this profession has. It can't be swept under the rug anymore.
 
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Sink or swim. If we take it, we will fail tremendously.

Expect severe push back from people making money from the new schools and podiatry specific exams.
 
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CutsWithFury said:
I don't think people need to worry about this. The podiatry schools and the CPME will come up with some excuse stating why their educational standards are fine and the APMLE is a legitimate test of the podiatry student's medical knowledge. A lot of people will LOSE a lot of money if podiatry students had to take the USMLE.

The problem with podiatry students taking the USMLE is that there are courses some podiatry schools don't offer to their students that would be tested on the USMLE. The only schools offering comparable medical level education are Western and AZPOD. DMU is not 100% with the medical students. The remaining podiatry schools offer watered down courses being taught by professors who have no business teaching.

I think the AOFAS and AAOS have made a good compromise. Pass our USMLE test and you have our respect. Now it is podiatry's turn to decide. If they balk at this then I think we open the door for severe scrutiny of our profession from the MD/DO world. Podiatry education would have to CHANGE an awful lot to prepare their students for the USMLE. Also, a lot of schools would come under further scrutiny if a lot of their students could not pass the USMLE.

The AOFAS/AAOS agenda is real. They just threw down the gauntlet

And the fact that we ALL KNOW THIS really shows the internal issues this profession has. It can't be swept under the rug anymore.
Click to expand...
Argument/excuse will be along the lines of USMLE vs COMLEX.

What would happen to students that can't pass a USMLE/COMLEX exam? Can they pass the APMLE and receive the title of chiropodist?
 
I don't think coursework really means a lot in terms of passing or doing well on USMLE. On MD/DO forums we often hear them saying that best way to study is not going to lectures and using school ppts but using other materials for USMLE. What is needed for USMLE studying is proper materials, time, self-discipline and motivation. Thousands of FMGs with basic English come to US and are able to do well on USMLE with proper studying. I don't think coursework will determine pod students' success on USMLE.

We might let pod students take USMLE to see how they do and then assess what needs to be done to help students pass USMLE. It doesn't have to be decided on first USMLE try. It might take several years. But I think pod students need to have general medical knowledge and pass USMLE. Current APMLE doesn't test much.
 
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Compromise.

We'll take the USMLEs if orthopods are forced to go through the ACFAS board qualification/certification process.
 
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This is a no-win situation that makes no sense at face value. For that reason, it is really not worth looking into any further.

It reminds me of the YouTuber who convinced a retired MMA grappling guy with back surgery to try boxing... or the retired boxer champ who fought an elite MMA guy (at boxing). It takes someone completely out of their lane, puts them in different "similar" place with vastly different rules, and makes a joke of it. It would be like saying a dirt bike pro isn't good at snowmobile racing and can't do well... no, probably not.

Very few MDs can do what good DPMs do, and that's the same for any specialty in today's medicine. Orthos don't generally know the new diabetes meds, cardiology can't do a nose job, etc. We sure don't have PAs trying to pass chiropractor boards or MDs trying to pass the dental boards, though. MDs have tons more threat from the rise of undertrained midlevels (esp "advanced practitioner" DNPs) than they ever will from DPMs. At the end of the day, the public and the insurances will get what they are willing to settle for... if they want a RN doing their bunionectomy, cool. If they want the best (DPMs) they will find that and pay for that :)

CutsWithFury said:
...The problem with podiatry students taking the USMLE is that there are courses some podiatry schools don't offer to their students that would be tested on the USMLE. The only schools offering comparable medical level education are Western and AZPOD. DMU is not 100% with the medical students....
Pass our USMLE test and you have our respect. Now it is podiatry's turn to decide....
...Podiatry education would have to CHANGE an awful lot to prepare their students for the USMLE. Also, a lot of schools would come under further scrutiny if a lot of their students could not pass the USMLE...
Click to expand...
A lot of the osteopath students don't attempt USMLE or don't pass the USMLE either.

For any podiatry students to try USMLE is a no-win situation. This talk and conjecture is nothing new, though. I was one of the best podiatry students in my class, but I would have had to study significantly different for USMLE pt1 than I was for podiatry national boards and my clerkships... and doubt I would have passed the USMLE (well, it was scored back then). Again, it's not even worth giving the idea credibility.

If podiatry was an MD specialty, it would probably be a 5yr residency like ENT or optho is... and podiatry would be at least average among MDs for competitive level in match. No joke. The very fact that podiatry school is adequate but comparatively weak in terms of general sciences/medicine is what makes the schooling able to be much better for foot and ankle anatomy/pathology/clinic - and that makes the DPM residency a couple years shorter than it would be in the MD route. Podiatry students will never take USMLE, though. It makes no sense.
 
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#1 - Like cuts said, podiatry rent seekers are gonna run from this hard core or they'll lose their jobs. I can't help but wonder is there anyone else in podiatry ie. school leadership etc asking themselves right about now "Who gave the APMA/ACFAS the authority to speak for us"
#2 - The NBME/LCME will not allow a single podiatry student to take Step 123 until all podiatry students have to take it.
#3 - The NBME/LCME will not allow a single podiatry student to take any step until that student has to take all the steps.
#4 - There will be no podiatry student bragging on a profile about how he passed Step 1 but isn't going to take steps 2,3.
#5 - The NBME will not allow a single podiatry school to have its students take the USMLE unless all schools are taking it.
#6 - The vast majority of podiatry schools will never be able to create a curriculum that meets the accreditation guidelines to allow taking Step 2. Many would struggle to create a curriculum for Step 1. Not to bash my alma matter, but I'm pretty confident if you told DMU they needed to find core discipline rotations (med/surg/obyn/psych,etc) for 50 more students - they couldn't do it. Des Moines is saturated as DMU/UofI are both trying to lock down every moment of relevant clinical medical experience for several hundred students already. The only way most of the schools could succeed in trying to duplicate curriculum would be to merge with another school.
#7 - They are not just going to say - what the hell - let's let these pods take the test and see what happens. They are going to force change at the schools first. Were they to simply allow DPM students to take the steps some podiatry students might prepare/use online materials/coordinate with their school and potentially pass. The MD side is not going to suffer an embarassment or "showing up". Everyone will have to show all of their cards.
#8 - At the end of this dark tunnel the simple and unfortunate truth is - there's already a foot and ankle specialty in medicine. In their world its called orthopedics. There is no world where they say - damn it, you win, ok you're real docs now.
#9 - Apart from the fact that most pod students probably can't pass the USMLE - if you do 3 years of LCME identical curriculum and pass steps 123 - do you really want to be a podiatrist? There are literally MD schools that are 3 years and feed to family medicine if I understand right. Its like - you just did 3 years of medical school and then its now time to do a bunch of garbage podiatry clerkships with trash podiatry residencies...

Last of all and most important of all. This whole thing was a concession. Not just that we will "walk" their path. We just agreed not to achieve our goals through legislation. That was a mistake. We literally just agreed to play by their game and their rules. Do you think that's going to work? Call me crazy, but while we've had delays and problems and issues - in general scope related state issues have been going well in the majority of situations that I'm aware of lately. I can't think of a state scope battle where progress wasn't made recently. Its terrible but the nursification of medicine shows there's a lot of power in just seeking legislation. I'm not saying its good for society but nurses have basically in certain states basically said "I'm a doctor and here's the legislation that shows it". The nurses don't know anything and are terrible, but they are winning. Ask the MDs in their forums. We just said we won't play that card - a card that, even though its awful, works. They aren't asking for permission. They aren't asking how can we be better. They're just taking what they want. If we try to change our path in the future they will punch us in the face with that white paper. There's a ton I hate about how this profession trains, educates, etc, but this profession does generate some smart surgeons/physicians/people who can help. We needed to continue to increase making capable people, hospital based surgeons, people who take on real problems and cases and at some point people looking in from the outside won't know the difference. All this talk of who is a real physician will seem irrelevant and stupid. Don't ask for permission. Take.

Do I believe everything I said above. I believe some of it. I want leadership that actually fights for us, but to fight for us they'd have to understand us. Our leadership is blindly stupid. They don't realize that in general a large part of our programs, schools, training sucks. They have no idea about how badly they are about to be exposed if they move forward with this. They probably won't though. Upton Sinclair has some insights about understanding and salary.
 
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heybrother said:
#1 - Like cuts said, podiatry rent seekers are gonna run from this hard core or they'll lose their jobs. I can't help but wonder is there anyone else in podiatry ie. school leadership etc asking themselves right about now "Who gave the APMA/ACFAS the authority to speak for us"
#2 - The NBME/LCME will not allow a single podiatry student to take Step 123 until all podiatry students have to take it.
#3 - The NBME/LCME will not allow a single podiatry student to take any step until that student has to take all the steps.
#4 - There will be no podiatry student bragging on a profile about how he passed Step 1 but isn't going to take steps 2,3.
#5 - The NBME will not allow a single podiatry school to have its students take the USMLE unless all schools are taking it.
#6 - The vast majority of podiatry schools will never be able to create a curriculum that meets the accreditation guidelines to allow taking Step 2. Many would struggle to create a curriculum for Step 1. Not to bash my alma matter, but I'm pretty confident if you told DMU they needed to find core discipline rotations (med/surg/obyn/psych,etc) for 50 more students - they couldn't do it. Des Moines is saturated as DMU/UofI are both trying to lock down every moment of relevant clinical medical experience for several hundred students already. The only way most of the schools could succeed in trying to duplicate curriculum would be to merge with another school.
#7 - They are not just going to say - what the hell - let's let these pods take the test and see what happens. They are going to force change at the schools first. Were they to simply allow DPM students to take the steps some podiatry students might prepare/use online materials/coordinate with their school and potentially pass. The MD side is not going to suffer an embarassment or "showing up". Everyone will have to show all of their cards.
#8 - At the end of this dark tunnel the simple and unfortunate truth is - there's already a foot and ankle specialty in medicine. In their world its called orthopedics. There is no world where they say - damn it, you win, ok you're real docs now.
#9 - Apart from the fact that most pod students probably can't pass the USMLE - if you do 3 years of LCME identical curriculum and pass steps 123 - do you really want to be a podiatrist? There are literally MD schools that are 3 years and feed to family medicine if I understand right. Its like - you just did 3 years of medical school and then its now time to do a bunch of garbage podiatry clerkships with trash podiatry residencies...

Last of all and most important of all. This whole thing was a concession. Not just that we will "walk" their path. We just agreed not to achieve our goals through legislation. That was a mistake. We literally just agreed to play by their game and their rules. Do you think that's going to work? Call me crazy, but while we've had delays and problems and issues - in general scope related state issues have been going well in the majority of situations that I'm aware of lately. I can't think of a state scope battle where progress wasn't made recently. Its terrible but the nursification of medicine shows there's a lot of power in just seeking legislation. I'm not saying its good for society but nurses have basically in certain states basically said "I'm a doctor and here's the legislation that shows it". The nurses don't know anything and are terrible, but they are winning. Ask the MDs in their forums. We just said we won't play that card - a card that, even though its awful, works. They aren't asking for permission. They aren't asking how can we be better. They're just taking what they want. If we try to change our path in the future they will punch us in the face with that white paper. There's a ton I hate about how this profession trains, educates, etc, but this profession does generate some smart surgeons/physicians/people who can help. We needed to continue to increase making capable people, hospital based surgeons, people who take on real problems and cases and at some point people looking in from the outside won't know the difference. All this talk of who is a real physician will seem irrelevant and stupid. Don't ask for permission. Take.

Do I believe everything I said above. I believe some of it. I want leadership that actually fights for us, but to fight for us they'd have to understand us. Our leadership is blindly stupid. They don't realize that in general a large part of our programs, schools, training sucks. They have no idea about how badly they are about to be exposed if they move forward with this. They probably won't though. Upton Sinclair has some insights about understanding and salary.
Click to expand...
Sounds like something not a real doctor would say.
 
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air bud said:
Sounds like something not a real doctor would say.
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I can't say this enough - it is amazing to me you started this thread but a short time ago and in a manner of days a formal document came out in which ortho said we're not real doctors. Gaze into your crystal ball and tell us more of the future.

A 50ish year old podiatrist in my town wants to spend 1.1 million dollars on property and a new office building. Everytime he tells me about it my eyes pop out of my head and I start coughing and shaking my head. Can you see his future?
 
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heybrother said:
I can't say this enough - it is amazing to me you started this thread but a short time ago and in a manner of days a formal document came out in which ortho said we're not real doctors. Gaze into your crystal ball and tell us more of the future.

A 50ish year old podiatrist in my town wants to spend 1.1 million dollars on property and a new office building. Everytime he tells me about it my eyes pop out of my head and I start coughing and shaking my head. Can you see his future?
Click to expand...
It is the year 2024. His cybertruck is parked directly outside of his office. He only comes in to the office to do pre op appointments for his nerve stimulator implant patients. There is a hum in the background, the ever present sound of a nail grinders drowning out the what ifs and sniffles of the newest associate. Nearby his wife is yelling at one of the front office staff. A patient is complaining that the ozone injection didn't fix her plantar fasciitis. There is a heavily worn copy of podiatry management on his desk. Life is good.
 
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Lol this IS funny. The thread started as a April fool's joke. Turns out the joke is life choices we made along the way to become pods. "But I CHOSE to go to podiatry school....."


But hey it's about the friends we made along the way.
 
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CutsWithFury said:
I don't think people need to worry about this. The podiatry schools and the CPME will come up with some excuse stating why their educational standards are fine and the APMLE is a legitimate test of the podiatry student's medical knowledge. A lot of people will LOSE a lot of money if podiatry students had to take the USMLE.

The problem with podiatry students taking the USMLE is that there are courses some podiatry schools don't offer to their students that would be tested on the USMLE. The only schools offering comparable medical level education are Western and AZPOD. DMU is not 100% with the medical students. The remaining podiatry schools offer watered down courses being taught by professors who have no business teaching.

I think the AOFAS and AAOS have made a good compromise. Pass our USMLE test and you have our respect. Now it is podiatry's turn to decide. If they balk at this then I think we open the door for severe scrutiny of our profession from the MD/DO world. Podiatry education would have to CHANGE an awful lot to prepare their students for the USMLE. Also, a lot of schools would come under further scrutiny if a lot of their students could not pass the USMLE.

The AOFAS/AAOS agenda is real. They just threw down the gauntlet

And the fact that we ALL KNOW THIS really shows the internal issues this profession has. It can't be swept under the rug anymore.
Click to expand...
This link pretty much summed up what you would expect from podiatry in response to this. But but but but....what about the CPME, people who write the APMLE, people who write the ABFAS??? Please noooooooo

Podiatry Management Online

Podiatry Management is the national practice management and business magazine, reaching over 22,024 subscribers.
podiatrym.com
 
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CutsWithFury said:
This link pretty much summed up what you would expect from podiatry in response to this. But but but but....what about the CPME, people who write the APMLE, people who write the ABFAS??? Please noooooooo

Podiatry Management Online

Podiatry Management is the national practice management and business magazine, reaching over 22,024 subscribers.
podiatrym.com
Click to expand...
I will give him one point of credit - he at least recognizes what APMA/ACFAS agreed to. Consider that PM News is also running a poll essentially suggesting that the agreement is just a way for pods to take the USMLE. Its not. Its a fundamental restructuring of the education/training of the profession and it does give LCME/NBME etc the lead. It won't happen and you've already pointed that out correctly.

His conclusions/concerns are establishment in nature. I despise the establishment of our profession, but we do need people to stand up for us as practitioners. I wish there was a way that could be separated out. That's a pretty common complaint of all physicians across all specialties of how they feel about their organizations. The leadership, board writers, etc are rent seekers or already profiting from the people destroying the profession.
 
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CutsWithFury said:
This link pretty much summed up what you would expect from podiatry in response to this. But but but but....what about the CPME, people who write the APMLE, people who write the ABFAS??? Please noooooooo

Podiatry Management Online

Podiatry Management is the national practice management and business magazine, reaching over 22,024 subscribers.
podiatrym.com
Click to expand...

There is no need for the CPME/APMLE if the LCME becomes the new accrediting body.
 
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DexterMorganSK said:
There is no need for the CPME/APMLE if the LCME becomes the new accrediting body.
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No kidding. I said that before.

This whole agreement is dumb. If we want to take the USMLE then the academic governing bodies from podiatry medical education to board certification need give up and walk away and let LCME/NBME take over. Then you can kiss the profession of podiatry goodbye and we just become a subspeciality of the MD/DO. Then the majority of the people who aspire to become podiatrists do not have the credentials to do so.

I think ultimately that is what AAOS/AOFAS wants. This is an agenda. If they control it then they can purely make podiatry non surgical like they've always strived for.

Lastly...if this ever got to this point (it won't so don't worry) then the current practicing podiatrists would be in trouble. Or, maybe for once, we get grandfathered into something like some of the older practicing podiatrists did with ABFAS board certification.

I would be interested to hear what @diabeticfootdr has to say about this as he is the closest person to the APMA that navigates this board
 
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CutsWithFury said:
If they control it then they can purely make podiatry non surgical like they've always strived for.
Click to expand...
Spot on.

Either they make podiatry non-surgical like most of Europe and Canada or only a few *cough*cough* great podiatric surgeons will be allowed to only do fore-foot surgery.

Kiss rearfoot and ankle surgery good bye.
 
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de Ribas said:
We might let pod students take USMLE to see how they do and then assess what needs to be done to help students pass USMLE. It doesn't have to be decided on first USMLE try. It might take several years. But I think pod students need to have general medical knowledge and pass USMLE. Current APMLE doesn't test much.
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Didn't California have a pilot program for Pod students to take at least part 1 USMLE? What was the end result of that.
 
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podoloco said:
Didn't California have a pilot program for Pod students to take at least part 1 USMLE? What was the end result of that.
Click to expand...

It was just one year at SMU that took the NBME Basic Science Exam (not USMLE) and the results were sealed.

PRESENT e-Learning Systems

PRESENT e-Learning Systems is a medical education and communications company (MECC) that currently runs 3 public online education community websites for medical professionals and publishes educational programming and other original content to over 100,000 members.
podiatry.com podiatry.com
 
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The more I read the discussion on the subject the more I am thinking of how graduates and residents will likely need to come back and sit for the USMLE 1,2 and 3 before they can be "considered physicians" in their eyes (assuming this is approved). I cannot imagine a podiatrist practicing for 10 years coming back to take all 3 of these exams just to gain that recognition. There must be a grandfathering aspect in this process if this comes to fruition but I am in agreement that this likely is not going to end well for us.
 
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OblivionGD said:
The more I read the discussion on the subject the more I am thinking of how graduates and residents will likely need to come back and sit for the USMLE 1,2 and 3 before they can be "considered physicians" in their eyes (assuming this is approved). I cannot imagine a podiatrist practicing for 10 years coming back to takes all 3 of these exams just to gain that recognition. There must be a grandfathering aspect in this process if this comes to fruition but I am in agreement that this likely is not going to end well for us.
Click to expand...
Young student - you have much to see and learn outside of school. Spend your time crushing your classes, mastering the material, crush clerkships and get solid, ethical training. Don't bother wasting your time trying to guess what these sham boards are going to do - but they sure do love suckering students with endless false hope :)
 
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The chair of social media for AAOS gives a little insight on Twitter for what we are walking into with all of this
5A271E8C-FB7C-4C8B-A27D-F6149775314E.jpeg
B9064DDD-F318-4662-87AD-3CC7975FFFB2.jpeg
02ADE78A-CE7F-4813-956B-5007C7768F15.jpeg
2182069D-5561-43E8-9F29-97F0D3ABEC8E.jpeg
EC810A9E-ECE5-40E6-B12E-54A5C1B77953.jpeg
C1776918-05D3-4236-98FC-DFEB66A1D84D.jpeg
70EE445D-2DE9-466F-9C89-C51C83EF95BF.jpeg
…
 
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ooo, that’s a spicy meatball!
 
Lol his page is so toxic.
 
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If I am not mistaken that article was completely picked apart by Lee Rogers in a rebuttle/letter to the editor. Its 100% biased against DPMs from the start with selective statistics.

He is cherry picking cases to make his point.

I have a F&A ortho in my area that has major complications and patients are in my office for revision.

I have some of MY patients in his office asking for revision due to my complications.

It goes both ways. I always tell patients during preop discussion "if you ever meet a surgeon who he or she says they never had a complication with surgery politely decline the case because they are lying".

I did around 3,000 separate F&A surgeries in Residency training under general surgery, general ortho, F&A ortho, and podiatrists. Operated sun up to sun down and often late into the night. I guess im not qualified though based on his cherry picked situations.

He is obviously threatened by our training.

- -
Edit the article I was remembering was a different campaign bash article against DPMs. https://cdn-links.lww.com/permalink/jbjsel/a/jbjsel_101_2_2019_04_03_chan_1701555-el01_sdc1.pdf

Regardless its well known that podiatrists get the diabetic, neuropathic, and arterial disease ankles. I have a really good relationship with ortho in my area and we send patients back and forth all the time. As far as I know there is no bad blood between any of us.

I do seem to get all the high risk complication ankle fractures referred to me though because "podiatry are diabetic experts". From time to time I also get their dehisced wounds sent to me heal because "They are better at wound care" which is probably true but I dont want their surgical complications.
 
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