How to become a podiatric surgeon?

[mednoob]

im thinking of becoming a podiatric surgeon...but im not sure of the path one needs to take after pod school.

i know 4 yrs undergrad + 4 yrs pod school and then residency.

but if i want to become a podiatric surgeon only and not involved in podiatric medicine, are there different residences that focus only on podiatric surgery? and if so, how long are the podiatric surgery residencies?

thank you

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[TheBee]

Most podiatry residencies are three year surgical programs now. I don't know how much of that is podiatric medicine vs. surgery, but maybe one of the people further along can speak to that.

 

[JEWmongous]

im thinking of becoming a podiatric surgeon...but im not sure of the path one needs to take after pod school.

i know 4 yrs undergrad + 4 yrs pod school and then residency.

but if i want to become a podiatric surgeon only and not involved in podiatric medicine, are there different residences that focus only on podiatric surgery? and if so, how long are the podiatric surgery residencies?

thank you

All the residencies now are called "Podiatric Medicine and Surgery" or "PM & S." There used to be all different kinds of residencies with confusing Short Bus acronyms but they are phased out. The new residencies are either 2 years or 3 years in length, with the majority being 3 years. They both provide surgery training however:

2 year residency = can sit for forefoot surgical boards
3 year residency = can sit for forefoot and rearfoot/ankle surgical boards

There is a move to make all the residencies 3 years long and that may be in affect by the time you graduate from pod school.

One thing to consider is a fellowship AFTER your residency. From what I read, they are 1-2 years in length. These often are specific ie diabetic limb salvage, reconstructive surgery, sports medicine, etc.

 

[jonwill]

im thinking of becoming a podiatric surgeon...but im not sure of the path one needs to take after pod school.

i know 4 yrs undergrad + 4 yrs pod school and then residency.

but if i want to become a podiatric surgeon only and not involved in podiatric medicine, are there different residences that focus only on podiatric surgery? and if so, how long are the podiatric surgery residencies?

thank you

Podiatric surgery is similar to any other surgical specialty in that clinic is part of the specialty. This is where many of your surgeries will come from. Your surgical patients will also require post operative care which is done in clinic. Clinic is a part of medicine, regardless of the specialty so I don't think you'll be getting out of that.

To answer the other part of your question, different residencies have different focuses. There are some that are definitely more surgical than others and different programs often even have a different surgical focus. The majority of residencies are now three years.

 

[mednoob]

thank u guys for your responses u all really cleared up some things for me.

however, im still somewhat confused. i just browsed the ABPS and they also said that to sit for the certification exam in foot surgery and/or reconstructive rearfoot/ankle, you need 4 years of clinical experience after you've obtained ur DPM. what?! lol. doesnt the "4 years of clinical experience" mean residency? and arent pm&s residences 2-3 years? so why did they say 4 years?

can anyone clarify this for me?

 

[dpmgrad]

thank u guys for your responses u all really cleared up some things for me.

however, im still somewhat confused. i just browsed the ABPS and they also said that to sit for the certification exam in foot surgery and/or reconstructive rearfoot/ankle, you need 4 years of clinical experience after you've obtained ur DPM. what?! lol. doesnt the "4 years of clinical experience" mean residency? and arent pm&s residences 2-3 years? so why did they say 4 years?

can anyone clarify this for me?

ABPS requires that one to have at least 4 years of clinical experience after graduating from Podiatry school before sitting for the Board Certification exam (ORAL exam). These 4 years can include your residency training. It is virtually impossible for any one to sit for the Board Certification oral exam right after residency since NONE of the surgery cases from residency can be used for submission for surgical case review as of 2007.

However, if a resident were to complete a PM&S or PSR residency program, you will be eligible to sit for the Board Qualification exam (written exam).

As for your comment about doing only Podiatric Surgery and not doing any Podiatric Medicine, I think that you really need to reconsider your decision about going to Podiatry. As jonwill stated, it is almost impossible to not do any Podiatric Medicine since the surgery patients will require preoperative evaluation / conservative treatments and postoperative care. For example, not every single heel pain patient will require surgery. Not every single patient with hammertoe deformity and corns will want you to operate on them right away.

 

[diabeticfootdr]

thank u guys for your responses u all really cleared up some things for me.

however, im still somewhat confused. i just browsed the ABPS and they also said that to sit for the certification exam in foot surgery and/or reconstructive rearfoot/ankle, you need 4 years of clinical experience after you've obtained ur DPM. what?! lol. doesnt the "4 years of clinical experience" mean residency? and arent pm&s residences 2-3 years? so why did they say 4 years?

can anyone clarify this for me?

The reason they require 4 years of clinical experience is so they can prevent competition from the newer residency graduates. The good old boys who are in charge don't want someone who just graduated from residency to open a practice next door and claim they are "board certified", instead they can use the term "board qualified" (after passing the written exam) which is a term that means nothing - LITERALLY. Look at the definition http://www.answers.com/topic/board-qualified-1?cat=health

Wait until you attempt to apply for privileges at a hospital and say, "I'm board qualified," then the credentialing specialist says, "what's that mean?" It happens.

Other specialties allow one to be board certified immediately after residency, the ABPOPPM allows this in podiatry now too. ABPS is stuck in the elitist classism of "I'm a surgeon, you're not" and if you are a surgeon, "I'm a rearfoot reconstructive ankle surgeon, you're a forefoot surgeon" = classism. Do hand surgeons have wrist and carpal surgeons vs. metacarpal and phalange surgeons? No, because it's only a hand, such a small piece of anatomy. In our field the powers that be should wake up. It's only a foot/ankle. Do we have to divide it up?

In reality, the profession needs to support the use of the word "podiatry". Our degree is Doctor of Podiatric Medicine. ACFAS is afraid of the word. Look at their website, the word podiatry is not used once. http://www.acfas.org/Home.htm Look at their website for patients, the word podiatry is also not used on the home page. http://www.footphysicians.com/

How is ACFAS helping the profession of podiatry, by refusing to admit what we all are ... PODIATRISTS. If you're embarrassed by the word because of what it used to mean, then rise above the fray and change the perception of the word by being an excellent podiatric physician.

 

[HenryH]

Hold on a second -- so you have to at least 4 years of clinical experience, and years of residency completed can contribute to this requirement (i.e., if I was to graduate from a 3-year residency, I would only need one more year of clinical experience)...

...but the actual cases worked on during residency may not be considered?!

Maybe I'm getting ahead of myself, but this sounds like a classic catch-22: you've gotta have experience to become "Board Certified," but to get experience, most hospitals mandate that you already have this certification.

So how do recent podiatry graduates get around this? Do they just bide their time doing "small-time" (e.g., in-grown toenails, warts, calluses, etc.) cases for 4 years?

 

[diabeticfootdr]

Maybe I'm Getting Ahead Of Myself, But This Sounds Like A Classic Catch-22: You've Gotta Have Experience To Become "board Certified," But To Get Experience, Most Hospitals Mandate That You Already Have This Certification.

Bingo!

 

[mednoob]

thanks dpmgrad and diabeticfootdr for the clarifications.

 

[mednoob]

by the way...diabeticfootdr and jonwill.....what is that contraption on the person's leg in your avatars? it looks insanely cool for some reason...not the condition the person is in lol...i just mean the device itself.

 

[Snake Doctor]

by the way...diabeticfootdr and jonwill.....what is that contraption on the person's leg in your avatars? it looks insanely cool for some reason...not the condition the person is in lol...i just mean the device itself.

I think you mean this frame? (I apologize if this isn't right as I'm not an expert on this)
http://jscms.jrn.columbia.edu/cns/2006-03-14/fido-charcotfoot/

I was doing a search on Podiatry and ran into this article.

Coincidentally, Dr. Rogers (aka diabeticfootdr) himself is in the article. Pretty neat huh?

 

[dpmgrad]

by the way...diabeticfootdr and jonwill.....what is that contraption on the person's leg in your avatars? it looks insanely cool for some reason...not the condition the person is in lol...i just mean the device itself.

CobraEvent is correct in that the contraptionon both diabeticfootdr and jonwill avatars are external fixator frame.

Judging from diabeticfootdr avatar, it looks like the standard external fixator frame. Jonwill avatar reveals a Taylor Spatial external fixator frame. There are many reasons for the use of external fixator frame.

 

[dpmgrad]

Hold on a second -- so you have to at least 4 years of clinical experience, and years of residency completed can contribute to this requirement (i.e., if I was to graduate from a 3-year residency, I would only need one more year of clinical experience)...

...but the actual cases worked on during residency may not be considered?!

Maybe I'm getting ahead of myself, but this sounds like a classic catch-22: you've gotta have experience to become "Board Certified," but to get experience, most hospitals mandate that you already have this certification.

So how do recent podiatry graduates get around this? Do they just bide their time doing "small-time" (e.g., in-grown toenails, warts, calluses, etc.) cases for 4 years?

It is a catch-22 situation unfortunately.

The number of required cases for submission are 65 forefoot cases for the Foot Surgery Board Certification Exam and 30 rearfoot cases for the Reconstructive Rearfoot Surgery Board Certification Board exam. If you graduated from a PM&S-36 program and joined a busy podiatric surgical practice group, potentially, one can easily attain the required 95 cases in one year and be eligible to sit for the board certification exam after one year of private practice. However, it is very unlikely that someone wlll be able to sit for the board certification exam after 1 year of private practice based on the current rules on surgical case submissions. First, there is a diversity of cases requirement. For the current residents, they know that they need to attain certain number of cases for each of the 5 podiatric surgical categories. In addition, the resident must also maintain surgical case diversification by maintaining in their logs that one type of procedures, such as Distal metatarsal bunionectomies (which includes Austin/Chevron, Youngswick, Silver, Reverdin, etc...) can not represent more than 33% of type of procedures for that particular podiatric surgery category. They have extended this requirement for the surgical case submission requirement for the ABPS boards. As a resident, it would be easy for someone to get the case diversification since the residents are exposed to a variety of cases from different attendings or from the hospital ER. In private practice, it may take you a few years to get the surgical case diversification. Secondly, ABPS no longer accepts any cases from residency training. In the past, one could use some of the surgical cases from residency for case submission to help with the surgical case diversiication. Hence, it would make it possible for a newly graduate to sit for the ABPS board certification exam after 1 year of private practice. Now, the graduate must rely on the cases that they do after residency training for case diversification.

Many of the hospitals and surgery centers will give a newly graduated DPM from residency, surgical privileges provided that they will attain board certiication status within a certain amount of time. For example, my hospital requires that I have to attain board certification status within 5 years from getting my surgical privileges at the hospital. Right now, I am able to do surgery to start building up my cases for the board certification exam. Unfortunately, there will be hospitals and surgery centers that may not grant a newly graduated DPM any surgical privileges without board certification. You will just need to find one place that will give you privileges to do surgery.

 

[iceman69]

In reality, the profession needs to support the use of the word "podiatry". Our degree is Doctor of Podiatric Medicine. ACFAS is afraid of the word. Look at their website, the word podiatry is not used once. http://www.acfas.org/Home.htm Look at their website for patients, the word podiatry is also not used on the home page. http://www.footphysicians.com/

How is ACFAS helping the profession of podiatry, by refusing to admit what we all are ... PODIATRISTS. If you're embarrassed by the word because of what it used to mean, then rise above the fray and change the perception of the word by being an excellent podiatric physician.

You bring up an interesting point, Dr. Rogers. Recently, I spent some time with some podiatry residents and one of them, the chief resident, always referred to himself as a foot and ankle surgeon, and that he went to Foot and ankle surgery school. Not once did he mention that he was a podiatrist who graduated from a podiatry school. I thought that it was odd, and that he was embarrassed of his profession.

 

[cool_vkb]

You bring up an interesting point, Dr. Rogers. Recently, I spent some time with some podiatry residents and one of them, the chief resident, always referred to himself as a foot and ankle surgeon, and that he went to Foot and ankle surgery school. Not once did he mention that he was a podiatrist who graduated from a podiatry school. I thought that it was odd, and that he was embarrassed of his profession.

The problem starts right from pre-pod days to podiatry school days. when we have podiatry students who are decieving general public by saying they go to Medical school (without one single mention of Podiatry) then compared to that a resident calling F&A surgery school is lot better in my eyes. atleast he acknowledges he is doing F&A.

The schools and APMSA should seriously do something about this. if we are so ashamed of accepting that we are podiatrists or podiatry school then think abt the future when these people will be practicing? and usually these people are guys & gals who were constantly rejected by med schools or dental schools and finally ended up in podiatry school.I just hope they dont end up as disgruntled podiatrists bcoz usually people who entered Podiatry as a backup profession end up either leaving pod school and pursuing something else or they end up in a complex abt titles and degrees.

 

[mednoob]

It is a catch-22 situation unfortunately.

The number of required cases for submission are 65 forefoot cases for the Foot Surgery Board Certification Exam and 30 rearfoot cases for the Reconstructive Rearfoot Surgery Board Certification Board exam. If you graduated from a PM&S-36 program and joined a busy podiatric surgical practice group, potentially, one can easily attain the required 95 cases in one year and be eligible to sit for the board certification exam after one year of private practice. However, it is very unlikely that someone wlll be able to sit for the board certification exam after 1 year of private practice based on the current rules on surgical case submissions. First, there is a diversity of cases requirement. For the current residents, they know that they need to attain certain number of cases for each of the 5 podiatric surgical categories. In addition, the resident must also maintain surgical case diversification by maintaining in their logs that one type of procedures, such as Distal metatarsal bunionectomies (which includes Austin/Chevron, Youngswick, Silver, Reverdin, etc...) can not represent more than 33% of type of procedures for that particular podiatric surgery category. They have extended this requirement for the surgical case submission requirement for the ABPS boards. As a resident, it would be easy for someone to get the case diversification since the residents are exposed to a variety of cases from different attendings or from the hospital ER. In private practice, it may take you a few years to get the surgical case diversification. Secondly, ABPS no longer accepts any cases from residency training. In the past, one could use some of the surgical cases from residency for case submission to help with the surgical case diversiication. Hence, it would make it possible for a newly graduate to sit for the ABPS board certification exam after 1 year of private practice. Now, the graduate must rely on the cases that they do after residency training for case diversification.

Many of the hospitals and surgery centers will give a newly graduated DPM from residency, surgical privileges provided that they will attain board certiication status within a certain amount of time. For example, my hospital requires that I have to attain board certification status within 5 years from getting my surgical privileges at the hospital. Right now, I am able to do surgery to start building up my cases for the board certification exam. Unfortunately, there will be hospitals and surgery centers that may not grant a newly graduated DPM any surgical privileges without board certification. You will just need to find one place that will give you privileges to do surgery.

ohhh so now i have a better understanding of how the "system" works. but still thats pretty stupid...hospitals should grant surgery privileges to more recent DPM graduates so they can attain board certification status quicker.

the ABPS should really work out something better. plus as you said, most places will not even grant surgical privileges without board certification. so therefore it would be difficult to find a place that allows you to do cases prior to board certification. is this the ONLY way to get board certified...by hunting and hunting for a hospital that allows you to do cases before board certification?

 

[dpmgrad]

ohhh so now i have a better understanding of how the "system" works. but still thats pretty stupid...hospitals should grant surgery privileges to more recent DPM graduates so they can attain board certification status quicker.

the ABPS should really work out something better. plus as you said, most places will not even grant surgical privileges without board certification. so therefore it would be difficult to find a place that allows you to do cases prior to board certification. is this the ONLY way to get board certified...by hunting and hunting for a hospital that allows you to do cases before board certification?

Based on my friends' and my experience, I think that majority of the hospitals and surgery centers do grant surgical privileges to the newly graduated DPMs who are at least board qualified.

 

[HenryH]

What about signing up for ER call during the week? Seems like a way to expedite the process of completing the minimum number of cases since you'd often be exposed to "disaster" patients that would require treatment via complex surgeries.

 

[dpmgrad]

What about signing up for ER call during the week? Seems like a way to expedite the process of completing the minimum number of cases since you'd often be exposed to "disaster" patients that would require treatment via complex surgeries.

This is not true. Yes, the ER will provide you a source of patients requiring fracture repair, some tendon repair such as Achilles Tendon, debridement of infected wounds, and amputations. However, you will be get your patient requiring bunion surgery, hammertoe surgery, flatfoot reconstruction, reconstructive surgery for hindfoot arthritis, lateral ankle ligament reconstruction surgery, other forefoot and rearfoot reconstruction, etc... from your private practice / office / clinic. Hence, most of your required cases for your boards will come from your private practice. Lastly, you may also encounter some of the similar patient problems that you get from the ER in your office.

 

[msa786]

One thing to consider is a fellowship AFTER your residency. From what I read, they are 1-2 years in length. These often are specific ie diabetic limb salvage, reconstructive surgery, sports medicine, etc.

[/B]

Why is that?