DPM and residencies?

[NRAI2001]

Do DPM's have to do a residency to practice general pod medicine? What types of pod residencies exist? Are residencies primarily for those seeking to do surgeries or can all pods do surgery after completing of school?

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[efs]

The residency situation in podiatry can be confusing. I'll try to clear some of it up.


Years ago residencies were not required. Many people just learned on the job. Some lucky folks managed to get in with someone already in practice and learn from them. Sort of ad hoc residency. Gradually all of the states began to require a minimum of one year residency training. Each state practice board could make those decisions. Each state also has its own scope of practice laws. That can certainly add some confusion.

A short couple of years ago there were 5 basic residencies offered. POR (Podiatric Orthopedic Residency) primarily biomechanical, RPR (Rotating Podiatric Residency), PPMR (Podiatric Primary Medicine Residency), PSR-12 and PSR 24 (Surgical in months). Many residencies were 2 or 3 years long by either combining programs (i.e. a PPMR year followed by a PRS-12 year), or by allowing 2 years to complete a 1 year program (some of that was to allow enough time to accumulate the required numbers of cases). Some were pyramid programs, where for example there might be 5 PPMR slots for the first year and only 2 PSR slots for the second year. That could get competetive and I don't think would make for a good climate.

You can see how that might get confusing. Hard to tell what kind of experience someone might have even if you knew what kind of residency they did.

About 2 years ago the wheels were set in motion to change the residencies. There are now 2 residencies offered. PM&S-24 and PM&S-36. (Podiatric Medicine and Surgery - number of months) Most residencies have converted (or ar in the process) to the new model. Both offer surgical training, as well as general podiatric medicine. They are essentially 1 year of any of the previous non-surgical combined with 1-2 years of surgical training. There are required numbers of cases that need to be met within a variety of categories. The primary difference is that the PM&S-36 requires rearfoot and ankle surgery training. This difference also rolls over into Board certification. Those with PM&S-24 training may only sit for the ABPS (American Board of Podiatric Surgery) Forefoot board certification. Those with PM&S-36 training may sit for both the Forefoot and Rearfoot/Reconstructive Ankle surgery boards. Those graduating in 2003 may still sit for the Rearfoot boards provided they completed a PSR-24 program.

Many of the programs are still in transition, and may be listed under the old terms. Expect this to continue changing. By the time the current incoming class is interviewing for residencies I would expect practically all to be converted to the new model.

Hope this helps.

 

[jonwill]

Wow efs, quite an explanation! It looks like you graduated from DMU the year I started (2003). The residency conversion in supposed to be complete by the end of 2006. I was looking at the residency guide at aacpm.org and a lot of programs have already made the transition.

 

[NRAI2001]

The residency situation in podiatry can be confusing. I'll try to clear some of it up.


Years ago residencies were not required. Many people just learned on the job. Some lucky folks managed to get in with someone already in practice and learn from them. Sort of ad hoc residency. Gradually all of the states began to require a minimum of one year residency training. Each state practice board could make those decisions. Each state also has its own scope of practice laws. That can certainly add some confusion.

A short couple of years ago there were 5 basic residencies offered. POR (Podiatric Orthopedic Residency) primarily biomechanical, RPR (Rotating Podiatric Residency), PPMR (Podiatric Primary Medicine Residency), PSR-12 and PSR 24 (Surgical in months). Many residencies were 2 or 3 years long by either combining programs (i.e. a PPMR year followed by a PRS-12 year), or by allowing 2 years to complete a 1 year program (some of that was to allow enough time to accumulate the required numbers of cases). Some were pyramid programs, where for example there might be 5 PPMR slots for the first year and only 2 PSR slots for the second year. That could get competetive and I don't think would make for a good climate.

You can see how that might get confusing. Hard to tell what kind of experience someone might have even if you knew what kind of residency they did.

About 2 years ago the wheels were set in motion to change the residencies. There are now 2 residencies offered. PM&S-24 and PM&S-36. (Podiatric Medicine and Surgery - number of months) Most residencies have converted (or ar in the process) to the new model. Both offer surgical training, as well as general podiatric medicine. They are essentially 1 year of any of the previous non-surgical combined with 1-2 years of surgical training. There are required numbers of cases that need to be met within a variety of categories. The primary difference is that the PM&S-36 requires rearfoot and ankle surgery training. This difference also rolls over into Board certification. Those with PM&S-24 training may only sit for the ABPS (American Board of Podiatric Surgery) Forefoot board certification. Those with PM&S-36 training may sit for both the Forefoot and Rearfoot/Reconstructive Ankle surgery boards. Those graduating in 2003 may still sit for the Rearfoot boards provided they completed a PSR-24 program.

Many of the programs are still in transition, and may be listed under the old terms. Expect this to continue changing. By the time the current incoming class is interviewing for residencies I would expect practically all to be converted to the new model.

Hope this helps.

 

[MurrayButler]

I am a PM1 at Scholl and there are so many rumors floating around concerning residencies. I was hoping someone who is currently going through the process (or has completed a residency recently) could help clear things up for me. The questions I am concerned with are things such as follows:

What are the hours like? - Do we work the same crazy hours as medical residents?
Is most of our work on podiatric patients? or do we have to deal with general medicine patients (In the ER or wherever that may be)
What is the salary like? I have heard everything from $20 or greater. Does anyone have some real numbers for me?
And how do people feel about their residences overall?

Thanks, Murray

 

[jonwill]

That's a big question. Go to

http://www.aacpm.org/residencies/casprcrip.asp

Download the residency handbook. It has lots of info and contacts. That should answer a lot of your questions (salaries, rotations, etc). Hours honestly depend on the program. As you get closer to the clerkship/residency part of your education, you can contact programs that you're interested in and they'll talk about hours and stuff. Most seem to be in the 10-12 hour range a day but some are more and some are less.

 

[RaiderNation]

That's a big question. Go to

http://www.aacpm.org/residencies/casprcrip.asp

Download the residency handbook. It has lots of info and contacts. That should answer a lot of your questions (salaries, rotations, etc). Hours honestly depend on the program. As you get closer to the clerkship/residency part of your education, you can contact programs that you're interested in and they'll talk about hours and stuff. Most seem to be in the 10-12 hour range a day but some are more and some are less.

That's 10-12 hours a day 7 days a week right?

 

[krabmas]

The DPM residencies follow the same laws as the MD residencies so it will be no more than 80 hours a week.

Depending on the number of residents in the program you chose you will have to work more or less "on-call". The more pods the less on call... I'm sure you get the point.

 

[NRAI2001]

Do you learn general medicine as a podiatrist? Could you potentially (maybe not legally) treat someone for a flu or some other minor medical issue?

 

[krabmas]

In pod school we learn internal medicine and all the other classes that MDs take except OBGYN.

Theoretically you would know what to Prescribe but corrct it would not be legal under most liscenses (sp) if not all to Rx flu meds for the treatment of the flu.

Pods can Rx systemic meds like Lamisil and antibiotics ... for the treatment of feet.

Also, if the reason for treatment is pre-surgical to get patient healthy for surgery pod can Rx meds especially if it is limb salvage (necessary).

As for what you learn about gen med in residency it depends on the residency. Some programs have the pods doing 2 weeks in general medcine and other rotations (anesthesiology, vascular, plastics...) and others spend 1 or 2 months in each rotation.

some programs have the 1st year pod residents and 1st year MD residents doing the same thing for that 1st year.

 

[governator]

my hospital St. Barnabas in bronx has the pod residents running almost the whole entire ortho service.... good thing? waste of time?

 

[NRAI2001]

my hospital St. Barnabas in bronx has the pod residents running almost the whole entire ortho service.... good thing? waste of time?

The entire ortho dept? So they do many of the surgeries that the ortho surgeons do?

 

[jonwill]

my hospital St. Barnabas in bronx has the pod residents running almost the whole entire ortho service.... good thing? waste of time?

My opinion is waste of time. It's one thing to receive training from an ortho in ankle surgery. Infact, a lot of good pod residencies are well integrated with ortho (U of F for example). However, as neat as it may be to do hip, shoulder, or knee surgery, I'd rather be spending time on my specialty. Keep in mind that many pod residents do ortho rotations in residency. I'm fine with that. I think the exposure is good. I'm just saying that when I'm in residency, I want to be focusing mostly on things that I'll be doing when I get out.

 

[dpmgrad]

The DPM residencies follow the same laws as the MD residencies so it will be no more than 80 hours a week.

Depending on the number of residents in the program you chose you will have to work more or less "on-call". The more pods the less on call... I'm sure you get the point.

I just wanted to clarify this issue since I am currently a resident. The 80 hour work rule ONLY applies hours spent working at the hospital. Hence, if the Podiatric residency program requires you to take call physically in the hospital, the 80 hour work rule would apply to the resident. If you take call from home, the 80 hour work rule would not apply to you. There are many residency programs where residents take call from home.

 

[dpmgrad]

My opinion is waste of time. It's one thing to receive training from an ortho in ankle surgery. Infact, a lot of good pod residencies are well integrated with ortho (U of F for example). However, as neat as it may be to do hip, shoulder, or knee surgery, I'd rather be spending time on my specialty. Keep in mind that many pod residents do ortho rotations in residency. I'm fine with that. I think the exposure is good. I'm just saying that when I'm in residency, I want to be focusing mostly on things that I'll be doing when I get out.

As you said, there are several Podiatry resdiency program that are integrated with Orthopedic Surgery. I am fortunate in that I am in one of the few such programs in Philadelphia area. I think that the skills that is gained from doing hip, shoulder, knee surgery can be applied to Podiatry surgery. Whether you are putting a screw in a hip or in the foot, it is the same principle. As I got to do knee arthroscopy with the orthopedic surgeon, the orthopod help me acquired some of the basics of arthroscopy (pistoning, triangulation, shaving, etc...) on a larger joint. When I got to ankle arthroscopy, I got a chance to fine tune my skills. I agree with you that we should focus more time on the podiatric relevant surgical procedures. In fact, I have learn to do various podiatric surgical procedural techniques via orthopedic surgeon point of view, which is sometimes different from podiatry point of view. It only adds on to our training.

Lastly, there are many podiatric surgical residency programs in certain states that are tied in with orthopedic depts because in those states, Podiatrists are not allowed to operate on the ankle joint above the talus. Hence, the three year Podiatric Surgical residency programs (rearfoot training programs) would rely on the orthopedic surgeons for ankle surgical training. Example of states where Podiatrist are not allowed to operate on the ankle joint (above the talus) include New York, Connecticut, etc...