If only there was an option for non surgical podiatry, then we wouldn’t have this demand for fellowships to backfill poor training from residency
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At this point less and less about poor training and more about marketing and getting a better job....
Narrator: they don't get a better job. But hey, it's about the friends we made along the way.
yup the fellowship at St. Johns wound care is joke. DONT GO THERE
Had an attending associated with our residency who did a top tier fellowship who was working a PP associate job with verbal promises of eventual partnership. A few months back the guy messaged me asking if there were any openings where I’m at because his boss backed out of giving him partnership (shocker).
What are people's thoughts on the Weil fellowship in IL?
From what I have seen their graduates do pretty well/get good jobs.
Agree most go on to do well. It also seems to help fill his associate jobs if one wants to live in Chicago. Have heard the track to partner though is fairly difficult.
Yeah, I assume have to have be a private equity bro. Patagonia vest critical.
Anybody know of a list of mini-fellowships (e.g. Bako) available to residents?
bro wut
Consider applying for my prestigious AO Fellowship, link in sig
Can't blame a young pod for trying to stand out - job market is as dry as diabetic foot skin
I guess there are some of those ACFAS and Arthrex/Stryker/medical device training courses out there - especially reasonable if your program has CME money for you. I've seen people put them down on their resumes/profiles similarly to the Bako mini-fellowship, and while it's good to keep learning, the way they're listed definitely makes them give off the same energy...
I guess there are some of those ACFAS and Arthrex/Stryker/medical device training courses out there - especially reasonable if your program has CME money for you. I've seen people put them down on their resumes/profiles similarly to the Bako mini-fellowship, and while it's good to keep learning, the way they're listed definitely makes them give off the same energy...
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Who has done a fellowship and can give me a thorough breakdown of what you actually do? I'm a third year resident.
It seems to me that fellowships are essentially a 4th year of residency.
Are they time consuming, work/life balance, will I be in charge of residents, academics annoying as a fellow? All the deets guys.
(You can DM me too)
It seems to me that fellowships are essentially a 4th year of residency.
Are they time consuming, work/life balance, will I be in charge of residents, academics annoying as a fellow? All the deets guys.
(You can DM me too)
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Correct.
I’m increasingly skeptical about how much a fellowship changes your standing outside podiatry. Early in the development of fellowship training, it may have helped graduates access better opportunities. Today, though, I’m not convinced the credential carries much weight with physicians outside our profession.
My concern is that podiatric training and surgical experience can still be overlooked. I perform 15–20 cases a week, and the surgeons, APPs, and OR staff I work with know my volume and track record. Yet I’ve still been asked by an orthopedic spine PA whether I would provide inpatient toenail care for a surgical patient.
That kind of interaction can make it feel as though some colleagues see podiatrists through a narrow stereotype, regardless of our experience. I’ve also found that collaboration with orthopedic groups can seem closely tied to shared financial interests. I can’t speak for every practice or every orthopedic surgeon, but those experiences have shaped my view.
So when people ask whether a fellowship is worth it, I think the answer depends on what they hope it will do. It may build skills, relationships, and confidence, but it may not automatically earn recognition from physicians outside podiatry or change how others perceive the profession.
That’s a frustrating reality, especially for those of us who have invested heavily in surgical training.
As someone in a group practice who hires new associates, I can tell you this:
1. Most of your surgical training should already happened in 3 years. An extra year of fellowship tells me that something is lacking.
2. For the reason above, I prefer 1 year of working experience to 1 year spent in fellowship. Knowing how to bill and handle clinic take priority over how quick you can do a calc ORIF.
3. There are some rare and high powered fellowships that are excellent in provide additional recon and limb deformity training. But recon surgeries pay very little and don't make financial sense in the private world, so I don't need fellows from these programs.
Traditionally fellows from some of the recognizable names were placed into ortho groups and hospital systems. But I think we have hit a ceiling there with the demand. So now more fellows from these high powered programs are working for private practices, with mismatched expectations and thus create more silent anger in this profession.
I'm less interested in how other specialties see my field and more interested in how a fellowship helps me obtain jobs, or what it can do for my career.
I don't even think the problem is how other fields view podiatry, its our own field (our leaders in the field) who just deny parity at every turn because it's not a financial incentive to do so, for those few individuals.
A majority of hospital jobs care much more about work experience than fellowship training. Podiatry fellowship is a complete scam. Unfortunate and sad to say that you would be much better off making a miserable 150 K as a private practice associate than 60 K as a borderline free labor fellow, As you would at least begin generating real world work experience and also make slightly more money.
BeaverBlade
Quadruple board certified in building Dams
You can do as much training as you want but you’re still a DPM to ortho
It doesn't. Not anymore. Most fellowship grads are working in private practice now. It means nothing. Only other podiatrists care about this nonsense.
^^Exactly... and that seemed to take maybe 8-10 years and a few dozen fellows from Hyer, CORE, etc top-flight fellowship programs. 😐
Absolutely. I think the truly elite fellowships still offer cool skills, but they've watered down since early times (more fellow/yr now... less cases/fellow), and there were only really a few ortho groups and hospitals willing to hire a DPM to do those kind of cases in the first place. They've largely been filled. The market is saturated now. Best chance for a hospital job is hospital job exp... not fellowship that tons of mediocre grads have.
...best bet for 99% of DPMs is just good residency, to offer all skills, pass Abfas, be flexible. If you can't find a high salary and/or partnership track job, then start your own PP. The PE supergroups are very bad news, but that is where most grads will end up (even fellowship ones).
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Every single hospital pod here will tell you if their hospital wanted to bring in another pod and they had a say...they would bring in the non fellowship with even 3 years of experience in real world vs a fellowship pod. We don't care about your skills...we good. We want to share the workload.
You want me to do the nails and the toe amps so you can do the flatfoot recons and ankle fx... and I know it.
Guys, one of the reasons I'm asking this now is because no one ever gets a fellowship after they start a job. So the only time to even ideally do a fellowship has to be at the end of residency. Because then its like you lose the chance forever, which I get it, fellowships aren't all that. But to me, I do have to make that lifelong choice soon. I really don't want to ever think about fellowship ever again over a year out of residency.
The learning skills and more part is of course important, but I would really like to have a fellowship, even if it's in a check-this-off-the-list type of way.
The learning skills and more part is of course important, but I would really like to have a fellowship, even if it's in a check-this-off-the-list type of way.
Then do one. It sounds like your mind's made up, and you are running out of time.
In the end, in math terms (which is how you pay off loans, grow investments, retire, etc), the fellow year is another year of compound interest working against you... rather than chipping down at student loans, putting some investments into Roth or etc to grow, and taking the training wheels off with billing and pt care solo skill level. You were given good advice above that most jobs - PP or hospital - want to know you can work, bill, run an office, do the job. It's just a job at the end of the day. The basics matter a lot more than some oddball surgeries that are rare as hen teeth outside big teaching programs.
...Honestly, if you are pgy3 with now only 8mo until graduation without any good job leads, it's nearly too late and a good job is becoming just a moonshot anyways. The time to have the fellowship dilemma as more in pgy2, but many people have this same breakdown nonetheless. Most of your peers have something finalized, or they're at least deep in interview and contract negotiation for what they'll start next summer after graduation from residency. You probably should do a fellowship at this point just to buy more time to hopefully find something decent and to avoid supergroup/PP associate jobs. Most of the good fellowships already have their fellow for next year, though (application deadlines passed, or interviews granted/done already)... so you'll likely be doing a mid/lower tier one. It's your life/career. GL
That's funny. I wouldn't have thought you wanted a fellowship based on your first post where you basically insult the process and suggest its a 4th year of residency. So just go for it. Boba hits it out of the park though.
The best part of all this is that you will ultimately waste a year of your life to pursue something that you can barely articulate why you want it and in doing so you will justify some fellowship PD's decision to offer an unnecessary fellowship that is merely being filled so some young person can check a box before ultimately working for private equity.
Or perhaps its your path to greatness and hospital employment.
The best part of all this is that you will ultimately waste a year of your life to pursue something that you can barely articulate why you want it and in doing so you will justify some fellowship PD's decision to offer an unnecessary fellowship that is merely being filled so some young person can check a box before ultimately working for private equity.
Or perhaps its your path to greatness and hospital employment.
There's a great post on LinkedIn right now of hey fellow basically begging for any leads... Talking about how he has all these skills related to surgery and everything. He's like hey I want to be in an ortho group or a hospital does anybody have any leads on these jobs.... He's going to end up in private practice
At this point this is why fellowships are now necessary if you want - a shot at - a non private practice job.
100% of the long time posters on here graduated without this level of competition of fellowship vs non fellowship. We are dinosaurs in this argument.
The cards are now different but everyone still beats the same dumb drum.
Hosptials/MSG/ortho/anything non DPM think fellowship = good.
If I were to graduate DPM residency this coming year I would strongly consider doing a fellowship. No - I take that back. I would do a fellowship.
Its all about the leg up in this terrible job market. Still not a guarentee but need every bullet point on the CV to beat out the competition.
When I was dabbling into fellowships in my PGY-2, I was very very specific about what I wanted in a fellowship and that was more reps in TAR cases and working with circular frames. Why? Because I didn't get a ton of exposure in exfixes in residency (except for deltas) and I only did about <15 TAR cases first assist. I knew if I didn't get into those fellowships, I won't do a fellowship.
In my 4th year of pod school, I was set on doing a fellowship no matter what until a F&A Ortho (yes ortho) beat some sense into me and he made a great point. According to him, DPMs were already niche so what are we trying to accomplish in a fellowship? Orthos do fellowships because they train in everything and some of them wanna become niche. He also said if you want to be niche in something then do a fellowship, otherwise, it is a waste of time. And that resonated with me. I am just giving you my piece of advice, take it as you will.
Also, if it answers your questions regarding jobs, a fellow who went to a top program in Phoenix ended up going to the same PE group that someone I know accepted a position in this year. That someone went to an average residency program BTW without a fellowship. I think job perspectives will only matter if you go to a very high powered program and the director has actual connections to land you a hospital job in the SAME state.
Yes but the problem is that anecdotally we are seeing as many fellowship grads end up in hospital jobs as we are PE jobs. Is another year of residency/debt/poor pay worth a coin flip to a good job vs PE job? Only person who can answer that question is yourself, but personally I would never.
Leg up is not as useful in a poor job market and when we are seeing superfluous fellowships like a Balance Health fellowship that bastardize the purpose of fellowships.
Get a job
ok but that isn't really a fair comparison. in the following scenario, what would you/the hospital choose? (assuming both went to at least an average residency program)
Applicant A:
no fellowship, 3 years of experience
Applicant B:
1 year fellowship, 2 years of experience
A
But I understand your point.
Sorry should clarify. 3 years hospital experience.
But I understand your point.
Yeah, the key thing is just to get onto the career/job track you want asap. That applies fellowship or not.
If you want to be a hospital pod, gotta get a hospital job asap... apply hard, apply everywhere. Take a crusty VA or CAH job that is far from your "target area" if you hae to. Can always try to get a better pay or location hospital job later on. An associate in PP and PE for 10yrs out of residency is likely stuck there.
Same for solo PP. It can be done to start up or buy out an office age 40+ or even 50+, but we all know it's unlikely. It is usually done fairly young out of residency - basically as soon as one has the $$ and location/drive/means. For that 10yr+ or 20yr+ associate, it becomes less and less likely that they'll do it. You simply have less energy when you're older, and you also wouldn't have as many years of higher earning once you build it (unless you wanted to work to fairly late age... usually not the point of PP owner).
If you want to be a hospital pod, gotta get a hospital job asap... apply hard, apply everywhere. Take a crusty VA or CAH job that is far from your "target area" if you hae to. Can always try to get a better pay or location hospital job later on. An associate in PP and PE for 10yrs out of residency is likely stuck there.
Same for solo PP. It can be done to start up or buy out an office age 40+ or even 50+, but we all know it's unlikely. It is usually done fairly young out of residency - basically as soon as one has the $$ and location/drive/means. For that 10yr+ or 20yr+ associate, it becomes less and less likely that they'll do it. You simply have less energy when you're older, and you also wouldn't have as many years of higher earning once you build it (unless you wanted to work to fairly late age... usually not the point of PP owner).
There is no guarentee in podiatry. Fellowship or no fellowship. Which was what I was trying to say above. Applicant numbers reflect this. The writing is on the wall. Its just too high of a risk.
But at this point with a large percentage of grads doing a fellowship it can give you a leg up on at leat half the non fellowship comptition. I think a lot of the DPMs on SDN are way too hard on the now graduating residents. Most of us are mid career or later. Its a total different game than when we graduated and <5% did a fellowship. There were about 10 fellowships when I graduated for 500ish graduates. It was rare to get one/pursue one. I dont see an exact number of fellowships but appears to be quite a few approved/conditional approved fellowships. Estimate 25% graduating class will do fellowship now? Thats a lot.
Stats are stats. Bullet points on a CV are bullet points. These jobs are sorting through stacks of applicants and narrow it down to 2-3 to interview.
Ive personally done this process when we hired my associate. I did have a fellowship candidate in the final 3 based on resume alone. In the end we went with a non fellowship grad with 5 years MSG experience. I was largely involved with this process but if it were hospital admin I can guarentee it would have been the fellowship grad. CV was impressive and management was locked onto this persons CV.
The guy we hired went to a rock star residency and i knew that. Admin had no idea. I had to have a discussion with admin why i personally thought the guy we hired was superior (he also had a better personality/less cocky - I wanted someone who knew their stuff but doesnt flaunt it).
So it is possible but I also understood the candidates training better than a non DPM would. Without my comments admin would have went with the fellowship grad.
I got my job without a fellowship. I had good references from ortho docs I worked with during training. One of them offered to make phone calls for me if I need his help. I worked hard to learn from him/them, helped run their service and in return gained a lot of cut time and also the above. To me current residents feel if they are at a strong program they’re entitled to everything without putting more effort in. I’ve always told everyone I meet to network and out hustle every single resident out there. You don’t have to follow what I did but I was determined to outwork everyone else to give myself the best advantage.
Maximize your 3 years of training. Get off instagram and facebook. Don’t assume a fellowship will somehow increase your chances.
Ortho chief told me they interviewed many fellowship trained grads that did not have real work experience yet and that made the difference.
Our group is expanding quite a bit and considering adding a DPM in the future. My rationale will be very similar to DYK post above.
Maximize your 3 years of training. Get off instagram and facebook. Don’t assume a fellowship will somehow increase your chances.
Ortho chief told me they interviewed many fellowship trained grads that did not have real work experience yet and that made the difference.
Our group is expanding quite a bit and considering adding a DPM in the future. My rationale will be very similar to DYK post above.
Kinda the hard part across medicine. Admin sees Yale versus Thomas Jefferson on a piece of paper, which one is impressive? Get you the Ivy League kid right? People in ophtho/retina know Yale is average at the very best as opposed to a T5 in Jeff (Wills Eye). Last time we hired I threw a CV away because I knew they came out of arguably the worst residency in the country. If we were hiring today, I’d never bring in a fresh fellow from Oklahoma or Indiana since I’ve heard both are down to one surgical attending.*
So yeah, comes back to connections and general knowledge within fields. Outside of reading the residency review thread, I’d have no clue what a rock star pod residency is.
*caveat: I’ll only hire a fellowship trained surgical doc anyway
Exactly this. The pod with 2-3 years of HOSPITAL employed experience is going to get picked nearly every time over the fellowship trained pod that has several years of only private practice experience.
Why does the comparison always have something that favors the nonfellowship trained grad?
The debate is whether a fellowship is worth it or not. So the only variable should be +/- fellowship training, not extra variables that are in favor of the other person.
Fair comparisons would be:
1) PGY3 resident vs current fellow applying for a 1st job out of training
2) residency-only with 2-3 years of PP experience vs fellowship grad with 2-3 years of PP experience
3) residency-only with 2-3 years of hospital employment vs fellowship grad with 2-3 years of hospital employment
The debate is whether a fellowship is worth it or not. So the only variable should be +/- fellowship training, not extra variables that are in favor of the other person.
Fair comparisons would be:
1) PGY3 resident vs current fellow applying for a 1st job out of training
2) residency-only with 2-3 years of PP experience vs fellowship grad with 2-3 years of PP experience
3) residency-only with 2-3 years of hospital employment vs fellowship grad with 2-3 years of hospital employment
There are way more pods that did not do a fellowship so they are going to be applying disproportionately for the same jobs, and plenty of them already have hospital experience. So after a fellowship pod gets stuck in private practice, it’s going to be that much harder for them to claw out of making 160k per year.
I agree with your statement.
But I would bet a lot of money that a significantly higher percentage of fellowship grads end up in hospital/MSG/ortho type practices compared to the non-fellowship cohort.
Experience will win out. I'm not debating that at all. but at some point in order to get experience you have to get your first hospital employed position. and i think having fellowship training gives you an advantage over a nonfellowship grad.
i could make a hypothetical situation of a fellowship trained pod with 6 years of hospital experience and ABFAS RRA certified vs a residency grad applying for a hospital position. but what would be the point of that comparison?
in your example, there will also be fellowship trained pods also applying for those same positions, plenty of them already with hospital experience. when the hospital is doing an initial review of their CVs, do you think they would have an advantage over the non-fellowship trained pods?
But I would bet a lot of money that a significantly higher percentage of fellowship grads end up in hospital/MSG/ortho type practices compared to the non-fellowship cohort.
Experience will win out. I'm not debating that at all. but at some point in order to get experience you have to get your first hospital employed position. and i think having fellowship training gives you an advantage over a nonfellowship grad.
i could make a hypothetical situation of a fellowship trained pod with 6 years of hospital experience and ABFAS RRA certified vs a residency grad applying for a hospital position. but what would be the point of that comparison?
in your example, there will also be fellowship trained pods also applying for those same positions, plenty of them already with hospital experience. when the hospital is doing an initial review of their CVs, do you think they would have an advantage over the non-fellowship trained pods?
Well if ACFAS and the profession cared about this stuff...they would give us data. You want to be an acfas certified fellowship? Publish employment outcomes from previous fellows. Obviously we all love anecdotal evidence around here.
Anecdote: I was at a recent course and we were doing some case presentations...2 fellowship trained pods used the phrase: this was originally my bosses patient....then proceeded to show excessive surgery and external fixation on crappy patients .
Well you should be hedging your bets then....if a hospital job is the holy Grail....be applying for fellowships and hospitals...if hospital opens up cancel the fellowship search ...no hospital job then try again during fellowship. Be fellowship curious not committed
I get it. If I was in this situation and I was a 28 year old facing this job market and future....I would do one because I don't know any better and don't what's on the other side and would drink the Kool aid that I have been drinking for the last 7 years
BeaverBlade
Quadruple board certified in building Dams
I think a good fellowship could be a valuable experience if you want to work for ortho/hospital. The problem is a lot of fellowships are just pgy4 and there aren't a lot of good fellowships. Careers are long if you're truly committed to the ortho side of the profession then you may benefit.
Don't do a fellowship if the only reason is you can't find a good job because a year later you likely still won't be able to find a good job. it's podiatry.
I think airbud and a lot of the posters here are spot on about fellowships.
Don't do a fellowship if the only reason is you can't find a good job because a year later you likely still won't be able to find a good job. it's podiatry.
I think airbud and a lot of the posters here are spot on about fellowships.
Of course it would be a good experience. We are all arguing that just because you do one, getting said job is not guaranteed...so what was the point besides the feels
BeaverBlade
Quadruple board certified in building Dams
A lot of the process with podiatry is about living in denial
you go through school in denial
you go through residency in denial
when reality starts creeping in about the crappy job opportunities you decide to extend denial by doing a fellowship for a year.
unfortunately the interest on student loans don't care if your in fellowship or not and it'll still accrue.
I'm not trying to be super negative here like we usually are. I just find this to be certainly true. I remember in school a lot of my classmates though they would be doing surgery everyday, making 300k+, etc. and that unfortunately just wasn't the case for 95% of the people I graduated with. At a certain point you have to live in reality and find your niche in this field whatever it is......
At this point you should be applying to jobs and fellowships and take whatever you can get.
