Making the best of a limited scope clinic?

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Santyl Claus

Santyl Claus

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Our director has begun "phasing out" 11721 / 11055 pts. We used to be an ABN-only nail clinic, but now we are referring pts to a nail salon b/c "we just don't do nails".
We don't do wounds. We don't do elective surgeries... proximal to mets is Ortho anyways. Patients have been getting really angry and confrontational, they say we made them wait an hour for nothing. No amount of compounding cream Rx seems to change their minds.
I am still trying to take something out of residency.
How would you make the best of a clinic like this?
 
Santyl Claus said:
Our director has begun "phasing out" 11721 / 11055 pts. We used to be an ABN-only nail clinic, but now we are referring pts to a nail salon b/c "we just don't do nails".
We don't do wounds. We don't do elective surgeries... proximal to mets is Ortho anyways. Patients have been getting really angry and confrontational, they say we made them wait an hour for nothing. No amount of compounding cream Rx seems to change their minds.
I am still trying to take something out of residency.
How would you make the best of a clinic like this?
Click to expand...
You can't. It sounds like bull****. You're in a podiatry clinic that don't do podiatry. This sounds like a particular NYC program a friend of mine went to that was as useless as tits on a bull. You can't make chicken salad out of chicken shot
 
Santyl Claus said:
Our director has begun "phasing out" 11721 / 11055 pts. We used to be an ABN-only nail clinic, but now we are referring pts to a nail salon b/c "we just don't do nails".
We don't do wounds. We don't do elective surgeries... proximal to mets is Ortho anyways. Patients have been getting really angry and confrontational, they say we made them wait an hour for nothing. No amount of compounding cream Rx seems to change their minds.
I am still trying to take something out of residency.
How would you make the best of a clinic like this?
Click to expand...
I really hate to hear this **** because people enter the profession in good faith that if we do the good thing and get good grades and pass boards we get good training and a chance at a stable job with decent income then people end up in bull**** like this

Hello I'm in podiatry clinic but we don't do surgery wounds nails, and probably other stuff. What the **** do you do? No student/resident deserves this
 
Sounds like at least you know billing….

But this issue should be reported to cpme or whatever it’s called. Shouldn’t be a program if it’s setup like this.

Are you doing any surgeries?
_____

Residency should really be about as much surgery as possible. I did like 2.5x minimum numbers and it still wasn’t enough to feel confident or competent in even basic podiatry procedures. You’re going to have a hard time cutting on your own after this program it sounds like.

Residency in general should have some competence associated besides minimum numbers too.. but that’s a whole other thread. You can scrub 10,000 cases and never touch a patient and have no idea what you’re doing and still graduate.
 
Homo sapien said:
Hello I'm in podiatry clinic but we don't do surgery wounds nails, and probably other stuff. What the **** do you do? No student/resident deserves this
Click to expand...
What we do:
  • Rx NSAIDs
  • Rx steroids
  • Rx ketoconazole
  • Rx betadine
  • Rx lotions
  • Rx compounding cream (that fixes neuropathy)
  • Print out target website for corn pads (we do not sell)
  • Print out amazon website for OTC inserts (we do not sell)
 
MortonExtension said:
Sounds like at least you know billing….

But this issue should be reported to cpme or whatever it’s called. Shouldn’t be a program if it’s setup like this.

Are you doing any surgeries?
_____

Residency should really be about as much surgery as possible. I did like 2.5x minimum numbers and it still wasn’t enough to feel confident or competent in even basic podiatry procedures. You’re going to have a hard time cutting on your own after this program it sounds like.

Residency in general should have some competence associated besides minimum numbers too.. but that’s a whole other thread. You can scrub 10,000 cases and never touch a patient and have no idea what you’re doing and still graduate.
Click to expand...
I've done 13 forefoot & 3 rearfoot since July. It's a little light, frankly. Allegedly we will retract for Ortho before graduation to hit our #50 rearfoots.
 
Santyl Claus said:
What we do:
  • Rx NSAIDs
  • Rx steroids
  • Rx ketoconazole
  • Rx betadine
  • Rx lotions
  • Rx compounding cream (that fixes neuropathy)
  • Print out target website for corn pads (we do not sell)
  • Print out amazon website for OTC inserts (we do not sell)
Click to expand...
What the ****. So you do nothing. Is there even surgery?
 
Santyl Claus said:
I've done 13 forefoot & 3 rearfoot since July. It's a little light, frankly. Allegedly we will retract for Ortho before graduation to hit our #50 rearfoots.
Click to expand...
Wtf. What year are you?

Your program is a joke. You're going to have a **** time doing independent podiatry even outside of nailcare if that happens
 
Homo sapien said:
What the ****. So you do nothing. Is there even surgery?
Click to expand...
We do the handful of unavoidable forefoot amps we run into each month. Mainly metatarsal head resections and TMAs. We don't even suture - our policy is to leave amp incisions open.

Homo sapien said:
Wtf. What year are you

I hope you're a pgy1. These **** places need to be reported
Click to expand...
Yeah I'm PGY-1 thankfully lol
 
Santyl Claus said:
What we do:
  • Rx NSAIDs
  • Rx steroids
  • Rx ketoconazole
  • Rx betadine
  • Rx lotions
  • Rx compounding cream (that fixes neuropathy)
  • Print out target website for corn pads (we do not sell)
  • Print out amazon website for OTC inserts (we do not sell)
Click to expand...

Your story is obviously generating a fair amount of outrage with the readership here. Help me with something - you presumably traveled the country for 4th year, yes? What did you see when you traveled elsewhere? Is this what you thought residency would be? Does it resemble other programs you saw? To me it sounds dreadful, but your posting is somewhat passive. Toenails and billing are attending problems.

What are you not telling us. What are your 3rd years saying and doing. Are you at a VA? My presumption is you probably won't tell us where you are, but did you want to do your residency here?

Your residency sounds so pathetic that I somewhat wonder if you are trolling us. No, your residency is not normal. It sounds terribly below average and it sounds like they'd probably have to lie to pass an audit.
 
Santyl Claus said:
We do the handful of unavoidable forefoot amps we run into each month. Mainly metatarsal head resections and TMAs. We don't even suture - our policy is to leave amp incisions open.


Yeah I'm PGY-1 thankfully lol
Click to expand...
That sounds stupid. Wtf leave them open? Is it supposed to heal by magic
 
heybrother said:
Your story is obviously generating a fair amount of outrage with the readership here. Help me with something - you presumably traveled the country for 4th year, yes? What did you see when you traveled elsewhere? Is this what you thought residency would be? Does it resemble other programs you saw? To me it sounds dreadful, but your posting is somewhat passive. Toenails and billing are attending problems.

What are you not telling us. What are your 3rd years saying and doing. Are you at a VA? My presumption is you probably won't tell us where you are, but did you want to do your residency here?

Your residency sounds so pathetic that I somewhat wonder if you are trolling us. No, your residency is not normal. It sounds terribly below average and it sounds like they'd probably have to lie to pass an audit.
Click to expand...
Yes. It sounds like some particular NYC programs we've all heard of
 
I'm going to assume you are not trolling.

Your residency sounds terrible, you should leave, even if it means redoing your PGY1. I have heard of one or two programs that sound as bad as yours, but in general this is far below what your peers are learning. This type of training is locking you into a non-operative position, likely a nursing home gig.
 
heybrother said:
Whenever you read something a podiatrist does that doesn't make sense - presume its a coding thing and you'll be right most of the time.
Click to expand...
🤣true. But when you learn what the Delayed closure codes pay vs what the amps pay….

I think if it’s badly infected for sure leave it open if it’s clean just go ahead and close though. That’s my thought. A policy to “leave everything open” that’s nefarious..
 
heybrother said:
Your story is obviously generating a fair amount of outrage with the readership here. Help me with something - you presumably traveled the country for 4th year, yes? What did you see when you traveled elsewhere? Is this what you thought residency would be? Does it resemble other programs you saw? To me it sounds dreadful, but your posting is somewhat passive. Toenails and billing are attending problems.

What are you not telling us. What are your 3rd years saying and doing. Are you at a VA? My presumption is you probably won't tell us where you are, but did you want to do your residency here?

Your residency sounds so pathetic that I somewhat wonder if you are trolling us. No, your residency is not normal. It sounds terribly below average and it sounds like they'd probably have to lie to pass an audit.
Click to expand...

Yes, I traveled the country for 4th year. This program is much less strenous than any externship I've visited. I write with passive voice because I don't want to bite the hand that feeds me. Do not want to anger the Podfather. This isn't a VA, but ironically the "best experiences" in this program (first assists, fusions) ended up being from the V.A.
I did not originally want to come here - I was convinced I would match to the program you may associate with a one "immediate past president of ABPM" . I got skimpy with my rankings, and ended up in the Empire State scramble. Silly me.
I'm aware that this is a sub-standard program, I'm more asking if this is salvageable (via self-study) vs. non-salvageable.
 
Santyl Claus said:
Yes, I traveled the country for 4th year. This program is much less strenous than any externship I've visited. I write with passive voice because I don't want to bite the hand that feeds me. Do not want to anger the Podfather. This isn't a VA, but ironically the "best experiences" in this program (first assists, fusions) ended up being from the V.A.
I did not originally want to come here - I was convinced I would match to the program you may associate with a one "immediate past president of ABPM" . I got skimpy with my rankings, and ended up in the Empire State scramble. Silly me.
I'm aware that this is a sub-standard program, I'm more asking if this is salvageable (via self-study) vs. non-salvageable.
Click to expand...
Try to transfer to a decent pgy2 spot somewhere else. Avoid repeating pgy1 if possible. Pgy1 is mainly for getting off service rotations done anyways. A good/decent program for pgy2 and pgy3 would be in your best interest.

I vote nonsalvageable. Based on what you’ve mentioned.
 
Santyl Claus said:
Yes, I traveled the country for 4th year. This program is much less strenous than any externship I've visited. I write with passive voice because I don't want to bite the hand that feeds me. Do not want to anger the Podfather. This isn't a VA, but ironically the "best experiences" in this program (first assists, fusions) ended up being from the V.A.
I did not originally want to come here - I was convinced I would match to the program you may associate with a one "immediate past president of ABPM" . I got skimpy with my rankings, and ended up in the Empire State scramble. Silly me.
I'm aware that this is a sub-standard program, I'm more asking if this is salvageable (via self-study) vs. non-salvageable.
Click to expand...
On what you said this is non salvageable

Your option is transfer somewhere good or remain crappy
 
Santyl Claus said:
Yes, I traveled the country for 4th year. This program is much less strenous than any externship I've visited. I write with passive voice because I don't want to bite the hand that feeds me. Do not want to anger the Podfather. This isn't a VA, but ironically the "best experiences" in this program (first assists, fusions) ended up being from the V.A.
I did not originally want to come here - I was convinced I would match to the program you may associate with a one "immediate past president of ABPM" . I got skimpy with my rankings, and ended up in the Empire State scramble. Silly me.
I'm aware that this is a sub-standard program, I'm more asking if this is salvageable (via self-study) vs. non-salvageable.
Click to expand...
You are very polite. I actually clerked at a program that had a VA rotation that seemed pretty decent so I somewhat know what you are talking about. You are not the first person to stare down the barrel of nothing or NYC and blink. A friend of mine was in the same situation. Everything the program told him was a lie.

I wish you the best of luck trying to find something else. There's obviously nothing much available on the CASPR open residencies page. You can obviously pour yourself into videos and cadaver labs, try to scrub extra cases after hours, find a mentor etc. You can try calling every residency across the country and asking if anything is available, but know you'll have to continue to be polite because your PD will have to release you.

Whatever role you may have played in your situation - the simple truth is you were failed by the entire profession. NYC residencies like yours should not exist. Year after year they are allowed to creep on for the benefit of their attendings. Since I've been on SDN there has been a clear consensus that NYC is terrible. This isn't news to anyone. At some point what you realize is that this isn't an accident - its intentional. The people who run the profession do not care. They aren't going to do anything to resolve bad training. APMA leadership literally comes to this forum and tries to argue that podiatry is great and everything is fine. If you want to help the profession - keep a diary of your experiences and when you are done and employed come back and share your NY experience. Theres a terrible Demotivational poster out there that says - Sometimes the purpose of a person's life is to serve as a warning to others. We can post on here that no one should go to NY, but maybe your personal experience will provide more perspective.
 
Santyl Claus said:
I'm more asking if this is salvageable (via self-study) vs. non-salvageable.
Click to expand...
While I'll agree, you should try to transfer to a program where you can get better training, but if we can salvage a rotting diabetic foot, we can salvage a rotten NYC training experience!--Or if we can't, let's at least have the discussion because this is a discussion board after all.

Fact of the matter is everyone is looking for their way out. If a spot opens up at a good residency, there's a 100% chance that someone will get the spot, so it might as well be you. But what if it's not? Personally, my training was good/not great. If I was ever going to do RRA/trauma, those days are well in the rearview mirror. And that's ok, there's a ton of work to do in the forefoot. If you're not comfortable doing infection cases, don't worry, practice makes perfect, and complications are commonplace so on one will care if it turns out badly--that's what everyone expects at baseline.

If you don't have cases, get experience doing everything but cases. Read a lot. Watch as many videos as you can by different presenters showing different ways of doing the same thing. One good thing about NYC is that it's swarming with implant reps who will do cadaver courses. Do every single one, even if it means scheduling a vacation day to go to it. And don't just do the planned procedure on the cadaver, dissect everything, practice your anatomy. Somebody died and left you their body to learn from, do them the respect of learning about it. Pocket suture material from the OR. If the nurses in the OR are watching you, the ones in the ER aren't and you can get some there. Practice your suturing on cadavers. Buy ham hocks and practice that way too. I used to practice square-knots on the draw strings on garbage bags as I was taking out trash at home. Be self-critical, if no one else is going to care about how little you are learning, you have to be the one who cares.

For me, residency was in many ways a speed-bump. I'm in private practice, I do a lot of lobster work which has nothing to do with what we learn in residency, because you can figure it out on your own without any residency training if you're clever enough. No, my clinic isn't glamorous, I do work that no one wants to do for rates most would find unacceptable. But it all adds up, and bottom feeders always survive where others can't 🦞
 
[QUOTE="Santyl Claus, post: We do the handful of unavoidable forefoot amps we run into each month. Mainly metatarsal head resections and TMAs. We don't even suture - our policy is to leave amp incisions open.


Yeah I'm PGY-one thankfully lol[/QUOTE]

If you’re truly in danger of not making your MAVs and the training experience isn’t commensurate with what the curriculum requires in CPME Three-Twenty***, you should file a complaint with CPME.

*** spelled numbers to avoid the emojis
 
This has to be satire.

Username is quite good BTW.
 
My jaw just dropped reading all this. I couldn't wrap my head around it so I turned to AI for help. This is actually a pretty good summary.

Conclusion:​

The thread underscores the challenges faced by residents in underperforming programs and the importance of robust clinical training in podiatry. The resident is advised to explore all options, including transferring programs, self-study, and seeking external mentorship, to mitigate the limitations of their current training environment. The discussion also reflects broader concerns about the quality of podiatry residencies and the need for systemic improvements.
 
Adam Smasher said:
While I'll agree, you should try to transfer to a program where you can get better training, but if we can salvage a rotting diabetic foot, we can salvage a rotten NYC training experience!--Or if we can't, let's at least have the discussion because this is a discussion board after all.

Fact of the matter is everyone is looking for their way out. If a spot opens up at a good residency, there's a 100% chance that someone will get the spot, so it might as well be you. But what if it's not? Personally, my training was good/not great. If I was ever going to do RRA/trauma, those days are well in the rearview mirror. And that's ok, there's a ton of work to do in the forefoot. If you're not comfortable doing infection cases, don't worry, practice makes perfect, and complications are commonplace so on one will care if it turns out badly--that's what everyone expects at baseline.

If you don't have cases, get experience doing everything but cases. Read a lot. Watch as many videos as you can by different presenters showing different ways of doing the same thing. One good thing about NYC is that it's swarming with implant reps who will do cadaver courses. Do every single one, even if it means scheduling a vacation day to go to it. And don't just do the planned procedure on the cadaver, dissect everything, practice your anatomy. Somebody died and left you their body to learn from, do them the respect of learning about it. Pocket suture material from the OR. If the nurses in the OR are watching you, the ones in the ER aren't and you can get some there. Practice your suturing on cadavers. Buy ham hocks and practice that way too. I used to practice square-knots on the draw strings on garbage bags as I was taking out trash at home. Be self-critical, if no one else is going to care about how little you are learning, you have to be the one who cares.

For me, residency was in many ways a speed-bump. I'm in private practice, I do a lot of lobster work which has nothing to do with what we learn in residency, because you can figure it out on your own without any residency training if you're clever enough. No, my clinic isn't glamorous, I do work that no one wants to do for rates most would find unacceptable. But it all adds up, and bottom feeders always survive where others can't 🦞
Click to expand...
Be like AdamSmasher. Gobble the Podiatry ass
 
Adam Smasher said:
You remind me (in a good way) of the character Craig from South Park who used to just show up and give the finger without saying much else
Click to expand...
My residency was decent so I didn't have too much to add there
 
Like everyone else said.

Report to CME

Transfer to a different program for PGY2
Go to every rep cadaver lab/ training session
Get into contact with private practice attendings in or outside of the program. Be their free labor if you have to but learn and do as much as they let you.
 
msion said:
My jaw just dropped reading all this. I couldn't wrap my head around it so I turned to AI for help. This is actually a pretty good summary.

Conclusion:​

The thread underscores the challenges faced by residents in underperforming programs and the importance of robust clinical training in podiatry. The resident is advised to explore all options, including transferring programs, self-study, and seeking external mentorship, to mitigate the limitations of their current training environment. The discussion also reflects broader concerns about the quality of podiatry residencies and the need for systemic improvements.
Click to expand...
How can you improve them when the sitting APMA president runs the ****tiest program in the state?
 
Last edited:
There's only 3 VAs in the NYC region, in the Bronx, Brooklyn, and Manhattan. Brooklyn and Manhattan are part of a VA-based NYC residency (Harbor Healthcare) but looks like they're closing their residency starting this application cycle - I haven't heard if it was being stripped for parts to buff up other residencies in the area, but I'll admit I'm out of the loop here. I also don't recall New York Community Hospital having a VA-based rotation - I didn't think they needed to since "podiatry is the only residency" in the hospital, but I could be wrong. Based on this, there is a non-zero possibility that OP may be trolling.

But just in case...OP, if you truly are in a New York Sh*tty residency, you ought to transfer.
 
Homo sapien said:
You can't. It sounds like bull****. You're in a podiatry clinic that don't do podiatry. This sounds like a particular NYC program a friend of mine went to that was as useless as tits on a bull. You can't make chicken salad out of chicken shot
Click to expand...
Add in VA Tucson, VA Pheonix, and VA Loma Linda to that list
 
echoing previous posters but you should quit and go anywhere else.
 
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