CPME approved vs ACFAS approved vs not approved Fellowships?

[Aresnebula]

I have been looking into doing specific limb deformity fellowships and searching up on SDN and there appear to be few CPME-approved as well as ACFAS-approved fellowships? And then there are other fellowships out there which do not have any of these two institutional approval and yet people go there. I am a bit confused with all of these. Are there training differences between them? What is the con of going to a fellowship which ACFAS or CPME doesn't recognize? Also, I have been hearing that more places are hiring people with fellowship grads over non fellowship grads, especially West Coast?

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[Feli]

Do whatever you want. 98% of the time, podiatry fellowships are basically a CV thing (in theory) and product of the bad pod job market.

ACFAS fellowships are much better attendings in general, but even half or more of the ACFAS ones are just not worth doing (attendings/cases are really no better than at a good/great residency). The top 5 or 10 ACFAS ones are pretty good with much surgery and complex stuff... but if you did good residency, it's still basically a glorified 4th year of residency with different attendings - but still more reps and more good cases.

None of the CPME ones are quality. That is why they're not ACFAS. It's an 'accredited' group where the "fellowship director"s who aren't even Abfas cert themselves or any fellowship can just sign up for a cheap associate spot. The only reason to even consider them would be longshot attempt CV build or pod who did a truly terrible residency (and can't get an ACFAS fellow spot).

...Rest assured, the training wheels will come off someday. 🙂

Rest assured again, your loans will gain interest and you will make very little in the fellowship year.

Rest very assured, it is terrifically tough - as a DPM - to get complex refers or "limb deformity" work. It's easy to delay and talk oneself into something, but look up recent fellows of any program you consider (ACFAS ones list them), and see if the grads are now doing that type of work.... or just doing regular MSG or PP jobs just like any residency grad does. Also, keep in mind most podiatry fellowships have recently watered down, so it's much harder for 2 or 3 grads/yr to get good jobs than the 1/yr the program did in years past.

To truly get DPM jobs, you simply have to pass Abfas qual/cert to have all options open, and call and call and network and call. You will almost certainly be disappointed with the pay and/or location of your job - even if you do five different fellowships. Once you are in an area, if you're likeable and do good work, you'll probably have options for that area (hospitals, groups in the area). If you ever want to leave the area, it's calling and calling and hoping and networking yet again. It is a far cry from MD/DO job search where they're recruited and rare. Any decent advertised job for DPMs will get tons of interest, so it's really your call as to whether a fellowship year time/debt is worth it. You will still have to face the job market sooner or later. 😉

 

[deleted1162946]

One Problem with fellowships that is never addressed is most are affiliated with residency programs so they end up just taking away cases from residents. It’s a viscous cycle. I don’t think fellowships should be allowed to work with residencies. It harms residents education.

 

[Weirdy]

Are you the same guy that asked about doing a reconstructive limb salvage fellowship before you even started residency?
You're 1 year into residency.
Not too early to start thinking I guess but try to stick to the top 5 or 6 or whatever programs that was in your other post.

Edit: Good fellowships out there for major reconstructive surgery?

 

[air bud]

Remember.....if you have to ask SDN questions about fellowships...you aren't a legit candidate for the good ones.

 

[GreenHousePub]

good ones.

Thats an oxymoron

 

[Retrograde_Nail]

Remember.....if you have to ask SDN questions about fellowships...you aren't a legit candidate for the good ones.

Wrong. Anyone can do a fellowship these days. They create new ones every year. We got podiatrists with less than 3 years of experience starting fellowships. Somehow because they did a fellowship it means they have infinite experience and are ready to train others.

This is why podiatry is bad.

If MD/DO cared to understand this new trend they would be even more critical of us. But it flies under the radar and they recognize it as something still good rather than something that is becoming really bad.

More and more fellow grads are not landing these hospital jobs. They are joining private practice mills. Thus accomplishing nothing from the fellowship experience. Just making the ROI even worse.

Long term this will have devastating effects on the job market. As majority of grads will be "fellowship trained". Any new grads who do NOT go after fellowship training will be at a disadvantage for even private practice gigs due to saturation.

Saturation is coming. Worsening ROI is coming. Winter is coming.....

Podiatry is slowly becoming a ticking time bomb.

 

[HeySister]

I have also watched with concern that younger podiatrists, albeit well trained so far from what I've seen, are starting fellowships after just a few years in practice.

A true fellowship should have multiple attendings with years of experience, hopefully in an academic center. Wait....that's supposed to be residency!

Maybe I will start one too, it's a good maternity/paternity leave plan. "I got to take 8 weeks off private practice because my fellow could run my clinic." This is all jokes until it's not.

 

[air bud]

Wrong. Anyone can do a fellowship these days. They create new ones every year. We got podiatrists with less than 3 years of experience starting fellowships. Somehow because they did a fellowship it means they have infinite experience and are ready to train others.

This is why podiatry is bad.

If MD/DO cared to understand this new trend they would be even more critical of us. But it flies under the radar and they recognize it as something still good rather than something that is becoming really bad.

More and more fellow grads are not landing these hospital jobs. They are joining private practice mills. Thus accomplishing nothing from the fellowship experience. Just making the ROI even worse.

Long term this will have devastating effects on the job market. As majority of grads will be "fellowship trained". Any new grads who do NOT go after fellowship training will be at a disadvantage for even private practice gigs due to saturation.

Saturation is coming. Worsening ROI is coming. Winter is coming.....

Podiatry is slowly becoming a ticking time bomb.

literally said the good ones...anyways everything else you said is true. It is becoming a self fulfilling prophecy.

 

[Adam Smasher]

I would like to use this space to announce I am starting the Adam Smasher AO Fellowship.

With the rising popularity of minimally invasive surgical techniques, there is concern that otherwise capable graduating residents might not have adequate exposure to this increasingly important skillset using a cutting burr.

This is why I see the need to start a fellowship focusing on techniques in Advanced Onychomycosis. Graduating fellows will learn how to:
-hold the burr
-use the burr
-clean the burr afterwards

While the  AO fellowship doesn't involve any actual surgical training, the fellow will hone foundational skills that carry over into all facets of podiatry. It is well known that the demands of wakeful onychomycosis patients greatly exceed those of patients under sedation anesthesia, and therefore overcoming the challenge of burring these patients' toenails ensures the fellow will be equipped to handle all other foot and ankle pathology. In addition, graduating fellows will be able to:
-pad their resume
-apply for private practice jobs
-apply for other fellowships
-describe yourself as a fellowship trained foot and ankle surgeon

Application requirements:
-3 letters of recommendation
-podiatry school transcripts
-minimum GPA 3.5

Salary: $20/h

 

[diabeticfootdr]

None of the CPME ones are quality. That is why they're not ACFAS. It's an 'accredited' group where the "fellowship director"s who aren't even Abfas cert themselves or any fellowship can just sign up for a cheap associate spot. The only reason to even consider them would be longshot attempt CV build or pod who did a truly terrible residency (and can't get an ACFAS fellow spot).

Totally wrong.

ACFAS Recognition for fellowships is just an application, pay a fee, and the director must be an ACFAS member. The bar couldn't be lower.

I say this, not being critical of what ACFAS is trying to accomplish. ACFAS started recognizing fellowships because CPME wasn't doing its job.

Quality of fellowships vary and doesn't have anything to do with a program's ACFAS status.

 

[diabeticfootdr]

I have been looking into doing specific limb deformity fellowships and searching up on SDN and there appear to be few CPME-approved as well as ACFAS-approved fellowships? And then there are other fellowships out there which do not have any of these two institutional approval and yet people go there. I am a bit confused with all of these. Are there training differences between them? What is the con of going to a fellowship which ACFAS or CPME doesn't recognize? Also, I have been hearing that more places are hiring people with fellowship grads over non fellowship grads, especially West Coast?

I've been pretty vocal about the problems with fellowships in podiatry. There is no standard naming scheme or curriculum (unlike ACGME-accredited fellowships). Most of this is due to CPME's failures.

But doing a fellowship can be life-changing and change the trajectory of your career, especially if you're interested in academics or research.

So, here's my advice for people looking at fellowships now:

First, CPME-approval or ACFAS-recognition doesn't guarantee quality.

The most important consideration is to choose a fellowship with a good mentor(s), regardless of its accreditation.

I did my fellowship with Dr. Armstrong (while he was at Scholl) and it was unaccredited. The UT San Antonio fellowship probably the oldest in the US (31 years) and we just applied for CPME-approval last year.

But there are some other considerations.

CPME-approved fellowships must follow standards in CPME Documents 820/830. That means you have many of protections that you did during residency, like a contract, PTO, health insurance, a grievance policy, no non-compete, etc.

CPME-approved fellowships are eligible for GME funding from CMS. ACFAS fellowships are not. This means your salary and benefits will be similar to other fellows in the same institution (in fact, that's a standard in 820).