Advice Needed Please

[Creflo]

I am a 2nd year resident. When I visited the program prior to match, I asked the director if the program could provide a rearfoot certificate to me. I knew at the time that you have to have the actual certificate to sit for ABPS rearfoot certification. I was told that yes, it could be provided. Thus I ranked the program high, and matched. A little over a year into the program, I was told that I would not be able to obtain the certificate. Now the program is saying that they only agreed to let me get rearfoot cases, denying that I was told I could obtain the certificate. Apparently the program doesn't want to pay a $2700 fee and do the paperwork for CPME to provide the certificate. I called CPME and was told that I could get the certificate, but the fee would have to be paid. I offered to pay the fee myself, but the program is still refusing. Now they are asking me to sign a document saying I will only get the forefoot training (PMSR without rearfoot). I had already signed the same document indicating rearfoot certification several months ago. Apparently the program didn't realize that getting the rearfoot certificate is not the same as getting rearfoot cases, and now that they realize more paperwork and a fee is involved, they are going back on their word.

Should I sign the form that says I will get forefoot training only, or hold my ground and refuse to sign?

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[Feli]

It depends if you want to do RRA work or not. Personally I'd recommend you refuse to sign it, but you will probably have to cave in and sign in a couple months (I'm guessing annual July-June contracts and this one is a contract addendum for your 3rd year or something?). Man up and tell the director you don't appreciate being misled about the program leading to the ABPS RRA qualification exam (he didn't technically lie... told you the RRA cred could be provided, not that it necessarily would be), and you could contact CPME further.

Assuming that doesn't work, I'm no attorney, but I don't really see you having much ground to stand on. The director and the program didn't technically lie, and even if they did, nothing was in writing when you signed the residency program contract. It might be worth your time to pay a retainer and contact a health care attorney, though... that's MUCH cheaper than doing a fellowship year (although you would also get some other benefits from fellowship if your RRA numbers and exp in residency are borderline). As it stands now, plan to do a fellowship (or possibly transfer into a RRA cred program for your 3rd year?) if you want to sit for RRA boards.

This is a good example for students entering match in the future, though: NEVER, take a program based on future potential or promises. Read your residency contract and contact CPME and CASPR/CRIP website before match to verify program RRA/probation/etc status. Same goes for residents taking a job contract with the verbal carrot dangling of partnership, future shares in the hospital, future raises, etc. You have to get things in writing before the fact, and don't count on it later. The stakes are too high, JMO.

 

[that1guyfromFL]

As it stands now, plan to do a fellowship (or possibly transfer into a RRA cred program for your 3rd year?) if you want to sit for RRA boards.

It's my understanding that fellowship RRA numbers are not counted towards obtaining the RRA certification needed to sit for RRA boards.

Basically, if you don't obtain the RRA during your 3 year residency, doing a fellowship won't get you the certification or allow you to sit for the RRA exam.

 

[dtrack22]

the CPME

 

[Creflo]

My understanding is that you cannot sit for rearfoot boards without a rearfoot certification from a 3 year residency, so doing a fellowship won't cut it.

My program indicated before the match that they had a relatively new foot and ankle orthopedic surgeon that would be able to provide enough cases for "one resident" out of two per year to obtain the certification. Then 6 months after my residency began, the ortho doctor left. I will be going into the military after residency, and they (military) want me to get the training, so I have arranged to scrub cases at the local military base to get the rearfoot cases. Getting the numbers isn't a problem. Yet the residency program is unwilling to pay the fee and complete the paperwork for the rearfoot certificate...

Hindsight is 20/20 but when you are a student you aren't really in a position to negotiate and make demands when applying to programs, I was nervous enough about matching in the first place. That said, I did have encouragement from other programs that already offered the certificate and I could have probably matched at one of them, but I ranked this one higher, counting on that they would provide the certificate, and due to other positive attributes of the program.