Duke fellowship

[sinustarsi]

Anybody know What duke podiatry fellowship like? They have foot and ankle orthopods(Nunley) who don't like podiatrist.
I liked Hyers program.

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[pacpod]

I looked into it but was told to get a NC license to be allowed to apply. It's a drawn out process and I didn't want to obtain a full license just to be able to apply to a program. It certainly surprised me that they started one. I'm curious to see how it goes. Good luck on your fellowship hunt.

 

[josebiwasabi]

Looking at their website they have 3 MD F&A fellows on top of their DPM fellow. I know nothing about their program but from that alone I would be concerned about quantity and quality of rearfoot cases.

 

[ldsrmdude]

I also don't know anything personally the fellowship, but I think that the concerns everyone has brought up are huge concerns. I honestly didn't know there was a fellowship for DPM at Duke until this thread. It's also not an accredited or recognized as far as I can tell. North Carolina has a reputation for being a tough state to get a license in with a written and oral exam that is only offered once a year. I'd hate to pay several hundred dollars and take a 2-day test only to not get a spot or worse, get a spot and watch the MD F&A fellows do cases for a year.

 

[I post PRN]

Can't imagine that going well for any DPM. That's like the mecca of F&A ortho.

 

[MarquetteGuy]

Can't imagine that going well for any DPM. That's like the mecca of F&A ortho.

Well, I can tell you that one of those renowned Duke University FA ortho MD's just flew out to my town of practice, across the country, to train me, a DPM, as the first trained surgeon in the country (MD, DO, or DPM), in their new total ankle replacement system, outside of the 3 principle designers of this new total ankle system at Duke University. That must say something positive about our profession.

 

[bobtheweazel]

Current APMA president made it sound like the Duke fellowship came about as a result of the Receipt of Care and Reduction of Lower Extremity Amputations in a Nationally Representative Sample of U.S. Elderly study done by Duke. Whether that's actually the case...

 

[I post PRN]

Well, I can tell you that one of those renowned Duke University FA ortho MD's just flew out to my town of practice, across the country, to train me, a DPM, as the first trained surgeon in the country (MD, DO, or DPM), in their new total ankle replacement system, outside of the 3 principle designers of this new total ankle system at Duke University. That must say something positive about our profession.

That's awesome. Good sign for sure.

 

[dtrack22]

Well, I can tell you that one of those renowned Duke University FA ortho MD's just flew out to my town of practice, across the country, to train me, a DPM, as the first trained surgeon in the country (MD, DO, or DPM), in their new total ankle replacement system, outside of the 3 principle designers of this new total ankle system at Duke University. That must say something positive about our profession.

That's sweet, when are they finally going to launch? And I'm assuming if you put them in your patient's will be included in their initial trial/data set?

Back to the fellowship...I also don't know much about it but I hope the DPM fellow gets the same experience as the MD/DOs. They do have a DPM on staff, Kerzner, but he does a lot of the stuff that nobody else in the group will or wants to (see: wounds and charcot recon). Not that its the only part of his practice...but they didn't hire him to come up from FL and do total ankles...

 

[MarquetteGuy]

That's sweet, when are they finally going to launch? And I'm assuming if you put them in your patient's will be included in their initial trial/data set?

Back to the fellowship...I also don't know much about it but I hope the DPM fellow gets the same experience as the MD/DOs. They do have a DPM on staff, Kerzner, but he does a lot of the stuff that nobody else in the group will or wants to (see: wounds and charcot recon). Not that its the only part of his practice...but they didn't hire him to come up from FL and do total ankles...

They have already launched technically, with a limited rollout. I've been putting them in for the past few weeks.

 

[dtrack22]

Limited is right, they still don't have the Vantage up on the exactech website. That's why I assumed it hadn't launched yet, since they've had FDA clearance to market it since Q1 of last year. Cool stuff man.

 

[Racer543]

Do you guys think a fellowship is worth it?

 

[DexterMorganSK]

The Duke fellowship isn't worth it but other fellowships are. But there are a lot of new fellowships run by reputable attendings but the fellow either isn't doing very much or is being treated like a PA to see post op patients while the attending can see more new patients.

Very few fellowships do it right. Right in terms of giving the fellow autonomy in the OR after a certain grace period and allowing them to run their own clinic where they get to treat brand new patients themselves and manage them with little oversight. If you visit a fellowship program and you are not seeing the above mentioned happening you are better off going out into practice and figuring it out on your own. Do more courses if you have in order to fill in the gaps.

All the current fellowships out there are run by reputable attendings who didn't complete a ACFAS fellowship except for a few programs. That pretty much tells you how valuable a fellowship really is.


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It seems like the number of spots for fellowships is pretty limited at the moment according to the link below. Making it extremely competitive.

List of Approved Fellowships | CPME

Would you know if that list is current because there are only 12 available spots? Maybe there are other places that are not yet approved by CPME?

 

[bobtheweazel]

It seems like the number of spots for fellowships is pretty limited at the moment according to the link below. Making it extremely competitive.

List of Approved Fellowships | CPME

Would you know if that list is current because there are only 12 available spots? Maybe there are other places that are not yet approved by CPME?

There are also ACFAS approved/certified/whatever fellowships.

Sent from my Nexus 5X using SDN mobile

 

[pacpod]

There are CPME approved and ACFAS approved fellowships. I'm not sure how many hold dual accreditation.

List of Available Fellowships - ACFAS

List of Approved Fellowships | CPME

 

[ExperiencedDPM]

I have a slightly different perspective on the Duke program. Although it's always beneficial to learn in a quality program, my feeling is that the name Duke alone can open doors.

I will explain. A lot of mainstream medicine still don't really understand podiatric education or training. To top it off, there are a significant number of residency programs based out of small community hospitals or VA hospitals. VA programs for the most part don't have the greatest reputation. And the smaller community hospitals are simply unknown to most who aren't in that geographic area.

There are residency programs associated with Harvard and Yale, and while those programs may not be top programs, I know many of their grads who have landed great jobs with Ortho or multi specialty groups due to name recognition.

I believe DeKalb is a great program, but now they also use "Emory" when mentioning the program. It's all about name recognition.

My feeling is that when applying for positions with an MD group, whether it's multi specialty or ortho, is that when they see a Duke, Harvard, Yale, Penn-Presbyterian, Univ of Pitt, Loyola, UMDNJ, etc., and they recognize the institution (vs a small community hospital) it's a definite "plus".

Once again, I'm not suggesting that all these programs are top notch, but to MD outsiders, having a Duke fellowship or training at a major institution they recognize is beneficial.

Just my perspective on this issue.

 

[car36]

The Duke fellowship isn't worth it

And how did you come about this "knowledge". It's only in its first year and you know nothing about it? You spit a lot of personal opinion as facts that don't have any real substance or evidence to back it up.

 

[car36]

Apparently I've struck a nerve with you. Do you train in North Carolina?

This is an open forum and I am free to share personal opinions. Duke orthopedics is the mecca of foot and ankle ortho. AOFAS does not like or respect podiatry. If you do not believe in that then you are delusional.

I train in Seattle and listen to people like Bruce Sangeorzan and Steve Benirshke bash podiatry in front of me while we attend their radiology rounds every Monday afternoon.

I am well aware and have ample experience with dealing with/ listening to some of the preeminent foot and ankle orthos and how they really feel about podiatry.

Are you telling me Nunley , DeOrio, Easley, Parekh, Adams really care about podiatry other than when they want a DPM to be a consultant with them on a new product they designed? You do know that Easley openly wrote a letter on the behalf of the AAOS and AOFAS stating he did not think DPMs deserve equal pay in the VA hospitals right? Please see attached.

Does that sound like a man who would support a legitimate podiatry fellowship? Do you see Easley handing over the knife to DPM fellow? I don't.

No I do not practice in NC. You base your advice to someone off of your presumption of a program without any real knowledge. The appropriate thing to recommend to someone asking about a fellowship is to encourage them to reach out to the current fellow. You may be surprised about how well the Duke Pod fellow is integrated into the Ortho F&A Fellow training. That would require actual familiarity with a program instead of Sherlock like conclusions.

 

[I post PRN]

No I do not practice in NC. You base your advice to someone off of your presumption of a program without any real knowledge. The appropriate thing to recommend to someone asking about a fellowship is to encourage them to reach out to the current fellow. You may be surprised about how well the Duke Pod fellow is integrated into the Ortho F&A Fellow training. That would require actual familiarity with a program instead of Sherlock like conclusions.

While I do agree that calling the fellow is a good idea, not many fellows will say, oh ya our program is terrible, don't come here. They will try and play it off as a great program, even if it isn't.

But ankle breaker is speaking lots of truth, whether you want to admit it or not. For the most part, F&A ortho doesn't like DPM's. Then when you take in mind the names that are at Duke. Doesn't seem promising. Just saying, doesn't take Sherlock or Watson to figure that out. Just someone that is current on podiatry/Ortho relations.

 

[car36]

I would be absolutely shocked if the DPM fellow gets treated the same and gets as much hands on experience as the foot and ankle ortho fellow. Absolutely shocked.

That would be contradictory to everything the AOFAS stands for and has stated about podiatry their standards of education and training (see above attached PDF). Ever go to their website and see their promo?

Its well done but takes subtle jabs at podiatry without really talking about us. They emphasize their training of how they are well versed in general medicine rather than being a focused specialty that only really has knowledge about the lower extremity. That is what AOFAS is really about.

But yes I do not have direct experience. Neither do you. Essentially you are arguing with me about the ethics of my posts. This is an ethical argument you are projecting on me. Ok, yes, from an ethical point of view I should not comment on things I do not have experience on.

But I like to live in reality.

That not surprising about the AOFAS, its a business and political organization. Everyone knows that. You could say the same thing about ACFAS and APMA battles that have gone on through the years. Your reality again is not actualized with experience.

 

[car36]

While I do agree that calling the fellow is a good idea, not many fellows will say, oh ya our program is terrible, don't come here. They will try and play it off as a great program, even if it isn't.

But ankle breaker is speaking lots of truth, whether you want to admit it or not. For the most part, F&A ortho doesn't like DPM's. Then when you take in mind the names that are at Duke. Doesn't seem promising. Just saying, doesn't take Sherlock or Watson to figure that out. Just someone that is current on podiatry/Ortho relations.

F&A Ortho and DPM relationships are extremely regional. One person's experience in a couple of residency locations does not speak to the them all.

 

[dyk343]

I've never once had an issue with an ortho or an ortho F&A specialist. They have all been very welcoming and let me perform a majority of the case when I work with them. We send them second opinions. They send us second opinions. It's professional around here.

And just because some ortho F&A may trash talk podiatrist... There are an equal amount of podiatrists who trash talk ortho.

In the end it all comes down to money.

If you're good you are busy and probably don't care what the guy down the street is doing because you're busy enough with your own practice. If you are hurting a bit you might take a look at the guy down the road an see what trouble you can wrestle up.

 

[dtrack22]

Is that Ortho FA MD/DO going to go to bat for you and for your surgical privileges when you apply for them at the hospital they currently work/scrub cases at too? Probably not...

And just because some ortho F&A may trash talk podiatrist... There are an equal amount of podiatrists who trash talk ortho.

Along these lines, I'm going to an area where podiatrists in cities 50 miles away are going to make it harder for me to get certain privileges than the ortho down the street will. It's the podiatrists that are going to make me jump through hoops where the local orthos are totally fine with granting me the same "core" foot and ankle privileges they have...which is everything.

I have been (or will get) screwed far more often by Podiatrists than I will by Orthos. Primarily for this reason...

In the end it all comes down to money.