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AOFAS Policy Statement on Podiatry

Discussion in 'Podiatry Students' started by dpmgrad, May 9, 2007.

  1. dpmgrad

    dpmgrad Senior Member
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    Here is something interesting that came in my email today.

    AOFAS Board Approves Policy Statement on Podiatry

    Last fall, leaders of the American Medical Association (AMA), American Academy of Orthopaedic Surgeons (AAOS), American Orthopaedic Foot & Ankle Society (AOFAS), and the American Podiatric Medical Association (APMA) met together at the podiatry organization’s request. Discussion focused on podiatry education and training and on the established path to unrestricted licensure, i.e., medical school, USMLE, and residency training. The AMA’s follow-up letter advised the APMA to discuss podiatry education and training with the ACSME and ABMS, The AOFAS statement that follows is consistent with the dialogue with the APMA.

    Position Statement: The AOFAS and Podiatry

    1. The AOFAS believes that members of the podiatric community provide a valuable service when they function within their education and training.
    2. The AOFAS believes that nationally recognized educational standards which are widely accepted by the medical profession are an essential means of educating and credentialing practitioners to provide safe and effective patient care. These standards are essential to maintain the public trust.
    3. The AOFAS believes that au practitioners who provide surgical care should meet the uniform educational and training standards established by the Accreditation Council on Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS). All foot and ankle care providers should be educated, trained and credentialed by the same standards as other medical and surgical specialties.
    4. The AOFAS believes that separate and unequal credentialing and accreditation are not in the best interest of quality patient care.
    5. The AOFAS believes that patient care would be best served it the podiatric community: a) prepares all podiatric students to take and pass the standardized U.S Medical Licensing Examination (USMLE) at the completion of podiatry school, as is required of medical students; b) attains and maintains ACGME accreditation for all podiatric residency programs, and c) prepares and requires podiatric res dents to pass a certifying examination prepared by a member board of the ASMS.
    6. The AOFAS is willing to assist regulatory and credentialing bodies to achieve these goals.
    7. The AOFAS is willing to work with the podiatric community for the benefit of patient care.

    AOFAS Board of Directors

    Source: AOFAS Newsletter via Marque Allen, DPM
     
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  3. jonwill

    jonwill Podiatrist
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    Interesting. I think what you're seeing is that ortho is realizing and willing to admit that pods are the future of foot and ankle surgery. Those poor people still have the rest of the body to worry about!
     
  4. Feli

    Feli ACFAS Member
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    I agree that this is big news.

    Dr. Allen is a very respected man in podiatry. I had the privilege of attending a pair of his presentations at a sports medicine seminar, and they were highly informative. It really makes you consider the possibilities and what hard work it takes to reach the pinnacle of a medical specialty. His practice was very interesting to me and appeared fairly unique for a DPM, but I hope many more of our colleagues are able to foster successful relations and gain the mutual respect of the orthopaedic surgical community in the ways he has.
     
  5. krabmas

    krabmas Senior Member
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    Hey Jon and Feli - did you read the whole thing?

    The beginning was fine but the rest was basically saying that they only support us if we follow their guidelines and tests.

    I am not against the USMLE but why should we take a test by ASMS(?) when we already have the only certifying F &A board/exam? We should require the ortho F &As to take our test.
     
  6. dpmrunner

    dpmrunner Junior Member
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    Interesting, I completely agree, we should take the USMLE then no one can say "oh we did this or that"......BUT, then what about the pods that go to school and start arguing that if they pass the same test what if they change their mind and want to try for a regular residency....

    The more I think about it the more I like the idea, there would be a transition year or two but it would be the next logical step. Keep the pod colleges and organizations around for a while but start taking the regular physician licensing exams. Give pods an option if they want to try for other residencies.....within a year or two there will be MUCH more competitive pod schools, and you would still get the ones that couldn't quite get into other specialties so they're in podiatry, and you'll still get the ones that can't make it.

    It is coming to the point where the whole podiatry thing should be another residency option for MD/DO but based on the history of podiatry that would take a long time to transition to if at all.
     
  7. Feli

    Feli ACFAS Member
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    I am in full agreement.^ I think pods should start taking (and passing) the USMLE pt1 if they want to further the parity argument, but we'd have to be allowed to first.

    As far as I know, USMLE part 2 for DPMs would be pretty questionable. Pods do so many more hours of 3rd/4th year pod clinic than MD/DO, and the current NBPME pt2 has a lot of important and pod-specific content that the USMLE does not give much/any attention to (biomech, radiology, etc).

    As for the other surgical certification exams, I'm not really far enough to comment; you'd know a lot more than me.

    I can't say I am of the same opinion.^ It's certainly been discussed, but I think that a DPM education is different (radio, biomech, LEA, pod-specific classes and clinics, etc). Podiatry school graduates get podiatry residencies... No matter what boards they pass, that's my view.
     
  8. cool_vkb

    cool_vkb Member
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    Then Podiatry will lose its essence. i had stats to go to DO school or school in Australia or carribean. But i chose Podiatry over all because that i wanted to do. i knew from beginning i wanted to be in orthopedics. And podiatry appealed to me bcoz it was offering a specialization right from beginning and cutting the extra courses like gyno, psychiatry,etc which are basically useless if someone is dead serious in ortho ,etc.

    So if tomorrow Pod schools start blending and ameding their curriculum so that pods cud change mind and join other residencies then pods will be losing their identity and whats the whole point of having a pod school then. we could just start calling it a regular medical school.
     
  9. dpmrunner

    dpmrunner Junior Member
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    Cool- I could have went to other schools and other things too, that wasn't my original intention for my point of view. Any way you look at it, it goes back to the history of podiatry, if it didn't start the way it did it would be and stay part of an MD/DO curriculum.

    I also agree Feli that we would lose the essence of podiatry but as of right now it is still shifting quite a bit and some of the oldies could say the same, IF it ever did switch to how I said (which I don't think will really happen in the near future or close to near future) the residency would have to be longer, as general physicians have a wider knowledge base when podiatry students start to specialize more and learn more how certain things relate to the lower limb. You can't deny though that within a year or two the applicant pool would increase and the quality of students going through ALL podiatry schools would increase if switched to the USMLE boards.

    An interesting idea would be "what if every specialty started to branch out like podiatry" The way medicine is, you really only apply certain aspects you learn in the basic science years, and with the ever increasing knowledge of every field, the free time could be spent to be that much more of a master of the specialty as with podiatry, things can be tied to aspects of the specialty right away. There would be medical universities but with several colleges. The downfall of course would be that everyone would be locked into a specialty right away, which many people don't like the idea of.....not sure if my views of this came off as clear or not....oh well, back to physical diagnosis
     
  10. dpmrunner

    dpmrunner Junior Member
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    Feli- I also just skimmed over your post before posting a reply (I know real intelligent of me...) but yes, I think just taking part I and then skipping part II for now would be a good plan that would help to level the playing field when such people as some on these boards like to try and justify their school choice and how something may be superior then something else....

    Never got that, arguments start of intelligently then degress quickly to who is better when they are two separate things and that is why they are separate, it seems simple to me.....but enough of getting off topic
     
  11. Feli

    Feli ACFAS Member
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    That is an interesting though; I was thinking along those lines a couple months ago:
    http://forums.studentdoctor.net/showthread.php?t=371332&highlight=specialties+podiatry (post #15)

    I think Feelgood and krabmas were right in their replies in that thread, though: pod schools will become integrated with or swallowed up by MD/DO schools before MD/DO schools would ever break into separate specialty programs a la pod school...
     
  12. Dr_Feelgood

    Dr_Feelgood Guest
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    I just want to point out that of the DO programs about 50% of the DOs that take USMLE Part I pass. Usually the DOs that take the test our the top students, so what makes you think that DPMs are going to score well enough to pass?
     
  13. Feli

    Feli ACFAS Member
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    I don't disagree at all. I think barely any podiatry students would pass USMLE pt1 if they took it the weekend before or after NBPME pt1. Off the top of my head, my rough guess would be that maybe 20-30% of AZPod and DMU and 10-20% from the other pod schools would pass USMLE pt1. Agenda #6 and #7 in the original post are interesting, though, and it seems that ortho is willing to work with pod to reach universal standards (including taking USMLE) and help raise patient care levels.

    Like I said in another thread when someone asked about how hard podiatry pt1 boards are ( http://forums.studentdoctor.net/showthread.php?t=394090 ), I think NBPME will be a lot easier than the USMLE. I guess I have no proof of that other than the fact that USMLE questions have more answer choices (and the anecdotal basis that the practice USMLE questions in my prep books are significantly harder for me than the practice NBPME ones).

    The USMLE might be a nightmare for most pod (and DO?) students, but I feel that it's a vital part of making the parity argument legit and making our profession better in the end. I don't know about most pod students, but I'd probably kick up my studying a few notches if I knew that I was taking the USMLE in addition to, or instead of, the NBPME pt 1 in a couple months. Pod students who pass USMLE could then maybe apply for unfilled ortho F&A fellowships after residency (or can they already?) and those same top student/grads would probably be preferred in hiring processes from some hospitals and ortho groups.

    Wow, am I ever gonna look dumb if I fail boards in July :laugh:
     
  14. oncogene

    oncogene Senior Member
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    Hey feelgood I am not sure that most of the DOs that take the USMLE are the top students. I know that most of the top do but, many others take it as well. How do you know that. Just curious.
     
  15. densmore22

    densmore22 Member
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    It's not really the board test that you take that attracts students to the profession (I hope not at least). Why would we want to sit for the USMLE? Why not the COMLEX because there's more of an affiliation of Podiatry schools with DO schools than MD. We've got a great, valid test (independently proven). It assesses our knowledge and skill level. We're starting to get into dangerous territory here. I think we're at a place/juncture here where the MD/DO professions are finally starting to back up what DPM's are doing and the schooling we're receiving and this is just another way to piss them off (not that we need their approval or blessing or anything like that). If you want to make our profession better, then we should be focusing on a national scope or no scope (like what MD's/DO's have-thanks feelgood). That will go way further than us sitting for the USMLE. It's an aribitrary goal to want to sit for the USMLE IMO because, as stated, we already have a valid test. If you want to take the USMLE or COMLEX, then go to MD/DO school. We don't have Pharmacists, Dentists, Optometrists, etc sitting for it, so why would we? I just don't get it. The statements above posted by dpmgrad is just a board of people acknowledging that Podiatry is a legit field, but they want US to conform to what THEY want. They're not inviting us to do what we want, they're basically saying that if you want this, you have to do what we say. I'm not down with that. We're a completely autonomous profession and we don't really need the approval of an MD/DO group to function.
     
  16. Feli

    Feli ACFAS Member
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    This is very logical thinking, and I don't totally disagree.

    I just think that it's very hard to evaluate whether students from three different degree programs (MD, DO, DPM) are on the same academic level and have the similar enough curriculum standards when they're taking three different tests. I'm certainly not saying the NBPME should be scrapped, but I don't think it's unreasonable to ask pods to take the USMLE if we want the same rights/pay/scope/etc that MDs get...
     
  17. Podman

    Podman Senior Member
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    I'm a fan of taking the USMLE. Not only does this help the image of our profession and fit with what we're trying to accomplish in the long run, but it also forces the schools to up and raise their standards. No school, with the exception of DMU and AZPOD, is really preparing their students for the USMLE - yes we all take the same path, pharm, anatomy, and physio classes but Medical schools gear their curriculum to prepare their students for their respective boards - the USMLE. And because, DMU and AZPOD already have their classes integraded with medical programs, then their students have the advantage - therefore, the opportunity to sit for the USMLE alongside their DO counterparts. My point here, is that with the opportunity to sit for the USMLE, we are putting the pressure on the not-so top schools to up their standards.
     
  18. Dr_Feelgood

    Dr_Feelgood Guest
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    I agree with your points. I would like to see the USLME write a podiatric version of the USLME. The questions would be taken from the USMLE bank but LE anatomy would still be included. Then we would get the benefits (respect, cheaper test) and decrease the negatives (lower scores b/c the LE section would be easy points, boards that do not address podiatric needs).
     
  19. Afternoon -

    I have been searching past articles from professional organizations (AOFAS, APMA) and the SDN commentaries... and wondering if anyone had heard anything new about the AOFAS and APMA - the area I'm particularly looking for is anything describing the AMA AOFAS working/not-working with APMA to draw clear lines of universal distinction and acceptance.

    Any leads would be much apprecaited, thanks!
     
  20. SubRosa

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    :thumbup:

     
  21. jonwill

    jonwill Podiatrist
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    No, I haven't heard anything since the AOFAS released the statement. I don't see the podiatry world changing much over it because I think most see it as a last ditch effort by the AOFAS to get some sort of control over something that has already been lost. They produce a handful of foot and ankle surgeons every year while we produce four to five hundred. Couple that with the many foot and ankle fellowships that remain open year after year and it's not hard to see where this is all going. I was, however, quite fond of a few suggestions (USMLE).

    I don't see this as a negative thing though. You have to realize that most orthopedists do very little foot/ankle surgery anyway. That is the entire reason that podiatric medicine has evolved into largely a surgical sub-specialty (I just finished up with a trimalleolar ankle fracture in the ER and ortho is alive and well at our hospital). That's not to say that there still aren't some very talented foot and ankle orthos out there because there are. At the same time, it's not hard to see what the future holds. And in my opinion, that is OK because those poor people have enough to deal with as it is.
     
  22. IPODiatrist

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    very well put.
     
  23. Sundarban1

    Sundarban1 Devil in disguise
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    Please provide the logic behind the bold (no pun intended) statement. I fail to see how taking the USMLE will expand the scope or salary of podiatrists and curious to know why you think the contrary.
     
  24. Creflo

    Creflo time to eat
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    We're the ones wanting parity, so if we want parity, we should take the same board exam. If we don't want parity, then we should not. If our goal is parity, and they are willing to work with us to take their board exams, then I say go for it.
     
  25. zephryus14

    zephryus14 zephyrus14
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    A mute point, but Scholl also takes classes with their MD counterparts and has a similar curriculum set up.
     
  26. Feli

    Feli ACFAS Member
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    I never said that taking the USMLE would make scope or pay the same, but it would certainly help to further the parity agreement. There is a reason that APMA's #1 goal in the 2015 parity plan is education. Legislation, PR, and interprofessional relations are all fine and good, but they're going to be pretty tough until it's proven that our education is on the same level. The USMLE is the quickest and simplest way to prove that competence, so it's likely that, as well as maybe ACGME approval of residencies, is where podiatry is headed if they really do want parity.

    Right now, I think podiatry's current curriculum and board exam structure is adequate, but may have to lose much of what makes us different (specialized and focused F&A knowledge in schools and boards) in order to get true parity. As it stands, there is really no concrete answer if other medical societies (ie AOFAS) claim that podiatry's education or board exams are dissimilar or easier than those which MDs must pass. Those kind of claims could potentially limit scope or privileges, and that would likely mean loss of pay and inability to utilize the full extent of our training.

    Osteopathy went through this decades ago, and they didn't achieve full parity in pay, scope, training opportunities, etc until they made their curriculum and boards basically parallel to those MD programs. Today, some DO students pass the USMLE, some of them fail it, and many don't even attempt. Still, it's a step to prove their education is highly similar. They still have their limitations in terms of residencies/fellowships, but their education is proven to be highly similar.

    This is exactly right.^

    Personally, I'm fine with where pod is at right now. We have many good education programs and training systems available. Patients and primary care docs come to realize who in their area can provides the best care for the pathologies. If choose not to visit or refer to the best trained specialist just because of his/her degree title, then that's not really a business connection you want anyways. 2015 is mostly just about egos and reimbursements IMO, but it would be nice to prove to the MD community, once and for all, that pods are highly trained. That would probably help to cut down on the turf, privileges, and scope battles/ Still, those scuffles will go on forever as they always have between all kinds of medical specialties (ENT/plastics, g-surg/GI, ortho/plastics, vasc/rad, anesth/neuro/spine sx, derm/path, etc etc etc).
     
  27. Sundarban1

    Sundarban1 Devil in disguise
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    Well, you did say that you would not be adverse to students taking the USMLE "if we want the same rights/pay/scope/etc that MDs get..." which at the very least implicitly suggests a connection between taking the USMLE and an increase in pay and scope of practice. Since I did not see the connection, I posed the question. If you meant the change would pave the road for the 2015 parity objective, I agree.

    It's obvious that the current education system of pod schools mirrors the allopathic coursework for the most part, however as you point out, and highlighted in the article, there would have to be greater emphasis on education if we expect pod students to be on par with their allopathic counterparts in terms of USMLE performance. The elephant in the room then becomes raising the standards of admission to pod school.
     
  28. Moniker

    Moniker Member
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    :laugh:

    you're a riot. i'm trying to figure out which part of your post to put in bold as particularly hilarious, but it's all so priceless i can't choose.

    as far as the topic is concerned...

    edit: ah screw it. whatever.
     

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