...In other words, is there really much of a point to enduring a PM&S-36 unless you just enjoy learning surgery? It just seems that, if you're not actually going to implement many (or any) of your advanced surgical skills or improve income, what's the point in spending the extra year learning them?...
More and better training always correlates with higher
average income. That is because you will have more job options (and can pick the best of them), but it's probably also just because most people who will go get a tough and long residency will also work more hours when they go out into practice (again, on
average). "Top" residencies also typically provide good external rotations and research support; those factors will facilitate their grads obtaining fellowships or teaching and leadership jobs after residency.
Surgery does make money. The problem is getting enough cases, and centralizing them. If you are driving to a hospital to do 2 cases. Driving to a remote surgery center to do 1 case the next day, taking call at a hospital in the 'burbs to do an ER call late at night, etc, then it really isn't a big money maker in per hour terms. Think of how many office patients you could've seen in that timespan. This is where group practices come in, and it's also where being in a metro area helps most surgeons' income greatly.
As for jobs after residency, yes, there are certainly groups looking for an associate that will take low salary and do the C&C work that the senior partners don't want to do. As you can imagine, situations like that is where the pod "doom and gloom" stories and websites stem from. Well, if you have good training, you can probably laugh at those job offers and move on to others, but for some residency grads, it might be the only options they have (at least in the area they want).
Even if you get that high level surgical training, there will be always be offers that try to pay you a lot less than you are worth. Groups of older pods or ortho might want to hire you to do most/all of their group's F&A surgery since you are efficient. However, presby made a great point awhile ago that you will probably become unhappy very fast if you are a hired surgical gun being paid $120k salary yet you are earning the practice two or even five times that money.
Basically, think of it this way. The current senior pod students who just matched with highly regarded PMS-36s this year are probably
not thinking "SHOW ME THE MONEY." It's far more likely they're saying to themselves "nice, I get to learn from the renowned Dr. so-and-so" or "wow, I get to be a resident at one of the few programs in the country that will teach me advanced endoscopy and ankle arthroplasty."
IMO, that is the beauty of podiatry. It can be a family friendly 8a-5p career with basic, typically non-urgent, pathology if you want it to be that way. It can also be a surgical subspecialty that exposes you to complex, urgent, and even some emergent cases if you go out and acquire that training. You get good variety. In the end, you don't have to use everything you are trained for (and few DPMs do), but you can't (well, probably shouldn't) ever do things you weren't exposed to and taught in training. It will never hurt you to learn more.