"Best" Fellowships?

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Ipronate

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Hello everyone,

What are the top fellowship programs in foot and ankle surgery?

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If you had a program where you didn't get a lot of skin to skin, you feel unprepared, you barley got your numbers, you wanted to do more of something like trauma or rearfoot, then maybe its worth looking into to feel more comfortable and confident.

If you are doing it for better job prospects then hahahaha.
 
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Hello everyone,

What are the top fellowship programs in foot and ankle surgery?

There is no best fellowship, because it depends on your reason for seeking one.

Where to find a fellowship?

1. CPME only “approves” 16 fellowships (out of about 90 available). Those are in institutions and have agreements that protect the fellow and residency (if there is a co-located PMSR). You can find them on the CPME website.

2. ACFAS “recognizes” about 50-60 fellowships. They’re light on requirements and there is a risk you could be treated like an apprentice. So speak to current and previous fellows in your due diligence.

3. Some fellowships are neither, like UTHSCSA (although we just submitted the CPME application, UTSW, USC, and others. These advertise separately or are word of mouth. Fellowships that are in major academic centers with GME programs are likely to be protective of you since the agreements come from the University. They have all the elements I list below plus a process to address grievances like sexual harassment, etc.

*In your fellowship agreement make sure there is PTO, sick time, CME, malpractice all clearly spelled out. Also make sure there are no non-competes or malpractice tails. Also if it is a billing fellow (you have independent privileges) your cases can count for your boards so make sure there is an agreement to allow you access to the records after you end.

Why do you want to do a fellowship?

1. To improve become proficient in a subspecialty of podiatry. There are many for limb salvage (some more reconstructive than others), some for trauma, some for podiatric sports medicine, a few for research, and a few for podo-peds, + a few others.

2. To improve your skills from residency. Look for the foot and ankle surgery fellowships. F&A surgery is a part of residency and you shouldn’t need to do one to be competent. In fact, IMO, CPME shouldn’t even approve these since they’re duplicative. But they can help if you need more cases for general F&A surgery.

3. To be an academic. Choose a fellowship in an academic medical center. You’re working side-by-side with many other specialties and sub specialties and can collaborate on research.

4. To be mentored. That’s why I did a fellowship. Find someone you respect and want to emulate your career.
 
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Oh um then UT San Antonio with Dr. Rogers is the best fellowship to do

If you’re referring to the fellowship in Amputation Prevention and Research at UT, I am not the director, Dr. Collin Pehde is.

But it most certainly is the best if you want to learn the administrative and leadership skills necessary to start your own hospital-based limb salvage center. Leadership potential is the top attribute we look for in a candidate.

The fellow also learns to function on a multidisciplinary team in a large academic medical center and how to prepare research, publications, and lectures.

It is not the place to come if you just want to improve your surgical skills. A fellow candidate for UT must be proficient in surgery when starting and their primary role in the OR is teaching residents and students how to do surgery.

Aside from complex Charcot reconstruction which is a niche offered by the program. Fellows get experience with 2-3 recons per week, including pre-operative planning by 3-D printing.
 
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I’ve asked this question before but never get an answer. Where do I start if I want to make my voice heard and start contributing to the profession?
 
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I want to get involved. Who’s ring do I have to kiss to get into the super secret club?

Or do I need to waste my time and do a fellowship at Penn to make it in this profession?

1. First be a member. You’re not going to be a leader of anything by never being a member of anything. APMA, State Association, Local Association, College/Society, Board, etc. Get involved and show interest.

2. Just ask. There are plenty of opportunities at all levels to be involved. Do you know someone on the BOD of any of these organizations? Ask them if there are any committee opportunities. You might not get your first choice, but do a good job and you’ll move quickly.

3. Write something. Start sharing your opinion in blogs on PM News or Podiatry Today.

4. Create a following. Communicate with others. Discuss the problems facing the profession and how to help.

5. An ounce of patience (and prove yourself). There are few leaders in the profession. If you want to lead and can convince others to support you (sometimes it’s just one decision-maker, other times you have to win an election), but it won’t take long if you have the desire and skill.
 
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This thread probably needs to be locked. It's a **** show. Y’all need to get ahold of yourself and cut the bickering.


However, fellowships rarely seem to be worth it as you are sacrificing another year of decent income to more or less continue residency a fourth year, and it probably won't help job prospects all that much.

I see many fellowship trained pods take the same associate gigs as everyone else, so was it really worth it? Only you can say, I suppose.

But also keep in mind, that student debt keeps accumulating interest while you are arguably only marginally improving yourself professionally and probably not improving yourself at all financially.
 
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If you had a program where you didn't get a lot of skin to skin, you feel unprepared, you barley got your numbers, you wanted to do more of something like trauma or rearfoot, then maybe its worth looking into to feel more comfortable and confident.

If you are doing it for better job prospects then hahahaha.
Winner right here. ^^

When you think it through, most fellowship directors are 2yr or 3yr trained. If you did a good 3yr podiatry residency, you should be all set. You already did more surgical- and especially medical/hospital- training than most fellowship and residency attendings. If you didn't do good 3yrs or want to go above + beyond, fellowship might be considered... but training wheels will still need to come off someday. :)

Good reasons = more cases, research, great attending(s) to learn with
Questionable = can't find a job, trying to make connections, want to work for the fellowship group/hospital afterwards

It'd be a diff convo if DPM fellowships changed your specialty/boards and led to some extra specialized cert or more income (as MD/DO ones do)... but they do not.

...best fellowships are all among the ACFAS ones:
Hyer
Scott (CORE)
Camasta
Cotton
Klutts
Hollawell
Hofbauer
Klutts
Ng
(others... depends on what kinda cases one likes or feels incompetent in after residency)

Even a lot of the ACFAS ones unfortunately aren't amazing if you did a decent residency. The ones above are mostly in ortho groups or otherwise get very good refers for big cases. Many are just attendings from a residency who knew that by starting a fellowship that they basically get a dedicated chief resident or two to assist and see clinic and pub papers for them 24/7... awesome for them, not ideal for workhorse fellow or especially not good residents who lose/share those cases.

In the end, it's a personal decision. :thumbup:
 
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ACFAS “recognizes” about 50-60 fellowships. They’re light on requirements and there is a risk you could be treated like an apprentice.

Many are just attendings from a residency who knew that by starting a fellowship that they basically get a dedicated chief resident or two to assist and see clinic and pub papers for them 24/7... awesome for them, not ideal for workhorse fellow

So the real question is how does one go about starting a fellowship 🤔

I've always been amused that anything can be a fellowship, as long as it's packaged properly. "The Advanced Outpatient Fellowship" or AO Fellowship for short. One more year of general podiatry but you get to call yourself a fellowship trained foot and ankle surgeon at the end.
 
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So the real question is how does one go about starting a fellowship 🤔

It is a real question and unfortunately has a real simple answer ... desire to start a podiatry fellowship and Bob's your uncle!

That's why it's still buyer beware for podiatric fellowships.

Much of this is the fault of CPME. They have abdicated their responsibility to provide meaningful oversight for fellowships, like ACGME would. The newly adopted standards were just published in CPME 820. They're heavy on institutional standards and light on any standardization and curriculum. I wrote comments from ABPM (attached here in PDF) which were largely ignored ... but would have greatly improved this and created parity with ACGME processes for fellowships.

CPME gets their lacy undergarments in knots when any board (other than one) mentions the word surgery, since they claim it's in their purview to oversee, however, they don't seem to care if ACFAS (or anyone else) provides oversight for fellowships, also under their purview. Imagine if that happened in the MD/DO world?

The 17 or so fellowships listed on the CPME website are all at institutions with good directors, but CPME hasn't made approval of fellowships attractive or worthwhile.

Lesson here is to decide WHY you want a fellowship first, then target based on those reasons. I'm a supporter of fellowships. My fellowship in 2006-2007 was probably the single best thing to advance my career on the trajectory it became.
 

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Wow mods really be power tripping in here today. Wild. :unsure:

Feel free to call each other out in person or in DMs, but not in this thread.
Anymore personal attacks from both sides and thread will be locked.

Personal opinions regarding program quality, format of current podiatry fellowship culture/training, benefits/detriments of fellowships do not break TOS

Personal opinions that belittle users or are contrived from ad hominems will be deleted.
 
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It'd be a diff convo of DPM fellowships changed your specialty/boards and led to some extra specialized cert or more income (as MD/DO ones do)... but they do not.

Wow! A different convo indeed ... :cool:

Screen Shot 2023-07-24 at 5.12.09 AM.png

And speaking of parity with MD/DOs in specialty certification ...

Screen Shot 2023-07-24 at 5.12.45 AM.png
 
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All of these issues are a byproduct of a massively oversaturated field with podiatrists tripping over each other trying desperately to make a better living.
you need to move next to Dr. Rogers then!
1690212760863.png

Podiatrists listed on Google near zip 78229
 
I think the big thing to keep in mind whether it’s worth it or not to do a fellowship is that the high powered fellows are the types of people who would be able to land big 300k jobs with or without the fellowship to begin with. They were already exemplary residents from strong high volume programs who go to fellowship for their own reasons.

If you’re just chasing money it can be a toss up whether fellowship is worth it or not. If you aim to be involved in academics, speaking, leadership especially on the ACFAS side of things it can be very important to introduce you into that world. Many high powered fellows I know continue to be actively involved in teaching post fellowship for example and have a true passion for their work.
 
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I think the big thing to keep in mind whether it’s worth it or not to do a fellowship is that the high powered fellows are the types of people who would be able to land big 300k jobs with or without the fellowship to begin with. They were already exemplary residents from strong high volume programs who go to fellowship for their own reasons.

If you’re just chasing money it can be a toss up whether fellowship is worth it or not. If you aim to be involved in academics, speaking, leadership especially on the ACFAS side of things it can be very important to introduce you into that world. Many high powered fellows I know continue to be actively involved in teaching post fellowship for example and have a true passion for their work.

There’s a couple of fellowships that will plug you right in to medical device industry/consulting which is valuable. I mean there are DPMs who are lecturing and “teaching” at courses before they are even board certified. Which is laughable, but hey…Podiatry.
 
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There’s a couple of fellowships that will plug you right in to medical device industry/consulting which is valuable. I mean there are DPMs who are lecturing and “teaching” at courses before they are even board certified. Which is laughable, but hey…Podiatry.

Yup.

I chose not to do fellowship but im also not a type A person quite frankly I just want to work and go home.

But those I know who have done those high power fellowships are absolutely killing it and very successful. So I try not to crap talk fellowship to be honest.
 
Yup.

I chose not to do fellowship but im also not a type A person quite frankly I just want to work and go home.

But those I know who have done those high power fellowships are absolutely killing it and very successful. So I try not to crap talk fellowship to be honest.

Now let’s compare the success/employment outcomes of the handful of high powered fellowships with the dozens of other unregulated fellowships.
 
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Now let’s compare the success/employment outcomes of the handful of high powered fellowships with the dozens of other unregulated fellowships.

Yeah I think you’ll find a massive difference there.
 
you need to move next to Dr. Rogers then!
View attachment 374711
Podiatrists listed on Google near zip 78229

Or move in! We're up to 10 DPMs at UT this year, recruiting 2 more now. Probably at least another 2 next year.


You could have a podiatrist on every street corner here and there would still be plenty of business.
 
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We're recycling some old talking points here but here's my $0.02.

Fellowship training is good for some, wasteful for many, and overall bad for podiatry. As it stands, 7 years is too much training for fungus, heel pain, and forefoot surgery. We can romanticize that "oh some of us will choose to do fellowship and some of us will choose not to" but there's so much one-upmanship in this profession that fellowship training, or at least applying for fellowship, is going to become the norm if it has not already. Just as schools prepare us for residency and not for practice, residencies will prepare us for fellowship and not for practice.

Here's why this is bad for podiatry: pre-health students aren't stupid. They want to know how many years are they going to spend before they hit that pot of gold at the end of the rainbow. They'll vote with their feet.
 
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Or move in! We're up to 10 DPMs at UT this year, recruiting 2 more now. Probably at least another 2 next year.


You could have a podiatrist on every street corner here and there would still be plenty of business.
Pretty impressive growth! Something to be proud of.
 
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Or move in! We're up to 10 DPMs at UT this year, recruiting 2 more now. Probably at least another 2 next year.


You could have a podiatrist on every street corner here and there would still be plenty of business.
Nice.
 
Here's why this is bad for podiatry: pre-health students aren't stupid. They want to know how many years are they going to spend before they hit that pot of gold at the end of the rainbow. They'll vote with their feet.
Is there even a pot of gold at the end anymore? Few will be lucky to get some silver. Most (unfortunately) will end up with a pot of fungal dust at the end of the rainbow.
 
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Or move in! We're up to 10 DPMs at UT this year, recruiting 2 more now. Probably at least another 2 next year.


You could have a podiatrist on every street corner here and there would still be plenty of business.
What is driving this growth? I know the podiatry division has been around for a long time but seems since you started you've essentially doubled the group. San Antonio has certainly grown as a city so makes sense but still 14 pods at UTHSCSA would be impressive. Are you employing any PAs/NPs in the division?
 
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