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True Stories From Podiatric Clerkships

Discussion in 'Podiatry Students' started by pacpod, May 15, 2013.

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  1. pacpod

    pacpod Who Dey! Staff Member Administrator SDN Senior Moderator Gold Donor

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    SDN Members don't see this ad. (About Ads)
    This is a sister thread to the "True Stories From Podiatric Residency" thread. We would like this to be a place for academic discussion of cases you see as a student. If you have something to say (student, resident, attending, etc), jump right in to the discussion!

    If you read a good article recently, feel free to add a pubmed link. Please do not upload actual articles so that copyright rules are not violated.
  2. Ankle Breaker

    Ankle Breaker Senior Member

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    Few things I've noticed while being out on rotations.

    Podiatrists in IL are still very much viewed as chip and clip docs. Just finished an orthopedic rotation at a Chicago hospital where there is also a podiatry residency program. Pods do all forefoot surgery while the orthos get everything from the midfoot and proximal.

    I've rotated at other programs in different states where the podiatric residency program handles ALL foot and ankle pathology.

    A lot of my classmates want Chicago programs because they want to stay local. I personally think they are short-changing themselves since there are lots of other programs around the US that don't have to put up with the politics that ortho presents.

    Just my two cents.
    Last edited: Jun 16, 2013
  3. ldsrmdude

    ldsrmdude Pod Mod 'Dude Administrator SDN Senior Moderator Gold Donor

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    I never did find a place out on rotations where politics, especially with ortho, didn't come up in some aspect (I'm sure they exist). We still have to deal with it occasionally at my program. I didn't rotate in IL at all so I can't comment on that aspect. You definitely don't want a program that is treated unfairly or not respected. If you say that all programs in IL are like that, then I would put that on my list of things to consider when choosing rotations.
  4. Ankle Breaker

    Ankle Breaker Senior Member

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    That's interesting because I've clerked at two programs where the podiatry residents handled everything that came in for the foot and ankle...including significant trauma. The residents of these podiatry programs also serve as the ortho residents whenever ortho needs extra hands for their surgeries. I think this paramount to find out prior to choosing clerkships.
    Last edited: Jun 16, 2013
  5. ldsrmdude

    ldsrmdude Pod Mod 'Dude Administrator SDN Senior Moderator Gold Donor

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    Yeah, I meant politics in a more general term, not just who gets trauma. Places like you are describing are becoming more common (we're not there yet at my program, but we're pretty close). It's something to consider when looking at programs. I wouldn't call it paramount, but just another factor to consider.
  6. dtrack22

    dtrack22

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    One of the programs I'll be at, the pod residents are a part of the ortho department and are the FAOS in the hospital. Ortho has to ask pod residents and attendings to scrub to get their F&A numbers, not the other way around. Really have an excellent working relationship w/o any signs of "politics". Will be interesting to see and compare with other programs for sure.
  7. Ankle Breaker

    Ankle Breaker Senior Member

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    Why not paramount? I'd rather be at a program where I am not splitting hairs with ortho for the ankles, calcs, and pilons. You are the resident though. Care to expand on your point if view?
  8. ldsrmdude

    ldsrmdude Pod Mod 'Dude Administrator SDN Senior Moderator Gold Donor

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    I'd want to be at a program like that too. All I meant is that I think that there are other things as important if not more important than whether you share trauma with ortho or not. When you said paramount, I took that to mean "the most important thing." Most decent programs will give you an adequate number of ankles, calcs, etc even if they don't get all that come through the ER. Of course, this depends on your goals. If you have trauma as your highest priority, then it may be paramount. That wasn't my highest priority, so it wasn't paramount for me. I guess as time goes on, I'm seeing things less in black and white, and so I'm hesitant to say something is "paramount" because what's number 1 for me may not matter that much to you. Sorry for the ramble.
    Last edited: Jun 16, 2013
  9. Ankle Breaker

    Ankle Breaker Senior Member

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    Makes sense. Thanks for discussing your point of view.
  10. pacpod

    pacpod Who Dey! Staff Member Administrator SDN Senior Moderator Gold Donor

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    Yeah, one of the things I'm looking for is a good relationship with ortho. It isn't my absolute most wanted thing, but it is certainly something toward the top. Along with many other things, it could make the three years good or rough.
  11. DrRock44

    DrRock44 TUSPM

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    what is the best way to go about "finding out"?
  12. ldsrmdude

    ldsrmdude Pod Mod 'Dude Administrator SDN Senior Moderator Gold Donor

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    Word of mouth usually. Talking to upperclassmen who rotated at programs, residents, etc. Asking questions on SDN is usually decent as well, but take everything with a grain of salt.
    Last edited: Jun 17, 2013
  13. Podophile

    Podophile R-rated

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    This actually is possible in one of two ways: the more obvious is to ask students who have rotated through programs. The even easier is looking at the hospital website and determining if there is an orthopedic residency program there. While it's not guaranteed the podiatry residents will automatically get to scrub the ankles that ortho brings, and it also doesn't mean there will be some sort of turf war between the two sides, but overall it means less mouths to feed from the trauma that does come in, and podiatry residents who play their cards right just might have a good chance of scrubbing those cases.

    That being said, the F/A cases that I've seen done by non-F/A orthopods has been less than stellar and fairly low yield IMO. Scrubbing a real F/A orthopod would be of significant more benefit, from the few that I've seen. So I suppose checking a hospital website and seeing if there is one of these specialists on staff and if they work with podiatry residents would be useful information.
  14. Ankle Breaker

    Ankle Breaker Senior Member

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    Talk to anyone and everyone about programs. Talk to DPM profs that you respect and ask their opinions. Talk to upperclassmen at your school. Make friends with students from other schools and ask them questions. SDN can be a great gateway to meeting and contacting students at different schools. It has served me well when I was researching programs.

    Lastly, do your own research! Don't ever approach someone and say "help me". If you put in the time and learn as much as you can about programs but still have questions, in my experience, people are more inclined to help you.

    People you don't want to listen to: your classmates, DPMs who hold more administrative roles at your school, random crap that is posted on SDN about programs.
  15. pacpod

    pacpod Who Dey! Staff Member Administrator SDN Senior Moderator Gold Donor

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    This goes a long way. Do as much research as you can about the program. Have a list of questions/comments/concerns ready before you call people for advice and help. If you have things ready to go instead of trying to think up stuff while you have the student or resident on the line shows that you respect their time and they will be more willing to share information.
  16. Ankle Breaker

    Ankle Breaker Senior Member

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    I'm currently on my ER rotation in a hospital in IL. I work with MDs and medical students every shift. I explain what podiatry is and what we do on a regular basis. It's almost laughable how little they know about our profession.

    Things they didn't know about podiatry:

    1) We get residency training
    2) We get three years of residency training
    3) We do surgery
    4) We do surgery on the ankle

    They view me as a professional nail clipper, orthotic dispenser, and someone who will charge large amounts of money to do both. It's really has been an eye opening experience.
  17. zdlamkin8195

    zdlamkin8195

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    Do they treat you fairly as far as learning in the ER environment?
  18. Ankle Breaker

    Ankle Breaker Senior Member

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    Some attendings are better than others. One attending told me I could only see patients who had issues from the knee down. This is reality in IL. Not sure if other students have had similar experiences. Maybe students are just too proud to admit they've been belittled before. But this is what I'm experiencing during my non-podiatry core rotations.
  19. MaxillofacialMN

    MaxillofacialMN Osteopathic Foot Dentist

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    I often wonder how worthwhile this "physician first" dogma of DPM education is. I mean, I guess I'd rather be over trained than under trained, but still....

    That being said, I better get back to studying about glycolipid degradation :lame:
  20. MaxillofacialMN

    MaxillofacialMN Osteopathic Foot Dentist

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    What's confusing about, "anything below the knee send to pod"?

    This is a genuine question - I don't understand how the podiatrist's services can be confusing...
  21. PeaJay

    PeaJay

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    I can understand the confusion regarding podiatry. Our skills and scope place us in a unique situation. We have full autonomy, but the training that makes us special also limits our scope. It can be confusing and I can empathize with those who do not fully understand the profession. We are in need of a better PR campaign as you mentioned previously.

    I cannot speak for those currently in practice, but we are currently being trained to firstly view the patient as a whole and evaluate the systemic pathology. Only then should we focus on the pathology pertaining to the foot and ankle. In the future you may not have the experience of podiatrists treating sans full evaluation.

    My question pertains to your comment regarding the treatment of LE pathology stemming from issues outside of our scope. In those cases a podiatrist should identify possible etiologies of the peripheral symptoms and make the appropriate referrals. Is this practice different from that of other specialists? An F/A orthopedic surgeon may have a full scope, but I doubt they are going to dabble in cardiology, vascular, or neurology.
  22. zdlamkin8195

    zdlamkin8195

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    This was my thought as well. I also would think that if a pod STUDENT was on rotation, that an attending would take the time to teach them what they are there to learn in order to be better at treating patients as a whole. It seems a little depressing that they wouldn't take the time to teach you just because of the degree the student is working towards. It would be the same if any MD/DO was treated unfairly by an attending based on specialty. I understand both sides of the confusion, but at the end of the day why would you not just teach the person?? I may only end up with a limited scope of practice, but I want to know more in order to serve my patients the best possible way. I am in school next to DO's every day and I don't intend to let my limited scope ever be an excuse to what I learn

    I do appreciate the insight from someone outside of the small world of podiatry on this forum, and don't mean any of this to be insulting/degrading to anyone else btw...
  23. MaxillofacialMN

    MaxillofacialMN Osteopathic Foot Dentist

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    :uhno:
  24. MaxillofacialMN

    MaxillofacialMN Osteopathic Foot Dentist

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    I wasn't actually offended. You seem uninformed about current podiatric medical education, so I won't hold it against you. That being said, chiropractors can't really be compared to a physician or dentist, because they practice real medicine, but whatever not a huge deal.

    Undergraduate podiatry education is identical to any allopathic/osteopathic premed... Perhaps you meant professional school?

    Podiatry residencies wouldn't exist the way they currently do if recent DPM grads weren't competent physicians.
  25. ldsrmdude

    ldsrmdude Pod Mod 'Dude Administrator SDN Senior Moderator Gold Donor

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    I haven't had any experiences similar to that. Every place I did rotations (off-service or podiatry) knew what podiatry was. Sure, there was the occasional student who didn't know (maybe even a resident or two) but it wasn't wide spread. I suppose it all depends on where you rotate.
  26. dyk343

    dyk343

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    I was belittled from a physician's assistant once. Other than that one experience I have had excellent relationships with other professions.
  27. pacpod

    pacpod Who Dey! Staff Member Administrator SDN Senior Moderator Gold Donor

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    I've actually had the opposite experience so far this year. I'll enjoy it while it lasts. ;)
  28. Podophile

    Podophile R-rated

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    I wouldnt be able to keep my cool taking that from someone with a Master's and no postgraduate training. But those people are typically insecure and few and far between
  29. JR2011

    JR2011

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    Just dropping my two cents....

    I don't think people give as much credit to PA's. In training there are numerous situations where the PA's are your boss, even though you are a podiatry doctor/ student. A key example is in the acute trauma team setting. The PAs are putting in central lines, Arterial lines, Chest tubes and at times running the traumas. They will teach you and then you will get to do it. In that situation, you are in their world...they will belittle you, teach you, school you, boss you around, etc. Especially when a pts life is on the line. Acting arrogant as if you are too good is the worst possible thing you can do.

    Another example is in the Ortho realm. Many orthos have PA's as assistants. Treat the PAs with respect and you will likely find yourself as the lead assistant with the Ortho as the PA will chose not to scrub to give you the benefit.
  30. dyk343

    dyk343

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    I don't think I ever said anything negative about PAs. I suppose if I re-read what I wrote it could comes off as me sounding supreme. That is not the case, and not what I meant.

    I actually like working with PAs as they tend to be a little more approachable.
  31. Ankle Breaker

    Ankle Breaker Senior Member

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    On my journeys I've come across many residents, from a variety of different programs, that state DeKalb is a tough environment to receive your F/A training. The attendings have strong personalities and the residency experience is more like pledging fraternity. It's hard to determine this during a clerkship because the students are supposedly treated pretty well. Buyer beware.
    Last edited: Sep 23, 2013
  32. ldsrmdude

    ldsrmdude Pod Mod 'Dude Administrator SDN Senior Moderator Gold Donor

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    What you've said (post-edit) is pretty accurate, from my experience there for a month. Like I've said before, I thought that the month was beneficial as a student. I learned quite a bit, and they do treat students pretty well in that for $100 you get an apartment, free food, opportunity to help in cadaver workshops, cadaver labs. The residents (at least when I was there) were willing to take time during the day to give lectures, run through concepts, etc. I've obviously never been a resident there, but it wasn't program that I was interested in for my residency due to some of the things you mentioned. I didn't feel like I fit in, and I felt like I could get the same quality of training in a place I fit in better and not have to put up with some of the negatives. The DeKalb residents I have met though have been solid. Every program has it's plusses and minuses.

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