Cert results

[GreenHousePub]

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I wonder if you guys are arguing different things. There’s a difference between timing on when to operate on elective Charcot recon on a stable foot that has no wound but is preulcerative and a bit painful vs infected acute Charcot

Probably are, but that takes the fun out of an Internet argument

 

[Bored Snorlax]

I wonder if you guys are arguing different things. There’s a difference between timing on when to operate on elective Charcot recon on a stable foot that has no wound but is preulcerative and a bit painful vs infected acute Charcot

Charcot recon? More like reconstructing what was said through an emoji6 minefield

 

[Adam Smasher]

It’s not dicey.

Everyone in the room knows these patients are gonna lose their leg if they’re not dealt with surgically for offloading or reconstructive surgery. But people like to hide behind an A1c.

If this is how you practice then do not do limb salvage surgery because you’re doing a grave disservice to the patient .

This is what bugs me about podiatry because we have so many different podiatrist. Who say they do Wound Care and limb salvage, but it really is just debridement and skin substitutes and no surgery because they are too afraid to operate if the A1C is not perfect.

Learn MIS

Not sure if this is directed at me personally or just a broadside against more conservative DPMs. But it is a fact that there is increased risk with high HgA1c. So yes, it's dicey. That doesn't mean never do it, you just weigh risks and benefits.

I like doing MIS bumpectomies and tendon releases because I just need the patient to heal a 5mm skin portal, and nothing needs to fuse no matter how much they ignore my instructions. I don't do your Charcot heroics; I send those pts to a certain elite podiatry residency in my metro, where the DPMs there have published on this and some were formerly on the ABFAS board. They have turned away patients of mine because of...high HgA1c.

PLUS, even if I wanted to, the anesthesia dept at my hospitals/surgery center won't allow me to schedule an elective case if the HgA1c is too high.

 

[air bud]

Not sure if this is directed at me personally or just a broadside against more conservative DPMs. But it is a fact that there is increased risk with high HgA1c. So yes, it's dicey. That doesn't mean never do it, you just weigh risks and benefits.

I like doing MIS bumpectomies and tendon releases because I just need the patient to heal a 5mm skin portal, and nothing needs to fuse no matter how much they ignore my instructions. I don't do your Charcot heroics; I send those pts to a certain elite podiatry residency in my metro, where the DPMs there have published on this and some were formerly on the ABFAS board. They have turned away patients of mine because of...high HgA1c.

PLUS, even if I wanted to, the anesthesia dept at my hospitals/surgery center won't allow me to schedule an elective case if the HgA1c is too high.

Bro, 5mm is MIS? Check the meme thread

 

[Adam Smasher]

Bro, 5mm is MIS? Check the meme thread

Elaborate, please

 

[Bored Snorlax]

Elaborate, please

Bro, 5mm is MIS? Check the meme thread

Maximally invasive surgery vs Minimally invasive surgery 😏

 

[MicroPod]

I used to joke in residency that we did MIS… Maximally Invasive Surgery

 

[air bud]

I used to joke in residency that we did MIS… Maximally Invasive Surgery

My director used to say "small incisions small brains"

 

[Retrograde_Nail]

My director used to say "small incisions small brains"

Well you went to a crappy residency program so it makes sense.

 

[diabeticfootdr]

ABFAS has 2 tiers of certification for the same training program. If you don't get RRA, you aren't certified in everything from your residency training. This is unlike every MD specialty certifying board. The American Board of Radiology doesn't certify you to read x-rays with one test, and then MRIs with another test. ABPM will certify you in the entirety of your residency training with one exam based on the residency curriculum.

 

[Feli]

ABFAS has 2 tiers of certification...

Which one did you pass?

 

[Retrograde_Nail]

ABFAS has 2 tiers of certification for the same training program. If you don't get RRA, you aren't certified in everything from your residency training. This is unlike every MD specialty certifying board. The American Board of Radiology doesn't certify you to read x-rays with one test, and then MRIs with another test. ABPM will certify you in the entirety of your residency training with one exam based on the residency curriculum.

All residency programs are not the same. Unfortunately. The training is too variable even at the residency level. Everyone knows this.

That is why there is a foot and rearfoot/ankle board.

Don't get upset at the organization. Get upset at the quality of training overall throughout this profession. If we can't all train the same and maintain the same quality then there are just too many podiatrists being pushed through school and through residency training.

This training disparity does not exist in any MD/DO specialty.

 

[blessed.pod]

So, I passed my RRA but failed my foot. 470/500. Dinged for patient satisfaction, Dinged presumably for not putting an ambulatory patient on blood thinners. Patient developed a DVT 6 weeks post metatarsal osteotomy.

Also heavily Dinged for a BL lakewater-contaminated open lisfranc fracture dislocation with cuneiforms also having been dislocated in opposite directions. Patient wanted to return home to the other side of the country for definitive care. I only did provisional pin fixation. They didn't like the look of my mini C intra-op films and I didn't get full post op films. Also didn't like my post op documentation. Patient was flying home the next day.

Also Dinged for not getting pre op films on a bunion. I mean, sure. But if they don't want the x-ray, how "medically necessary" is it?

Hi Jehjr. What resources did you use for ABFAS?

 

[blessed.pod]

ABFAS has 2 tiers of certification for the same training program. If you don't get RRA, you aren't certified in everything from your residency training. This is unlike every MD specialty certifying board. The American Board of Radiology doesn't certify you to read x-rays with one test, and then MRIs with another test. ABPM will certify you in the entirety of your residency training with one exam based on the residency curriculum.

Hi Dr Rogers. Do you by chance have a list of hospital that accept ABPM. I'm just planning ahead for life after residency... Mainly hospitals in Texas, California, Nevada, Arizona, or Washington. Thanks in advance.

 

[Feli]

Hi Dr Rogers. Do you by chance have a list of hospital that accept ABPM. I'm just planning ahead for life after residency... Mainly hospitals in Texas, California, Nevada, Arizona, or Washington. Thanks in advance.

Perhaps also request a list of patients who will want surgery with podiatry docs who don't pass the surgical board?

Bravo.

This was a witty joke... I hope? 🤣

 

[Hybrocure]

Perhaps also request a list of patients who will want surgery with podiatry docs who don't pass the surgical board?

Bravo.

This was a witty joke... I hope? 🤣

I hate to be that guy - truly I do. But ABFAS has shafted you twice now why do you Stan so hard for them.

We all know you do quality work and should have been board cert from the start. It’s a horrible system

 

[dtrack22]

But ABFAS has shafted you twice now why do you Stan so hard for them.

Battered Woman Syndrome: What it is and how to get help

 

[Feli]

I hate to be that guy - truly I do. But ABFAS has shafted you twice now why do you Stan so hard for them.

We all know you do quality work and should have been board cert from the start. It’s a horrible system

Well first, if you have only seen the Em vid, you have to see this one... genius.

...but it's not an ideal system, no.
It (ABFAS) is also a system that's pretty hard and does not discriminate. A lot of people study hard, some fail, a lot have to retry.
ABPM just passes everyone and doesn't eval cases (trusts our crummy residencies to have done that). So, they're both flawed... yeah.
But that doesn't change the fact that ABFAS is useful and ABPM is something bogus that everyone has (or has better).

But the advice to anyone remains the same: don't do anything that'll limit yourself from things you want (or may want) to do.
I don't think anyone would tell a resident "sure, you'll be fine with ABPM." No way... that's a lie. If they try ABFAS and don't pass with best effort, then that's another story.

...Podiatry is mega-saturated. Fellowships fad and the Linkedin peacocking and even the VA or podunk hospital jobs being competitive now prove this 100x over. Jobs are competitive and getting moreso (but it only takes one good one to make someone's ROI go from 3:1 to maybe 1:1). There is such a huge difference in having a hospital pod or good pay job... versus working a typical pod associate or supergroup job. Again, it only takes one.

There is obviously no list of hospitals that will take ABPM for hiring or for OR privi or etc. There's no list of groups that'll throw away non-ABFAS applications (I've been denied interview for not having ABFAS, and we all have... whether we know it or not). Things can change even once on staff or hired at a hospital that'll allow ABPM today. Bylaws may change if they have issues with DPM surgery or one who understands our boards gets hired or just gets on the med staff and/or has input on bylaws. Most quality facilities and groups/hospitals know what ABFAS is... so it's shortsighted not to try for it (assuming you want to do surgery... it's the appropriate board).

There is just no situation where having ABFAS qual or cert hurts a DPM... and there are many where it helps them.
Nobody would even say studying for ABFAS hurts anyone, so yeah... it's the recommendation to try for it.

 

[Hybrocure]

Well first, if you have only seen the Em vid, you have to see this one... genius.

...but it's not an ideal system, no.
It (ABFAS) is also a system that's pretty hard and does not discriminate. A lot of people study hard, some fail, a lot have to retry.
ABPM just passes everyone and doesn't eval cases (trusts our crummy residencies to have done that). So, they're both flawed... yeah.
But that doesn't change the fact that ABFAS is useful and ABPM is something bogus that everyone has (or has better).

But the advice to anyone remains the same: don't do anything that'll limit yourself from things you want (or may want) to do.
I don't think anyone would tell a resident "sure, you'll be fine with ABPM." No way... that's a lie. If they try ABFAS and don't pass with best effort, then that's another story.

...Podiatry is mega-saturated. Fellowships fad and the Linkedin peacocking and even the VA or podunk hospital jobs being competitive now prove this 100x over. Jobs are competitive and getting moreso (but it only takes one good one to make someone's ROI go from 3:1 to maybe 1:1). There is such a huge difference in having a hospital pod or good pay job... versus working a typical pod associate or supergroup job. Again, it only takes one.

There is obviously no list of hospitals that will take ABPM for hiring or for OR privi or etc. There's no list of groups that'll throw away non-ABFAS applications (I've been denied interview for not having ABFAS, and we all have... whether we know it or not). Things can change even once on staff or hired at a hospital that'll allow ABPM today. Bylaws may change if they have issues with DPM surgery or one who understands our boards gets hired or just gets on the med staff and/or has input on bylaws. Most quality facilities and groups/hospitals know what ABFAS is... so it's shortsighted not to try for it (assuming you want to do surgery... it's the appropriate board).

There is just no situation where having ABFAS qual or cert hurts a DPM... and there are many where it helps them.
Nobody would even say studying for ABFAS hurts anyone, so yeah... it's the recommendation to try for it.

Yet they’re still failing pretty damn good surgeons.

I’d wager the criteria to pass ABFAS nowadays is likely more difficult than it was back in the day.

 

[diabeticfootdr]

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Which one did you pass?

Which “ONE” did you?

The difference is that I don’t need it because ABPM certifies me in everything I do and I have full privileges.

 

[diabeticfootdr]

Hi Dr Rogers. Do you by chance have a list of hospital that accept ABPM. I'm just planning ahead for life after residency... Mainly hospitals in Texas, California, Nevada, Arizona, or Washington. Thanks in advance.

That list would be impossible to maintain. Just like ABFAS doesn't maintain a list and the hospital's don't make their Bylaws or DOPs public. So we only get notified there's a problem reported, not if everything is ok.

But in reality, the list of those who recognize ABPM is far shorter. Off the top of my head:

In AZ, we've had issues with Yuma Medical Center. In CA, San Antonio Regional Hospital. In TX, we're having difficulty with the Memorial Hermann System, but hopefully resolved soon. I don't recall any issues in NV.

We've been successful in helping a Diplomate get privileges in almost every instance they've reached out for assistance (over 100). We have a privileging attorney on retainer and engage local counsel when needed. There have only be 2-3 in the last 5 years in which we couldn't help.

 

[Bored Snorlax]

ABFAS vs ABPM again... I signed up to fix feet, not pick a side in the Cold War.