Forum Members ABFAS/ABPM

[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

 

[icebreaker32]

Future hospital job posting 2043:

We are seeking a candidate that is board certified by ABFASM (American Board of Foot and Ankle Surgery and Medicine). One must have also completed a fellowship or have a CAQ in RRA to apply.

Probably should have been a meme.

 

[DPM TRUTH]

Hello collegues, hope everyone is doing well!

The predicate for the "abfas gurus" to not allow the abpm caq in surgery is "public safety and public confusion".

Ladies & gentlemen......these are the "gurus" who changed their name from the American Board of PODIATRIC surgery to the American Board of foot and ankle surgery. Why did they do this? Patient safety? Patient confusion? Hide their real credentials (podiatrist)?

If the "abfas gurus idea" was so genius why dont other specialties follow? Instead of the Board of dermatology, name it the American Board of skin surgery? Instead of the American Board Cardoithoracic surgeons, name it the American Board of heart and lung surgery? We could go on and on.

 

[icebreaker32]

Hello collegues, hope everyone is doing well!

The predicate for the "abfas gurus" to not allow the abpm caq in surgery is "public safety and public confusion".

Ladies & gentlemen......these are the "gurus" who changed their name from the American Board of PODIATRIC surgery to the American Board of foot and ankle surgery. Why did they do this? Patient safety? Patient confusion? Hide their real credentials (podiatrist)?

If the "abfas gurus idea" was so genius why dont other specialties follow? Instead of the Board of dermatology, name it the American Board of skin surgery? Instead of the American Board Cardoithoracic surgeons, name it the American Board of heart and lung surgery? We could go on and on.

You have a point, but most of the younger doctors usually have foot and ankle and not podiatry on their scrubs and lab coats. Practice names typically now have the words foot and ankle in them also and not podiatry. A typical podiatry group practice these days for example would be called Riverside Foot and Ankle and not Riverside Podiatry Associates. I doubt you will get much pushback about using foot/ankle over podiatry.

When someone asks you what you do for a living how do you answer? I still answer podiatrist as I consider it my occupation regardless of how people feel about the word. No matter how you answer the question there will be a follow up question.

1. Podiatrist

The next question will be do you do surgery?

2. Podiatric Surgeon

The next question will be that is children correct?

3. Foot and Ankle Surgeon

The next question will be are you a podiatrist or an orthopedic surgeon.

 

[pod squad]

When someone asks you what you do for a living how do you answer? I still answer podiatrist as I consider it my occupation regardless of how people feel about the word.

Spot on. Meanwhile, all the foot and ankle hardos out there:
'What do you do?'
-I'm a doctor
'Oh cool! What kind of doctor'
-I'm a Foot & Ankle Surgeon
'Nice, so you do orthopedics'
-Yes
....3 questions later:
'Where'd you go to Med school?'
-Oh it's a small school in California you probably never heard of it (i.e. Samuel Merritt)

 

[Boba Foot]

Reminds me of a fella in my class in school who was active on the dating apps. He used to try to impress them by saying he was studying to become a "foot and ankle surgeon". Showing ladies that he was too insecure to say he was studying to become a podiatrist did not increase his body count.

 

[de Ribas]

I basically failed case review last year (first attempt) for lack of pre-op documentation from cases sent to me already worked up for surgery. This year, I understand the process better

How does having couple extra sentences in pre-op note protect the public and make one a better surgeon? Sure, the BC needs to be challenging to make sure surgeons are well trained and know how to work up a patient for correct type of surgery and able to carry it out with best skills and great results.

It seems BC process is focused on unnecessary documentation details that have no effect on patient outcomes like the one you mentioned.

Hard and twisted BC process does not equal great surgeon and protected public. It can be just that - hard and complicated process. Basically, candidates fail not because they are not great surgeons or do not know what to do but they get tangled by the process. Process has to be clear and simple and test only what makes one a great physician and surgeon. Adding more stress, time constraints, challenges with keeping hundreds of notes and imaging from various jobs does not help while already being busy with patient care.

 

[Feli]

How does having couple extra sentences in pre-op note protect the public and make one a better surgeon? Sure, the BC needs to be challenging to make sure surgeons are well trained and know how to work up a patient for correct type of surgery and able to carry it out with best skills and great results.

It seems BC process is focused on unnecessary documentation details that have no effect on patient outcomes like the one you mentioned.

Hard and twisted BC process does not equal great surgeon and protected public. It can be just that - hard and complicated process. Basically, candidates fail not because they are not great surgeons or do not know what to do but they get tangled by the process. Process has to be clear and simple and test only what makes one a great physician and surgeon. Adding more stress, time constraints, challenges with keeping hundreds of notes and imaging from various jobs does not help while already being busy with patient care.

Yes, it's tough.
I know more than a few talented and well-trained surgeons who have failed - esp RRA - multiple times or even given up on it due to the documentation (mostly pre-op, also post-op LTF and re-scheds, didn't attend PT, etc). That's particularly true for trauma, which are almost always add-on to already busy days or evening/weekend that you sure don't have time to have pristine notes on. I dont' think the pus/amp cases matter too much as they're basic and they won't tend to pick those. I trained with a guy who was ABFAS prez, and I know how to document... I guess sometimes you just want to take better care of pts than notes (and the job switches make you decide HIPAA and your time/sanity versus grabbing notes during a job change and usually a move). No easy answers.

I was at a crossroads last month between collecting cases + XRs from the office I was leaving (for future ABFAS, esp RRA) before I was out of that EMR forever versus setting up my new office on the weekends. I obviously chose the latter, and it has paid off... but it probably cost me RRA case reviews chances (maybe ABFAS as a whole). We shall see.

...From talking to friends and colleagues, the cert process was quite a bit better when it was face to face for case reviews (like most MD surgeon boards pt2 for cert are). It was probably not fun for both sides to travel, but they knew they were dealing with someone who already passed the didactics and understood the indications, complication, fundamentals, etc. It was much easier to justify or explain the pt had missed an XR f/u, the portable XR machine was down, that the patient had absolutely refused MPJ1 fusion and that's why Valente was done for stage 3 rigidus, that the bone was highly osteoporotic and that changed fixation plans, etc. Now, you have to hope the reviewers read your mind or see that in the notes (if you even had time and documented it... and if they find it). It was also certainly easier for the reviewer to discern who had legit thought process and who really thinks their OIF of an avulsion fifth met fracture was indicated and performed well.

The comments section on the cases this year is a bit of an improve, but it's still lacking. Since COVID is essentially as over as cold/flu for all public health intents and purposes, hopefully they'll bring in-person case reviews back soon. That would be a great move.

 

[heybrother]

After much mockery from airbud and cutswithfury about podiatrists who don't include the word PODIATRIST in their linkedin profile I have added it to my top line ...*cough* followed by & Foot and Ankle Surgeon.

 

[dtrack22]

I think they meant the other guy.

Oh I know, just pointing out it’s a bit “pot meet kettle,” with certain posters weird vendettas on here.

If one does not get their required surgical cases in 7 years then one can never get board certified by ABFAS.

Maybe not any more, but again, there are people here well outside of 7 years that are being allowed to continue to sit for ABFAS. To pretend that they are consistent (and superior) in terms of certification standards is a joke.

All surgical boards in every specialty require cases after residency and active surgical privileges

But they do not have case “diversity” requirements, nor do they have the same onerous documentation standards, failure rates, they generally have short logging windows and in person case review/defense. All for the same price that we pay reviewers to fail us remotely.

 

[Feli]

...Current board certification with ABFAS pushes recent residency grads to join large Podiatry groups as an associate in order to get cases for boards. When I was looking for jobs after residency every large group had the same sales line "well if you join us there's no path to partnership and it's only $100k base salary and you'll be taking lots of hospital call but you'll get your cases for boards." If one does not get their required surgical cases in 7 years then one can never get board certified by ABFAS...

Yes, 100%... job selections (and staying at a job) are often highly tied to getting BC for podiatrists. It makes it very hard to go solo out of residency, to take jobs starting a new pod clinic within MSG, etc for fear of not enough cases quick enough. It's too bad.

Ortho and gen or plastics or etc has it this way also, but they are pretty unlikely to not accumulate their cases/diversity in one year at any job they take. The do board cert reviews (XRs for ortho, photos for plastic, oral exam for some). Very few DPM jobs have any that... you're usually at an associate job for multiple years to get numbers/diversity (esp RRA), stay there another year to submit the cases, might fail cases (not f2f) and be there another year or more. It's difficult.

 

[DYK343]

I've said it before and ill say it again. If you are graduating residency your notes need to be 100% on point.

Document everything. Spend the time. It sucks. No one likes charting. But spending an extra 5-10 minutes on every surgical note (not that that doesnt add up..) or any case that might turn surgical in the future can mean the difference between pass and not pass.

I knew ABFAS was coming and I knew they wouldd nitpick my notes so I waaaaay overdocumented everything.

Preop I discussed and listed every possible complication I could think of as well as any alternative to surgery or alternative surgical procedure and why I chose the procedure I chose.

Surgical dictation was very detailed with explaination in the note for any funny business or oddity in the xray or case.

Post op documentation was very in tune with describing no complications and ensuring the reader I was looking for complications. Or if there was a complication spending extra time describing how I am going to fix it.

Passed both foot and RRA first time. Document document document. If you dont you are your own enemy.

Document like you think an attorney is going to read the note someday and you are the defendant.

 

[Feli]

I've said it before and ill say it again. If you are graduating residency your notes need to be 100% on point.

Document everything. Spend the time. It sucks. No one likes charting. But spending an extra 5-10 minutes on every surgical note (not that that doesnt add up..) or any case that might turn surgical in the future can mean the difference between pass and not pass.

I knew ABFAS was coming and I knew they wouldd nitpick my notes so I waaaaay overdocumented everything.

Preop I discussed and listed every possible complication I could think of as well as any alternative to surgery or alternative surgical procedure and why I chose the procedure I chose.

Surgical dictation was very detailed with explaination in the note for any funny business or oddity in the xray or case.

Post op documentation was very in tune with describing no complications and ensuring the reader I was looking for complications. Or if there was a complication spending extra time describing how I am going to fix it.

Passed both foot and RRA first time. Document document document. If you dont you are your own enemy.

Document like you think an attorney is going to read the note someday and you are the defendant.

Yep... this should be a sticky. ^^

Also, the surgical pt notes HAVE to be taken with when leaving a job if not BC yet (Foot +/- RRA depending non what one is aiming for). They just have to be taken to maintain BC chances. It will take many hours... days. It is crippling to not have them later when those cases are pulled. Pristine documentation does one no good if a hostile office won't release them or a facility whose EMR the candidate can no longer access is too busy to help with case review.
Even if places you are leaving are friendly and may want to help you later on, they often won't understand or be able to find what you need. They won't treat the info collection like the candidate will. Just because a candidate has another DPM or staff member friend at the old job, that doesn't mean that friend will be there forever or that they'll have time to help when the time comes. It's in every candidate's best interest to print screen all XRs and download or cut-n-paste all notes. Privacy and etc be what they will... remove major identifiers if you wish, but have the records for case reviews. That is really the only way to do it if leaving jobs while BQ. Tldr = learn from Feli mistakes 🙂

 

[DYK343]

Yep... this should be a sticky. ^^

Also, the notes HAVE to be taken with when leaving a job if not BC yet (Foot +/- RRA depending non what one is aiming for). They just have to be taken to maintain BC chances. It is crippling to not have them later when those cases are pulled. Pristine documentation does one no good if a hostile office won't release them or a facility whose EMR the candidate can no longer access is too busy to help with case review.
Even if places you are leaving are friendly and may want to help you later on, they often won't understand or be able to find what you need. They won't treat the info collection like the candidate will. Just because a candidate has another DPM or staff member friend at the old job, that doesn't mean that friend will be there forever or that they'll have time to help when the time comes. It's in every candidate's best interest to print screen all XRs and download or cut-n-paste all notes. Privacy and etc be what they will... that is really the only way to do it if leaving jobs while BQ. 🙂

I didnt move locations but we changed EHR mid way thru my 2nd year out. I had the foot cert but not RRA yet.

Despite them promising me that all medical records would be uploaded they were not. Notes were absolutely lost in the transition.

Luckily being OCD over the process I printed every document for every RRA patient.

 

[dtrack22]

staying at a job

This is a requirement for ortho. If podiatry had a 6 month logging window, no diversity requirement and an oral case review with the same documentation standards as ortho (no f***ing facility audits or circulator notes for example) I probably would have stayed at my first job for more than 8 months.

If you think about it, a board certification process that essentially mirrors ortho would even be beneficial to PP owners. And Podiatric foot and ankle “surgeons” as well as limb salvage folks could all still be boarded by the American Board of Podiatric Medicine and Surgery

 

[dtrack22]

It is crippling to not have them later when those cases are pulled.

Yeah I would just delete those logged cases. They can’t pull what isn’t logged.

 

[air bud]

Yeah I would just delete those logged cases. They can’t pull what isn’t logged.

Yep, can't be accused of a crime if you get rid of the evidence.

 

[ExperiencedDPM]

Let me play devil’s advocate for a minute. I get the fact that many never use the “p” word.

But in the case of the ABFAS, I think I understand at least part of their rationale.

What differs “Podiatric” surgery vs foot and ankle surgery? Aren’t the procedures all foot and ankle surgeries? What exactly signifies “Podiatric” surgery? Does that simply mean it’s a case performed by a DPM?

So I think the name change may simply reflect the anatomical area we treat.

 

[deleted1138023]

At least ABPM tries to come up with solutions

 

[newfeet]

Yep, can't be accused of a crime if you get rid of the evidence.

 

[Adam Smasher]

The word "podiatry" comes with a lot of baggage. I won't fault anyone for wanting to downplay that in order to portray themselves in a way that they believe is more accurate. I use the word to describe myself not because I'm proud of it but because it's simply accurate. No matter how much surgery I do, I will never not be a podiatrist.

Not unrelated, remember the AOFAS campaign "Look for the O?" Makes sense why they would do it, but if you have a dirty mind you can see a double meaning

 

[pod squad]

Yeah I would just delete those logged cases. They can’t pull what isn’t logged.

I thought they could still request deleted cases when they do the facility audit? And if there are 'missing' cases then you're screwed?

 

[Utvolsdpm]

I thought they could still request deleted cases when they do the facility audit? And if there are 'missing' cases then you're screwed?

Yes that would be an automatic failure… but only if you get caught

 

[malleolusman]

The word "podiatry" comes with a lot of baggage. I won't fault anyone for wanting to downplay that in order to portray themselves in a way that they believe is more accurate. I use the word to describe myself not because I'm proud of it but because it's simply accurate. No matter how much surgery I do, I will never not be a podiatrist.

Not unrelated, remember the AOFAS campaign "Look for the O?" Makes sense why they would do it, but if you have a dirty mind you can see a double meaning

Oh I would love to see more of that.

The Look for the O is actually a white power symbol/ and used by the whole far right 4chan crowd. Hence when they started this campaign circa 2016 or so, the whole far right thing was raging as well. And then all of sudden, it disappeared, along with their website look for the O.

At least we know now, the AOFAS is deep in the closet with WP! Look for the power, the white power of ortho good old boys. “They (podiatrists) STINK!” - Clayton Bigsby

You are being redirected...

 

[deleted285117]

All the F&A orthos i’ve known shake their heads in shame over this nonsense. In their eyes, podiatrists are integral to the “team”. Wish they all had this view...

 

[malleolusman]

All the F&A orthos i’ve known shake their heads in shame over this nonsense. In their eyes, podiatrists are integral to the “team”. Wish they all had this view...

Hasn’t been my experience with foot and ankle ortho. Most have given me plenty of reasons to hate their guts; I really have tried to have an open mind about this, and I agree it’s regional. In the south; it’s particularly nasty. Give me good reason to respect you, and I will. The exception being a trauma surgeon who liked foot and ankle, and how ironic - he was disliked by his fellowship foot and ankle guys too.

 

[pod squad]

All the F&A orthos i’ve known shake their heads in shame over this nonsense. In their eyes, podiatrists are integral to the “team”. Wish they all had this view...

In my somewhat limited experience, the F&A orthos that view DPMs as an integral, respected part of the team is <1%. Best case scenario, they view us as helpful in dealing with diabetics, gas gangrene, amps etc. Most commonly, they want nothing to do with us and actively sabotage us within hospitals/orgs.

 

[ExperiencedDPM]

The word "podiatry" comes with a lot of baggage. I won't fault anyone for wanting to downplay that in order to portray themselves in a way that they believe is more accurate. I use the word to describe myself not because I'm proud of it but because it's simply accurate. No matter how much surgery I do, I will never not be a podiatrist.

Not unrelated, remember the AOFAS campaign "Look for the O?" Makes sense why they would do it, but if you have a dirty mind you can see a double meaning

Yep, my mind is in the gutter.

Look for the G spot and you’ll soon discover the “O”.

 

[Feli]

All the F&A orthos i’ve known shake their heads in shame over this nonsense. In their eyes, podiatrists are integral to the “team”. Wish they all had this view...

They usually fond of podiatrists who don't do surgery and just do the non-op (it actually feeds them, like PCPs... they will sometimes hire them).
They could care less if DPMs inject or make insoles or take XR... the surgery will still be needed eventually.

They tend to be somewhere between neutral and hate on anyone who does the same stuff they want to do (F&A surgery).
That is basically the case for medicine in general - especially any surgery/procedure docs.
The only obvious exception is same/similar surgeons in the same group, but even that can sometimes get messy.

 

[dtrack22]

I thought they could still request deleted cases when they do the facility audit? And if there are 'missing' cases then you're screwed?

The facility audit is one random month that happens to be a similar month/time for most folks.

ABFAS claims they will pull newer cases and that you can discuss hardship with charts from previous jobs directly with them after cases are selected. They claim to be flexible. In the case of someone who has 5,6,7…11 years of logs, there is no way that deleting a group of cases or a whole facility from years ago will (or even can) get audited. If you delete cases from august the year that you register for the case review, then sure, good chance the audit winds up being that month. Then you fail. I would never actually suggest people delete cases…or would I?

 

[dtrack22]

Here’s a question for ABFAS homers…why do I even have to log soft tissue cases, HWR, Amputations, or anything else they will never pull for case review?

 

[DYK343]

Here’s a question for ABFAS homers…why do I even have to log soft tissue cases, HWR, Amputations, or anything else they will never pull for case review?

Because they want to audit 1 month and make sure youre uploading ALL cases.
I cant remember why I had to call and ask a question about logging but I distincly remember Venson told me on the phone they would never pull an I&D or toe amp. "Maybe a TMA or chopart amp".
It can pad some of the numbers to sit though...

 

[dtrack22]

Because they want to audit 1 month and make sure youre uploading ALL cases.
I cant remember why I had to call and ask a question about logging but I distincly remember Venson told me on the phone they would never pull an I&D or toe amp. "Maybe a TMA or chopart amp".
It can pad some of the numbers to sit though...

That makes no sense. If a facility submits all of the cases you did one month then ABFAS could easily look at the list and see the cases you didn’t log were I&Ds and Amps and HWR and DPCs, etc.

 

[Feli]

...I distincly remember Venson told me on the phone they would ...

Lol, I think every ABFAS candidate in the last long while has talked to him on the phone. The Oracle.

This year I was, "hey, so I don't have any pre-op Xrays on a couple of the cases you guys pulled. I am pretty sure from reading my notes that the patients had brought in a CD, but those were years ago and I'm no longer at those offices. They don't keep CDs and don't have the pre-op images. Can you pull another case?"

And I get, "well, you won't fail just on that. If you have the other documentation on them, send what you have and see what happens."

My think bubble: "Uh, well, I would rather not fail at all." 🤔

 

[Othello]

Hasn’t been my experience with foot and ankle ortho. Most have given me plenty of reasons to hate their guts; I really have tried to have an open mind about this, and I agree it’s regional. In the south; it’s particularly nasty. Give me good reason to respect you, and I will. The exception being a trauma surgeon who liked foot and ankle, and how ironic - he was disliked by his fellowship foot and ankle guys too.

Sig Hansen is a legend. A lot of the west coast pods on the acfas/abfas scene were lucky enough to train with him

 

[malleolusman]

Here’s a question for ABFAS homers…why do I even have to log soft tissue cases, HWR, Amputations, or anything else they will never pull for case

Sig Hansen is a legend. A lot of the west coast pods on the acfas/abfas scene were lucky enough to train with him

Not referring to him.

 

[DYK343]

That makes no sense. If a facility submits all of the cases you did one month then ABFAS could easily look at the list and see the cases you didn’t log were I&Ds and Amps and HWR and DPCs, etc.

I didnt say it was logical but thats why they do it.
They want to make sure all and every case is logged so youre not hiding anything.

Its been years but I believe Venson said in an annoyed voice "Look were not going to pull a toe amp or I&D. Maybe a TMA or chopart. Were just making sure youre logging everything and not trying to hide cases".

Paraphrase as I cant remember exactly but thats what he said. I cant even remember why I called. I think I mislogged a case they picked and I called for clarification.

 

[DYK343]

Lol, I think every ABFAS candidate in the last long while has talked to him on the phone. The Oracle.

Pretty grumpy guy on the phone.

 

[wakaflocka88]

Pretty grumpy guy on the phone.

He hasn’t operated in over 50 years but still takes part in ABFAS.

 

[Sweatshirt]

ABFAS actually sent this email out acting like this is some sort of accomplishment 🤣🤣🤣 man they are such a trash organization
24% of the entire class failed all 4 exams!

 

[Feli]

ABFAS actually sent this email out acting like this is some sort of accomplishment 🤣🤣🤣 man they are such a trash organization
24% of the entire class failed all 4 exams!

I dunno... no easy answers.

MD pass rates for in-training/ BQ aren't 100% either... but MDs are a ton stricter on admissions and residency formation/re-cred evals. Their programs and attendings also consistently help and teach board exam prep.

At the end of the day ABFAS doesn't do admissions or open/close residencies. It is not asking the world for residents of a "surgical" and "RRA" residency to pass a surgical written test... or at least pass one on foot surgery (without RRA).

It's a combo failing by the pod schools (mainly admissions/grads), the residencies (too many too fast, letting garbage ones persist, directors/programs that don't or can't prep residents well to pass), and also the ABFAS (not giving more tools to residencies/directors to prep?). I would honestly say ABFAS is certainly the lowest of the three in terms of contributory negligence, though.

 

[icebreaker32]

If one complains about the exams the student is not studying hard enough or the school admitted students that might not be good test takers. I agree residency assistance is often week.

As soon as ABFAS feels the residencies have acceptable standards then I think consideration should be given to considerably easing or even eliminating case requirements. Ortho requires case, but I think general surgery does not.

I feel bad for the non surgical podiatrists but with one board I just don’t see a way for them to maintain active board certification without active surgical privileges. Maybe they could get a surgically non active designation.

There may not be the ability to directly stop more schools from opening or control how poorly employers pay, but those at the top need to do something even if it discussing what to do is behind closed doors. How can you expect good students to enter this profession and enter it in numbers with the length and cost of our training with our horrible job market?

 

[Sweatshirt]

I dunno... no easy answers.

MD pass rates for in-training/ BQ aren't 100% either... but MDs are a ton stricter on admissions and residency formation/re-cred evals. Their programs and attendings also consistently help and teach board exam prep.

At the end of the day ABFAS doesn't do admissions or open/close residencies. It is not asking the world for residents of a "surgical" and "RRA" residency to pass a surgical written test... or at least pass one on foot surgery (without RRA).

It's a combo failing by the pod schools (mainly admissions/grads), the residencies (too many too fast, letting garbage ones persist, directors/programs that don't or can't prep residents well to pass), and also the ABFAS (not giving more tools to residencies/directors to prep?). I would honestly say ABFAS is certainly the lowest of the three in terms of contributory negligence, though.

I have an easy an easy answer. It's quite simple. ABFAS has a long proven track record of being a trash organization that writes garbage exams with abysmal pass rates. They are incompetent and out of touch with the profession. They also have a long, expensive, and ridiculous case submission/review process. They should not be seen as the gold standard of podiatry anymore and should be defunded, abolished, and die off as an organization

 

[icebreaker32]

I have an easy an easy answer. It's quite simple. ABFAS has a long proven track record of being a trash organization that writes garbage exams with abysmal pass rates. They are incompetent and out of touch with the profession. They also have a long, expensive, and ridiculous case submission/review process. They should not be seen as the gold standard of podiatry anymore and should be defunded, abolished, and die off as an organization

Just to play devil’s advocate….

Do our schools all have acceptable admission standards?

Are all of our residencies of acceptable quality?

Do the majority of podiatry jobs offer reasonable surgical volume? Do podiatrists that open up solo at least get guaranteed surgical volume through paid ER call while they build their practice?

If there was a different exam but comparable in difficulty to other specialties what would our pass rate be?

 

[malleolusman]

Just to play devil’s advocate….

Do our schools all have acceptable admission standards?

Are all of our residencies of acceptable quality?

Do the majority of podiatry jobs offer reasonable surgical volume? Do podiatrists that open up solo at least get guaranteed surgical volume through paid ER call while they build their practice?

If there was a different exam but comparable in difficulty to other specialties what would our pass rate be?

It’s both. Call me cynical (which I am), but there is a reason why I am not seeking out leadership positions. It’s because I would like to tell the truth out loud about what is happening. The same reason I want to spit in the face of and trash so called thought leaders and ABFAS /ACFAS crowd.

If you are in leadership in these organizations, there is just no way you don’t realize what is happening and what the actual problems are.

These guys are on their knees with their mouths wide open ready to take it all to maintain their positions and jobs with ortho etc. They know how precarious it is out there. But will deny it, and crow the company agenda to rake it more dollars and speaking gigs. They should be openly vilified, price of crappy leadership.

I don’t agree with a lot of Dr Rogers dilly dallying initially, but I give him credit for being part of these forums and coming around to what we all have been saying.

Both admission standards and ABFAS/ACFAS are not mutually exclusive, they are very much intertwined. These guys are “thought leaders”, you wouldn’t believe how many students and ladder climbers were riding these guys jocks and still do.

In short, let’s all get back to grinding nails. Those of you with lucrative gigs - stay put, and STFU. No one is coming to save this profession.

 

[Sweatshirt]

Just to play devil’s advocate….

Do our schools all have acceptable admission standards?

Are all of our residencies of acceptable quality?

Do the majority of podiatry jobs offer reasonable surgical volume? Do podiatrists that open up solo at least get guaranteed surgical volume through paid ER call while they build their practice?

If there was a different exam but comparable in difficulty to other specialties what would our pass rate be?

Don't care. I live in the real world and don't play in hypotheticals. I know what ABFAS is in their current status and everything I said is 100% true

 

[DYK343]

Don't care. I live in the real world and don't play in hypotheticals. I know what ABFAS is in their current status and everything I said is 100% true

OK so thinking back at least 30-40% of my class I wouldnt let come anywhere near me with a surgical blade.
Their exam isnt perfect but it was passable if you know your stuff.

 

[malleolusman]

OK so thinking back at least 30-40% of my class I wouldnt let come anywhere near me with a surgical blade.
Their exam isnt perfect but it was passable if you know your stuff.

Sure. But again, where is leadership in all of this?

You do realize that ABFAS actually benefits from schools accepting so many dumb dumbs…. More failures…. More exams…. More money. This isn’t about protecting the public. I’ll add - in the city I practice in; there’s a pod I know who is just wired a little differently; ABPM cert, does 10-15 total ankles a year. This is in a major metro. He’s too busy and can’t be bothered to submit to ABFAS for cert. Does this mean this guy didn’t know what he was doing in school?

Then you have where I trained; two of the busiest pods who were ABFAS - had the worst ethics and surgical ability I had seen in residency; and later I went to practice next to one of these Foot/RRA guys. Utter scumbag of a human being; and an incompetent surgeon. A broken clock is still right twice a day. Somehow got both certs and so did his partner, who couldn’t figure out how to put in an interfrag screw. You can’t make this stuff up, but hey — because podiatry. Poop stains still make jt through the system. In Ortho and Podiatry. More so with podiatry because we are saturated.

When in doubt; follow the money. Dr Rogers posted some good info on one of these threads showing how much money they were bringing in.

Gotta ask the right questions - why is it that no one in ACFAS leadership (lots of overlap with ABFAS leadership) isn’t talking about market saturation and the terrible job market here? Follow the money.

Was at ACFAS this year, not one single lecture or seminar or breakaway or lunch break or bathroom break dedicated to a discussion on market conditions for a newly minted surgeon or mobility and improving perception in the allopathic world of what it is that we do.

Full disclosure: certed by foot/rra and ABPM. Both have utility, one just has a better perception and opens a few more doors. That’s it. Only reason I would say get ABFAS, you don’t know which organization will eventually win this fight.

 

[JewOnThis]

As of today (2023), I can say there are quality surgeons with both ABPM and ABFAS who are recently trained. By recent, I mean within the past 10 years.

 

[icebreaker32]

As of today (2023), I can say there are quality surgeons with both ABPM and ABFAS who are recently trained. By recent, I mean within the past 10 years.

It is because they are doing the same residencies now.

Although there was a time when no residency was needed, there was also a long run where only some were surgically trained and could even get ABFAS (ABPS). Many of those surgically trained also could not even get ABPM (forget old name) based on the type of residency they did (PSR 12/24/36/36+). Of course during this time period they were much better trained. Now all residents can get both boards and some get tripped up with the ABFAS process like they always have for various reasons, but are still competent surgeons,

Why get ABFAS? There are definitely still certain parts of the country you need it.
The job market is competitive, so it is an edge for certain jobs that most will not get anyways. I would not be surprised if soon it it is mainly ACFAS fellows getting these desirable jobs. Many more are achieving ABFAS than in the past.

Our main problem is the job market. If we were in demand and a certain area was not ABPM friendly you would just pick from a long list of jobs elsewhere. The board situstion is not ideal and can hopefully be merged one day. It does not mean we should not talk about. It does not mean there are not sad stories whose life it ruins like Dr. Rogers has mentioned. The truth is though, that it still pales in compassion to our job market. Our poor job market continuously ruins many more podiatrists’ lives.

In podiatry you need a strategy to get a good job. You need a strategy to open an office. Finally, you often need a strategy to get board certified in surgery (choose a job with enough numbers and do not job hop for a better job). Hard work, many years and money spent on an education and finishing your residency is usually not enough to be a desired commodity with recruitment and jobs paying 200K with good benefits, signing bonuses and loan repayments etc. For a good ROI this is what it should be like. Yes 200-350K is attainable with many hospital jobs or many successful (or scammy) private practices. The job most will get though is nothing close to this and opening an office is not easy and without risk. The good jobs often require one to be geographically open, and to an extent the location of where to open an office does also.

Yes 300K and 7-8 years beyond college and you need strategies for things like getting a good job and board certification in surgery. For those already here play the game and you might end up having the doctor’s life someday. For those considering podiatry I would highly recommend you think long and before hard choosing podiatry given our job market. If we were not saturated this profession would be so much better.

 

[DYK343]

Sure. But again, where is leadership in all of this?

You do realize that ABFAS actually benefits from schools accepting so many dumb dumbs…. More failures…. More exams…. More money. This isn’t about protecting the public. I’ll add - in the city I practice in; there’s a pod I know who is just wired a little differently; ABPM cert, does 10-15 total ankles a year. This is in a major metro. He’s too busy and can’t be bothered to submit to ABFAS for cert. Does this mean this guy didn’t know what he was doing in school?

Then you have where I trained; two of the busiest pods who were ABFAS - had the worst ethics and surgical ability I had seen in residency; and later I went to practice next to one of these Foot/RRA guys. Utter scumbag of a human being; and an incompetent surgeon. A broken clock is still right twice a day. Somehow got both certs and so did his partner, who couldn’t figure out how to put in an interfrag screw. You can’t make this stuff up, but hey — because podiatry. Poop stains still make jt through the system. In Ortho and Podiatry. More so with podiatry because we are saturated.

When in doubt; follow the money. Dr Rogers posted some good info on one of these threads showing how much money they were bringing in.

Gotta ask the right questions - why is it that no one in ACFAS leadership (lots of overlap with ABFAS leadership) isn’t talking about market saturation and the terrible job market here? Follow the money.

Was at ACFAS this year, not one single lecture or seminar or breakaway or lunch break or bathroom break dedicated to a discussion on market conditions for a newly minted surgeon or mobility and improving perception in the allopathic world of what it is that we do.

Full disclosure: certed by foot/rra and ABPM. Both have utility, one just has a better perception and opens a few more doors. That’s it. Only reason I would say get ABFAS, you don’t know which organization will eventually win this fight.

I dont disagree. ABFAS is not a perfect exam. But everyone here talks about how hard it is to get certified yet a dumb dumb (the RRA cert person you describe) was able to do it.

THere has to be something to show competance in the surgical world. Podiatry admissions allow in anyone with a heart beat and a paycheck. Not everyone is destined to be a surgeon with a 2.5gpa in undergrad and 2.6 in podiatry school with a residency in new york.

Hell even the 4.0 students some of them (there was one in my class) that I wouldnt let anywhere near me. Just because youre book smart doesnt mean you should be a surgeon. MDs have different paths. Podiatrists should too. ABPM cert for clinical. ABFAS for surgery.

I dont think board exams should be in charge of job market saturation. That should be on the APMA/CPME. ACFAS is a surgical board. ABPM is a board. They are not in charge of making sure everyone gets a paycheck.