Good Residencies in Pennsylvania and New Jersey

[FutureDPM123]

I'm trying to narrow down a list of clerkships to do and was hoping for some insight as to which of these programs are known to be good (high surgical volume). The list includes Bryn Mawr, UPMC Pinnacle, Crozer-Chester. Jefferson Health (PA), Reading, Inspira medical, Chestnut hill, Albert Einstein, Virtua Voorhees, Lower bucks, and Roxborough.

Any experience or advice would be appreciated.

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[Pronation]

I'm trying to narrow down a list of clerkships to do and was hoping for some insight as to which of these programs are known to be good (high surgical volume). The list includes Bryn Mawr, UPMC Pinnacle, Crozer-Chester. Jefferson Health (PA), Reading, Inspira medical, Chestnut hill, Albert Einstein, Virtua Voorhees, Lower bucks, and Roxborough.

Any experience or advice would be appreciated.

Roxborough is one of the crappiest residency programs in the country…

 

[xoxo111]

Roxborough is one of the crappiest residency programs in the country…

Could you please expand on that?

 

[HardRoadPaved]

These are all medicore at best programs with mostly community dpm providing an average surgical experience. No major directors that can provide you with a better shot at a good fellowship program. You'll just be getting traditional case diversity of the forefoot and diabetic wound variety.

 

[CutsWithFury]

Aria Health used to be great until Justin Fleming left. Jersey Shore medical center is rock solid for NJ. UMDNJ is good too. UPMC, West Penn, Reading are good.

 

[Feli]

These are all medicore at best programs with mostly community dpm providing an average surgical experience. No major directors that can provide you with a better shot at a good fellowship program. You'll just be getting traditional case diversity of the forefoot and diabetic wound variety.

With a good program, you won't need a fellowship. But yeah.. name program/director places do get the better fellowships.

UPMC, West Penn, and Penn Presby have been strong for decades. I don't think you can talk about best PA programs without those.

UPMC is one of the strongest programs in the whole country even with the loss of Wukich. West Penn lost a ton of their surgical volume and quality when Mendicino left, but there other good thinkers there and I'm sure you could do much worse. Presby has a good depth chart... some attendings are getting long in the tooth but it looks like they definitely brought in other well-trained young ones. I clerked there and it can definitely give you what you need, but I didn't apply for the interview since it is 4yr (and it's in Philly).

 

[619]

Hoboken is also a good program in NJ

 

[JewOnThis]

Times have changed. Programs have changed. Don’t listen to us old folks, but do talk to your more “recent” alumni.

 

[HardRoadPaved]

Aria Health used to be great until Justin Fleming left. Jersey Shore medical center is rock solid for NJ. UMDNJ is good too. UPMC, West Penn, Reading are good.

Yea Aria Health was built as a major F&A trauma factory under Fleming. But when Jefferson took over ortho and politics got involved, he moved on. (see the other thread about job security of hospital gigs). Most programs don't have a solid trauma training bc level 1 trauma centers have their own ortho residents/fellows to feed.

Seems like the OP is looking for more east PA/NJ. UPMC Pinnacle is in central PA not the known one in Pitt with a good reputation. Others mentioned hoboken which is practically NY. Many programs will let you visit for the day if you want to check out a small town like Reading to see if you would even want to live there for 1 month let alone 3 years.

 

[mdphd123j]

Have you considered Cooper?

 

[FutureDPM123]

Have you considered Cooper?

I did, but I’m not sure I’d be happy in Camden

 

[ExperiencedDPM]

Roxborough is a horrible program. Crozier-Chester is very, very mediocre at best. Cooper is NOT a strong program at all. I had interviewed several Copper residents and they were not well trained and had no confidence. Lower Bucks is not a good program unless you like being free labor for the director. Penn Presby is a strong program if you can deal with some of the old school attendings. Pitt is still a very strong program, even without Wukich. Reading is fair/good. Bryn Mawr is only fair. Temple is a 4 year program at a major hospital and does see trauma. West Penn is still a good program. Aria is a decent program but certainly changed since Fleming left. Inspira is fair at best. Morristown is a very good and often over looked program. The Jefferson system in NJ is a thumbs down. Virtua in NJ is a decent program with good volume. Einstein in Philly is one step above Roxborough and is not a good program at all. You will not learn any RF or ankle. UMDNJ is strong.

Bryn Mawr, Roxborough, Lower Bucks, Crozier, are all rinky dink community hospitals. Not great learning institutions

I am basing my comments on my time as someone who was involved with Credentialing programs and interviewing and hiring many residents over the years.

 

[heybrother]

I was going to go to their CASPR pages and quote the sections where they claim to be amazing rearfoot programs, but amusingly the first one I looked at (Crozer) does not. The thing that stands out to me about Crozer and Rox when I look at their pages is - they take 4 residents a year. As of late, when I see 4 residents a year I think - lot of work, but not necessarily enough surgery. I visited several good 2 resident programs that said CASPR was trying to push another resident on them. The programs all knew that the strength of their program was not diluting their surgical volume.

 

[AttendingPod]

I graduated residency within the last 5 years and I know most of these programs very well with first hand experience (most of my rotations you listed and one of which I was chief resident). Is there a way you can private message me on here? Not sure if you can but if so, I can go through some of it with you. Good luck!

 

[NobodyDPM]

Roxborough is a horrible program. Crozier-Chester is very, very mediocre at best. Cooper is NOT a strong program at all. I had interviewed several Copper residents and they were not well trained and had no confidence. Lower Bucks is not a good program unless you like being free labor for the director. Penn Presby is a strong program if you can deal with some of the old school attendings. Pitt is still a very strong program, even without Wukich. Reading is fair/good. Bryn Mawr is only fair. Temple is a 4 year program at a major hospital and does see trauma. West Penn is still a good program. Aria is a decent program but certainly changed since Fleming left. Inspira is fair at best. Morristown is a very good and often over looked program. The Jefferson system in NJ is a thumbs down. Virtua in NJ is a decent program with good volume. Einstein in Philly is one step above Roxborough and is not a good program at all. You will not learn any RF or ankle. UMDNJ is strong.

Bryn Mawr, Roxborough, Lower Bucks, Crozier, are all rinky dink community hospitals. Not great learning institutions

I am basing my comments on my time as someone who was involved with Credentialing programs and interviewing and hiring many residents over the years.

I have been following this site for years and made this account only to address the bold above.

We have had excellent feedback from students who have visited and externed at our program. We have a very high passing rate for our Residents on their surgical boards. Our graduating residents have had no problem getting jobs across the country. And have been successful at them. We have attendings that are committed to the program and to the education within it. Some of our residents stayed in the area and are excellent resources for information about the program. They are also active within the residency by both bringing cases of all calibers to the residency and helping tremendously with the educational side of things. Pre-COVID our residents got their numbers by mid second year, and now, their numbers are ramping up quickly again.

In the distant past we've had issues, as every program has had, but have been working very diligently to improve the student and resident experience. And, according to the feedback we've gotten, we've been successful in this regard.

Thumbs down? Not so much.

I would encourage any student in the area interesting in learning more about us, to come visit. Thanks.

 

[ExperiencedDPM]

I have been following this site for years and made this account only to address the bold above.

We have had excellent feedback from students who have visited and externed at our program. We have a very high passing rate for our Residents on their surgical boards. Our graduating residents have had no problem getting jobs across the country. And have been successful at them. We have attendings that are committed to the program and to the education within it. Some of our residents stayed in the area and are excellent resources for information about the program. They are also active within the residency by both bringing cases of all calibers to the residency and helping tremendously with the educational side of things. Pre-COVID our residents got their numbers by mid second year, and now, their numbers are ramping up quickly again.

In the distant past we've had issues, as every program has had, but have been working very diligently to improve the student and resident experience. And, according to the feedback we've gotten, we've been successful in this regard.

Thumbs down? Not so much.

I would encourage any student in the area interesting in learning more about us, to come visit. Thanks.

You failed to mention the program you are defending. The comment that residents meet their numbers is meaningless.

I was in a position to review programs and I can tell you factually that many of the programs with the highest numbers were simply unethical Medicaid factories. Patients are used as guinea pigs to keep clinics busy, pad the pocket of the attendings and get cases for the residents, whether surgical intervention was indicated or not.

So don’t try to impress me with the number of cases the residents complete. Their skill and morals are only as good as what they are taught.

I know too much about our profession and the programs to listen to BS. I’ve visited programs with huge numbers that are literally crippling people and putting out butchers who don’t know what they don’t know or worse, don’t care about what they don’t know.

Nice try.

 

[heybrother]

You failed to mention the program you are defending. The comment that residents meet their numbers is meaningless.

I was in a position to review programs and I can tell you factually that many of the programs with the highest numbers were simply unethical Medicaid factories. Patients are used as guinea pigs to keep clinics busy, pad the pocket of the attendings and get cases for the residents, whether surgical intervention was indicated or not.

So don’t try to impress me with the number of cases the residents complete. Their skill and morals are only as good as what they are taught.

I know too much about our profession and the programs to listen to BS. I’ve visited programs with huge numbers that are literally crippling people and putting out butchers who don’t know what they don’t know or worse, don’t care about what they don’t know.

Nice try.

He was referring to Jefferson. He bolded their name in your quote (its why he references thumbs down etc).

 

[NobodyDPM]

You failed to mention the program you are defending. The comment that residents meet their numbers is meaningless.

I was in a position to review programs and I can tell you factually that many of the programs with the highest numbers were simply unethical Medicaid factories. Patients are used as guinea pigs to keep clinics busy, pad the pocket of the attendings and get cases for the residents, whether surgical intervention was indicated or not.

So don’t try to impress me with the number of cases the residents complete. Their skill and morals are only as good as what they are taught.

I know too much about our profession and the programs to listen to BS. I’ve visited programs with huge numbers that are literally crippling people and putting out butchers who don’t know what they don’t know or worse, don’t care about what they don’t know.

Nice try.

I hope you are not suggesting that the program I am part of is being unethical in how it is training its residents. That is a pretty serious accusation.

We work hard to assure a great experience for the students that visit and extern with us, and work even harder to assure that our resident graduates know how practice their profession ethically and responsibly.

Just FYI, this is precisely the type of response I made a point of not contributing to avoid. I am being genuine. And this is how it is welcomed. The Mods should take note.

 

[NobodyDPM]

He was referring to Jefferson. He bolded their name in your quote (its why he references thumbs down etc).

Indeed. And once again, I encourage anyone who has an interest in the program to not take my word for it. As students, please come visit, or preferably extern, and make up your own mind. Thanks.

 

[HardRoadPaved]

You failed to mention the program you are defending. The comment that residents meet their numbers is meaningless.

I was in a position to review programs and I can tell you factually that many of the programs with the highest numbers were simply unethical Medicaid factories. Patients are used as guinea pigs to keep clinics busy, pad the pocket of the attendings and get cases for the residents, whether surgical intervention was indicated or not.

So don’t try to impress me with the number of cases the residents complete. Their skill and morals are only as good as what they are taught.

I know too much about our profession and the programs to listen to BS. I’ve visited programs with huge numbers that are literally crippling people and putting out butchers who don’t know what they don’t know or worse, don’t care about what they don’t know.

Nice try.

Amen. If you teach sound surgical technique and do it a few times, I would be more impressed than 100x of hacking at tissue and getting suboptimal results and malreductions. A simple look at surgeons boasting on their Instagram pages all while they have a post-op lapiplasty with an IMA of 20 or a calc fracture with a non-reduced posterior facet.

Hate to say it but these run of the mill programs are usually not going to give you solid training that will build you a surgical foundation. Will you see cases? Sure. Will the cool case of the year come in? Sure. But the docs that fix the other docs mistakes, that's who you want to train under.

Heck, it looks like Jeff-NJ director who isn't ABFAS-cert just hires his own residents and Kennedy residents to fill his clinics. This is not an academic center, but merely a community practice that takes cases to nearby community facilities.

Compare these two dpm websites:
Robert J. Warkala, DPM

Justin J. Fleming - UOANJ - NJ Orthopaedic Associates

Justin Fleming, DPM, FACFAS, is a foot and ankle surgeon board certified by the American Board of Foot and Ankle Surgeons (ABFAS). He obtained his medical degree from Temple University and his undergraduate degree from Widener University. He received extensive training in foot and ankle...

www.uoanj.com

Indeed. And once again, I encourage anyone who has an interest in the program to not take my word for it. As students, please come visit, or preferably extern, and make up your own mind. Thanks.

Agreed. To each their own. You only have a few precious months to extern before interviews. I would have a good idea about each externship prior to going. Visits are the best way to get a feel for the environment prior to committing and possibly wasting a month that can be used on a program you would consider.

 

[CutsWithFury]

Heck, it looks like Jeff-NJ director who isn't ABFAS-cert just hires his own residents and Kennedy residents to fill his clinics. This is not an academic center, but merely a community practice that takes cases to nearby community facilities.

How can you have a residency program if you are not ABFAS certified?

 

[NobodyDPM]

Amen. If you teach sound surgical technique and do it a few times, I would be more impressed than 100x of hacking at tissue and getting suboptimal results and malreductions. A simple look at surgeons boasting on their Instagram pages all while they have a post-op lapiplasty with an IMA of 20 or a calc fracture with a non-reduced posterior facet.

Hate to say it but these run of the mill programs are usually not going to give you solid training that will build you a surgical foundation. Will you see cases? Sure. Will the cool case of the year come in? Sure. But the docs that fix the other docs mistakes, that's who you want to train under.

Heck, it looks like Jeff-NJ director who isn't ABFAS-cert just hires his own residents and Kennedy residents to fill his clinics. This is not an academic center, but merely a community practice that takes cases to nearby community facilities.

Compare these two dpm websites:
Robert J. Warkala, DPM

Justin J. Fleming - UOANJ - NJ Orthopaedic Associates

Justin Fleming, DPM, FACFAS, is a foot and ankle surgeon board certified by the American Board of Foot and Ankle Surgeons (ABFAS). He obtained his medical degree from Temple University and his undergraduate degree from Widener University. He received extensive training in foot and ankle...

www.uoanj.com

Agreed. To each their own. You only have a few precious months to extern before interviews. I would have a good idea about each externship prior to going. Visits are the best way to get a feel for the environment prior to committing and possibly wasting a month that can be used on a program you would consider.

Bolded again.

I absolutely beg to differ. Have you personally attended any of our weekly Academic sessions? Or any of the multitude of workshops we prepare for our residents, and the students present that month to participate it? Or seen the feedback we've received about our academics from students who visited and externed. The feedback is anonymous, btw. We also have an annual workshop where we invited students from Temple to participate as well. And not only is it well received, students who attended it in the past encourage their underclassmen to attend.

Yes, we are all community doctors that bring our cases to the local hospital. Which happens to be owned and operated by Jefferson University. Not a bad place to get trained. And until Jefferson decides to hire a bunch of their own Podiatrists, which will likely never happen, that's what's available. Is that a bad thing?

I've had the privilege of knowing Justin Fleming for many years. He is truly a once in a generation type of practitioner, and those who train under him are very lucky. That being said, since there is only one of him, so sorry, but there is only one of him. Is he now the benchmark for all other training facilities? Is that what people here think? That unless you are trained by the very elite of the elite, you can't make a living being a Podiatrist? Because truly, out in the real World, no one gives a rip where you trained, or who you trained under. If you are a kind soul, have good bedside manner and reasonably good surgical skills, you have everything you need. Oh and btw, doing all those BIG cases won't make you the kind of money you think you're going to make. Unless you do what Justin did and join a large Orthopedic group. Good for you, and best of luck in that endeavor.

 

[NobodyDPM]

How can you have a residency program if you are not ABFAS certified?

You'd be surprised how many residency directors aren't. Have you checked each one?

I want you to look at what goes on on this site. And how people who run programs, and make an effort to educate the next generation are treated. Of course there are some bad apples, but those are the ones everyone harps on. Not so easy to be a Residency Director. Nor an Attending in a community type setting. We bring our private cases to teaching hospitals to help teach the next generation of surgeons. We don't get paid, and some of us even go above and beyond for the programs we participate in. Just to pay it forward. And look at what some here say about the programs some of us commit time and effort into. "Thumbs down". Yeah, thanks. For nothing. When you are in a position to participate, I challenge you to do it, and do it better than I am. And then come and read these forums, and see how much our profession appreciates you. I double dog dare you.

What's equally hilarious is how the people here see the board certification process. Look around and you'll how it's universally despised. So why does anyone care so much if a residency director is board certified or not? It's a sham anyway, right?

 

[CutsWithFury]

You'd be surprised how many residency directors aren't. Have you checked each one?

I want you to look at what goes on on this site. And how people who run programs, and make an effort to educate the next generation are treated. Of course there are some bad apples, but those are the ones everyone harps on. Not so easy to be a Residency Director. Nor an Attending in a community type setting. We bring our private cases to teaching hospitals to help teach the next generation of surgeons. We don't get paid, and some of us even go above and beyond for the programs we participate in. Just to pay it forward. And look at what some here say about the programs some of us commit time and effort into. "Thumbs down". Yeah, thanks. For nothing. When you are in a position to participate, I challenge you to do it, and do it better than I am. And then come and read these forums, and see how much our profession appreciates you. I double dog dare you.

What's equally hilarious is how the people here see the board certification process. Look around and you'll how it's universally despised. So why does anyone care so much if a residency director is board certified or not? It's a sham anyway, right?

A residency director should be board certified. There has to be some standard.

 

[NobodyDPM]

A residency director should be board certified. There has to be some standard.

I don't necessarily disagree. That being said, if you came onto this site, and read what people say, would you want to be a Residency Director? When you are in the position to be, I challenge you to become one. And fight the good fight. We need more good people to train the next generation. Despite all the negativity.

 

[Feli]

Being a residency director is a thankless job. Nobody will say it is not.

There are many programs that try hard and do the best they can, but they just don't have the cases... in terms of quality, volume, or all of the above. It take YEARS and multiple good groups of DPM attendings working together to have a solid residency program. It takes solid F&A surgeons who are willing to be simply one of the residency attendings - even though they could almost all be a director of their own residency or fellowship elsewhere based on their training and skill set. It also takes director/admin restraint to keep the program quality high and not dilute it when CPME comes asking if your hospital wants more $$$ to take more residents, which can crush any good program fast.

That teamwork is the difference between the top ('name') programs and the mediocre 2nd teir podiatry ones. The top ones all have a half dozen - maybe a dozen or more high quality attendings who do RRA and teach well and work together. As was said, they're also typically at large teaching hospitals with a lot of MD teaching programs. ExpDPM is spot-on with that. The 2nd teir ones (such as Flemings' prior program in PA or dozens like it) just ride on basically one guy or maybe two... and you'd be screwed if that guy got in a car accident or left with short notice. Those are more of fellowships posing as residencies. Can they be good or continue to grow? Sure. Should any student who has the grades choose them over a proven winner? Not wise.

I checked into many up-and-coming programs when I was a student. Every resident or director feels their program is the best or has potential. The bias is unavoidable. I talked to some directors who were fantastic well-trained surgeons and were expecting big continued improvement at their program... "best in the city pretty soon." Did I end up visiting any of those? Nah, I left those for other students and clerked all historically strong 'name' programs. I respect what they were trying to do at the startups or community programs, but there was not enough time. I'm not going to put all my eggs in one basket just because the director is pretty good. That is what fellowship is for: to follow one or a few excellent surgeons around... except you don't even need that if you have a good residency. You already are the excellent surgeon.

 

[619]

That unless you are trained by the very elite of the elite, you can't make a living being a Podiatrist? Because truly, out in the real World, no one gives a rip where you trained, or who you trained under. If you are a kind soul, have good bedside manner and reasonably good surgical skills, you have everything you need. Oh and btw, doing all those BIG cases won't make you the kind of money you think you're going to make.

This is 100% correct and anyone who disagrees with this statement is just trying to feed his/her ego. In the real world, your money is made in clinic and doing the quick 45 mins-1 hour surgery cases. Charcot recon, IM nail, triple and those big cases pay very little compared to what you deal with in the long post-op period. Good training at a good program is 100% important however after graduation, it all goes down to personal responsibility, good personality, networking, building income, paying back your student loans, having a balanced life etc.

In regards to residency directors being ABFAS Certified. Why don't we ask the same question if the residency director is ABPM Board Certified? Because most directors that are not ABFAS Board Certified are certainly ABPM Board Certified. ABFAS does not hold a monopoly on Board Certification. In my opinion ABPM Board Certification is equal and parallel to ABFAS Board certification however just like everything in life people like to up one another by saying ABFAS is better which is complete bull.

Pick one Board Certification and move on with life. Waste of energy to be pursuing double board certification. If you are ABFAS Board Certified, good for you. If you are ABPM Board Certified, good for you. If you are both ABFAS and ABPM Board Certified, good for you. Out in practice, nobody really cares.

Finally, I agree that a Residency Director should be Board Certified!

 

[NobodyDPM]

This is 100% correct and anyone who disagrees with this statement is just trying to feed his/her ego. In the real world, your money is made in clinic and doing the quick 45 mins-1 hour surgery cases. Charcot recon, IM nail, triple and those big cases pay very little compared to what you deal with in the long post-op period. Good training at a good program is 100% important however after graduation, it all goes down to personal responsibility, good personality, networking, building income, paying back your student loans, having a balanced life etc.

In regards to residency directors being ABFAS Certified. Why don't we ask the same question if the residency director is ABPM Board Certified? Because most directors that are not ABFAS Board Certified are certainly ABPM Board Certified. ABFAS does not hold a monopoly on Board Certification. In my opinion ABPM Board Certification is equal and parallel to ABFAS Board certification however just like everything in life people like to up one another by saying ABFAS is better which is complete bull.

Pick one Board Certification and move on with life. Waste of energy to be pursuing double board certification. If you are ABFAS Board Certified, good for you. If you are ABPM Board Certified, good for you. If you are both ABFAS and ABPM Board Certified, good for you. Out in practice, nobody really cares.

Finally, I agree that a Residency Director should be Board Certified!

Bold mine.

These days, with everyone having had three years of surgical based podiatric residency, there is no reason whatsoever not to get ABFAS certified. Unless you can't pass or comply with the requirements for some reason. In the past, where not all students even got a residency at all, this distinction was much more important.

That being said, many of the current, older residency directors didn't have three years of training. Some had only one year of post graduate training. And when they were coming up, board certification was not required for hospital privileges, like they are now in many places. They still all deserve the utmost respect, as without them, we would not be where we are today.

 

[HardRoadPaved]

Let's get back to the OP.

I'm trying to narrow down a list of clerkships to do and was hoping for some insight as to which of these programs are known to be good (high surgical volume).

Yes, there is surgical volume at any program. You want to see a bunch of forefoot slams and an occasional cool case then yes go to any average program. But do you want to move onto ortho practice or fellowship after residency? If so, you are not going to Hyer coming from just any program. Connections are the game and this is a small field. But if you want to do community dpm work like the 90% of graduates, then find a nice place to settle down for 3 years and learn on some medicaid patients what to/not to do.

 

[Feli]

...That unless you are trained by the very elite of the elite, you can't make a living being a Podiatrist? Because truly, out in the real World, no one gives a rip where you trained, or who you trained under. If you are a kind soul, have good bedside manner and reasonably good surgical skills, you have everything you need. Oh and btw, doing all those BIG cases won't make you the kind of money you think you're going to make...

This is simply not true. Making money and actual medical/surgical skill are two very different things. If money was the only thing, people should drop out of residency after a year or two, do nursing homes, and hire a couple associates. Training matters very much, though. It will limit what you can and cannot offer patients.

Residencies are academic institutions. They are teaching programs. The goal is to learn or to as much as possible. Some do a much better job than others: bona fide teaching hospitals doing complex cases and research... versus community hospitals with a doc/group running the "residency" while just using the residents basically as podiatry PAs to increase the amount of consults and clinic that they can do.

Anyone with great training for ankles and trauma can always decide to just do bunions and toes and wounds. The converse is NOT true. So, in the end, the individual DPM themselves are the ones who ultimately care where they trained and, most importantly, what they learned... because that determines what they offer patients and what jobs are open or closed to them for decades of practice.

But yes, of course you can make a living never getting board certified and just doing basics. For most, it is more reassuring to know that you have the best diagnostics and knowledge you could get to help the patients and community, though.

...These days, with everyone having had three years of surgical based podiatric residency, there is no reason whatsoever not to get ABFAS certified. Unless you can't pass or comply with the requirements for some reason...

100%... but the pass rates are much higher from residencies that teach well and attract good students to begin the PGY years.

...In regards to residency directors being ABFAS Certified. Why don't we ask the same question if the residency director is ABPM Board Certified? Because most directors that are not ABFAS Board Certified are certainly ABPM Board Certified. ABFAS does not hold a monopoly on Board Certification. In my opinion ABPM Board Certification is equal and parallel to ABFAS Board certification however just like everything in life people like to up one another by saying ABFAS is better which is complete bull....
Pick one Board Certification and move on with life. Waste of energy to be pursuing double board certification. If you are ABFAS Board Certified, good for you. If you are ABPM Board Certified, good for you. If you are both ABFAS and ABPM Board Certified, good for you. Out in practice, nobody really cares.

No man, this is way off.

You will have many doors closed to you and likely miss out on offering patients many services since you won't be able to get privileges at most facilities and/or won't be considered for most jobs. It is likely that not passing ABFAS costs a practicing DPM millions of dollars in their career based on surveys of incomes. It can sometimes be circumvented in private practice and allow you to still make a good living financially if you get enough of the non-operative stuff or find an area that doesn't know/care about our boards,, but again, monetary success vs medical/surgical is quite different. Bamboozling the CMO of some rural hospital that has never had podiatry is one thing... but looking in the mirror knowing you have a STJ fusion scheduled that you have almost no idea how to do is probably not ideal for that surgeon or anyone else.

 

[Shiyuan]

No man, this is way off.

In terms of getting hired by a podiatrist/pod group, some ortho groups or hospital - true.

In terms of getting hired by MSG, some other ortho groups, others (derm, ID, FQHC, VA, etc.) - IMO not true.

No MD or DO in my group (>40 docs) has any clue what the difference between ABPM or ABFAS is. They just know that I am a surgical podiatrist able to see anything that comes into the office and I perform foot/ankle surgery.
I am ABPM cert.

 

[NobodyDPM]

This is simply not true. Making money and actual medical/surgical skill are two very different things. If money was the only thing, people should drop out of residency after a year or two, do nursing homes, and hire a couple associates. Training matters very much, though. It will limit what you can and cannot offer patients.

Residencies are academic institutions. They are teaching programs. The goal is to learn or to as much as possible. Some do a much better job than others: bona fide teaching hospitals doing complex cases and research... versus community hospitals with a doc/group running the "residency" while just using the residents basically as podiatry PAs to increase the amount of consults and clinic that they can do.

Anyone with great training for ankles and trauma can always decide to just do bunions and toes and wounds. The converse is NOT true. So, in the end, the individual DPM themselves are the ones who ultimately care where they trained and, most importantly, what they learned... because that determines what they offer patients and what jobs are open or closed to them for decades of practice.

But yes, of course you can make a living never getting board certified and just doing basics. For most, it is more reassuring to know that you have the best diagnostics and knowledge you could get to help the patients and community, though.


100%... but the pass rates are much higher from residencies that teach well and attract good students to begin the PGY years.


No man, this is way off.

You will have many doors closed to you and likely miss out on offering patients many services since you won't be able to get privileges at most facilities and/or won't be considered for most jobs. It is likely that not passing ABFAS costs a practicing DPM millions of dollars in their career based on surveys of incomes. It can sometimes be circumvented in private practice and allow you to still make a good living financially if you get enough of the non-operative stuff or find an area that doesn't know/care about our boards,, but again, monetary success vs medical/surgical is quite different. Bamboozling the CMO of some rural hospital that has never had podiatry is one thing... but looking in the mirror knowing you have a STJ fusion scheduled that you have almost no idea how to do is probably not ideal for that surgeon or anyone else.

I respectfully disagree with your (bolded) statement. Anyone with great training for ankles and trauma, but not with bunions, hammertoes and wounds can most certainly not be competent at the forefoot procedures. I've seen this myself. With my very own eyes. Orthopedic foot and ankle surgeons who were mostly trained via trauma cases are a perfect example of this.

The goal of podiatric medical school and residency training is to graduate competent physicians. It is up to the physician to decide what and how they then practice. I can also tell you that as you progress in your practice life, you will quickly realize that what some may consider "lesser" cases are where its at. Both financially and for quality of life as a physician. Do you really believe that all these RRA program graduate all do these "complex" procedures? Or should for that matter? I promise you, they don't. And many shouldn't.

 

[ExperiencedDPM]

NoBodyDPM…..you speak very proudly of the “Jefferson” program as if it’s as prestigious as the Jefferson University Hospital legacy.

Until relatively recently, your program was known as Kennedy Hospital. Jefferson University Hospital in Philadelphia decided to aggressively expand into South Jersey. It took a relatively unknown hospital system (Kennedy) and gave it a nationally recognized name.

But let’s be honest, do your residents ever rotate through Jefferson in Philadelphia? Jefferson in Philadelphia is one of the most unfriendly hospitals in the region regarding DPMs. University of Pennsylvania/Presby has surgical DPMs on staff. Temple University Hospital has surgical DPMs on staff. Einstein has surgical DPMs on staff. But Jefferson in Philadelphia has ZERO DPMs doing surgery in their hospital.

The Jefferson name is great to have in lieu of the former Kennedy name, but let’s not kid anyone that your academics are on par with Jeff in Philadelphia.

In your first post, I did not realize you were referencing Jefferson in NJ. I will agree that it’s not a surgical Medicaid mill filled with unethical attendings. Those comments were directed to other programs mentioned in the Philadelphia region.

I don’t know you other than the fact it disturbs me that a residency director is not ABFAS certified. But again, I know the program and you aren’t putting out superstars. I looked up the staff at your hospital and there are no heavy hitters. I do recognize some names and assure you I wouldn’t want them teaching me.

It’s heart warming that you defend your program. Again, your program is not one of the unethical programs I referenced. But you won’t convince me that your program is anything but mediocre. Sorry to tell you my honest opinion, but I have never seen what I consider a strong program that wasn’t headed by an ABFAS certified director.

And it bothers me WHY with all the attendings at your program, why there isn’t an ABFAS certified director.

Your program is mediocre and doesn’t attract or produce the cream of the crop.

I was a residency director and know what it takes. I commend you on your honesty and time commitment. But be honest with yourself. Having great lectures or academics doesn’t cut it if the residents aren’t learning from top notch surgeons.

 

[DexterMorganSK]

Just a reminder that attacking one another or inflaming is not allowed as per the TOS. Please use the ignore function instead.

Also, there is a reason externship exists, so let's leave it to the current students to decide if a program is worth their time or not.

 

[Feli]

In terms of getting hired by a podiatrist/pod group, some ortho groups or hospital - true.

In terms of getting hired by MSG, some other ortho groups, others (derm, ID, FQHC, VA, etc.) - IMO not true.

No MD or DO in my group (>40 docs) has any clue what the difference between ABPM or ABFAS is. They just know that I am a surgical podiatrist able to see anything that comes into the office and I perform foot/ankle surgery.
I am ABPM cert.

What you describe is a minority of places. I am glad you have a job you like and got surgical privileges with just ABPM, but I would not advise anyone to count on it. There will always be places that don't understand our boards or need to be flexible due to location or whatever. Those are the exceptions... not the norm.

If that MSG you work for already had a DPM, do you think your application would even be considered against ABFAS board qual/cert applicants willing to work for the same money? ABFAS qual/cert is generally a minimum for most good jobs and for privileges (OR cases) at prestigious hospitals.

... would you want to be a Residency Director? When you are in the position to be, I challenge you to become one. And fight the good fight. We need more good people to train the next generation. Despite all the negativity.

This is noble thinking, and I was guilty of it back when I was a student. The director spot is the prestige and the title and blah blah. A lot of young DPMs fall for that and want to start their own program or fellowship instead of being "just one of the attendings" at "somebody else's" program. Many of those guys do start up or take over a program to be "the man" instead of just one of the contributors at a good existing program. Those are your up-and-coming or maybe even 2nd tier programs. The ego is what prevented them from being elite Presby or UPMC or West Penn, though.

At most of the best programs, the director is not even the best or busiest surgeon, though. That is the case for PI, Kaiser, PSL, Orlando, and most of the best programs around. Sure, the directors are usually no slouch and they are quite competent as surgeons, but they usually aren't the RRA captain of the attendings list... they have multiple other guys who fill that role. It is a team approach that takes many docs to do well. Some of the solid ones rotate directors every 5 or so years to have fresh ideas and prevent the paperwork/admin burnout; that's more common in MD programs but gaining steam in DPM also. The fact of the matter is that any of the top 5-10 attendings for most truly good 'name' programs as above could easily start up their own program, could be the best surgeon at another area program, etc. The fact that they stay around and work together and keep a very solid depth chart within one powerhouse program is what makes them excellent programs and not just mediocre or startup programs, though.

I fell for the ego stuff for my first couple of years out. I wanted to be voted favorite attending by the residents. I wanted a director job to open up. With what I know now, I think it was a real good thing I wasn't... that would've meant I was teaching at fairly weak programs. I was able to help a lot more by bringing good cases and fresh perspective to residents at other existing top residency hospitals in my area. You don't have to have any special title to "train the next generation." None of my most influential attendings during residency did either... they were all just guys with solid surgical skill who were owner or partner in private groups.

I see almost zero need for anyone in podiatry to start a program. What we'd benefit from is more well-trained DPM attendings joining staff at existing residency programs to bring cases, community hospital and tiny hospital programs moving to local academic teaching locations to sponsor the residency, existing directors working to get their residents more podiatry cases and better MD rotation months at outside facilities (if they can't get them to busy academic hospitals), etc. We shall see.

 

[NobodyDPM]

NoBodyDPM…..you speak very proudly of the “Jefferson” program as if it’s as prestigious as the Jefferson University Hospital legacy.

Until relatively recently, your program was known as Kennedy Hospital. Jefferson University Hospital in Philadelphia decided to aggressively expand into South Jersey. It took a relatively unknown hospital system (Kennedy) and gave it a nationally recognized name.

But let’s be honest, do your residents ever rotate through Jefferson in Philadelphia? Jefferson in Philadelphia is one of the most unfriendly hospitals in the region regarding DPMs. University of Pennsylvania/Presby has surgical DPMs on staff. Temple University Hospital has surgical DPMs on staff. Einstein has surgical DPMs on staff. But Jefferson in Philadelphia has ZERO DPMs doing surgery in their hospital.

The Jefferson name is great to have in lieu of the former Kennedy name, but let’s not kid anyone that your academics are on par with Jeff in Philadelphia.

In your first post, I did not realize you were referencing Jefferson in NJ. I will agree that it’s not a surgical Medicaid mill filled with unethical attendings. Those comments were directed to other programs mentioned in the Philadelphia region.

I don’t know you other than the fact it disturbs me that a residency director is not ABFAS certified. But again, I know the program and you aren’t putting out superstars. I looked up the staff at your hospital and there are no heavy hitters. I do recognize some names and assure you I wouldn’t want them teaching me.

It’s heart warming that you defend your program. Again, your program is not one of the unethical programs I referenced. But you won’t convince me that your program is anything but mediocre. Sorry to tell you my honest opinion, but I have never seen what I consider a strong program that wasn’t headed by an ABFAS certified director.

And it bothers me WHY with all the attendings at your program, why there isn’t an ABFAS certified director.

Your program is mediocre and doesn’t attract or produce the cream of the crop.

I was a residency director and know what it takes. I commend you on your honesty and time commitment. But be honest with yourself. Having great lectures or academics doesn’t cut it if the residents aren’t learning from top notch surgeons.

Thank you for this. It is appreciated.

We don't profess to put out superstars. I was initially responding to your "thumbs down" comment about us. I speak proudly of the program, because there are many of us, who put a significant effort in training the next generation of podiatrists, with little to no vested interest in doing so. Other than paying it forward. Truly, and I can only speak for myself, but I'm not involved in the program to drive the perception of our program to anyone but students who are looking for an excellent residency experience. I can honestly say that, for better or worse, my feeling is that all of our attendings are in it for the greater good of the profession. Not for accolades or for some fictitious pedestal podiatrists tend to put themselves on because they train residents.

What is a "superstar" in Podiatry? Why is that even important? Other than these forums, and in some academic and lecturing circuits, do you think most practicing podiatrist know who Justin Fleming is? Do you most residents even want to be "superstars"?

Again, my view on the process is that it is a preparation for life as a practicing podiatrist. And for all the rearfoot mumbo jumbo students all seem to salivate over, ultimately, for most practicing podiatrist, it represents a very small proportion of what is done in practice on a daily basis. And also happens to not be very financially viable compared to other things done in the office. One office visit with a pair of custom orthotics pays more than most insurances will pay for a triple arthrodesis. I'm also talking in generalities. There will always be exceptions to every rule, but that what they are. Exceptions.

Again, appreciate your post very much. Be well and stay safe.

 

[NobodyDPM]

What you describe is a minority of places. I am glad you have a job you like and got surgical privileges with just ABPM, but I would not advise anyone to count on it. There will always be places that don't understand our boards or need to be flexible due to location or whatever. Those are the exceptions... not the norm.

If that MSG you work for already had a DPM, do you think your application would even be considered against ABFAS board qual/cert applicants willing to work for the same money? ABFAS qual/cert is generally a minimum for most good jobs and for privileges (OR cases) at prestigious hospitals.


This is noble thinking, and I was guilty of it back when I was a student. The director spot is the prestige and the title and blah blah. A lot of young DPMs fall for that and want to start their own program or fellowship instead of being "just one of the attendings" at "somebody else's" program. Many of those guys do start up or take over a program to be "the man" instead of just one of the contributors at a good existing program. Those are your up-and-coming or maybe even 2nd tier programs. The ego is what prevented them from being elite Presby or UPMC or West Penn, though.

At most of the best programs, the director is not even the best or busiest surgeon, though. That is the case for PI, Kaiser, PSL, Orlando, and most of the best programs around. Sure, the directors are usually no slouch and they are quite competent as surgeons, but they usually aren't the RRA captain of the attendings list... they have multiple other guys who fill that role. It is a team approach that takes many docs to do well. Some of the solid ones rotate directors every 5 or so years to have fresh ideas and prevent the paperwork/admin burnout; that's more common in MD programs but gaining steam in DPM also. The fact of the matter is that any of the top 5-10 attendings for most truly good 'name' programs as above could easily start up their own program, could be the best surgeon at another area program, etc. The fact that they stay around and work together and keep a very solid depth chart within one powerhouse program is what makes them excellent programs and not just mediocre or startup programs, though.

I fell for the ego stuff for my first couple of years out. I wanted to be voted favorite attending by the residents. I wanted a director job to open up. With what I know now, I think it was a real good thing I wasn't... that would've meant I was teaching at fairly weak programs. I was able to help a lot more by bringing good cases and fresh perspective to residents at other existing top residency hospitals in my area. You don't have to have any special title to "train the next generation." None of my most influential attendings during residency did either... they were all just guys with solid surgical skill who were owner or partner in private groups.

I see almost zero need for anyone in podiatry to start a program. What we'd benefit from is more well-trained DPM attendings joining staff at existing residency programs to bring cases, community hospital and tiny hospital programs moving to local academic teaching locations to sponsor the residency, existing directors working to get their residents more podiatry cases and better MD rotation months at outside facilities (if they can't get them to busy academic hospitals), etc. We shall see.

I love this post!! Very well said.

I did bold a portion, because I may be misunderstanding what you're saying. The programs highlighted have HUGE egos there, LOL.

 

[Shiyuan]

Surely all agree that:

ABFAS < all 6 certs from ABMSP combined

... right? 😜

 

[GreenHousePub]

Surely all agree that:

ABFAS < all 6 certs from ABMSP combined

... right? 😜

I just scrolled through the ABMSP list and there are two people in the US that have all 6 ABMSP certs. One in Las Vegas, the other in Carlsbad.

If your residency director isn't sextuple-certified then why even bother going to the program?

 

[ExperiencedDPM]

Surely all agree that:

ABFAS < all 6 certs from ABMSP combined

... right? 😜

If you have a pulse and a check book…..PASSED!

 

[ExperiencedDPM]

Thank you for this. It is appreciated.

We don't profess to put out superstars. I was initially responding to your "thumbs down" comment about us. I speak proudly of the program, because there are many of us, who put a significant effort in training the next generation of podiatrists, with little to no vested interest in doing so. Other than paying it forward. Truly, and I can only speak for myself, but I'm not involved in the program to drive the perception of our program to anyone but students who are looking for an excellent residency experience. I can honestly say that, for better or worse, my feeling is that all of our attendings are in it for the greater good of the profession. Not for accolades or for some fictitious pedestal podiatrists tend to put themselves on because they train residents.

What is a "superstar" in Podiatry? Why is that even important? Other than these forums, and in some academic and lecturing circuits, do you think most practicing podiatrist know who Justin Fleming is? Do you most residents even want to be "superstars"?

Again, my view on the process is that it is a preparation for life as a practicing podiatrist. And for all the rearfoot mumbo jumbo students all seem to salivate over, ultimately, for most practicing podiatrist, it represents a very small proportion of what is done in practice on a daily basis. And also happens to not be very financially viable compared to other things done in the office. One office visit with a pair of custom orthotics pays more than most insurances will pay for a triple arthrodesis. I'm also talking in generalities. There will always be exceptions to every rule, but that what they are. Exceptions.

Again, appreciate your post very much. Be well and stay safe.

I just read and re-read your post. Sorry for my brutal honesty, be you seem to settle for mediocrity.

You ask why a “superstar” is even important. Did you REALLY ask that question?

Without “superstars” our profession will remain stagnant. Without “superstars” our profession will always be followers and not leaders. Without “superstars” current procedures and technology will never be questioned whether it can be improved. Without “superstars” it will always be business as usual. Without “superstars” our profession will never gain respect. Without “superstars” there will he no research or originality. With “superstars” our residents will be cookie cutter and will continue to be taught by drones who have no right teaching surgery. Should I go on?

Those who don’t perform major rearfoot, reconstructive and ankle surgery (I don’t believe those procedures are in your armamentarium) are always preaching how you really can’t make any money doing those cases.

Sure, you can make lots of money hawking $700 orthoses when the majority of those patients would have equal success with a pair or $50 PowerSteps.

Sure, you can convince a patient to have laser surgery for nails for lots of money, knowing that it won’t have any beneficial effect.

Sure, you can sell antifungal nail polish at your front counter, knowing you’ve REALLY helped patients with that crap.

Sure, you can sell vitamins to “cure” their neuropathy, knowing they can buy the same ingredients at Target.

You carefully avoided ALL my prior questions when I asked if your “Jefferson” (NJ) residents have any rotations at Jefferson University Hospital in Philly. You avoided my question whether you are REALLY banging your chest that this is “Jefferson” when in reality it’s a former nationally unknown NJ hospital system that was recently purchased by Jefferson. Time for a reality check.

Sorry, but I keep going back to your statement about doing a triple vs making orthoses. When is the last time you did a triple to know from experience? So when that patient comes in and NEEDS a triple and your holy grail magical plastic inserts (orthoses) don’t work, what do you do?

Do you tell the patient that a triple doesn’t pay as much so you’re not doing it? Do you tell them there are no “superstars” in your practice that can do it? Or do you now refer them to a “superstar” DPM or orthopedic surgeon?

What message are you sending to your residents? “I don’t think you should learn or perform these surgeries because they don’t pay enough?” Is it all about how much more you can make in your office or is about offering and providing the best care, regardless of reimbursement?

And for what it’s worth, I know lots of well trained DPMs who perform a LOT of major cases and are doing VERY well financially.

Let’s get back to your mediocrity. You ask “do the residents even want to be superstars?” No, I pick residents who all want to be mediocre. Are you kidding me? Again, did you REALLY write that comment? I don’t know if a particular resident wants to be a superstar but the residency committee and I ALWAYS attempted to choose those who we felt had the knowledge, skill and drive to WANT to be a superstar and we thought COULD be a superstar.

Sorry to hear that you don’t have the same feeling. Mediocre is certainly very easy and very safe.

You also state you have no or minimal vested interest. I would hope you’d have lots of vested interest. You should be heavily vested with your time, skills, guidance and knowledge. I will presume you meant no FINANCIAL interest. But if these residents rotate through your office and see patients, it’s free labor and you do have a financial interest. If they spend time working up patients in your office and seeing your post op patients, it’s free labor and you do have a financial interest. If you receive a stipend for being the residency director, you do have a financial interest (when I was a residency director I donated every penny back to the program to help pay for quality CME courses, books, journals, etc).

You seem like a nice guy and run of the mill DPM who stays safe within his own little comfort zone. But you shouldn’t be hindering the training of residents based on your happiness with mediocrity.

Again, don’t tell me about your great journal club or cadaver labs. That really is meaningless if the overall training is as you describe and I know.

My advice? Swallow your pride and search for a “superstar” to run your program, up the quality of the program and potentially put out some new “superstars”.

 

[deleted1097413]

this thread is probably the worst I’ve read on here in a long time.

Times have changed. Programs have changed. Don’t listen to us old folks, but do talk to your more “recent” alumni.

This is the only reply that was actually useful.

 

[DexterMorganSK]

I believe OP received their answer a while ago, and this thread has derailed enough since.

Locking!