Increased Interest in Fellowships

[ldsrmdude]

I've been thinking about this for a while now. I think it's pretty clear that there has been an increased interest in fellowships among graduating residents in podiatry over the past few years. I was curious why you all think that is. Just a natural by-product of the increasing level of specialization in medicine, dissatisfaction with residency training or opportunities provided post-residency? Thoughts?

---

Members don't see this ad.

 

[Ankle Breaker]

I've been thinking about this for a while now. I think it's pretty clear that there has been an increased interest in fellowships among graduating residents in podiatry over the past few years. I was curious why you all think that is. Just a natural by-product of the increasing level of specialization in medicine, dissatisfaction with residency training or opportunities provided post-residency? Thoughts?

I think the increased interest in fellowship training is multifaceted. When fellowships first started coming about they were a mode to increase training in areas where maybe a resident was lacking. For some residents that still maybe the case but over the years it appears residents want fellowship training to further increase their already above average training to reach "elite" status. Yeah I said it, a lot of its ego driven now IMHO. I could give specific examples of individuals who now hold leadership positions in the profession who graduated from excellent residencies but then chose to pursue fellowship training at high volume fellowships on top of that. But, I'm not going to do that because this is not the forum to call out specific people. But its occurring with more frequency then it really should be. I do not fault these individuals for pursuing further training as they are increasing their skills, their "connections" and making themselves more valuable when it comes to seeking professional employment. There is absolutely nothing wrong with that. My problem is with how fellowship training has evolved. Going from the mode of increasing training in deficient areas to another mode of further distinguishing oneself from others.

On top of all this there are fellowship directors who won't give an applicant, with deficient training, even an opportunity at fellowship training. They want applicants who graduated from excellent programs and who are already surgically well trained. Which would have defeated the purpose of fellowship training maybe 10 years ago but is now an accepted practice. You talk to 25 different attendings and you will most likely get 25 different answers on the true purpose of fellowship training. One thing is tried and true in podiatry is that there will always be people who want to distinguish themselves from the pack through any means necessary. A theme that continues to rear its ugly head in podiatry. The "have and have nots". ACFAS vs. APMA. Foot and Ankle surgeon vs. podiatrist. Now the 4 year fellowship-trained DPM vs. 3 year trained DPM.

It is not unrealistic to think that over the course of our professional career until we retire that the standard of training for podiatry might be 4 or even 5 years of residency training. You may balk at such a notion BUT can YOU seriously say to yourself that it absolutely will NOT happen? When has anything in podiatry been CONSISTENT?

 

[Creflo]

Ortho groups are used to getting fellowship trained ortho docs. ortho docs often need to be fellowship trained to be proficient in a certain area such as foot and ankle. so when they interview pods, they look for fellowship trained. doesn't necessarily mean that a well trained pod needs a fellowship, but often we have to play the game to get hired.

 

[JR2011]

They are certainly en vogue. The quality fellowships out there are very good for the profession IMO. However, I think there should certainly be strict guidelines for what qualifies as a legitimate fellowship. I'm not sure what ACFAS looks at for accreditation but they certainly embrace the idea of approved fellowships. Anything that provides further knowledge and competency is good for patients as well as our place in the medical community. I think there are some out there that are probably a total waste of time....places that seek to hire cheap labor to do all the call, rounding, and assisting in surgery while being independent and fully licensed unlike a resident. Emphasis really needs to be put on offering a specific area of expertise. ie- Reconstruction, Research, Trauma, Sports medicine, wound care. Being mad for those with great training wanting to do a fellowship is silly. The top fellowships out there are not given to those that "need" them. They are highly competitive and offer great opportunities to expand skill level and knowledge. I'd argue that it may even be dangerous if those without a strong training background being put into a high volume advanced fellowship that demands a high skill level.

Mary Crawford explained it very well back in 2009. She was spot on IMO and what she said still holds true today. See link below
http://download.journals.elsevierhealth.com/pdfs/journals/1067-2516/PIIS1067251608004523.pdf

 

[ROBPOD]

They are certainly en vogue. The quality fellowships out there are very good for the profession IMO. However, I think there should certainly be strict guidelines for what qualifies as a legitimate fellowship. I'm not sure what ACFAS looks at for accreditation but they certainly embrace the idea of approved fellowships. Anything that provides further knowledge and competency is good for patients as well as our place in the medical community. I think there are some out there that are probably a total waste of time....places that seek to hire cheap labor to do all the call, rounding, and assisting in surgery while being independent and fully licensed unlike a resident. Emphasis really needs to be put on offering a specific area of expertise. ie- Reconstruction, Research, Trauma, Sports medicine, wound care. Being mad for those with great training wanting to do a fellowship is silly. The top fellowships out there are not given to those that "need" them. They are highly competitive and offer great opportunities to expand skill level and knowledge. I'd argue that it may even be dangerous if those without a strong training background being put into a high volume advanced fellowship that demands a high skill level.

Mary Crawford explained it very well back in 2009. She was spot on IMO and what she said still holds true today. See link below
http://download.journals.elsevierhealth.com/pdfs/journals/1067-2516/PIIS1067251608004523.pdf

How do you feel about a fellowship where you are fully licensed but the main focus is reconstruction/research? I'm not sure how rare this situation is out there, but I know it does exist. From what I hear, in situations like this you are able to use some cases for ABPS.

 

[JR2011]

How do you feel about a fellowship where you are fully licensed but the main focus is reconstruction/research? I'm not sure how rare this situation is out there, but I know it does exist. From what I hear, in situations like this you are able to use some cases for ABPS.

Yes. I think depending on what you are trying to get out of it, these are the ones that really make sense to me. Some of the fellowships offer the opportunity for board certification which may otherwise take some time to gather enough cases. I think pretty much all of them require a full active license.

 

[Gigantron]

My problem is with how fellowship training has evolved. Going from the mode of increasing training in deficient areas to another mode of further distinguishing oneself from others.

What exactly is wrong with this, if you don't mind me asking? It seems implied that as fellowship training has evolved, so too have residency programs that used to have deficient areas of training. Aren't residencies without areas of deficiency a good thing? Obtaining fellowship training to distinguish oneself from others is how most fellowships in just about every other medical specialty operate now. I would say fellowships are good if you want to have the surgical numbers and more confidence in your skills and in your overall training, like you also mentioned earlier in your post. It just seems silly to say that the only purpose of fellowship training is to only help those with deficiencies in their training, though.

Being mad for those with great training wanting to do a fellowship is silly. The top fellowships out there are not given to those that "need" them. They are highly competitive and offer great opportunities to expand skill level and knowledge. I'd argue that it may even be dangerous if those without a strong training background being put into a high volume advanced fellowship that demands a high skill level

Agreed with this wholeheartedly.

 

[Ankle Breaker]

What exactly is wrong with this, if you don't mind me asking? It seems implied that as fellowship training has evolved, so too have residency programs that used to have deficient areas of training. Aren't residencies without areas of deficiency a good thing? Obtaining fellowship training to distinguish oneself from others is how most fellowships in just about every other medical specialty operate now. I would say fellowships are good if you want to have the surgical numbers and more confidence in your skills and in your overall training, like you also mentioned earlier in your post. It just seems silly to say that the only purpose of fellowship training is to only help those with deficiencies in their training, though.

For starters, nobody is mad here. Maybe my initial post came off that way but I'm really not.

IMHO fellowships are definitely a good thing for the profession but your assumption that residency training has uniformly increased throughout US is not accurate. Currently, residency training may be equal in the number of years being offered but programs are certainly not equal in the actual training they provide. Chicago, for example, has some really terrible programs and I'm not afraid to say it. There is an extremely large orthopedic presence in the city, between Rush, Northwestern and many others, therefore there are not a lot of DPMs doing TARs or other large RF cases. Only a handful of Chicago programs, out of many, actually provide these experiences. Some programs have residents that don't reach their numbers until late in their third year. There are plenty of programs out there where the resident gets their numbers shortly into their 2nd year at the very latest. In fact I consider that to pretty average and if the program you are clerking at doesn't have their residents reaching their numbers by that time frame I would be pretty wary of the quality of surgical training that program may provide. It should be duly noted that there are a handful of programs that have residents getting their numbers towards the end of their first year. Along with all of this one needs to understand how diluted our surgical logging standards have now become by going from a logging A/B/C cases format to the new logging system. This can allow weaker and newly generated programs to survive but definitely misleads the medical community in the actual amount of cases podiatry residents are actually doing.

Another thing that should be talked about is that fellowship training has now become extremely competitive. Despite that, there are certain programs who are consistently placing their residents in fellowships. Kaiser SF Bay is one that comes to mind. Two out of their three 3rd year residents will be doing fellowships next year. Wheaton Franciscan has placed one of their grads in fellowship. INOVA has placed some grads in fellowship. West Houston usually wants to take one of their own residents to fill their fellowship position. See the trend here? These are all high powered programs with high powered attendings. Everyone knows everyone. On top of that, these programs already offer pretty elite training and high surgical numbers to begin with. If you don't happen to match with a high powered during the match, which statistically is pretty likely, you could be out of luck.

 

[ldsrmdude]

It shouldn't be too surprising that some programs consistently place graduates in fellowships. Residents who are gunning for fellowships are the same ones who were gunning for the high-powered residency programs. I think the type of student a residency attracts is what matters more. There are several residents heading out for fellowship from good programs but not what I would consider traditional "high-powered" programs, just here in the MI area.

Just to add to what AnkleBreaker said about numbers, I am probably in the minority, but I don't really get hung up on the numbers. There is so much variability in programs and things like how they do off-service rotations that I don't think how early you get your numbers (or even how many total cases a resident does) tells the whole story.

 

[Ankle Breaker]

Just to add to what AnkleBreaker said about numbers, I am probably in the minority, but I don't really get hung up on the numbers. There is so much variability in programs and things like how they do off-service rotations that I don't think how early you get your numbers (or even how many total cases a resident does) tells the whole story.

I agree the off service rotations at some programs are pretty hit or miss. For example the off service rotations at West Houston are pretty weak considering the program is not a teaching hospital. You pretty much shadow private docs. Where at Carilion you matriculate in with each off service team and are held to the same standards in a university/teaching hospital setting. Same could be said about the University of Cincinnati program which also has very strong off service rotations.

I propose this question then: Why does Wheaton Franciscan consistently place their graduates into Ortho groups? Their numbers are insane and they get a ton of work with F/A ortho. I'm sure the LOR from the F/A ortho is helpful but their numbers probably allow them to market themselves specifically to ortho practices. Potential employers, either multi-specialty or ortho groups, need something to go off of other than the interview. It's most likely the LOR from the MD and the high volume case load.

 

[g squared 23]

It shouldn't be too surprising that some programs consistently place graduates in fellowships. Residents who are gunning for fellowships are the same ones who were gunning for the high-powered residency programs. I think the type of student a residency attracts is what matters more. There are several residents heading out for fellowship from good programs but not what I would consider traditional "high-powered" programs, just here in the MI area.

Just to add to what AnkleBreaker said about numbers, I am probably in the minority, but I don't really get hung up on the numbers. There is so much variability in programs and things like how they do off-service rotations that I don't think how early you get your numbers (or even how many total cases a resident does) tells the whole story.

I do agree that "numbers" being the sole measure of a program's worth is not the best system for an extern to evaluate a program. While it is the most objective, an overall quality of a program's cases needs to be determined. Scrubbing occassionally with poor attendings with poor surgical skills is actually a good thing: a resident needs to learn how to NOT do surgery just as much as they need to learn HOW to do surgery. There is also the situation where the resident is with the attending who books cases that they are not comfortable with and rely on the resident to perform. These are also a good gauge of how much the resident has learned from quality attendings and allows them to practice their skills without any guidance. But if a program is lacking attendings who are great technical surgeons and are interested in teaching (which doesn't mean the resident has to do every case skin-to-skin), then it doesn't matter how astronomical the numbers are, that resident will come out under trained.

There needs to be a balance between quantity and quality, and this becomes a difficult question to answer, because it's different for every person: how many cases are "enough"? Externs need to judge the residents' skills and confidence as they rotate through. If the residents seem capable and are likely pursuing fellowships because they are gunners and again want to get ahead of the curve, that's great. And some people, whether their training is adequate or not, just need another year with the "training wheels" still on. But a trend of graduates who aren't really confident and have so-so numbers that choose the fellowship route would indicate major holes in their training.

 

[ldsrmdude]

I propose this question then: Why does Wheaton Franciscan consistently place their graduates into Ortho groups? Their numbers are insane and they get a ton of work with F/A ortho. I'm sure the LOR from the F/A ortho is helpful but their numbers probably allow them to market themselves specifically to ortho practices. Potential employers, either multi-specialty or ortho groups, need something to go off of other than the interview. It's most likely the LOR from the MD and the high volume case load.

I think you answered your question. Add that to the fact that most of the students attracted to Wheaton probably are interested in ortho groups and it's a good recipe. Keeping it sort of on topic, how did placing graduates in ortho groups become some sort of surrogate measure of a programs strength? And do you (everybody) think that increased attractiveness to ortho groups is/should be a reason to do a fellowship?

 

[ldsrmdude]

I agree the off service rotations at some programs are pretty hit or miss. For example the off service rotations at West Houston are pretty weak considering the program is not a teaching hospital. You pretty much shadow private docs. Where at Carilion you matriculate in with each off service team and are held to the same standards in a university/teaching hospital setting. Same could be said about the University of Cincinnati program which also has very strong off service rotations.

In addition to the quality of off service rotations, there is a lot of variability in terms of quantity and timing of those rotations. I have a buddy in the Midwest whose program does the bare minimum number of off service rotations. I have another friend whose program doesn't hardly do any podiatry rotations their first year. We do a pretty good mix at my program with about half of the year off service and about half on service.

 

[MaxillofacialMN]

I think you answered your question. Add that to the fact that most of the students attracted to Wheaton probably are interested in ortho groups and it's a good recipe. Keeping it sort of on topic, how did placing graduates in ortho groups become some sort of surrogate measure of a programs strength? And do you (everybody) think that increased attractiveness to ortho groups is/should be a reason to do a fellowship?

Amongst my classmates, the number of students matching into ortho groups is a measure of success/strength of a program simply because that is where every podiatry student wants to go. I honestly haven't heard any of my classmates ever say, "I want to be an associate at an established podiatry office." Everyone wants to be a surgeon and make lots of money - something ortho groups provide. Whenever we have guest speakers, practicing podiatrists (even if they aren't employed in an ortho group!!), residencies, etc. there is always at least one question to the effect of, "What can I do now to get a residency that will get me an ortho job/what should i look for in a residency that will get me an ortho job." So, to get back to your question, students measure the strength of a program by their ability to give them the opportunity to land an ortho job.

Personally, I just want to open my own practice, but that might become even harder to do than landing an ortho job will be in 6 years.

 

[DrRock44]

I too have noticed this as a first year. It seems like all the teachers/guest speakers ever talk about is surgery. I also think that a lot of students have the (false) perception that they will basically be F/A orthos when they graduate and only do surgery all day. While many may take jobs with hospitals or ortho groups and do quite a bit of surgery, there is still a large part of the profession focused on other things. People aren't breaking their ankles at an increasing rate, but we do have an aging population and a diabetic epidemic. So the demand is actually rising for the more non-surgical side of podiatry and that means money will be there.

As for fellowships, I hear APMSA just passed a motion limiting residency to 3 years. It will be interesting to see how this effects the few competitive four year residencies like temple and if it will affect the number of fellowships or the interest in fellowships.

 

[Telekinesis]

Amongst my classmates, the number of students matching into ortho groups is a measure of success/strength of a program simply because that is where every podiatry student wants to go. I honestly haven't heard any of my classmates ever say, "I want to be an associate at an established podiatry office." Everyone wants to be a surgeon and make lots of money - something ortho groups provide. Whenever we have guest speakers, practicing podiatrists (even if they aren't employed in an ortho group!!), residencies, etc. there is always at least one question to the effect of, "What can I do now to get a residency that will get me an ortho job/what should i look for in a residency that will get me an ortho job." So, to get back to your question, students measure the strength of a program by their ability to give them the opportunity to land an ortho job.

Personally, I just want to open my own practice, but that might become even harder to do than landing an ortho job will be in 6 years.

I honestly see solo practices phasing out or becoming non economical. I personally aspire to join a group 1 day.

 

[MaxillofacialMN]

As for fellowships, I hear APMSA just passed a motion limiting residency to 3 years. It will be interesting to see how this effects the few competitive four year residencies like temple and if it will affect the number of fellowships or the interest in fellowships.

Check your sources on this. It's not accurate.

 

[MaxillofacialMN]

I honestly see solo practices phasing out or becoming non economical. I personally aspire to join a group 1 day.

I know... decreased reimbursements (or rather, non-increasing) are really bumming me out.

 

[Gigantron]

As for fellowships, I hear APMSA just passed a motion limiting residency to 3 years.

Source? This is very disheartening to hear if that's true.

 

[ldsrmdude]

Why would the APMSA pass a resolution about residencies? Aren't they responsible for student interests? Would it be a binding resolution?

 

[MaxillofacialMN]

Why would the APMSA pass a resolution about residencies? Aren't they responsible for student interests? Would it be a binding resolution?

This resolution literally did not happen. Idk where drrock got that information from.

 

[dtrack22]

I see TUSPM under his avatar. I am not surprised by anything he said.

With all of the extremely bright kids I've met from Temple, I've never understood how it can be such a breeding ground for misinformation/rumors/lies. Great school that I hear the craziest s*** from.

 

[DrRock44]

Heard from someone who allegedly heard from one of our class's reps. I didn't really think APMSA had that kind of influence. Thanks for clearing that up

 

[JR2011]

I would guess most seeking fellowships want the very highest level of training and expertise possible. For the most part, these types of people so happen to already be in very good residencies. Maybe there are some out there trying to fill major voids in training, but they are likely not as competitive for the higher caliber fellowships. I'm not so confident that a mediocre fellowship will do much to fill these voids. Not trying to be negative but I think that's the reality of the situation.

 

[Ankle Breaker]

Keeping it sort of on topic, how did placing graduates in ortho groups become some sort of surrogate measure of a programs strength?

I can't say for sure but I know that when I was looking into podiatry, 4 years ago, becoming the "foot and ankle guy" for an ortho group was extremely appealing. I'm pretty sure its a big selling point for a lot of pre-pods who are taking a hard look at podiatry as a potential professional career. I viewed it back then and still see it as the easiest way to "get paid" coming right out of residency. Unless you work for the Kaiser hospital system or get hired by another large teaching hospital after residency you probably will be making a little over 100K your first year out if your first job is joining another podiatry group. That's not good enough for me.

Kaiser CA positions start off high (>200K) but the ceiling point is low (maxing out at 275K). I met an attending who was the first to graduate from a University hospital setting program (the University Hospital/Cincinnati podiatry residency program) and he ended up getting hired by the University of Cincinnati Hospital itself. His starting base salary was +150K. That's a pretty solid gig. Other than getting ortho positions, getting hired by large teaching hospitals is another solid professional move. Graduating from residency programs that are affiliated with large level 1 trauma centers and teaching hospitals make you more valuable when applying for these kinds of positions. You need to know how to medically manage your patients if you want to hold these kind of positions. Doing surgery at surgery centers all day everyday doesn't really offer these experiences. You do the surgery and move on. You don't get a lot of follow up on the pts and you don't learn how to deal with complications. University of Cincinnati and Carilion Roanoke Memorial hospital are programs I believe offer these kind of training opportunities, that I have first hand experience with, that can make it easier for you to obtain a salaried hospital position out of residency.

Another thing to consider, if getting an ortho position is your top priority, is how affiliated the podiatry residency is with orthopedics. If the program offers opportunities to work side by side with ortho this becomes an opportunity to obtain LORs from these doctors which will most likely take you further than your actual training or LORs from your podiatry attendings. I could be wrong about that but if "big brother" ortho is going to hire a DPM then they probably want to read LORs from "their" colleagues and not from podiatrists. Wheaton Franciscan, Carilion Roanoke, Jewish in KY all come to mind since I clerked/visited these places. I wasn't a big fan of Jewish but the residents are affiliated with and scrub cases with THREE Ortho docs who do F/A cases. One of them being Dr. Seligson who is pretty well known in the orthopedic profession and another Dr. Hockenbury who received his training from Dr. Sammarco (F/A ortho icon).

And do you (everybody) think that increased attractiveness to ortho groups is/should be a reason to do a fellowship?

Like stated above, if your residency program offers strong affiliations with Ortho docs then I don't think a fellowship will be necessary if you feel confident you can secure an ortho position right out of residency. It would be a waste of a year, even if you did obtain new skills, if your overall goal is to join an ortho practice. If you are coming out of a program where you didn't have a strong ortho affiliation then fellowship may be another way for you to distinguish yourself as an applicant and extend your professional network, which in itself, could lead to opportunities to interview with orthopedic practices.

Again this is all speculation, just my opinions. I don't claim to know how "it all works". I just share what I do know as I go along. Most likely my opinions will continue to change as I start to experience residency training in less than 5 months (fingers crossed).

 

[g squared 23]

I wasn't a big fan of Jewish but the residents are affiliated with and scrub cases with THREE Ortho docs who do F/A cases. One of them being Dr. Seligson who is pretty well known in the orthopedic profession and another Dr. Hockenbury who received his training from Dr. Sammarco (F/A ortho icon).

I didn't think much of it either, but having Seligson's name on a LOR will get you way further with an Ortho group than a letter from Jack Shuberth or Jeff Christensen. And for some reason that is the absolute pinnacle of a career in most Podiatry students' inferiority complex driven minds these days. Even if most of them have a lower ceiling and will never let you become a partner.

 

[Ankle Breaker]

I didn't think much of it either, but having Seligson's name on a LOR will get you way further with an Ortho group than a letter from Jack Shuberth or Jeff Christensen. And for some reason that is the absolute pinnacle of a career in most Podiatry students' inferiority complex driven minds these days. Even if most of them have a lower ceiling and will never let you become a partner.

Just offering up my opinion. It's a public forum. Kind of the entire point. No inferiority complex here. Proud to be a future DPM. Don't like what I have to say? That's cool. If you want to make personal attacks then you are entitled to do that. Go crazy...doctor.

 

[janV88]

I didn't think much of it either, but having Seligson's name on a LOR will get you way further with an Ortho group than a letter from Jack Shuberth or Jeff Christensen. And for some reason that is the absolute pinnacle of a career in most Podiatry students' inferiority complex driven minds these days. Even if most of them have a lower ceiling and will never let you become a partner.

I suspect this might have more to do with state laws than discrimination. Apparently most states only allow professionals with the same license to form professional corporations. Therefore it's the law that doesn't allow podiatrist to become partner in a physician group.

 

[g squared 23]

Just offering up my opinion. It's a public forum. Kind of the entire point. No inferiority complex here. Proud to be a future DPM. Don't like what I have to say? That's cool. If you want to make personal attacks then you are entitled to do that. Go crazy...doctor.

I was actually generalizing and commenting how every podiatry student wants to be an ortho associate without knowing what the real world situation actually entails. But if you want to take personal offense to a blanket statement not directed at you, then I'm sorry? I quoted your statement regarding Jewish.

 

[Ankle Breaker]

I was actually generalizing and commenting how every podiatry student wants to be an ortho associate without knowing what the real world situation actually entails. But if you want to take personal offense to a blanket statement not directed at you, then I'm sorry? I quoted your statement regarding Jewish.

Hard to determine what's generalized and what is a personal attack without actually hearing how it's articulated. It read like a backhanded remark. No harm done.

 

[g squared 23]

I suspect this might have more to do with state laws than discrimination. Apparently most states only allow professionals with the same license to form professional corporations. Therefore it's the law that doesn't allow podiatrist to become partner in a physician group.

That's a bunch of bs. Like most things in life, the reasons come down to $. I'm sorry to burst the ortho group bubble for all you aspiring orthopaedic podiatrists. Where's Feli to give some real world advice when you need him...

 

[dtrack22]

That's a bunch of bs. Like most things in life, the reasons come down to $. I'm sorry to burst the ortho group bubble for all you aspiring orthopaedic podiatrists. Where's Feli to give some real world advice when you need him...

Not entirely. The one DPM on here who cannot become partner in his ortho group is restricted by state law. In fact newankle is the only podiatrist I've heard of who can't become partner and it is for legal reasons. I know there are others out there who are just getting railroaded by the group but how common is that really?

I only know 2-3 other DPMs who are in ortho groups, all of whom are partners. I guess I was unaware of this common issue where DPMs are being hired by ortho groups to be money making perma-associates

 

[g squared 23]

I only know 2-3 other DPMs who are in ortho groups, all of whom are partners. I guess I was unaware of this common issue where DPMs are being hired by ortho groups to be money making perma-associates

The big DMU attending that every student dreams to be like is of course a managing partner in that particular ortho group. The OTHER big ortho group in town is/was actually known for hiring podiatry associates as employees, with no option to partner. Needless to say the turnover rate was quite high and it was not a highly sought position for that reason. Who knows, maybe things have changed.

 

[janV88]

That's a bunch of bs. Like most things in life, the reasons come down to $. I'm sorry to burst the ortho group bubble for all you aspiring orthopaedic podiatrists. Where's Feli to give some real world advice when you need him...

According to NYS law...

"Article 15 of the Business Corporation Law authorizes the formation of a professional service corporation, in which all shareholders must be licensees of one profession and whose members practice only that profession. The one exception is that the design professions of engineering, land surveying, architecture, and landscape architecture may incorporate to offer those design services in one professional service corporation."

 

[MarquetteGuy]

I'm a recent residency graduate from this past June, and I joined an orthopaedic group coming out residency. It's a 9-physician group, plus several PA's, and I was given the exact same contract structure as every other first-year physician when they joined the group, which includes full, equal partnership after the first year. In fact, every orthopaedic group I received offers from included full partnership opportunities of some sort, which was equal to the contract structure that the rest of the partners had received upon joining said group. Not once did I have an orthopaedic group disclose to me that I would not be offered partnership opportunities consistent with the rest of the physicians. Simply based off my experience, none of the orthopaedic groups I interviewed with and received offers from had any reservations about offering me partnership opportunities. Maybe this is quite rare and I'm in the minority with my experience, but from my first-hand experience with the whole job search process coming out of residency, the option of being a partner in an orthopaedic group just never seemed to be a big deal to the groups who offered me a position. Possibly times are changing, one could hope. Again, this is just my experience.

 

[zdlamkin8195]

I also have the feeling that most of the pod students haven't spent much time in the OR before, and once they do many will decide it's not for them. As with most things, I bet everyone's drive to be a surgeon will work itself out over time. Just my 2¢

 

[JR2011]

Its lame how the thread is about interest in fellowships, but totally derails into dropping names of people in the profession and arguing about ortho groups and partnership. Did anyone want to know about letters of recommendation from anyone???? So why would you go dropping names of people or even talking about that?

 

[Ankle Breaker]

Its lame how the thread is about interest in fellowships, but totally derails into dropping names of people in the profession and arguing about ortho groups and partnership. Did anyone want to know about letters of recommendation from anyone???? So why would you go dropping names of people or even talking about that?

Since when did talking about specific attendings become an untouchable topic?

I can't tell you how many times I've been on rotations and attendings ask where I clerked and as soon as they hear a specific program they go bananas and talk crap about specific attendings affiliated with the program. Everyone does it and no one cares if it's get back to them.

We are talking about attendings and the training they offer. Which is a positive thing, not a negative. Frankly, after meeting some big time surgeons during my travels, I strongly believe they could care less if we were talking about them or not.

 

[JR2011]

Since when did talking about specific attendings become an untouchable topic?

I can't tell you how many times I've been on rotations and attendings ask where I clerked and as soon as they hear a specific program they go bananas and talk crap about specific attendings affiliated with the program. Everyone does it and no one cares if it's get back to them.

We are talking about attendings and the training they offer. Which is a positive thing, not a negative. Frankly, after meeting some big time surgeons during my travels, I strongly believe they could care less if we were talking about them or not.

I'm not going to continue to debate with you why you think it's ok to call out the names of people at hospitals across the country and openly discuss what you think of them on a public Internet forum. I understand that you will always have a comment on why you feel you are correct and some may share your viewpoint. All I said was to be careful when talking about specific people but you didn't like that. So continue to openly discuss specific people by their last names. Not sure what the moderators of SDN think about making personal comments but I'd guess they value the site too much to have it shut down because some hero podiatry student wanted to tango with defamatory comments. All I said was exercise some common sense and keep it objective. Or if you don't have nice things to say don't say it. You think you can spend a month as an Extern and discuss practice habits of people and their personality. Sorry this doesn't sit well with me but we've already established that we disagree. Fine. But now you carry the debate into the fellowship thread. Haha.

Tell you what if you feel so strongly let's have your first and last name and maybe some residents or attendings can enlighten us on how stellar of a podiatry Extern you were on your rotations. Not sure if you would appreciate that on the internet?? Well programs need to know what they are getting into before they except you right?

Some advice for students and externs while on rotation.... Nobody cares what you saw at your last program or how they did things. Furthermore I'd strongly discourage talking about people at other programs while rotating. Keep quiet and work hard. I feel the program reviews are great information. Id still exercise caution if talking about people but that's just my opinion.

 

[Ankle Breaker]

No one is making defamatory comments about attendings. If they did they were from anonymous posters who wanted to share their opinions which no one has the right to control. Sharing information and discussing topics are the primary purposes of this website. No one is on a crusade.

But I get your point about naming attendings specifically. I will refrain from naming attendings directly for now on. But again I insist I never made serious defamatory remarks about anyone on this website. I just wanted to share information about programs for other readers, which I think a lot of posters appreciate.

 

[JR2011]

Thanks for seeing my side of things. You are certainly correct. Awesome debate in the fellowship thread BTW.

 

[dtrack22]

Not sure what the moderators of SDN think about making personal comments but I'd guess they value the site too much to have it shut down because some hero podiatry student wanted to tango with defamatory comments

Quit being a drama queen. You clearly have no idea what "defamatory" means, nor do you understand common law.

Let's play a game, "spot the defamatory comment". Here are the only instances where a practitioner was called out by name in this thread. One of them was by you, JR:

Mary Crawford explained it very well back in 2009. She was spot on IMO and what she said still holds true today.

One of them being Dr. Seligson who is pretty well known in the orthopedic profession and another Dr. Hockenbury who received his training from Dr. Sammarco (F/A ortho icon)

having Seligson's name on a LOR will get you way further with an Ortho group than a letter from Jack Shuberth or Jeff Christensen.

The above is what JR2011 decided to write a novel about. Which one of the above is defamatory? Oh, none of them? Are we done taking our personal crusade (one which wasn't valid from the start, in the residency review sticky) from thread-to-thread throughout the podiatry forums? It was an awesome debate about fellowships and even a good discussion about the idea that ortho groups are the "holy grail" of job opportunities that is prevalent among many pod students and residents. That is, until you made some baseless accusations and complaints, derailing the whole thing. Thanks.

 

[ldsrmdude]

Let's try to keep things on topic here. I don't want to lock this thread because no one can play nice (I will if I have to though). If you feel you can't help but respond to a member on here, try to use the ignore function which will block their posts from your view.

 

[JR2011]

Quit being a drama queen. You clearly have no idea what "defamatory" means, nor do you understand common law.

Let's play a game, "spot the defamatory comment". Here are the only instances where a practitioner was called out by name in this thread. One of them was by you, JR:





The above is what JR2011 decided to write a novel about. Which one of the above is defamatory? Oh, none of them? Are we done taking our personal crusade (one which wasn't valid from the start, in the residency review sticky) from thread-to-thread throughout the podiatry forums? It was an awesome debate about fellowships and even a good discussion about the idea that ortho groups are the "holy grail" of job opportunities that is prevalent among many pod students and residents. That is, until you made some baseless accusations and complaints, derailing the whole thing. Thanks.

It doesn't take a genius pod student to know what defammatory means. Sounds like you should have went to law school instead of podiatry school
de·fam′a·to′ry adj. defamatory (dɪˈfæmətərɪ; -trɪ). adj. 1. (Law) injurious to someone's name or reputation.

You will not find me talking about people by their last name and my opinion about them on a public podiatry forum. I don't think anyone said anything defammatory but there is potential when people start speaking about others and listing their names and where they work. I did however link an article talking about fellowships while discussing fellowships in the fellowship thread as that is the topic of the thread. I'd love to hear more about what you think is the holy grail among pod students especially with your vast experience with law and podiatry practice. You better play nice before I ignore function you.