PACtoDOC

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Man I'll tell you, if all Pods had to go through the type of residency they have here at John Peter Smith in Fort Worth, Texas, Pods would get a great deal more respect!! These residents are super. They act as interns on the medicine service just as MD/DO's, and I have found them very competent. If consistency could be spread across the board for all Pod residencies to meet this standard, and if Pods could take the USMLE, then I think their proliferation would indeed be sealed.

So if you are a Pod student and are looking for a bad ass residency, its here in Fort Worth.
 

diabeticfootdr

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PACtoDOC said:
Man I'll tell you, if all Pods had to go through the type of residency they have here at John Peter Smith in Fort Worth, Texas, Pods would get a great deal more respect!! These residents are super. They act as interns on the medicine service just as MD/DO's, and I have found them very competent. If consistency could be spread across the board for all Pod residencies to meet this standard, and if Pods could take the USMLE, then I think their proliferation would indeed be sealed.

So if you are a Pod student and are looking for a bad ass residency, its here in Fort Worth.
DPM residencies have to comply with the manditory standards set up by the Council on Podiatric Medical Education by 2006. Most residencies have already converted to the new system of comprehensive, nationally standardized residency.

So soon, all residency trained DPMs will have the same training no matter where they do residency.

yes, the Texas residencies are known for being very good!
 
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PACtoDOC

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diabeticfootdr said:
DPM residencies have to comply with the manditory standards set up by the Council on Podiatric Medical Education by 2006. Most residencies have already converted to the new system of comprehensive, nationally standardized residency.

So soon, all residency trained DPMs will have the same training no matter where they do residency.

yes, the Texas residencies are known for being very good!
When I was a PA, we had a Pod in our practice and he got stuck with sharing a private office with me. We became very good friends and still are today. He was a preceptor for residents in the Houston (Harris County) program and I was always amazed at how little these guys had to do in the hospital and in clinic. It was not like it is here at JPS. it was more like a shaddowing experience.
 

ILuvScut

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PACtoDOC said:
When I was a PA, we had a Pod in our practice and he got stuck with sharing a private office with me. We became very good friends and still are today. He was a preceptor for residents in the Houston (Harris County) program and I was always amazed at how little these guys had to do in the hospital and in clinic. It was not like it is here at JPS. it was more like a shaddowing experience.
Why on earth would ANYONE go to a Pod for surgery instead of an ankle and foot Orthopod - just makes no sense. Please stay to clipping toenails.
 
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PACtoDOC

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ILuvScut said:
Why on earth would ANYONE go to a Pod for surgery instead of an ankle and foot Orthopod - just makes no sense. Please stay to clipping toenails.
There are lots of foot surgeries that neither require the expertise of the Ortho foot surgeon nor can wait to see one. In our institution there are no Ortho foot guys which means the patient either travels 30 miles, waits 6 months, or has it done by Pods who do routine surgeries all the time. I used to think like you in many respects. But there just are not enough ortho foot specialists around to see every foot problem.
 

efs

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I think most people (including medical folks) have no idea what podiatrists really do. My residency is extremely busy. We function in the same capacity as other residents while we are on rotations outside of podiatry. I have heard similar comments to the above more than once.

Knowing what I do, I would choose a podiatrist over an orthopod for just about any foot (or ankle) surgery. There are not that many orthopods that have the experience or training in foot stuff. Ankle fractures, pilon fractures and so on are typically part of their training, but most have little experience with bunion surgeries, flatfoot surgeries, subtalar fusions, ankle fusions, ankle arthroscopy and lots of other stuff that (some) podiatrists do often. A podiatrists surgical training (these days) is typically 2-3 years. A foot and ankle orthopaedic fellowship may be 6 months to a year. Granted that they have a 5 year residency prior to that, but 6 months is stilla very short time to pick up what we get in residency and the additional stuff that we have had during school prior to residency. I think there are some good foot and ankle orthopods out there, but there are not very many of them. Many podiatrists are extremly well trained and competent to handle the same things.

Eric
 

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Amen! Neuromas need DPMs too. An ortho would realign the whole foot.

:cool:
 

diabeticfootdr

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efs said:
A foot and ankle orthopaedic fellowship may be 6 months to a year. Granted that they have a 5 year residency prior to that, but 6 months is stilla very short time to pick up what we get in residency and the additional stuff that we have had during school prior to residency.
Eric
Not only do I agree with the above, but to add to it: there is no board certification for ortho foot and ankle -- and if you read what Michael Pinzur, MD (foot and ankle orthopod) writes in his opinion papers about ortho foot and ankle fellowships -- there is little standardization among foot and ankle orthopods, some may have 40 ankle fractures, but only 1 subtalar fusion. (see reference below)

I would put a "well-trained" DPM against a foot and ankle orthopod any day (including Myerson).

The other thing to consider is few orthopedist operate on diabetic foot disorders, such as osteomyelitis or Charcot arthropathy (reconstruction). Most orthos even consider diabetes a contraindication to foot/ankle surgery. Our comprehensive knowledge of the diabetic foot allows us to perform these surgeries and gain "limb salvage" better than other surgeons. Anyone can fix a fracture and screw 2 bones together (DPM or MD), but getting these patients with vascular disease, impaired wound healing, and neuropathy to heal a reconstruction or amputation takes a lot of work.

Reference:
Pinzur-M. Foot and ankle experience in orthopedic residency. Foot Ankle Int 2003;24:567-9

LCR
 

ILuvScut

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There's a lot more involved in surery than knowing your anatomy. You can teach any monkey how to operate....doesn't mean they should be doing surgery though.
 

jconway

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ILuvScut said:
There's a lot more involved in surery than knowing your anatomy. You can teach any monkey how to operate....doesn't mean they should be doing surgery though.
while its true that a knowledge of anatomy has virtually no bearing on surgical ability...that argument has zero relevance to what we are talking about....

I havent noticed anyone claiming podiatrists to be able foot surgeons based on their experience with lower extremity anatomy

so...yeah....if at first you dont succeed..troll troll again...
 

ILuvScut

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jconway said:
while its true that a knowledge of anatomy has virtually no bearing on surgical ability...that argument has zero relevance to what we are talking about....

I havent noticed anyone claiming podiatrists to be able foot surgeons based on their experience with lower extremity anatomy

so...yeah....if at first you dont succeed..troll troll again...
I love how if anyone disagrees with anyone about policy or about the role of midlevels they are branded a troll. Really mature.
 

diabeticfootdr

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ILuvScut said:
There's a lot more involved in surery than knowing your anatomy. You can teach any monkey how to operate....doesn't mean they should be doing surgery though.
What a moronic statement!!! Surgery IS anatomy. Based on your comment, I can tell you're not a surgeon. Next time try offering comments about something on which you are knowledgeable -- if such a topic exists.
 

emedpa

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ILuvScut said:
I love how if anyone disagrees with anyone about policy or about the role of midlevels they are branded a troll. Really mature.
also last time I checked podiatrists are not midlevels thus the degree DR of podiatric medicine.
pa's and np's can have doctorates but are still midlevels. there are no podiatrists practicing without doctorate level degrees to the best of my knowledge.
by the way...you are a troll
 

AlKlineDPM

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PACtoDOC said:
Man I'll tell you, if all Pods had to go through the type of residency they have here at John Peter Smith in Fort Worth, Texas, Pods would get a great deal more respect!! These residents are super. They act as interns on the medicine service just as MD/DO's, and I have found them very competent. If consistency could be spread across the board for all Pod residencies to meet this standard, and if Pods could take the USMLE, then I think their proliferation would indeed be sealed.

So if you are a Pod student and are looking for a bad ass residency, its here in Fort Worth.

Great to hear, I did my Podiatric Residency at JPS (1992-1994). The hospital has always been 'resident run' , so you get a great deal of experience. I've had the priveledge to work with some great MD's in the program and capped it off by organizing the end of the year "golf tournament"! I have some fond memories of the program.

Regards,
Al Kline DPM

Podiatry Associates
 

AlKlineDPM

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ILuvScut said:
Why on earth would ANYONE go to a Pod for surgery instead of an ankle and foot Orthopod - just makes no sense. Please stay to clipping toenails.
What a moronic statement. Many podiatrists are happy just 'clipping toenails', but truth be said, Podiatric Surgeons who specialize in foot surgery get much more experience and case volume than most orthopods, even the ones who specialize in foot and ankle. I've seen a number of foot and ankle orthopods get out of that field of specialty all-together (probably because reimbursement for a shoulder, hip or knee is much better than most foot surgeries with half the complication head-ache. And from my personal experience, I've had to re-do too many foot and ankle surgeries by orthopods to actually recommend them, unless that is all they are doing. And don't even get started by saying anything about their training, Podiatrist get much more training in foot and ankle surgery than orthopods. Be my guest, go ahead, go to an othopedist who does a few foot cases a month, and see what kind of results you will find.
 

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I just want to say that I am so glad to have jconway back.


You just gotta love him!