Forum Members ABFAS/ABPM

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newpodgrad

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Hey guys

While looking for jobs , I inquired with a few local hospitals about how to go about getting privileges.

Several of them sent me info and I wanted to highlight a board concern.

Not sure how to really take it, but here’s a excerpt from one of the docs re: board status.

“Board Certification Requirement means certification from one of the following boards: the American Board of Medical Specialties, the American Osteopathic Association, the American Board of Foot and Ankle Surgery, or those Boards which may be approved by the Executive Committee to satisfy this Requirement”

As a disclaimer, I’m not a HUGE surgery pod. I enjoyed it , and did it in residency because, well, that’s what we had to do. And I’m fine with my forefoot procedures. I believe I’ve done well with them at my current level. I don’t care to do TARS, scopes mid foot fusions etc. I have no problem referring them out. I took the ABFAS qualifying tests etc, because again, it’s encouraged in residency and passed them.

Looking at this doc, it almost seems like this board required if you wanted to be on staff. The little statement at the end regarding “or those boards” seems like it might open the door for ABPM with some petitioning or something.

What do you guys make of this? I have heard from others that ABPM will get involved with issues regarding privileges etc. Is there more to this picture than meets the eye?

Thanks in advance for everyone’s take
 
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air bud said:
Can you tell us how you have chosen to gatekeep your fellow podiatrist?
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Cases and education.

Hospitals have a process called PPR (“proctored peer review”):

If you have cases and education you get the privileges.

If you go back and get more education but don’t have the cases yet, they (the privileging board) will find a peer who does have the privileges in the system to supervise/review your work to ensure it is to a safe standard.

If you don’t have the education or cases, you don’t get the privileges.
 
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Hey SouthOrBust great post. I agree.

I have been Division Chief, peer review committee member, medical executive board member, operating room committee member for several decades, I utilize a very similar logic as you for credentialing. I think it's fair and works well.

This is not as big of a deal as back 20 years ago when there were a lot of solo private practices. Now, I know most of the DPM groups and they make sure their "new person" is getting help from someone intra-practice so it rarely gets to peer review.

I also try to grab lunch with the new physician so we can get to know each other better with respect to goals. The last thing I do is I give the new physician my personal cell phone number in case they ever have questions or concerns.
 
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SouthOrBust said:
Or perhaps they are still doing ankle work because hospital privileging is ACTUALLY based on training and education, not board certification.

You can get ABFAS RRA certification and never do an ankle scope, ex-fix or TAR. Hospitals won’t give you ankle scope, ex-fix, or TAR privileges just because you have a signed piece of paper saying you’re one of the chosen few. They will ask to see your previous cases first.

Now the wildcard in all this is whether or not a sneaky ABFAS diplomat convinced their hospital to require the RRA certification to perform these surgeries. Which does happen. The orthopods don’t keep podiatrists down; the real villains are other entitled podiatrists.

Disclaimer: I sit on my hospitals medical executive board and privileging board and have done so for 6+ years.
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In Connecticut it is like this. It’s actually written in the state statutes you need ABFAS RRA to do ankle work and to get the ankle certificate. This is gate keeping at its finest. Podiatrists wrote these rules with the blessing of their master foot and ankle orthopods.
 
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SouthOrBust said:
Cases and education.

Hospitals have a process called PPR (“proctored peer review”):

If you have cases and education you get the privileges.

If you go back and get more education but don’t have the cases yet, they (the privileging board) will find a peer who does have the privileges in the system to supervise/review your work to ensure it is to a safe standard.

If you don’t have the education or cases, you don’t get the privileges.
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Gotcha you have the peer do the gate keeping...very nice Sir.
 
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CutsWithFury said:
In Connecticut it is like this. It’s actually written in the state statutes you need ABFAS RRA to do ankle work and to get the ankle certificate. This is gate keeping at its finest. Podiatrists wrote these rules with the blessing of their master foot and ankle orthopods.
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New York is similar.
 
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Feli said:
The wild thing is ABPM new CAQ lets someone be CAQ for foot surgery without ever doing a single foot surgery on their own. That is crazytown. They could have thought that through a bit. There is no MD surgical board that does that.
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We are following CMS standards, that competency is based on current experience. If you are 24 months out of training, CMS doesn't (and most hospitals don't) require you to provide case logs because you just completed the required variety of cases during training. We decided on 3 years as the cut off for case documentation because of the timing of residency completion (July) and the CAQ exams (February). 2 years would really be 1 year and 8 months. We didn't think the short-change was fair so we made it 3 years (which is really 2 years and 8 months).

Anyone more than 3 years from residency has to provide a variety of cases within the 5 categories of podiatric surgery established by CPME 320.

Conversely, if you are just "qualified" by other boards and have 0 cases documented you can still do any surgery for 7 years??? Which is crazytown?
 
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Boba Foot said:
The man's got a point....
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The ABFAS board qualification is a lot more robust and challenging to pass. A monkey can pass the ABPM exams. All "Doctors" who made it through podiatry school and got greased through residency training still do not deserve to practice medicine.

I think people are losing track that even today we are graduating a lot idiots who are practicing out there
 
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CutsWithFury said:
The ABFAS board qualification is a lot more robust and challenging to pass. A monkey can pass the ABPM exams. All "Doctors" who made it through podiatry school and got greased through residency training still do not deserve to practice medicine.

I think people are losing track that even today we are graduating a lot idiots who are practicing out there
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Easy evidence can be found on a simple instagram peruse of DPM accounts posting botched Lapiplasty or ankle fracture cases but still posting a video bragging about their work.
 
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CutsWithFury said:
The ABFAS board qualification is a lot more robust and challenging to pass. A monkey can pass the ABPM exams. All "Doctors" who made it through podiatry school and got greased through residency training still do not deserve to practice medicine.

I think people are losing track that even today we are graduating a lot idiots who are practicing out there
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There's a lot of podiatrists who do limb salvage but don't do trauma or electives. Do you feel there is a role in podiatry for people with this limited skillset/practice?
 
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AttackNME said:
There's a lot of podiatrists who do limb salvage but don't do trauma or electives. Do you feel there is a role in podiatry for people with this limited skillset/practice?
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Please send me all of your elective stuff and you can have all of the 2am pus foot you can dream of (or not because you wont get any sleep).
 
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AttackNME said:
There's a lot of podiatrists who do limb salvage but don't do trauma or electives. Do you feel there is a role in podiatry for people with this limited skillset/practice?
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Do you consider this real “skill”? Because I don’t. It’s also very redundant because ortho, vascular surgery or even general surgeons can do this stuff. They just choose not to. BIG DIFFERENCE.
 
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CutsWithFury said:
Do you consider this real “skill”? Because I don’t. It’s also very redundant because ortho, vascular surgery or even general surgeons can do this stuff. They just choose not to. BIG DIFFERENCE.
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We're all still just podiatrists. Also, you didn’t even answer the man’s question in your chest-thumping post.
 
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Boba Foot said:
We're all still just podiatrists. Also, you didn’t even answer the man’s question in your chest-thumping post.
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Can you read? I don’t think you can. I essentially said podiatry the profession is not needed.

We are here because other professions choose to not do the work.
 
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It's interesting, I have been seeing more and more orthopods not just Wukich (especially hospital employed) get into charcot recon. I don't blame them as the wRVUs for those cases are wild. For the most part, their images and clinical outcomes look great, if not better than some of the pods I know. But yes, most won't do these cases and there is plenty to go around.
 
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PatchAdamsFan said:
It's interesting, I have been seeing more and more orthopods not just Wukich (especially hospital employed) get into charcot recon. I don't blame them as the wRVUs for those cases are wild. For the most part, their images and clinical outcomes look great, if not better than some of the pods I know. But yes, most won't do these cases and there is plenty to go around.
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More and more foot and ankle orthopods are taking on these complex recon cases and do it very well and can do different things (if they need to) in the upper leg to correct the foot and ankle deformity that most podiatrists are not allowed to do.

AAOS/AOFAS are doing everything they can to phase us out. That is why this profession is so desperate for volume. Especially hospital employed podiatrists. They treat each other like garbage if a new podiatrist comes on board. They see it as a direct threat to their volume rather than building more volume for the entire department.
 
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CutsWithFury said:
More and more foot and ankle orthopods are taking on these complex recon cases and do it very well and can do different things (if they need to) in the upper leg to correct the foot and ankle deformity that most podiatrists are not allowed to do.

AAOS/AOFAS are doing everything they can to phase us out. That is why this profession is so desperate for volume. Especially hospital employed podiatrists. They treat each other like garbage if a new podiatrist comes on board. They see it as a direct threat to their volume rather than building more volume for the entire department.
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By other things you mean a BKA right?
 
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CutsWithFury said:
...We are here because other professions choose to not do the work.
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Yes, this is true. ^^

One of my professors (very well trained, did one of best programs around, RRA, was a residency director, etc) hypothesized that podiatry/chiropody probably began since people were uncomfortable asking their family doc to cut their toenails. He also joked that the first DPM hammertoe surgery was probably done in an exam room with all window shades closed since the doc was sick of shaving the same corn over and over and over.
...and that's probably not very far off. At all. 🙂

Boy, how we have grown!
But, CutsWith is not wrong... don't ever mistake the rest of the medical community not doing much/any of something for that something being hard to do or only DPMs can do it. High school kids or anyone working at pedicure places can cut toenails, PCPs can do heel/gout/arthritis injections or diabetic shoe Rx, vasc can do toe amps, ortho can do fx or deformities, ER can do ingrowns and sprains, etc. Tough facts 😉

We can still take pride in doing stuff well, like getting paid for it, help ppl out, etc. I sure do. I do find the wound wizard and RFC stuff pretty boring and even annoying... I let that find me and market mainly to the stuff I find more interesting and challenging. JMO
But yeah, bottom line: different doesn't equal special. Everyone has skills. We are all unique... just like everyone else.

A lot of MD specialties overlap in some form or another. Rheum or Gen Surg are ones that sorta ends up as a garbage bucket for all of the stuff other IM specialties or other surgical specialties respectively don't want (but they do still pay dang well and end up avg/hard to match also).
 
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Feli said:
Rheum or Gen Surg are ones that sorta ends up as a garbage bucket for all of the stuff other IM specialties or other surgical specialties respectively don't want
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On my gen surg rotation in residency, I got assigned to a peri-anal abscess case and the surgeon seemed pretty amused with himself after instructing me to stick my finger up the dude’s new second dingus to clear out the abscess.
 
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CutsWithFury said:
Can you read? I don’t think you can. I essentially said podiatry the profession is not needed.

We are here because other professions choose to not do the work.
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Interesting. So what do you think would be a better solution? If all these other doctors and surgeons don’t want to treat feet, what do you think they should’ve done to address it without a need for chiropody to evolve to what we are now?
 
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AttackNME said:
Interesting. So what do you think would be a better solution? If all these other doctors and surgeons don’t want to treat feet, what do you think they should’ve done to address it without a need for chiropody to evolve to what we are now?
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If feet paid really well MD/DO would be more interested in tackling it. Follow the money.

It’s why most orthos pushback when podiatrists want to fix ankle fractures but they have zero interest in fixing anything below the ankle.

If the quality of patient that typically has foot problems was different I think more MD/DO would be interested in taking it on.

These are just facts. It’s so factual that the AOFAS wrote a biased crappy research article demonstrating that podiatrists typically operate on sicker more complicated patients even though they try to make it look like we voluntarily do this when in reality MD/DO are deferring care to podiatry for these types of patients with these specific foot complaints because they do not want to deal with it. This is not an opinion. These are facts.
 
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CutsWithFury said:
If feet paid really well MD/DO would be more interested in tackling it. Follow the money.

It’s why most orthos pushback when podiatrists want to fix ankle fractures but they have zero interest in fixing anything below the ankle.

If the quality of patient that typically has foot problems was different I think more MD/DO would be interested in taking it on.

These are just facts. It’s so factual that the AOFAS wrote a biased crappy research article demonstrating that podiatrists typically operate on sicker more complicated patients even though they try to make it look like we voluntarily do this when in reality MD/DO are deferring care to podiatry for these types of patients with these specific foot complaints because they do not want to deal with it. This is not an opinion. These are facts.
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Doctors are getting better and better at extending patient’s lifespan, and so the quality if the patient with pedal problems will only get worse as the population ages.

Which leads us to your point about money, it's a good point. Who should solve the payment issue for feet problems and how would they do that? (assuming podiatry doesn't exist)
 
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APMA's latest statement.

September 16, 2022

APMA Calls for Collaboration between Certifying Boards​

The American Board of Podiatric Medicine (ABPM) recently released a statement titled "Introducing Podiatry Forward," in which it expands upon its previously announced Certificate of Added Qualification in Podiatric Surgery. The most recent statement mentions that the goal of one certifying board for podiatric medicine and surgery is an objective shared by APMA. As part of conversations around Vision 21st Century (originally Vision 2015), APMA and the two certifying boards have indeed discussed the possibility of a single certifying board. However, the profession has long recognized two distinct specialties in which to be board certified, and APMA strongly supports the rigorous processes developed by our two current boards. As a profession, we have much collaborative work to do before the goal of a unified certifying board could be accomplished.

Board certification is an indication of clinical experience and skill, trusted by patients and other health-care professionals. Any certification of a physician's surgical skills that does not demand that additional level of clinical experience falls short of our obligation to our patients and creates the potential to compromise the hard-won trust we have built within the health-care community. A certification process that ignores clinical experience in favor of furthering a political goal does not serve our profession well.

APMA has been in communication with the Council on Podiatric Medical Education (CPME) as this situation evolves. CPME continues to evaluate the actions of ABPM according to its established policies and procedures as they pertain to specialty boards and will follow those policies in dealing with this situation.

In the meantime, APMA once again strongly urges ABPM and the American Board of Foot and Ankle Surgery (ABFAS) to come together with APMA for an honest and collaborative discussion. We must move forward in a manner that respects our physicians' education and training, acknowledges the value of clinical experience, and honors our obligation to our patients.
 
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newfeet said:
APMA's latest statement.

​
September 16, 2022

APMA Calls for Collaboration between Certifying Boards​

The American Board of Podiatric Medicine (ABPM) recently released a statement titled "Introducing Podiatry Forward," in which it expands upon its previously announced Certificate of Added Qualification in Podiatric Surgery. The most recent statement mentions that the goal of one certifying board for podiatric medicine and surgery is an objective shared by APMA. As part of conversations around Vision 21st Century (originally Vision 2015), APMA and the two certifying boards have indeed discussed the possibility of a single certifying board. However, the profession has long recognized two distinct specialties in which to be board certified, and APMA strongly supports the rigorous processes developed by our two current boards. As a profession, we have much collaborative work to do before the goal of a unified certifying board could be accomplished.

Board certification is an indication of clinical experience and skill, trusted by patients and other health-care professionals. Any certification of a physician's surgical skills that does not demand that additional level of clinical experience falls short of our obligation to our patients and creates the potential to compromise the hard-won trust we have built within the health-care community. A certification process that ignores clinical experience in favor of furthering a political goal does not serve our profession well.

APMA has been in communication with the Council on Podiatric Medical Education (CPME) as this situation evolves. CPME continues to evaluate the actions of ABPM according to its established policies and procedures as they pertain to specialty boards and will follow those policies in dealing with this situation.

In the meantime, APMA once again strongly urges ABPM and the American Board of Foot and Ankle Surgery (ABFAS) to come together with APMA for an honest and collaborative discussion. We must move forward in a manner that respects our physicians' education and training, acknowledges the value of clinical experience, and honors our obligation to our patients.
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This is a circus. We will never progress as a profession functioning like this. Complete joke.
 
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ToeFather said:
ABFAS is a joke anyways. How many 1 year residency trained podiatrists are certified by abfas and “grandfathered” in?

I’ll always stand with the ABPM
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Hmm. I don't know if the fact that Red Sox tryouts are pretty hard automatically makes the Portland Sea Dogs baseball the best thing ever?

There are not just two choices here. The "I don't like A, so I have to choose B" is what elections do: back people into a corner.

ABFAS has its flaws. It is difficult. Rules have changed over the years.
ABPM didn't even exist until a few years ago... the ABPOPPM prior had a very very tiny % of DPMs as members and was totally different (it was made for the many DPMs who did non-surgical residencies to have a recognized board cert... back when there were PPMR and PSR, etc models for pod residencies). ABPM is now heading in a vastly different direction.
 
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Feli said:
Hmm. I don't know if the fact that Red Sox tryouts are pretty hard automatically makes the Portland Sea Dogs baseball the best thing ever?

There are not just two choices here. The "I don't like A, so I have to choose B" is what elections do: back people into a corner.

ABFAS has its flaws. It is difficult. Rules have changed over the years.
ABPM didn't even exist until a few years ago... the ABPOPPM prior had a very very tiny % of DPMs as members and was totally different (it was made for the many DPMs who did non-surgical residencies to have a recognized board cert... back when there were PPMR and PSR, etc models for pod residencies). ABPM is now heading in a vastly different direction.
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This whole situation wouldn’t be a problem if we valued non-surgical podiatry work. Why not just make ABPM the board for non-surgical podiatrists?
 
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The problem is that one person is single handedly driving ABPM into this surgical direction and then this person also has influence assisting with the creation of the new Texas podiatry school. Both things were not needed but this person took it upon themselves to do it and has been doing whatever they want unabated. Podiatry is worse off than it was before because of this person.
 
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CutsWithFury said:
Podiatry is worse off than it was before because of this person.
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Probably too soon to make a claim like that. Rocking the boat when the current board cert situation system is less-than-ideal can lead to long term changes that makes the system better for all.

This is purely in regards to the ABPM aspect. The RGV school is a completely stupid idea, no bone to pick on that. I’m from Texas and you couldn’t pay me to go to that school if I were a prospective student today. Simply not needed and also in the absolute worst part of the state.
 
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Boo hoo APMA!!!

APMA wants "one board"!

Yes one board where their friends (who never did a surgical residency) can have a surgery certificate in foot and ankle surgery after being grandfathered in.

Ok APMA, let's do it with one board.

First, tell all your friends that got in the back door they have to re-take the test. No grandfathering people in!

Is that cool APMA? Then we can have 1 unform surgery board where EVERYONE took the SAME test and EVERYONE completed a surgical residency.

Notice how APMA will NEVER address this. This is the REAL issue dividing our profession. They are more concerned about PM&S-36 trained dpms getting a caq in foot surgery. Why you ask.....$$$$!!!
 
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I’m all for one Board exam... The pathway to get there is going to take many years. Have to retire out all the “grandfathered” doctors first to let everyone on the same playing field from the start.
 
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The leadership in our profession is not good and largely self-serving. I would be more inclined to participate in APMA and ACFAS if leadership exhibited an offensive strategy to dealing with all the issues lined out in this thread.

Instead, we get marketed lectures about 1st MTP arthroscopy.
 
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Personally, I feel the only profession who really doesnt like us is ortho and thats because were competitors. I have not had any bad blood with ortho but I have always practiced in podiatry/ortho friendly areas of the country. But I know it exists. Especially in northeast, seattle, and parts of the south.

ED, hospitalist, gen surg, primary care, etc do not look down on podiatry in any way shape or form. I just got a phone call yesterday from a MD I knew as a hospitalist who moved on. His kid injured his foot and he wanted to know what to do. I've operated on anesthesia's wife (haglunds) a couple years ago, Ive operated on radiologists wife (lapidus) last year, primary care providers are always knocking on my office door asking for advice on a patient of theirs. I fixed an OB/GYN bunion/hammertoes 6-8 months ago. I have RNs in my office from the hospital floor/ER all the time.

Podiatry is well liked in the medical field. That has been my experience at least.
 
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To make one unifying board like ABFAS, for example, it means to grandfather all ABPM members. But if we have one board and keep current ABFAS certification process, what do you do with 40% of people not being able to achieve board status?

Or should it be one board with surgical vs non-surgical distinctions? Would there have to be residency programs with surgical vs non-surgical training?
If non-surgical, then why 3 years for both?

It seems like all residency programs became 3-year long and surgical just to show that we have standards in training. It created more problems than it solved. By just declaring all programs PMSR/RRA did nothing to improve actual quality of training, surgical diversity, numbers, etc.

We wanted to look better as a profession making it look like all graduates are now qualified surgeons, but having one board reject certifications for nearly half of podiatrists shows clearly that training still sucks and that there is no standardization in training among in this profession. Orthos are correct when they say that. It is true. Stop increasing class sizes, opening new schools and either shut down some residency programs or make sure they provide excellent training so every graduate has a potential to get certified by ABFAS or whatever board claims to be the best.

Low pass rate for ABFAS clearly shows that something is wrong with how profession runs. The pass rate should be at least 90%. Either we need to accept less people to make sure people who enter this profession are more likely to pass Boards and become certified and/or make sure pod school and residency training becomes more rigorous and on par with the standards of certifying board.

MD schools train their students according to LCME and residency programs train according to ACGME expectations. Seems like in podiatry there is gap between what schools/residencies teach and what ABFAS expects.

CPME should work with ABFAS and residency programs to make sure everyone is on the same page. Obviously, programs should get hard hits if they don't train according to standards or if repeatedly graduate residents not able to get certified. But of course they don't want to do that because you don't want to have less residency spots than there are pod school graduates because it will make poor marketing. With historically low applications, the last thing they want to do is slash numbers of residency programs. But anyone who wants to take 350k loan will do a research and see how this small profession can't get things together. I don't expect applicant numbers to increase anytime soon considering this divisive statements.
 
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de Ribas said:
...We wanted to look better as a profession making it look like all graduates are now qualified surgeons, but having one board reject certifications for nearly half of podiatrists shows clearly that training still sucks and that there is no standardization in training among in this profession. Orthos are correct when they say that. It is true...
...MD schools train their students according to LCME and residency programs train according to ACGME expectations. Seems like in podiatry there is gap between what schools/residencies teach and what ABFAS expects.
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100%
 
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de Ribas said:
Or should it be one board with surgical vs non-surgical distinctions? Would there have to be residency programs with surgical vs non-surgical training?
If non-surgical, then why 3 years for both?

It seems like all residency programs became 3-year long and surgical just to show that we have standards in training. It created more problems than it solved. By just declaring all programs PMSR/RRA did nothing to improve actual quality of training, surgical diversity, numbers, etc.

MD schools train their students according to LCME and residency programs train according to ACGME expectations. Seems like in podiatry there is gap between what schools/residencies teach and what ABFAS expects.
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Podiatry chose 3 year residency just to match the minimum length of ACGME residency training. It’s an attempt to show another profession that we’re like them. Just because a residency is 3 years does not mean it’s good. MD residencies have actual standards.

If we weren’t trying to impress MDs with 3 years of residency and quality of pod residencies was close to that of MDs we could probably do it in less than 3 years.

Besides, the MD world does not notice anything we do, they are not paying attention. Most I’ve talked to have no idea how long we go to school, residency, etc. so much of what this profession does is rooted in an inferiority complex. Always trying to prove ourselves.

Dentistry has multiple specialities that take various amounts of time to complete. Oral and Maxillofacial surgery awards a dual MD/DDS at the end of training. Maybe if podiatry had something similar the people who want to be MDs so badly could try to pursue that.
 
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call1800doctorb said:
Podiatry chose 3 year residency just to match the minimum length of ACGME residency training. It’s an attempt to show another profession that we’re like them. Just because a residency is 3 years does not mean it’s good. MD residencies have actual standards.

If we weren’t trying to impress MDs with 3 years of residency and quality of pod residencies was close to that of MDs we could probably do it in less than 3 years.

Besides, the MD world does not notice anything we do, they are not paying attention. Most I’ve talked to have no idea how long we go to school, residency, etc. so much of what this profession does is rooted in an inferiority complex. Always trying to prove ourselves.

Dentistry has multiple specialities that take various amounts of time to complete. Oral and Maxillofacial surgery awards a dual MD/DDS at the end of training. Maybe if podiatry had something similar the people who want to be MDs so badly could try to pursue that.
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I don’t know Nova had the DO for DPMs program and it wasn’t popular.
 
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call1800doctorb said:
If we weren’t trying to impress MDs with 3 years of residency and quality of pod residencies was close to that of MDs we could probably do it in less than 3 years.
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Completely agree, at most residencies only two of those years are actually productive and useful. The remaining mixed 12 months is filled with some useless rotations mixed with senior residents showing up sporadically or whenever they want. Or floor work that is only marginally useful.

I always felt bad for those poor souls that get conned into going to a TUSPM-like 4 year program. Basically a residency + fellowship without even being able to tout a fellowship or having a fellowship experience.
 
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People say that if we get rid of some pod-specific courses in podiatry schools, we will lose "our identity" or our education will suffer or we will become less competent in foot and ankle. I haven't looked at all podiatry residency programs, but all that I have seen make their residents rotate at off-service rotations on average 9-12 months in 3 years, basically making it 2-year podiatry residency, not 3. Is that some kind of trick we did? Made programs 3-year long but increased the length by making residents rotate at unrelated specialties?

If our leadership thinks that we need exposure at other specialties, then better do it in 3rd/4th year of pod school rather than during residency. Why orthos and some other specialty residencies do not make their residents rotate for a year, but we do? At most they rotate for 3-6 months out of 5 years. We do 9-12 months out of 3 years.

This just doesn't make sense when I hear that we don't take more medicine courses or rotations in pod school because it will impact our competence or "distinction". Those pod courses and rotations are mediocre in quality at best. We all know how schools make their students rotate at their local clinics seeing 2 patients per day debriding nails. Even at good programs, as clerks, what do you do? Attend mediocre academics 1-2 per week, shadow in clinic watching someone clip nails? You are not really involved.

I think it would be better to move those off-service rotations, done during residency, to 3rd/4th years of pod school, and spend more time on pod service, working and learning as a resident. Because as a resident you are more involved in direct care of the patient in contrast to shadowing as a student. But I feel like many programs like it because they canNOT offer enough surgeries or exposure for all of their residents so they move them to off-service. Basically, they never have all residents on service. I know some "strong" programs, even with keeping their residents to off service rotations for about a year, cannot offer enough surgeries and exposure to the rest of the residents on service. Shame.

Meanwhile, we are entertained by 2 boards clashing with each other.
 
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Boba Foot said:
Completely agree, at most residencies only two of those years are actually productive and useful. The remaining mixed 12 months is filled with some useless rotations mixed with senior residents showing up sporadically or whenever they want. Or floor work that is only marginally useful.

I always felt bad for those poor souls that get conned into going to a TUSPM-like 4 year program. Basically a residency + fellowship without even being able to tout a fellowship or having a fellowship experience.
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3 full years of good quality podiatry training would be more than enough. Mostly pods get 2 years of low to mediocre training, that's why now you need a fellowship year of mediocre quality.
 
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air bud said:
As a board certified podiatrist (foot/rra) you bet your ass I am doing what I have to in order to keep a non certified pod 7 plus years out (qualified didn't get certified) from doing surgery at a hospital I go to.
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If you review things like Federal Law we find that per CMS: §482.12(a)(7): Ensure that under no circumstances is the accordance of staff membership or professional privileges in the hospital dependent solely upon certification, fellowship, or membership in a specialty body or society.

What that means is per federal law you cannot discriminate based on (ABPM versus ABFAS) certification for any hospital privileges.

If you do discriminate it is encouraging illegal behavior which is an ethics violation.

We had a situation like this at a local hospital where a local podiatrist felt "only ABFAS" was acceptable. ABPM had an attorney get in contact with the hospital to address the situation. Your malpractice may also cover it, and if it comes to it it would cost about $3K per an attorney I spoke with on the issue, which is way cheaper than the ABFAS process.
 
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