Are there enough RESIDENCY slots this year?
Started by footpodguy
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i'm not sure if it was just podiatry, but the residency shortage i believe began
in the 60's and 70's. so more spots were created, and more students entered podiatry and med school to avoid the draft, during vietnam war. this led to a projected surplus in 1986, and various allegations of insurance fraud by pods decreased spots. then came the 90's, and enrollment was increased again. this lead again to a projected "surplus" and so, the
Balanced Budget Act of 1997, which i believe is still in effect, was created. this act established reduction in Medicare-allowed fees. It also froze Medicare-funded resident positions.
keep in mind however residency was not mandated prior to this act. pods still did 1 yr programs and were ok for private practice.. there were more spots than students entering residency before 97.
what did the schools do to address this? again, at that time i believe there were still 2 yr residencies. pods were still able to practice i think without a residency=mostly private practice. also, there were fewer pod schools as well. so the situation basically resolved itself.
now that the 2yr residencies are being phased out, and residency is mandated, with the addition of another school, increasing enrollment, and some residencies only for the military or the VA not opening up new spots..i think now is a true shortage, as opposed to the 90's, but again, i could be wrong.
>pods still did 1 yr programs and were ok for private practice.. there were >more spots than students entering residency before 97.
I agree with the above. We were better off with the 1 yr RPR, PPMR, POR, PSR12. That way everyone had a program.
This idea of a PMS 24 / PMS 36 is just stupid
No one needs a 3 year residency to study and work on the foot...lol. That's a joke. So, I think some of these lazy people in charge of the residencies need to fix this!!! They fail to adress this problem over & over again. They seem to actually make it worse.
There are still a lot of students without programs for this year. I have heard 30-40+, that is alot. What are these students to do?
Let's get back to the 1 years programs. That is what my friends did & for most of them they are doing good...but not all. In school, they never taought us how to run a practice.
So, instead of paying residents for 2 or 3 years & having only a few. Why not spread the money out, eliminate these long programs & make some shorter one.
I agree with the above. We were better off with the 1 yr RPR, PPMR, POR, PSR12. That way everyone had a program.
This idea of a PMS 24 / PMS 36 is just stupid
No one needs a 3 year residency to study and work on the foot...lol. That's a joke. So, I think some of these lazy people in charge of the residencies need to fix this!!! They fail to adress this problem over & over again. They seem to actually make it worse.
There are still a lot of students without programs for this year. I have heard 30-40+, that is alot. What are these students to do?
Let's get back to the 1 years programs. That is what my friends did & for most of them they are doing good...but not all. In school, they never taought us how to run a practice.
So, instead of paying residents for 2 or 3 years & having only a few. Why not spread the money out, eliminate these long programs & make some shorter one.
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Why do all MDs and DOs do at least 3yrs of post grad residency? They're "a joke"?
It's all about standardization of training and comprehensive medical and surgical education. It gets pretty old trying to explain why some pods are qualified to do a triple arthrodesis or calc fracture yet others shouldn't be given privileges for hammertoe procedures or even OR wound debridements.
I have 2 good friends, one did a 1 yr PPMR, the other I think an RPR & a POR. They are just chip & clippers...they do not want to do surgery. They are making excellent money. They like what they do.
I have a friend who has done 3 residencies, including an advanced program, I take it that means surgery. he chips & clips for another pod.
Everyone does not want to do surgery. you can make a good living with a basic podiatric practice. I have scrubbbed on cases....achilles tendon re-attachemnt, man that pod messed that person up, at the school clinic on top of things, I have been in on hammertoes, heel spurs, etc.
Just makes me think of that surgeon who did the achilles re-attachment. Man that anchor flew out of this person & hit the wall, lucky the school had an extra anchor.
My point, everyone does not need a PMS24/36.
I have friends that are MD's & Do's...yes that is a lot more leanring & should require a 3 year residency. But, you do not need 3 years to know the foot.
I have a friend who has done 3 residencies, including an advanced program, I take it that means surgery. he chips & clips for another pod.
Everyone does not want to do surgery. you can make a good living with a basic podiatric practice. I have scrubbbed on cases....achilles tendon re-attachemnt, man that pod messed that person up, at the school clinic on top of things, I have been in on hammertoes, heel spurs, etc.
Just makes me think of that surgeon who did the achilles re-attachment. Man that anchor flew out of this person & hit the wall, lucky the school had an extra anchor.
My point, everyone does not need a PMS24/36.
I have friends that are MD's & Do's...yes that is a lot more leanring & should require a 3 year residency. But, you do not need 3 years to know the foot.
Again...I agree
If you have some old CASPR books, look back at the amount of programs a few years ago. Next year a lot of these programs shut done because they never got filled. Why isn't anyone trying to get them back. If I still have the info I will list them.
One I remember:
Coatsville VA ( no longer around)
We need to bring back these one year programs for general practice. This will be of some help.
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Coming from a students standpoint, I think that most of us do want to be able to do surgery, and in fact that is one aspect that attracted many of us to podiatry. There are some students that end up not liking surgery after doing their rotations, but even for them, my opinion as a student is that they should get surgical training in residency, and then when they are practicing, they can tailor their practice to their desires.
And, I could also agree with you. As I said, I did scrub for surgeries, at more then one place. As you said some students end up not liking it. I did not think it was so great waking up at 5:00 am & being in surgery by 7 and then having a full day ahead of you. I would rather have a nice 9-4 office setting. Just where do you draw the line, & when is enough enough
Maybe most of you want to do that, fine. I did not. I went into this field because it looked like a nice profession without the schedule of a MD or DO....if so I could have tried that route. I was accpeted to all 3 pod schools & I applied to one DO school, which I cancelled my interview at the DO school.
My point that I am trying to make in Re: to another post...is why not bring back some of these other programs for those not into surgery. By the way, you still do surgery rotaions in PPMR. Anyway I even scrubbed in on General surgery.
A PPMR offers a nice alternative. Because most of the pod students are unaware of this, they seem to disagree. So, many of you are now stuck without a program. Why?.....because, all the 1 year programs where dropped to make way for these 3 years programs.
I agree with you. A single year residency program option should be available to all students. This meets most if not all state requirements and will allow the DPM to work in conservative care podiatry, where there is THE MOST NEED IN THE COMMUNITY! Some DPMs will make a living working in conservative care. Let those who wish to continue on to surgery have that option. The high powered surgical programs will get candidates who actually want to be there, not because it's the only place the student could get. My friends with surgical training do primarily C&C because that's what the community needs are; it's what the patient base is in many regions of the US.
Conservative care pods can still do minor surgeries like nail avulsions and verruca curretage. Malpractice insurance is less and overhead is often less for conservative care practice.
It would be very nice to see 1 yr residencies with an option to continue on into surgical training rather than mandatory surgical training for all to be able to get state licensure. 👍
getting the one year back will never happen, just because (and could be wrong) but PA, DPT, they do more than a year. that's the way healthcare is. but the second year residencies are being phased out, because of the belief you need a three year residency to become board certified.. that would be true if there were one surgical board..but we have many, and not all require a three year residency. while students are strongly urged to do so, if all i can get is a two year spot, so be it. but not getting one at all? well, as another student said, we got what we wanted--3 yr residencies..and so, this is what we get.
there is a need for competent students who excel in primary care. not everyone was cut out to do just surgery. you can still scrub in on surgery cases in a 2yr residency..compared to the older pods who never did residency per se, and are teaching students btw..even a two year is a step up.
its not so much the length of training that will give us parity with the other physicians..heck, MDs who go into anesthesia or surgery etc never take the classes we do, they learn it hands on..its the emphasis and knowledge of general medicine, speaking the language with other residents that will show the medical community we are worth our salt. but that is an issue that should be addressed with the schools first, not trying to gain parity by increasing residency training. fix the schools, then worry about how much surgery a pod can do. and besides, a three year surgery residency for us when an orthopod can do a 6 month fellowship and still do what we do? and a three year doesn;t grant you unlimited surgical rights in every state, either. you can be qualified as you want, but some states want a MD supervising you anyway. no one however will dispute your right to treat wounds, manage DM patients with neuropathy, treat on the basis of biomechanics or orthotics, etc etc etc.
i don't know, man..it is what it is and we just have to take it, i suppose. hopefully this will resolve itself once we graduate.
D
dyk343
Not that it really matters for this discussion, but physical therapists have 1.5 years of course work and 1.5 years of clinicals... not "residencies"
They want only 3 year residencys so that everyone has the same training. I think the idea is that if everyone is standardized then all other specialties will know that every single pod can do full scope podiatry. All pods can do conservative care, foot surgery, and reconstructive surgery. This would make referrals easier since the referring physician doesn't have to figure out...wait does this pod do rear foot? does this pod do ankle? And even if the podiatrist is pm&s36 trained but does not want to do an ankle case...atleast he knows what needs to be done (since he has probably seen a similar case in residency) and can then refer to a pod who likes to do ankle cases.
In residency right?
Wait fix the school? But the MDs learn hands on...in residency...so how is the problem in the schools?
Fellowship after the 5 years of surgery in all other parts of the body. They have already learned a lot of surgery. They have a HUGE leg up once they start the fellowship. They already have good hands, they already understand a lot of surgical techniques, etc.
Which states?
Not all residencies are created equal, and adding a year of training will not change that, unfortunately. You need to log "X" amount of 1st assist rearfoot cases during residency to be qualified to take the rearfoot board certification.
If the residency is in an area where they don't see a lot of RF surgery for whatever reason, adding a year is not addressing the problem, its actually making it worse for that resident. Perhaps they wanted a 2 year residency and are not interested in rearfoot? Now what? So you spend an extra year of training with no added benefit (as far as standardization of the profession is concerned).
I could see adding extra slots to programs, that makes sense. Adding another year to the 2 year residencies just shows that the powers that be simply don't understand the problem with our profession.
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True, all residencies will be three year. However, not all pods graduating the new mandatory 3 year residency programs will have been trained in rearfoot. The 2 year programs that are being bumped to a 3, but have few rearfoot cases won't provide the rearfoot training.
I haven't heard exactly what the 3rd year of training for these programs will be. Has anyone else? I think they should be filled with more general medicine rotations.
I do know that they are looking for a way to denote whether a resident does have the rearfoot cases in residency...maybe like a seal on a diploma.
The idea is for everyone to do a 3yr residency that trains full scope podiatry.
Yes I think starting next year the 2yr residencys will now be 3 years long and (depending on the program) won't be qualified for RF. I would imagine that as the program grows (more attendings, etc.) it will qualify for RF in the near future. Also keep in mind that there are only a few 2yr (non-RF) programs remaining. I did a quick count and out of 211 programs, only 35 are 2yr. I think the reason for making the 2yr programs 3yrs long is 1) parity with MD/DO which are 3yrs minimum and 2) for them to eventually do RF
Yes I think starting next year the 2yr residencys will now be 3 years long and (depending on the program) won't be qualified for RF. I would imagine that as the program grows (more attendings, etc.) it will qualify for RF in the near future. Also keep in mind that there are only a few 2yr (non-RF) programs remaining. I did a quick count and out of 211 programs, only 35 are 2yr. I think the reason for making the 2yr programs 3yrs long is 1) parity with MD/DO which are 3yrs minimum and 2) for them to eventually do RF
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What? What state would that be?
The other statement that is misguided is that an orthopod can do a six month fellowship and "do what we do". No, they can't. Very few orthopods do what we can do. That is why podiatry exists. After a F&A fellowship, a lot of orthopods end up "dabbling" in foot and ankle but for various reasons tend to do a lot of other stuff. In my area, there are 3-4 F&A orthos that actually do a fair amount of mostly rearfoot/ankle stuff (5 million metro area) and they still send a lot of forefoot to us. Sure, you have a handful of nationally recognized F&A orthos around the country that do "everything" but these guys are the definite minority.
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That is a pretty ignorant statement. Patients come in without a foot but you never see a foot without a patient attached. As a medical provider, I would hope you would want to have knowledge of the body. Sure, you won't be treating CHF or managing diabetic meds, etc. but you should know how they affect the body. Medical management of patients will come during residency. All residencies should be 3 years, there has to be uniformed standards. If you get done and don't want to do ankles or any surgery, that's fine but you need to know it. Who wants to be clipping a patients nails and they ask you a question about a procedure they need and you can't even answer it because you only did 1 year of warts and toenails.
Some programs may never get the rearfoot case load needed. So even those programs won't train a resident to do everything that could be possible in that state. So we still won't be training full scope/knowledge breadth and still have a residency shortage!
I do disagree with your #2. Since all of this has started to get underway, I haven't heard anything about getting those 2 year programs RF numbers up. I do agree with #1 and have heard this as the only argument for increasing to 3 years. As of right now, there will still be a distinction between programs with enough rearfoot caseload and those who do not. So whether the diploma says PM&S 24 or doesn't say RRA, it's the same means to an end.
I personally think we should stick with both 2 and 3 year programs. There are great pods out there with a 2 year under their belt and do what they need to for their patients. Like I said before, some small community hospitals may never get the rearfoot #'s needed. There is no guarantee. So what are the residents learning for another year that makes them more functional than a recent 2 year grad?
The residency shortage came from schools accepting too many students. Not too long ago there was a huge residency surplus.
And I have heard that they are trying to do away with the number of certain procedures and go straight to direct observation. The argument is that 1) theres no evidence that doing for example 50 bunions makes you good at doing bunions...I guess they just picked the numbers with no basis on research. 2) direct observation is great at assessing competency...if you are doing the procedure correctly, etc. 3) it would allow residents to focus on technique instead of numbers. If this is done then this would allow those 2 yr programs who have some RRA but not enough according to the current numbers to become "real" 3 yr programs.
I admit I haven't been paying attention to the exact numbers but if I recall correctly, there were more 2 yr spots and less 3 yr spots last year than this year. A lot of 2 yr programs have transitioned into 3 yr programs because they have been able to finally get enough RRA volume.
And again, there are only a few 2 yr programs left. Only 35 out of the 211 programs. I truly think the idea is to transition these into full 3 yr programs.
I have not heard about what you talked about in the first paragraph, but it's really interesting. I agree that the numbers seem really arbitrary?!
There have been a lot of transitions into 3 years, before this new thing goes into effect. I think that if the powers-that-be put effort into local education & trained attendings, those programs might be able to convert to full training facilities. Hopefully this happens 👍
Here's the link... http://www.podiatry.com/etalk/Verification-of-Surgical-Competency-t2294.html
I don't know how in depth this topic is being discussed in the CPME but this is what one of the attendings on that forum said...
"A question was asked of the CPME board members at the 2nd weekend meeting regarding the validity of MAV's for competency. One of their board members, an ABPS member, stated to the audience that there was, in fact, NO evidence to backup repetition as a basis to judge competency."
This will never happen. It'd be asinine.
General surg, ortho, and every other surgical specialty still goes off numbers... minimum req volumes are needed to graduate residency/fellowship and to test for their specialty-specific cert boards thereafter. The other MD/DO surgical specialties don't do A/B/C logging in the way pod residencies log on PRR, but the MD/DO training surgeons just log reg cases and "chief cases" (implied as they did most of the case... aka our "C" logs). They have minimum volume of total cases and a min vol of chief cases to graduate their programs. Also, I may have heard wrong, but I'm fairly sure the current CPME pod residency PMS model numbers are at least loosely based off ortho F&A volume req numbers.
Yes, a competency based system would be ideal since I may do 300 bunions in my 3yrs but still suck at them while Joe Schmoe did 30 and is awesome, but numbers will always remain the easiest way to judge experience for training, board exam elgebility, hospital privileges, etc. Observation is subjective... numbers are not. Unless you are going to have the same master surgeon observe every chief resident in the country year after year - and remain unbiased while doing so - then observation instead of volume as a means of competency analysis is a pipe dream.
You bring up very good points. I admit I didn't really give it much thought...I just wanted to share some info I heard about in another forum.
Back to the 1yr vs. 2yr vs. 3yr debate...I recently spoke with a 4th year med student who will be starting his gen surg residency in a couple of months regarding this issue. He brought up a good argument for having only 3yr residencies. He said, "You should know everything about the foot and ankle, surgical and non-surgical, because you are the last person who will see that patient." When it comes to a foot and ankle problem, podiatry, as a whole, will be the last specialist that patient will see. And even if a certain Podiatrist doesn't do a certain procedure then atleast that podiatrist knows what the procedure will do, success rates, compications, etc. One of the "problems" in medicine is the disconnect between medicine and surgery. If podiatrists are trained in all aspects of podiatric medicine, then we will be able to provide better continuity of care.
Wow...lot of views...what did I start?
The truth...residency shortage.
Bring back the 1 yr PPMR pls...I have a job waiting if i can get a residency. I friend offered me a great offer. I just have been out of Podiatry a long time. I need a quick 1 yr res. that's all...it is reqiuired in his state.
thanks.
The truth...residency shortage.
Bring back the 1 yr PPMR pls...I have a job waiting if i can get a residency. I friend offered me a great offer. I just have been out of Podiatry a long time. I need a quick 1 yr res. that's all...it is reqiuired in his state.
thanks.
@podpal:
do one year residencies really meet state and hospital requirements? I thought that most hospitals want you to be BQ/BC in foot surgery and that would require more training than one year. If you are correct and I hope you are that is amazing because I would have to agree with you that bring back the one year for the overflow students that dont match so that they can start earning money after one year training.
@footpodguy:
agree with you that if you can practice in your community with a one year residency, then it should be brought back as a consideration for those who dont match. Why make those who didnt match wait another year, when really they can try for a one year psr 12 or ppmr and get into practice within 12 months and then later consider further training once their loans are well on the road to repayment.
BTW Coatsville was awesome, I remember Warren Joseph was an attending there. And those VA patients were strong and could take pain.
@jonwill
agree with you. in fact even in Canada we have 99% of rearfoot going to ortho and some forefoot going to pods.
the interesting or sad part (depending on how you look at it) is that to get into some provinces (states) in Canada you need to do a two year residency, even though you cannot get privileges in the hospital or do any major trauma or limb salvage. so i would have to agree with footpodguy that some basic residencies are required.
do one year residencies really meet state and hospital requirements? I thought that most hospitals want you to be BQ/BC in foot surgery and that would require more training than one year. If you are correct and I hope you are that is amazing because I would have to agree with you that bring back the one year for the overflow students that dont match so that they can start earning money after one year training.
@footpodguy:
agree with you that if you can practice in your community with a one year residency, then it should be brought back as a consideration for those who dont match. Why make those who didnt match wait another year, when really they can try for a one year psr 12 or ppmr and get into practice within 12 months and then later consider further training once their loans are well on the road to repayment.
BTW Coatsville was awesome, I remember Warren Joseph was an attending there. And those VA patients were strong and could take pain.
@jonwill
agree with you. in fact even in Canada we have 99% of rearfoot going to ortho and some forefoot going to pods.
the interesting or sad part (depending on how you look at it) is that to get into some provinces (states) in Canada you need to do a two year residency, even though you cannot get privileges in the hospital or do any major trauma or limb salvage. so i would have to agree with footpodguy that some basic residencies are required.
They might be not for profit, but that just means they are taking a different route in trying to make a profit. I worked for a not-for-profit hospital for 2 years. They were looking after their bottom line more than any other place I've been employed.
I'm not even sure it SHOULD happen. I realize that the 3 yr residency looks fantastic for the profession, but what about the people who don't really care about the surgeries the profession CAN do? Why not let them pursue a residency for 1-2 years in the area they feel they would be better at and forgo surgery.
Isn't this just part of life? No matter what profession you go into, there are going to be risks. Like Podfather, I'm all about changing our model to something similar to the dental. But until then I'm going to make sure I'm close to top of my class and ensure myself a quality residency somewhere.
If we don't have standardized education and don't pursue the full extent of our specialty...then how can we call ourselves the Foot and Ankle Experts? What is the big deal with learning more and spending another year or two in residency?
"Yes I'm an expert....but I don't know how to do an ankle fusion or when to do an ankle fusion because I'm not really interested in it..."
Do students do ortho residency but decide before starting that they don't want to do a certain aspect and therefore never get trained in it?
No, you get the best and most complete training possible and if you choose to not utilize all of it, that's fine but at least you were trained. No other medical speciality does less than 3 years, why should podiatry?
Any student entering podiatry school today should know and expect to be surgically trained. This isn't something new, the profession has been trending toward more and more surgery focused for years now.
Don't get me wrong, I think everyone should be getting the best training they can. But, I feel there is enough demand out there that those who want to do a 1 year residency and jump in and get started with their practices should be able to do that. Much like most dentists get started right after school, podiatrists shouldn't feel like they have to complete a 3 year program to do wound care or basic foot care. I have no problem going to my non-Oral-maxillofacial surgery DMD or DDS to have a cavity filled. Why should someone fret about having a non-surgical trained DPM do some debriding.
Those who want to pursue foot and ankle surgeries should be the ones duking it out for the residencies, much like dentists who want to do the OMFS and orthodontic residencies compete to get into those programs. It would solve the residency problem and improve the quality of the surgical residents which would only help podiatry in its efforts to gain the respect it deserves.
I guess my point is, why is podiatry pushing surgery on all the graduates? I'm sure a good number of graduates do not make good surgeons and a lot of those don't even want to be surgeons. Why put them through a 3 yr residency? And I'm sorry but I almost find it frightening when I see the number of 3 yr surgical residencies and think that the vast majority of podiatry students will get surgical training. Are we doing the profession a favor by allowing less than mediocre physicians practice surgery? Allowing each and every graduate access to surgery only waters down surgery in podiatry while limiting the surgical residencies would only help the profession in the long run.
Thoughts?
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I seriously doubt that anyone becomes an expert in EVERYTHING related to the foot and ankle. Especially with all the new technology and advancements in medicine. Life's just not long enough.
Podiatry advertises itself as the Foot and Ankle Experts. So why sell yourself short by doing a shorter residency purely because you "aren't interested in surgery or ankle reconstruction"? More training will only benefit you and what is another year or two? A 3 year residency is not THAT long at all. And the current 3 year residencies are the closest thing we have in fulfilling our role as the Foot and Ankle Experts.
IMO Podiatry is a surgical specialty. It is very procedural based. Yes Podiatrists do conservative care...so do other surgeons. Only when conservative care has been exhausted should a surgeon start cutting.
Just because you get surgical training doesn't mean you will do surgery. The hardest part about surgery is diagnosing the problem then figuring out which procedure to do. With surgical training, one can still practice non surgical podiatry but will also have a very good idea of when to refer the patient for surgery. If you don't know when to cut, then how will you know when a patient will need surgery?
The more training we do, the more patients we will be able to treat. If all Podiatrists do 3 year residencies, then all Podiatrists will be able to pretty much treat any and all Foot and Ankle problems. Referral sources will notice that and Podiatry will be able to get more and more of the patient base.
I can just imagine what happens now..."This patient has a ankle fracture." "Ok, so who do we send this to...ortho or podiatry?" "Do you know any Podiatrists who do ankles?" "Can they even do ankles?" "Screw it...just send them to ortho."
This is what probably happens now without standardized training. Because out of 10 Podiatrists in the area, 5 probably have no surgical training, 3 have forefoot surgery training, and 2 have RRA training. So why would a referral source go through all the trouble to see which podiatrists can take this case? They will just send it to Ortho.
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zloetakoe said:
They can drop out and go to PA school. PA's are gaining more and more procedural opportunities and they don't ever have to do surgery. Plus it's cheaper and only 2-3 years of training as opposed to 7.
Oh, they could become Dr. nurses too if the PA route doesn't appeal to them
i see what you are saying, but the real..ticker is, while every pod graduate who gets residency will have surgical training, that does not do away with the older pods who did not have the same level of training. they will still be in practice when the new pods get out. what the ortho or med community sees , or keeps in mind are these older professionals who did not do a three year residency. they do not, or are aware of what the new training is like. so why not keep the two year? you'll be just like the older generation who still makes a living and it was good enough for them. many of these dpms taught us right? even with a three year there is still a chance it will get referred to ortho anyway..shoot, the DO students I talk to don't even know we do surgery. that magically changes with a three residency? nope, because we have to change the face of podiatry--one that is still being carried by the older generation who are not going to step aside for the "new, improved pod grad".
on another note, this shift to extended residencies and tougher curriculum stats must make older pods nervous, no? i know i heard some crazy stuff about grandfathering on some boards..and back then , most schools were pass fail..true?
As a graduate of a 2 year residency in the mid 1980s, let me assure you that you or any of the "new, improved grads" do not make me nervous. This very attitude that the more senior DPMs are holding the profession back is irritating at best. My generation opened all of the doors your generation takes for granted. I train the new generation and to this day work at the state and national levels to continue to improve your future profession. Many of the 3 year graduates I now train can not keep up with some of our senior faculty both didactically and surgically. Yes the training we provide them is and should be more evolved than it was 25 years ago. That is true for any residency in any medical specialty. That doesn't mean that we (the older pods as you describe it) sat around and became outdated. Our experience and constant work to stay current keeps many of us at the top of our game and the profession. I respect today's graduates and continue to teach them so they in 25 years will be at the top of the profession giving back to their future colleagues. Nobody has been grandfathered (urban legend) in regards to board certification. Please keep your ego in check and rather than slam those who support you, I would prefer you just say Thank you.
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Some of the best pod surgeons I've scrubbed with did a 1yr residency. Not even joking. It's a matter of hard work, intelligence, determination, and attention to details... not simply chronological length of residency training.
The fact of the matter is that in podiatry, we need to constantly strive for better admissions criteria... harder working, more intelligent, more interested students. Like almost anything in life, it's a "get out what you put in" type of situation. That's probably a big reason I spend a fair amount of time on these forums: Yes, I enjoy it here and gain info, but I also like to help answer questions for interested pod and pre-pod students who are looking to apply themselves and "put in" the work to be good DPMs in the future. It's a great profession for those who have talent and apply themselves, but it goes without saying that the current pod school application pools have and continue to be a bit more "diverse" than MD or DO, esp at some of the schools.
My residency director likes to say that "we're all judged by the lowest common denominator," and he couldn't be more correct. If you have three good FACFAS pods doing high level diagnostics, rearfoot surgery well, etc yet a couple other DPMs mismanaging foot infections, putting TED hose on PAD patients, injecting steroids into renal failure patients, etc... then guess what the general view of podiatry will be by most staff physicians in the hospital? It's human nature to prefer watching or talking about a train wreck as opposed to the 99.9+% of safe, uneventful Amtrak trips. Pod is a small specialty, and that makes it fairly easy for bad apples ruin it for everyone.
I sure think (hope?) that the "lowest common denominator" will be improved with 3yr training across the board. The total number of H&Ps, med rotations, surgery cases, etc that today's pod residents are required to have done during training is ever-increasing. However, that's all pretty much out the window when residency ends; from that point on, it depends a lot on the individual's motivation and work. If DPM Jones doesn't do any surgery besides Austin bunions, neuromas, and hammertoes for his first 5 years out of residency, then he basically mised well have not done the more complex cases when he was there either. If DPM Stewart uses her journals as coffee cup coasters, would rather buy purses than textbooks, and sleeps through CME lectures after residency ends (and maybe did during it also?), they chances are that she'll be prescribing antibiotics and doing surgical procedures that are behind the times before too long. Everyone took geometry, gym, and US history in high school... but I doubt many people would say they'd ace those courses' final exams if given today.
Podiatry is an absolutely fantastic career for those who apply themselves. Today's middle of the pack grads are getting pretty good 3yr programs, yet there were smarter men than them getting no residency or just a 1yr post grad training not too long ago. Nonetheless, it's a mistake to write those past grads off or dismiss their skills as "grandfathered in." They worked hard for their skills, and they were smart people. They know the anatomy just as well. Furthermore, they probably retained a higher % of their relatively limited post grad educational experiences since they may have had to actively seek much of the education out while some more recent grads are 3yr trained yet might have been in cruise control for much of it. Clinical exposure and residency experience is priceless, but a lot of medicine ends up being "use it or lose it"... you always have to stay on top of your game in terms of new advances, developments, etc.
In all sincerity, THANK YOU! Generally the profession in headed in the right direction, and you "old" pods have made all the difference.
I see your point Feli, but also wonder if we shouldn't hold the graduates who are getting 3 yr residencies to a higher standard as well. Certainly, in a model where not everyone gets a 3 yr residency we need to provide a way for those who don't do the 3 yr residencies a way to make a living, but I feel raising standards both before pod school and before residencies would go a long way as far as getting respect for podiatric "surgeons". I like what your professor said about the LCD. If everyone is able to do a 3 yr, that common denominator is going to be lower as far as surgery and complicated cases is concerned. BUT, you make a good point- hopefully if everyone is doing a 3 yr, they'll all be learning enough to be excellent podiatrists in the future. Either way, the real battle is keeping as sharp as possible.
According to one of our faculty members, 93 fourth year podiatry students did not pass part II of the national boards. I have been told that his makes them ineligible for residency training and therefore all of those who had a residency position and did not pass will have to forfeit their spot. They will have to take a year off, retake part II, and if they pass they can enter next year's match.
This would seem to make the residency "shortage" now a moot point as there are now more positions than students that have passed part II.
This would seem to make the residency "shortage" now a moot point as there are now more positions than students that have passed part II.
It might seem that way. But you have to take into consideration that students fail part II every year at a fairly consistent rate (the national average was ~83% this year?). We were also told, that on average, only 1/2 of those those taking part II for the 2nd time will pass. So adding half of the 93 to next years total graduating students will be significant, but not devastating.
Also, those requiring a second attempt to pass part II will be at a significant disadvantage when reapplying to residency programs.
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Theoretically yes but from what has been stated before on these forums it seems like its the "kiss of death" if you fail any board exam. It could be very difficult for these students to ever land a residency position. Now are all of them NOT going to match the following year? Prob not. I am willing to bet there are some students who actually have solid gpas but maybe choked on their exams that might find a spot somewhere in the next match.
All I can say is DAMN! 93 students failing their 2nd board exam?!? Isn't the 1st board exam harder then the 2nd?
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g squared,
can we get a source? I'd love to read about this somewhere official rather than get it 2nd hand hearsay
I was under this impression as well, but was never told directly so I must have just assumed. Apparently schools don't advertise their part II scores as often because they aren't that impressive. Even here at DMU, the 4th year part II pass rate was only 93%, so ~3 people failed (again, this is what a clinician told our class this morning).
Part III is supposed to be easier than the first two exams by comparison. I heard from several residents to not even study for it (although they were fairly intelligent people).
As far as a source, I don't know of one. I will ask our academic dean if there is any official document or source that can be released.
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If I'm not mistaken, some residencies only allow to pass part I to start residency if the state laws allow it. In addition, the residency director has the discretion to allow their matched resident take part 2 again if they failed the first time as long as the results (pass) come out before July 1st (which it should).
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Good point gsrimport. Anybody else have any insight to this? If thats true then I guess that complicates things once again.
Here's a thread regarding the failing part II issue.
http://forums.studentdoctor.net/showthread.php?t=713421
http://forums.studentdoctor.net/showthread.php?t=713421
What a JOKE!!
You should not need to pass part 2 to get a residency.
When I graduated, you did NOT HAVE TO "PASS" part 2...you HAD TO TAKE IT, that is all. Not PASS...just TAKE it! Take it for what, for who? What was the the reason. Students took it, failed it, did a residentcy, THEN passed it...went on into practice...very simple.
Why...money, money & more money....who is getting this money..aacpm?
Now, why are these programs requesting passing of Part 2?
From what I understand..in Pa. you need Part 1, 2 & 3 in Podiatry...BUT...& I repeate BUT....if you are a DO or MD, you do not need all this...they grant you a temp license ..similar to what some programs in NY do.
So we are being taking advantage of. Face the fact. No one needs a 3 year program on the foot....if you want to do a triple ..great...go do it HOTSHOT!
I have a job offer..chip & clip & great money...but I have no residency, so this DPM hired someone to do it for him. Guess you can call him a pod assisiatnt...& he is doing well with cash.
Do not make podiatry similar to MD & Do's...we are not & never will be...I do not care what the CPME is trying to do with these studid 3 year programs.
We need the old one year programs back...PPMR, POR, RPR. Please believe me when I tell you. I know people who have done these programs & have done well. They did not even do a PSR 12. They do not what to do surgery. They have a nice lifestyle, nice homes, great money...more then what some of you will have.
I will tell you a story.. this goes back a while, I do not know what they are doing now. My friend completed a PPMR, 1 year. Went into practice & was doing 6 figures after a while. He was friends with a guy who did a surgical residency ( PSR24 , I think). I also knew this guy, but was not real close with him. These 2 guys kept in touch...the PSR guy even taught at one of the pod schools. Then left to go into practice. He was making far much less then the PPMR guy, and would call the PPMR gyuy for advice...what can he do. This PPMR guy was an average studentm his GPQA lower then mine & he is making a lot of money.
The point...no need for these stupid long programs. Let's get everyone a program, the overlow will continue. Let's get these 1 year programs back. If you do not want them, fine, go for the PMS 24, 36, you can do wht YOU want. But think of your classmates & people like me. I just need a simple PPMR, RPR or POR, and I have job offers.
Please...even if you are a PMS resident, push for this, help the others. Not everyone needs a big program. Let's work together, think of your fellow students & other DPM's like myself.
Thank you.
You should not need to pass part 2 to get a residency.
When I graduated, you did NOT HAVE TO "PASS" part 2...you HAD TO TAKE IT, that is all. Not PASS...just TAKE it! Take it for what, for who? What was the the reason. Students took it, failed it, did a residentcy, THEN passed it...went on into practice...very simple.
Why...money, money & more money....who is getting this money..aacpm?
Now, why are these programs requesting passing of Part 2?
From what I understand..in Pa. you need Part 1, 2 & 3 in Podiatry...BUT...& I repeate BUT....if you are a DO or MD, you do not need all this...they grant you a temp license ..similar to what some programs in NY do.
So we are being taking advantage of. Face the fact. No one needs a 3 year program on the foot....if you want to do a triple ..great...go do it HOTSHOT!
I have a job offer..chip & clip & great money...but I have no residency, so this DPM hired someone to do it for him. Guess you can call him a pod assisiatnt...& he is doing well with cash.
Do not make podiatry similar to MD & Do's...we are not & never will be...I do not care what the CPME is trying to do with these studid 3 year programs.
We need the old one year programs back...PPMR, POR, RPR. Please believe me when I tell you. I know people who have done these programs & have done well. They did not even do a PSR 12. They do not what to do surgery. They have a nice lifestyle, nice homes, great money...more then what some of you will have.
I will tell you a story.. this goes back a while, I do not know what they are doing now. My friend completed a PPMR, 1 year. Went into practice & was doing 6 figures after a while. He was friends with a guy who did a surgical residency ( PSR24 , I think). I also knew this guy, but was not real close with him. These 2 guys kept in touch...the PSR guy even taught at one of the pod schools. Then left to go into practice. He was making far much less then the PPMR guy, and would call the PPMR gyuy for advice...what can he do. This PPMR guy was an average studentm his GPQA lower then mine & he is making a lot of money.
The point...no need for these stupid long programs. Let's get everyone a program, the overlow will continue. Let's get these 1 year programs back. If you do not want them, fine, go for the PMS 24, 36, you can do wht YOU want. But think of your classmates & people like me. I just need a simple PPMR, RPR or POR, and I have job offers.
Please...even if you are a PMS resident, push for this, help the others. Not everyone needs a big program. Let's work together, think of your fellow students & other DPM's like myself.
Thank you.
Let's push for PPMR POR RPR.
We need these badly! The overflow will continue. Call aacpm & find out.
Remember, you might be here begging for this when you have no program. I know people who graduated with higher GPA's then I & did not get a program. I did, I matched....but that was a while ago. I need a simple one year to brush up my skills.
Undergrads, consider this...you to can be left out.
We need these badly! The overflow will continue. Call aacpm & find out.
Remember, you might be here begging for this when you have no program. I know people who graduated with higher GPA's then I & did not get a program. I did, I matched....but that was a while ago. I need a simple one year to brush up my skills.
Undergrads, consider this...you to can be left out.
