How specialized can a pod be and what state has best scope?

[capo]

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By this I mean, can a pod do ONLY foot and ankle surgery like an ortho that does ONLY surgery, evaluations/pain meds and consults for Phys. Ther., etc.? Obviously I know that genral podiatry opens more doors job-wise, but if you only want surgery of the foot and ankle -- can you make a living solely doing this with an ortho group?

Also which state CURRENTLY has the MOST latitude for a pod, as far as most liberal leg/lower leg surgery laws?

 

[krabmas]

By this I mean, can a pod do ONLY foot and ankle surgery like an ortho that does ONLY surgery, evaluations/pain meds and consults for Phys. Ther., etc.? Obviously I know that genral podiatry opens more doors job-wise, but if you only want surgery of the foot and ankle -- can you make a living solely doing this with an ortho group?

Also which state CURRENTLY has the MOST latitude for a pod, as far as most liberal leg/lower leg surgery laws?

you can if you get lucky. And you can because you can do anything that you put your mind to.

In reality - most that do only surgery took a long time to get there and paid their dues to be able to make a living or more doing just surgery.

I would not go into podiatry if you only want to do surgery. There is too long a road just in school and residency of learning about all the other aspects of podiatry. Maybe once you learn the other stuff you'll start to like it and realize that you want to do more than surgery but I wouldn't take that chance if I were you.

it seems like maybe you want to be an orthopedic foot and ankle surgeon.

 

[capo]

Thanks for the quick reply. I'm not only interested in surgery perse, as I'm into sports med and biomechanics as they relate to the need for surgical corrective measures as a last resort. I see your point and if I couldn't care less, about the entire foot/ankle mechanics other than making incisions all day -- I'd heed your advice and get out now.

As far as an ortho guy doing only foot and ankle, I'm not sure ortho's will get sufficient training in years to come doing this. It's a long road too, if you only want to retrict yourself to such an area. Also the podiatrist clearly, I agree, has the market on knowing the foot and ankle thoroughly and this I feel helps your chances of selling yourself down the road to an ortho group for exclusive rights to lower leg surgery.

But I do think I'll be quite able to adapt to overall general podiatry 1st to know the full spectrum of ailments related to lower leg problems, I will then use as much of my other talents and try to talk an ortho group into my services as their specialist in the foot and ankle. Thanks again for your info.

 

[IlizaRob]

Thanks for the quick reply. I'm not only interested in surgery perse, as I'm into sports med and biomechanics as they relate to the need for surgical corrective measures as a last resort. I see your point and if I couldn't care less, about the entire foot/ankle mechanics other than making incisions all day -- I'd heed your advice and get out now.

As far as an ortho guy doing only foot and ankle, I'm not sure ortho's will get sufficient training in years to come doing this. It's a long road too, if you only want to retrict yourself to such an area. Also the podiatrist clearly, I agree, has the market on knowing the foot and ankle thoroughly and this I feel helps your chances of selling yourself down the road to an ortho group for exclusive rights to lower leg surgery.

But I do think I'll be quite able to adapt to overall general podiatry 1st to know the full spectrum of ailments related to lower leg problems, I will then use as much of my other talents and try to talk an ortho group into my services as their specialist in the foot and ankle. Thanks again for your info.

Working for an ortho group is not the norm but it is definately on the rise. We see more and more graduates from DMU landing these jobs. But you are right on the money when you say that you will need to prove yourself first to those docs who will be refering their surgical candidates to you. This wont happen over night. It may take some time to prove your competency. Although all pod students will eventually do a surgical residency, it doesnt mean they will all be good surgeons. As is in any surgical specialty. The grads who usually land these spots out of residency normally were able to do certain small fellowships while in residency with big ortho dogs, such as the ilizarov fellowship in Russia. Ortho groups know these names and are more comfortable to let you join the practice. By the time you are out, things may be different either way. Something to think about.

 

[capo]

Perfect. You are right alot can and will change in 4-5 years from now, regarding just residencies I'm sure -- let alone job opportunities. Good luck at DMU too.

I still think this is the sleeper career in medicine, that'll blossom alot like DO's did in the last 20 years or so. In the 60-70's, DO's were oddballs -- now they walk almost every hospital in this country. Pods aren't far behind that same destiny. 👍

This may be the BEST kept secret in healthcare.

 

[dawg44]

As far as an ortho guy doing only foot and ankle, I'm not sure ortho's will get sufficient training in years to come doing this. It's a long road too, if you only want to retrict yourself to such an area. Also the podiatrist clearly, I agree, has the market on knowing the foot and ankle thoroughly and this I feel helps your chances of selling yourself down the road to an ortho group for exclusive rights to lower leg surgery.

.

I cant believe some people would think that foot and ankle orthopods don't get enough foot and ankle training. It seems to be only be some podiatrists and one MD that I wont name. Because it sure isn't the majority of MDs or DOs. Foot and ankle orthopod = 4 years of medical school 1 year intership 4 years of residency 1 year fellowship for a grand total of 10 years of training. We do foot and ankle during sports medicine, pediatrics, trauma and of course when we do foot and ankle. 2500+ surgical cases during my residency 582 Foot and Ankle cases during residency and 750 Foot and Ankle cases during Fellowship for a total of 1300+ procedures prior to even starting practice.

 

[dpmgrad]

I cant believe some people would think that foot and ankle orthopods don't get enough foot and ankle training. It seems to be only be some podiatrists and one MD that I wont name. Because it sure isn't the majority of MDs or DOs. Foot and ankle orthopod = 4 years of medical school 1 year intership 4 years of residency 1 year fellowship for a grand total of 10 years of training. We do foot and ankle during sports medicine, pediatrics, trauma and of course when we do foot and ankle. 2500+ surgical cases during my residency 582 Foot and Ankle cases during residency and 750 Foot and Ankle cases during Fellowship for a total of 1300+ procedures prior to even starting practice.

There are several high surgical volume 3 years podiatric surgical residency programs where each resident graduating easily with 2000+ procedures. Most of the decent 3 years podiatric surgical residency programs have residents graduating with somewhere between 1000 -1800 procedures. Similar to Ortho Fellowships, Podiatric residents can also pursue Podiatric Sports Medicine Fellowship, Reconstructive Foot and Ankle Fellowships, Diabetic and Limb Salvage Fellowship, Wound Care Fellowships, etc... Right now, I have been accepted to do the AO/ASIF Trauma Fellowship in Europe as a Podiatric Surgeon and also will be attending the Kurgan Ilizarov Mini Fellowship in Russia for further training in Reconstructive Foot and Ankle Surgery utilizing Ilizarov External Fixation Frames.

 

[Dr_Feelgood]

I've got some info on state scopes if you want to IM me and give me you email. The maps and files are too big to post on the forum.

 

[IlizaRob]

I cant believe some people would think that foot and ankle orthopods don't get enough foot and ankle training. It seems to be only be some podiatrists and one MD that I wont name. Because it sure isn't the majority of MDs or DOs. Foot and ankle orthopod = 4 years of medical school 1 year intership 4 years of residency 1 year fellowship for a grand total of 10 years of training. We do foot and ankle during sports medicine, pediatrics, trauma and of course when we do foot and ankle. 2500+ surgical cases during my residency 582 Foot and Ankle cases during residency and 750 Foot and Ankle cases during Fellowship for a total of 1300+ procedures prior to even starting practice.

I think he was mostly talking about general ortho. Fellowship trained Foot and ankle orthos are different.

 

[jonwill]

I cant believe some people would think that foot and ankle orthopods don't get enough foot and ankle training. It seems to be only be some podiatrists and one MD that I wont name. Because it sure isn't the majority of MDs or DOs. Foot and ankle orthopod = 4 years of medical school 1 year intership 4 years of residency 1 year fellowship for a grand total of 10 years of training. We do foot and ankle during sports medicine, pediatrics, trauma and of course when we do foot and ankle. 2500+ surgical cases during my residency 582 Foot and Ankle cases during residency and 750 Foot and Ankle cases during Fellowship for a total of 1300+ procedures prior to even starting practice.

You must have misunderstood a post somewhere. Foot and ankle orthos get very good training. There is no denying that. It is common knowledge that general orthos get less than sufficient foot and ankle training. Most general orthos will tell you that!

 

[capo]

You must have misunderstood a post somewhere. Foot and ankle orthos get very good training. There is no denying that. It is common knowledge that general orthos get less than sufficient foot and ankle training. Most general orthos will tell you that!

I wrote a long post reply to this effect last night, but it didn't go through. I meant that ortho's need only like, 10-20 cases on foot and ankle to get foot and ankle credentials. Also there is no recognizing board, I was told, that certifies foot and ankle ortho's. Is this true?

 

[dawg44]

I wrote a long post reply to this effect last night, but it didn't go through. I meant that ortho's need only like, 10-20 cases on foot and ankle to get foot and ankle credentials. Also there is no recognizing board, I was told, that certifies foot and ankle ortho's. Is this true?

Nope. none in trauma, none in spine, none in total joint arthroplasty, none in pediatrics. none of any significance anyway. The only one that does is Hand they have a CAQ test. The only thing that matters is that you are an orthopedic surgeon and fellowship trained.

 

[diabeticfootdr]

Nope. none in trauma, none in spine, none in total joint arthroplasty, none in pediatrics. none of any significance anyway. The only one that does is Hand they have a CAQ test. The only thing that matters is that you are an orthopedic surgeon and fellowship trained.

The purpose of a certifying board is for a profession to "self-police" to protect the public from practitioners less than competent.

I disagree with your previous statement ... just because you're and ortho surgeon and fellowship trained means you are competent.

And it is true that most general orthos are "undertrained" in foot and ankle. This statement has not only been made in the pod literature, but many times in the ortho literature, by Michael Pinzur, MD for one.

There should be standardization for ortho foot and ankle fellowships, to make sure they receive adequate training, but without any overseeing certifying board -- there is no standardization.

 

[capo]

The purpose of a certifying board is for a profession to "self-police" to protect the public from practitioners less than competent.

I disagree with your previous statement ... just because you're and ortho surgeon and fellowship trained means you are competent.

And it is true that most general orthos are "undertrained" in foot and ankle. This statement has not only been made in the pod literature, but many times in the ortho literature, by Michael Pinzur, MD for one.

There should be standardization for ortho foot and ankle fellowships, to make sure they receive adequate training, but without any overseeing certifying board -- there is no standardization.

Thank you. 👍 I thought for a moment I just heard that in my dreams. At least it was a fact, not something I just made up.

 

[dawg44]

The purpose of a certifying board is for a profession to "self-police" to protect the public from practitioners less than competent.

I disagree with your previous statement ... just because you're and ortho surgeon and fellowship trained means you are competent.

And it is true that most general orthos are "undertrained" in foot and ankle. This statement has not only been made in the pod literature, but many times in the ortho literature, by Michael Pinzur, MD for one.

There should be standardization for ortho foot and ankle fellowships, to make sure they receive adequate training, but without any overseeing certifying board -- there is no standardization.

Pinzur is the MD I wasn't going to name. You could do the same study with whatever specialty you feel like. And more than likely those programs that are lacking are not going to turn out surgeons itching to do those cases in whatever field it is. Some ortho programs are strong in hand, spine, totals foot and ankle, whatever it is. Thing is once you are board certified you can do what ever you feel comfortable doing. You want to do hand, total joints, trauma, foot and ankle, pediatrics go ahead. I don't need a fellowship to tell me I'm competent doing basal joint arthroplasties and distal radius fractures the board already has. You are eligible to do whatever you feel comfortable doing.
Maybe there should be standardization for all fellowships but it isn't likely to happen anytime soon. There are too many politics involved for all specialties in ortho across the board. Hand Surgery is about 15 years ahead of its time in establishing a CAQ but even then an orthopedic surgeon can do any type of hand surgery he/she wants to which is what it will always be even with standardization across the board.