Ortho F&A fellowships

[HenryH]

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I have read in various posts on the podiatry forums that, due to lack of interest from graduates of MD/DO orthopaedic surgery residencies, podiatry school graduates often are accepted to orthopaedic F&A fellowships. My question is, how difficult is to get accepted to one of these fellowships, especially when considering the fact that they are structured for MDs/DOs? Is it necessary to graduate from a top podiatric residency to even be considered?

 

[jonwill]

I have read in various posts on the podiatry forums that, due to lack of interest from graduates of MD/DO orthopaedic surgery residencies, podiatry school graduates often are accepted to orthopaedic F&A fellowships. My question is, how difficult is to get accepted to one of these fellowships, especially when considering the fact that they are structured for MDs/DOs? Is it necessary to graduate from a top podiatric residency to even be considered?

I'm really not sure if it matters where you did residency as long as you are surgically compentent. But again, I really don't know. I do know of two DMC residents that have done it as of late as well as one West Penn grad.

 

[HenryH]

Cool -- I guess if you can complete the same F&A fellowship as the ortho guys, then you really are equal in skill (when it comes to the F&A, at least)!

 

[PMSIII]

Cool -- I guess if you can complete the same F&A fellowship as the ortho guys, then you really are equal in skill (when it comes to the F&A, at least)!

You're missing the point of fellowships. People go through fellowships to further enhance certain aspects of their training with respect to foot and ankle surgery. This isn't about being "equal" to F&A orthos. You have to appreciate that we are different specialties with common ground.

From a marketing prespective however, it certainly would help you look better for job opportunities especially for ortho groups in my opinion. I don't know how many of those opportunities are available nationwide but I personally know 3 residents who have undergone or are currently pursuing further fellowship training. They all felt that they needed more out of their residencies so they pursued the fellowship to sort of "fill in some of the gaps".

 

[cool_vkb]

equal in skill (when it comes to the F&A, at least)!

You are missing the point man! Podiatry is not Orthopedics🙂, Podiatry involoves dermatology,vascular,orthopedics,infectious stuff,biomechanics,etc.

F & A orthopod cannot treat the patient's psoriasis or some other skin problem on foot where as a DPM can do that. or in that matter any thing that does not involve bones a F&A orthopod is not gonna do that. where as we pods can do anything you can imagine once you are below the tibial plafond.

 

[JEWmongous]

You are missing the point man! Podiatry is not Orthopedics🙂, Podiatry involoves dermatology,vascular,orthopedics,infectious stuff,biomechanics,etc.

F & A orthopod cannot treat the patient's psoriasis or some other skin problem on foot where as a DPM can do that. or in that matter any thing that does not involve bones a F&A orthopod is not gonna do that. where as we pods can do anything you can imagine once you are below the tibial plafond.

Are you sure this is the case cool? Is the F and A orthopod gonna do bunion surgery but refer out for the tinea pedis or psoriasis? Sounds like a waste of time and $ to me, but I could be wrong.

 

[HenryH]

You're missing the point of fellowships. People go through fellowships to further enhance certain aspects of their training with respect to foot and ankle surgery. This isn't about being "equal" to F&A orthos. You have to appreciate that we are different specialties with common ground.

From a marketing prespective however, it certainly would help you look better for job opportunities especially for ortho groups in my opinion. I don't know how many of those opportunities are available nationwide but I personally know 3 residents who have undergone or are currently pursuing further fellowship training. They all felt that they needed more out of their residencies so they pursued the fellowship to sort of "fill in some of the gaps".

Actually, that's the kind of perspective I was viewing fellowship training from. I don't know how it is in other cities, but where I live, the podiatrists are spoken of generally as: "I'll go to the foot doctor if I have an in-grown toenail, callouses, etc., but if I need actual ankle surgery, I'll definitely book an appointment with Dr. (Orthopaedic Surgeon)."

When it comes to surgeon status, podiatrists just don't seem to be revered with the same degree of respect as the local orthopaedic surgeons. In fact, I don't know of anyone who has ever consulted a podiatrist about having "real" surgery performed. Hopefully, the area that I'm in just represents an anomaly; there's a bigshot F&A orthopaedic surgeon here who is well-known and part of a family legacy of orthopaedic surgeons, so he seems to have "cornered" the market.

 

[cool_vkb]

Um . . . actually an F&A-trained Orthopaedist can treat whatever they want. They can pass out birth control, treat hypertension, or manage glaucoma. Physicians have no limitation on their scope of practice.

yeah tats true that physicians have no limitaions on their scope of practice. Family practioners can start doing heart transplants and gynocologists can perform knee replacements.

There is no such thing as a whole body physician. Someone is looking for a good ass whooping by lawsuits and general public if one speciality physician treats patients of a totally different speciality. Besides no insurance will pay or malpractice insurance will cover such an idiot's back.

 

[cool_vkb]

Are you sure this is the case cool? Is the F and A orthopod gonna do bunion surgery but refer out for the tinea pedis or psoriasis? Sounds like a waste of time and $ to me, but I could be wrong.

If orthos start treating psoriasis and tinea pedis, should Dermatologists start fliipin burgers or what? and if an F&A by mistake screws up while treating the patient for psoriasis, whose gonna cover him during lawsuit. the first question he is gonna face is "So where did you obtained your dermatology speciality training Dr.Skeleton?"

Medical specialities are well defined. Orthos are the masters of musculoskeletal system of whole body but anything else apart from that is really not something any wise ortho wud even try to do.

But Podiatry is a different concept. we are not defined by speciality, we are defined by location. A podiatrist is a doctor of lower extremity. End of the strory. now that can inculde anything in Lower exremity (any speciality) where as an FA orthopod is an "orthopod" of lower extremity. I hope you get the difference here.

 

[PMSIII]

Um . . . actually an F&A-trained Orthopaedist can treat whatever they want. They can pass out birth control, treat hypertension, or manage glaucoma. Physicians have no limitation on their scope of practice.

Absolutely. Legally they have no limitations. But tell me how often do you see a Foot and Ankle Orthopod managing glaucoma and passing out birthcontrol? Practice medicine today is so overwhelmed with liabilities and lawsuits so I can't imagine any physician managing conditions outside his or her respective specialty. However, in theory there is no question that legally an MD has an unlimited scope. Same way a Family practitioner can legally perform an ankle scope - will he/she do that? I would be no unless he/she is looking for a lawsuit.

 

[PMSIII]

Are you sure this is the case cool? Is the F and A orthopod gonna do bunion surgery but refer out for the tinea pedis or psoriasis? Sounds like a waste of time and $ to me, but I could be wrong.

I worked with a Foot and ankle ortho before as a student and I can tell you from my experience, he doesn't see tinea in his office. His practice consisted of many many referrals that involved complicated cases that required fusions, amputations, external fixation, and reconstructive procedures. He also did elective procedures like bunionectomies but I don't recall tinea or ingrowns.

 

[JEWmongous]

If orthos start treatig psoriasis and tinea pedis, should Dermatologists start fliipin burgers or what? and if an F&A by mistake screws up while treating the patient for psoriasis, whose gonna cover him during lawsuit. the first question he is gonna face is "So where did you obtained your dermatology speciality training Dr.Skeleton?"

Um cool, you sound ******ed buddy. 😴 You said a lot of dumb stuff before but this is just whack.

 

[cool_vkb]

Um cool, you sound ******ed buddy. 😴 You said a lot of dumb stuff before but this is just whack.

What did i do now😕

 

[PMSIII]

You are missing the point man! Podiatry is not Orthopedics🙂, Podiatry involoves dermatology,vascular,orthopedics,infectious stuff,biomechanics,etc.

F & A orthopod cannot treat the patient's psoriasis or some other skin problem on foot where as a DPM can do that. or in that matter any thing that does not involve bones a F&A orthopod is not gonna do that. where as we pods can do anything you can imagine once you are below the tibial plafond.

It's not a matter of them NOT being able to treat this conditions, but more so that they focus most of their time on cases that require extensive foot and ankle surgery.

 

[cool_vkb]

It's not a matter of them NOT being able to treat this conditions, but more so that they focus most of their time on cases that require extensive foot and ankle surgery.

Thats right but apart from that isnt the main issue about malpractice and dermatology reference base also. I mean they are Orthos, not derms. Will they not be facing a good lawsuit if the patient ends up with some problem?

 

[PMSIII]

Actually, that's the kind of perspective I was viewing fellowship training from. I don't know how it is in other cities, but where I live, the podiatrists are spoken of generally as: "I'll go to the foot doctor if I have an in-grown toenail, callouses, etc., but if I need actual ankle surgery, I'll definitely book an appointment with Dr. (Orthopaedic Surgeon)."

When it comes to surgeon status, podiatrists just don't seem to be revered with the same degree of respect as the local orthopaedic surgeons. In fact, I don't know of anyone who has ever consulted a podiatrist about having "real" surgery performed. Hopefully, the area that I'm in just represents an anomaly; there's a bigshot F&A orthopaedic surgeon here who is well-known and part of a family legacy of orthopaedic surgeons, so he seems to have "cornered" the market.

You're not totally off. What happens in your town happens in alot of areas around the country. Traditionally, podiatrists are viewed as warts, ingrown, and tinea practicitioners of the lower extremity. The surgical training that many view us to have comprises of forefoot and bunion procedures. This is part of the challenge that we face and must accept as future DPM's. However, the good news is that our residency training is become more and more standardized. 3 year residencies ensure that we have more interaction with other MD/DO's (especially during the PGY-1 year of residency) and better training at the "traditionally" complicated cases i.e. hindfoot and ankle. As a fourth year student, I've been previliged in working with MD/DO interns and they said nothing but great things about our profession and residents. The future looks great as long as we ensure that we are graduating competent doctors practicing within their scope

 

[PMSIII]

Thats right but apart from that isnt the main issue about malpractice and dermatology reference base also. I mean they are Orthos, not derms. Will they not be facing a good lawsuit if the patient ends up with some problem?

Sure but don't forget that they go through dermatology rotations during their residency and clinical years as students. These guys know their medicine. They don't treat these conditions because they chose to dedicate their time to lower extremity surgery.

 

[cool_vkb]

These guys know their medicine. They don't treat these conditions because they chose to dedicate their time to lower extremity surgery.

Iam not trying overstretch this argument and being a 4th yr iam sure you have knowledge that i am yet to get. But what you are saying is that they just chose to do lower extremity so they are not doing derm stuff and legally they can. But in the world which you and i live, wudnt that be seriously odd and big trouble for any specialist to treat someone from another speciality no matter he is a 4.0GPA MD or DO?

Wudnt this be a serious malpractice and insurance issue which any rational sane MD will take in account before trailing his way outside his domain/speciality

 

[PMSIII]

Iam not trying overstretch this argument and being a 4th yr iam sure you have knowledge that i am yet to get. But what you are saying is that they just chose to do lower extremity so they are not doing derm stuff and legally they can. But in the world which you and i live, wudnt that be seriously odd and big trouble for any specialist to treat someone from another speciality no matter he is a 4.0GPA MD or DO?

Wudnt this be a serious malpractice and insurance issue which any rational sane MD will take in account before trailing his way outside his domain/speciality

Read my response to the poster "tired" above.

 

[HenryH]

You're not totally off. What happens in your town happens in alot of areas around the country. Traditionally, podiatrists are viewed as warts, ingrown, and tinea practicitioners of the lower extremity. The surgical training that many view us to have comprises of forefoot and bunion procedures. This is part of the challenge that we face and must accept as future DPM's. However, the good news is that our residency training is become more and more standardized. 3 year residencies do not ensure that we have more interaction with other MD/DO's (especially during the PGY-1 year of residency) and better training at the "traditionally" complicated cases i.e. hindfoot and ankle. As a fourth year student, I've been previliged in working with MD/DO interns and they said nothing but great things about our profession and residents. The future looks great as long as we ensure that we are graduating competent doctors practicing within their scope

It's nice to hear that your MD/DO intern acquaintances view podiatry in a favorable light. I guess my biggest concern is that, after completing a 3-year surgical residency during which I become adept at reconstructing ankles and performing other complex surgical procedures, I take a job in a private practice but end up practicing medicine that is no more complex than what a 1 or 2-year residency-trained podiatrist would encounter (e.g., in-grown toenails, warts, etc.). If I'm going to train to be a foot and ankle surgeon, I want to be able to utilize the skills learned during residency -- not just the "bread and butter" of general/palliative podiatry.

 

[cool_vkb]

Read my response to the poster "tired" above.

aaah okie!

 

[cool_vkb]

Absolutely. Legally they have no limitations. But tell me how often do you see a Foot and Ankle Orthopod managing glaucoma and passing out birthcontrol? Practice medicine today is so overwhelmed with liabilities and lawsuits so I can't imagine any physician managing conditions outside his or her respective specialty. However, in theory there is no question that legally an MD has an unlimited scope. Same way a Family practitioner can legally perform an ankle scope - will he/she do that? I would be no unless he/she is looking for a lawsuit.

👍

 

[PMSIII]

It's nice to hear that your MD/DO intern acquaintances view podiatry in a favorable light. I guess my biggest concern is that, after completing a 3-year surgical residency during which I become adept at reconstructing ankles and performing other complex surgical procedures, I take a job in a private practice but end up practicing medicine that is no more complex than what a 1 or 2-year residency-trained podiatrist would encounter (e.g., in-grown toenails, warts, etc.). If I'm going to train to be a foot and ankle surgeon, I want to be able to utilize the skills learned during residency -- not just the "bread and butter" of general/palliative podiatry.

You have waays to go before becoming a foot and ankle surgeon but if you work hard and give it your all, I have no doubt that you would be a great one. As far as opportunities go, this is contingent on your training and where you practice. Alot of new 3 year residency grads take jobs in group practices that seek a qualified rearfoot and ankle surgeon. Those opportunities will come along but this is where your business sense kicks in with respect to attracting the patient population and marketing yourself to local doctors (even if you're an associate in a group practice).

FYI in-office procedures like in-growns pay better than other complicated foot surgery since their quick with minimum liability. But of course, I understand your aspiration to be a fully competent and comprehensive foot and ankle surgeon (which is my goal as well). Medicine has alot of business involved and it will take effort and time to build practices where you see nothing but surgery with financial reward (it makes no sense if you're losing money and practicing obviously). This goes for pretty much all other medical specialties not just podiatry - the business aspect of medicine.

 

[HenryH]

It's interesting that you bring up the financial dilemma about quick, in-office procedures being financially more viable than complicated, drawn-out surgeries. How do the ortho F&A surgeons, who do nothing but complex surgeries, make it economically sensible, especially considering the fact that they don't (usually) do any of the more minor office-based procedures that podiatrists may do?

 

[PMSIII]

It's interesting that you bring up the financial dilemma about quick, in-office procedures being financially more viable than complicated, drawn-out surgeries. How do the ortho F&A surgeons, who do nothing but complex surgeries, make it economically sensible, especially considering the fact that they don't (usually) do any of the more minor office-based procedures that podiatrists may do?

They get reumbursed more for the same procedures and they take call for non-foot/ankle pathology. Don't get me wrong, I know podiatrists who do extremely well with "complex" surgeries. I am merely bringing this up as a side note. An ingrown can pay anywhere from $350-$500 in a span of 15 minutes in your office. The risks and complications are minimal and the results are great therefore better referrals. This is part of the business sense that I mentioned earlier with respect to marketing and setting up a good referral base. Even if you're trained in complicated foot and akle surgery, don't overlook the quick in-office procedures that pay well. The beauty about our specialty is that we are very procedural based so we get compensated for injections, soft-tissue removals, paronychias, etc. The new generation of foot and ankle surgeons (DPMs) have the opportunity to really provide more clinical options for patients more than before. Our training has become more comprehensive and from what I'm seeing as a clinical fourth year student, the future is certainly bright with many opportunities.

 

[HenryH]

They get reumbursed more for the same procedures and they take call for non-foot/ankle pathology. Don't get me wrong, I know podiatrists who do extremely well with "complex" surgeries. I am merely bringing this up as a side note. An ingrown can pay anywhere from $350-$500 in a span of 15 minutes in your office. The risks and complications are minimal and the results are great therefore better referrals. This is part of the business sense that I mentioned earlier with respect to marketing and setting up a good referral base. Even if you're trained in complicated foot and akle surgery, don't overlook the quick in-office procedures that pay well. The beauty about our specialty is that we are very procedural based so we get compensated for injections, soft-tissue removals, paronychias, etc. The new generation of foot and ankle surgeons (DPMs) have the opportunity to really provide more clinical options for patients more than before. Our training has become more comprehensive and from what I'm seeing as a clinical fourth year student, the future is certainly bright with many opportunities.

Hold on a second -- if a podiatrist and an orthopaedic surgeon both do the same surgery, why does the ortho get paid more? That's a load of crap...what is the APMA doing to change this disparity?

Also, I thought I would throw this in -- roughly what percentage of gross earnings does overhead typically comprise? I'm guessing 50%?

I love that podiatry is so procedural; I would just hope that, as a practicing podiatrist, the majority of the patients I see in a "typical" day are coming to have some sort of procedure done (i.e., not just "consultations").

 

[JEWmongous]

Hold on a second -- if a podiatrist and an orthopaedic surgeon both do the same surgery, why does the ortho get paid more? That's a load of crap...what is the APMA doing to change this disparity?

Also, I thought I would throw this in -- roughly what percentage of gross earnings does overhead typically comprise? I'm guessing 50%?

I love that podiatry is so procedural; I would just hope that, as a practicing podiatrist, the majority of the patients I see in a "typical" day are coming to have some sort of procedure done (i.e., not just "consultations").

Search "resolution 2015" to see what the goals are for procedure parity.

 

[PMSIII]

Hold on a second -- if a podiatrist and an orthopaedic surgeon both do the same surgery, why does the ortho get paid more? That's a load of crap...what is the APMA doing to change this disparity?

Also, I thought I would throw this in -- roughly what percentage of gross earnings does overhead typically comprise? I'm guessing 50%?

I love that podiatry is so procedural; I would just hope that, as a practicing podiatrist, the majority of the patients I see in a "typical" day are coming to have some sort of procedure done (i.e., not just "consultations").

The disparity that you speak of has been around for years. This is nothing new, but still does not limit those of us who are qualified, to operate. The APMA is addressing this issue to my understanding and as the previous poster has mentioned, it is part of the resolution 2015 initiative.

As far as your comment regarding seeing procedural work goes, I will assure you that there is plenty of cookies in the jar to keep everyone happy. The rest is pretty much upto you and how good you get. The opportunities are out there for you to cease. You need to work hard in school, learn as much as you can, work your tail off in externships, and work/learn even more in residency. Ultimately, you're training and education is what you make out of it. If you pay your dues, I have no doubt in my mind that you will do well. No offence, but you are speaking as though you've finished your board certification for comprehensive foot and ankle surgery. You still got ways to go. I don't mean to be disrespectful but trust me, making it in medicine has alot to do with being BOTH a great clinician (not necessarily the best) and a smart business man too.

 

[cool_vkb]

If someone has 1000000n questions for every single issue, its really beneficial to shadow 2-3 DPMs and get first hand info straight from professionals. DPMs i shadowed were very helpfull and cleared all my doubts.

 

[cool_vkb]

No offence, but you are speaking as though you've finished your board certification for comprehensive foot and ankle surgery. You still got ways to go. I don't mean to be disrespectful but trust me, making it in medicine has alot to do with being BOTH a great clinician (not necessarily the best) and a smart business man too.

let him first clear the MEGA 1st yr. All podiatry scope worries are the last thing on mind and main issues that ponder the brain are organization of Brachial plexus & tracing down the ascending/descending pathways 🙂

 

[HenryH]

Unfortunately, cool_vkb, there aren't any podiatrists in my area with reputations for surgical prowess, so I'm out of luck in regards to shadowing a podiatrist whose practice is heavily subsistent on surgery. I suppose I will just shadow a "regular" one for now to become more familiar with office-based procedures...

 

[cool_vkb]

Unfortunately, cool_vkb, there aren't any podiatrists in my area with reputations for surgical prowess, so I'm out of luck in regards to shadowing a podiatrist whose practice is heavily subsistent on surgery. I suppose I will just shadow a "regular" one for now to become more familiar with office-based procedures...

Aaah thats sad! bcoz seriously shadowing resolves a lot of questions. You should atleast do a day or two shadowing somewhere out of town then. iam saying this bcoz u seems to be genuinely interested and want to make sure abt this field in every angle. which is a very good thing. but the questions you ask can be more effectively answered by people who are in market.good luck!

 

[HenryH]

Just thought about something -- to be considered for an MD/DO F&A fellowship, would you need to have graduated from a 3-year residency?

 

[PMSIII]

Just thought about something -- to be considered for an MD/DO F&A fellowship, would you need to have graduated from a 3-year residency?

Yes.

 

[cool_vkb]

Just thought about something -- to be considered for an MD/DO F&A fellowship, would you need to have graduated from a 3-year residency?

lol! are you serious! you didnt knew one has to do a residnecy first bfore doing any fellowship? dood this is like basic premed 101

anyways, To become a F&A orthopod you first have to finish a 3-5 yr Orthopedic residency [which is like one of the most hardest residencies in MD] and then you have to do a 6months-1yr Foot & ankle "Orthopedic" fellowship. Thats the reason why F&A orthopods can also see patients outside Foot & Ankle ,bcoz they do first an intense 5yr long ortho residency covering entire musculoskeletal system of the body🙂

 

[PMSIII]

lol! are you serious! you didnt knew one has to do a residnecy first bfore doing any fellowship? dood this is like basic premed 101

anyways, To become a F&A orthopod you first have to finish a 3-5 yr Orthopedic residency [which is like one of the most hardest residencies in MD] and then you have to do a 6months-1yr Foot & ankle "Orthopedic" fellowship. Thats the reason why F&A orthopods can also see patients outside Foot & Ankle ,bcoz they do first an intense 5yr long ortho residency covering entire musculoskeletal system of the body🙂

I don't think it was all that necessary to mock the student and I believe you misunderstood his question. He was referring to orthopaedic fellowship training for a podiatric physician

 

[HenryH]

lol! are you serious! you didnt knew one has to do a residnecy first bfore doing any fellowship? dood this is like basic premed 101

To clarify: I understand that podiatry students (currently) can complete 2 or 3-year residencies. To qualify for an orthopaedic F&A fellowship, does a student have to graduate from a 3-year residency, or will graduation from a 2-year program suffice?

 

[cool_vkb]

I don't think it was all that necessary to mock the student and I believe you misunderstood his question. He was referring to orthopaedic fellowship training for a podiatric physician

he said "Just thought about something -- to be considered for an MD/DO F&A fellowship, would you need to have graduated from a 3-year residency?

lol i thought he is asking to become MD/DO F&A fellowship does one needs to finish a 3yr residency or not. Podiatry angle didnt even came in my mind. I mean how many DPMs actually ever consider that F&A fellowship route (as far as i heard its very very rare). Mr.henry is totally unpredictable with his diverse range of questions. 🙂 .

 

[cool_vkb]

To clarify: I understand that podiatry students (currently) can complete 2 or 3-year residencies. To qualify for an orthopaedic F&A fellowship, does a student have to graduate from a 3-year residency, or will graduation from a 2-year program suffice?

These days i heard from the DPM i shadowed that they prefer 36month residency grads as they have more exposure,etc. But keep in mind though DPM students joining MD/DO ortho fellowships isnt that common and it doenst makes any big difference in practice. Its more of an academic achievement or may be added stars on your resume if you want to work for an ortho practice group.

 

[PharmD/DPM]

cool_vkb, you're right. It isn't that common at all for DPM's to get or do MD/DO ortho fellowships, but it will help you get into that Ortho group or multispecialty MD group. But, if you want private practice or Pod group, then I wouldn't bother. I do know a West Penn grad that will start a MD ortho f&a fellowship in Maine next month. But, this guy is definitely planning on joining a big ortho group, so a MD fellowship will open all the orthopod's eyes, even though he is a DPM.

 

[cool_vkb]

cool_vkb, you're right. It isn't that common at all for DPM's to get or do MD/DO ortho fellowships, but it will help you get into that Ortho group or multispecialty MD group. But, if you want private practice or Pod group, then I wouldn't bother. I do know a West Penn grad that will start a MD ortho f&a fellowship in Maine next month. But, this guy is definitely planning on joining a big ortho group, so a MD fellowship will open all the orthopod's eyes, even though he is a DPM.

hey! since you are a resident can you help me understanding this concept also. like i heard if you go to work for a hifi ortho group practice then that also does not guarantee us 100% surgery. and infact it could work out as an agreement between DPM & FA ortho guy that he does the big surgeries and we takeover the post operative stuff & then all woundcare,etc are managed by us(The pay still ends up to be in high 180s and both DPM & orthoFA are happy and have mutual respect for each other). is this a common practice or rare?

 

[Feli]

Fellowship training in podiatry is just not very common because 3yrs is already quite a bit of surgery if you were at a decent program where there's a busy surgery schedule and the attendings are happy to hand over the knife. Besides that, do you think a lot of people really want to work for $35k as a fellow when they are offered a $150k job? When it comes down to it, a fellow is basically an attending who makes only a small fraction of what other attendings make. That and the fact that most good 3yr programs already give you adequate knowledge are probably the main reasons why a fair amount of fellowships, even good ones, go unfilled or don't get a ton of apps. However, if you want to go above and beyond or want to get specialty skillsets (implants, research, limb salvage, ex-fix, etc), then fellowship is certainly a nice option to have. We are lucky that more and more fellowships are becoming available - both within and outside of CPME.

http://download.journals.elsevierhealth.com/pdfs/journals/1067-2516/PIIS1067251607005066.pdf

...like i heard if you go to work for a hifi ortho group practice then that also does not guarantee us 100% surgery. and infact it could work out as an agreement between DPM & FA ortho guy that he does the big surgeries and we takeover the post operative stuff & then all woundcare,etc are managed by us...

There would be very little point for a group that already had a F&A ortho to hire a DPM unless it is an absolutely giant group with a lot more F&A surgery than they can handle.

Presby made a quality post on this topic awhile back; search by his name in the pod forum and you'd find it. DPMs working with ortho groups are generally hired to do the group's F&A work (flatfoot, foot trauma, calc, ankles, etc) which their gen orthos might have been previously struggling with or referring away. Most ortho and multispecialty groups have realized that a F&A ortho coming out of fellowship costs ~$3-400k, but a DPM with similar skills might only run them about half that. While the DPM can't take general ortho call for the group, that is still a big savings and attractive from a business standpoint... especially when you add in the DPM's potential for some wound care and orthosis services.

 

[PharmD/DPM]

Feli brings up a good point, that most ortho groups won't have both a f&a orthopod and a DPM. Most DPM's that get into ortho groups usually become the sole foot and ankle specialist and will make quite a bit less than a MD f&a, but will still pull in close to $200k. I want to mention one more thing about this topic. Simply doing a MD f&a ortho fellowship doesn't mean that you might be deficient in skills, I know some people that just do it to get noticed and acknowledged by ortho groups. So, please don't assume that these DPM's feel inadequate about there skills, but maybe they think that 1 more year of making just $40k will just bump them up to that top tax bracket (150-200k) instead of the low 100's like most DPM's make right out of residency.

 

[jonwill]

Feli brings up a good point, that most ortho groups won't have both a f&a orthopod and a DPM. Most DPM's that get into ortho groups usually become the sole foot and ankle specialist and will make quite a bit less than a MD f&a, but will still pull in close to $200k. I want to mention one more thing about this topic. Simply doing a MD f&a ortho fellowship doesn't mean that you might be deficient in skills, I know some people that just do it to get noticed and acknowledged by ortho groups. So, please don't assume that these DPM's feel inadequate about there skills, but maybe they think that 1 more year of making just $40k will just bump them up to that top tax bracket (150-200k) instead of the low 100's like most DPM's make right out of residency.

You are absolutely correct. We've had a few guys at my program that have gone on to do F&A fellowships. They received very sound training during residency but felt that doing a fellowship would increase their stock so to speak. Whether that is true or not can be debated but they both ended up with phenominal jobs.

 

[HenryH]

The reasons and anecdotes retold by the last few posters are the same reasons I would want to complete a fellowship: professional clout, self-marketing ability, etc.

 

[PJAG]

Does anyone know how many Ortho F&A doctors there are?

 

[jonwill]

Does anyone know how many Ortho F&A doctors there are?

No, I have never been able to find the number. No one I know has been able to get an accurate number. This includes searching the AOFAS website as well.

This is sheer speculation on my part but something tells me that they don't want the number to go public. Something tells me it is extremely small.

 

[PJAG]

No, I have never been able to find the number. No one I know has been able to get an accurate number. This includes searching the AOFAS website as well.

This is sheer speculation on my part but something tells me that they don't want the number to go public. Something tells me it is extremely small.

Wow, it is pretty hard tying to figure out the number. I checked out the AOFAS website and searched for all the Orthopaedic doctors in the USA several times. Each time I received different amounts of doctors. However, when I looked for the amount in California only, the result ended up with 97 docs consistently. Either the website sucks or they are purposely not reporting all of their doctors.

 

[SportPOD]

I think one of the biggest reasons you will not find an accurate number is that you will have fellowship trained F&A docs doing general ortho and vice versa. So, it will be hard to come up with an exact number since AOFAS reports for foot and ankle trained orthos.

 

[Danmanwrx]

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