Picking a Residency

Started by deleted1119158
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What are your top 5 reasons for picking the residency that you did ?

What is considered a good surgical volume ? What is acceptable ?

Does a program need to do up to date procedures like MIS ?

Do you think an ER is important for trauma or is this not applicable to the “real world of podiatry”?

Any and all input helps is 4th year nooobz

Edit: thank you everyone for the super helpful advise and insight I never considered. I appreciate everyone’s time and guidance. Best forum ever, can’t beat real life experience that comes with time.
 
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saddog said:
What are your top 5 reasons for picking the residency that you did ?

What is considered a good surgical volume ? What is acceptable ?

Does a program need to do up to date procedures like MIS ?

Do you think an ER is important for trauma or is this not applicable to the “real world of podiatry”?

Any and all input helps is 4th year nooobz
Click to expand...

I’m starting my second year out of residency, so this mindset is fairly fresh in my head [emoji28]

I picked my program for the following reasons:

1) residents usually single scrubbed and only double scrubbed for huge cases. That way the attendings were very focused doing one on one teaching
2) the director had a big name, which was helpful during interviewing for jobs because most people have heard of him (he lectures, publishes, and did a lot for Podiatry in his state)
3) Many different rotations (spent 2 months on vascular single scrubbed, did a bunch of angios myself) this is nice because I feel like I have a better relationship with those specialties now.
4) completed all cases by the end of second year, therefore I have a many single scrub cases logged
5) scrubbed with around 40 attendings so you see a huge diversity of style and techniques

I was on track to have triple needed numbers, then COVID hit half way through third year so I have about 2.5 times needed numbers… not sure what to tell you what is acceptable, but you need to be comfortable when you are done

IMO MIS is not necessary, I’m doing just fine without it. I may take a learning course after I’m certified so I can offer that as well. But imo def not needed

Many jobs after residency do not offer trauma call, but some do and you don’t want to be limited to those without. My program was level 1 trauma center and I feel comfortable with everything… however so far my experience is most positions don’t get a lot of trauma (at least in PP)

Feel free to PM if you have other questions
 
Definitely don't let MIS factor into your residency program decision whatsoever. You can eventually go to some MIS in practice if that's your interest. Get good at doing things open, and MIS is super easy after that. I personally don't see the allure--I like to do some rear foot MIS (to prevent wound complications), but forefoot--why? It's not like we make huge incisions here.

ER with a variety of trauma is a huge plus---not that you will particularly be busy with that in "the real world" (unless you really want to push for it), but it helps you get comfortable seeing everything--makes you less afraid or nervous to do surgery once you've seen up close all the horrible things that can happen to a foot...

As far as volume--just kinda see how residents behave around surgery. Are the 3rd years anxiously trying to get in on every case? Double scrubbing/triple scrubbing all the cases??? Probably a bad sign. Some of this depends on how many attendings there are. Only 2 or 3? Probably a bad sign, and you're only going to see how 2 or 3 surgeons tackle a bunion or whatever. 40 attendings (above poster) is freaking crazy, but no wonder they had triple their required cases!
 
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Good posts above.

Number of attendings is an interesting topic with positives and negatives associated with each. Lower number of attendings (4-5) does limit your exposure to numerous ways to bake a cake but also allows you to develop a more personal relationship with the attending and understand the "why" behind the surgery rather than just showing up to an ASC and operating on a patient you have no background or familiarity with which can sometimes happen with these 40+ attending programs. With that said, there is certainly a lot of learning that can be done with the amount of surgical volume that comes with these larger attending programs and leaving a program with easily over 1K cases and 2-3K procedures can make a huge difference. The other thing to consider is that just because there are 40+ attendings, doesn't mean that all will know you and trust you enough to let you go skin to skin. Long story short, go to the place that has good surgical volume and diversity and where attendings will let you fly. Programs that just let residents do parts of cases or just drill and fill are a no go, you need the hands on experience skin to skin.

Lastly I will say that when possible I would advise going to programs that are well known and have attendings that are active in our field and well connected. Connections go a long way in this small profession and while they won't do the work for you, they can certainly open some doors. In the same light going to programs in certain regions or with certain poor reputations can be limiting even if you are an excellent resident. Im sure there are many that will disagree and have made lemonade out of lemons, but at this point in your career when you have the choice it makes sense to get in with the right people early on.
 
For residency, same as it ever was... choose mainly on volume and teachers (many RRA cert attendings, etc).

I would say priorities are:
1 - case volume and diversity (OR every day, first assist from early in training, RRA, 3x numbers, etc)
2 - good attendings and many of them (RRA cert, successful, various backgrounds.. not too inbred backgorund/thinking)
3 - lack of BS (excessive hours, call, academics, "heirarchy" crap, much mandatory research, etc... unless you like that)
4 - trauma for podiatry (via ER, many attendings' offices bringing, etc... need to know it for practice, boards, etc)
5 - office rotations (at least some basic billing, chances to hang out in attendings' PP clinics, etc)

Watch out for the many new and 'up-and-coming' programs with one awesome attending (usually director) but little or no 'depth chart'... that's a recipe for huge problems if something happens to that doc or if there are too many mouths to feed and double/triple scrubbing. Those programs are also usually in trouble for office rotations as that director will be doing hospital/complex stuff and not much bread-n-butter where you learn how to code, make money, talk to patients, market and get refers, etc. You need various perspectives and teachers.

ER is a must. What are you going to do after training if a calc fracture comes in? A bimall? A lisfranc? Jones fx? ...Poop your pants?
I get fractures daily from ER and Urgent Cares even though I am now as "real world podiatry" as can be. You can always choose not to do it, but you want exposure so you have those skills and basic understandings to at least recognize it, dx it, and treat it appropriately.

This is why you take the historically strong programs if you can get one. They have generally fixed these problems while the next teir residencies are trying to hash them out... and the crap programs have major holes for volume, case diversity, attendings depth and training, quality of residents, way too much C&C and wound basics, etc. Good resident/student will do well almost anywhere, but more reps and good co-residents and attendings to push you and mentor from makes it much easier.

Scrantonicity said:
Definitely don't let MIS factor into your residency program decision whatsoever. You can eventually go to some MIS in practice if that's your interest. Get good at doing things open, and MIS is super easy after that. I personally don't see the allure--I like to do some rear foot MIS (to prevent wound complications), but forefoot--why? It's not like we make huge incisions here...
Click to expand...
Concur. ^^

MIS was dumb years ago in podiatry ("Shannon burr"), and it's still fairly dumb now - even though we have cannulated screws. A 5mm incision and a 15cm incision heal same rate. If one won't heal, the other won't either (person has PAD)... just use good tissue handling and proper pt selection, pt education, and get adequate exposure. Use lido epi to see the structures in good contrast color, prevent edema and pain without cuff, and do plastics closures if you like (I do all of those for most elective). It is better to get adequate room for instruments or visualizations than to try retract hard on flaps and rasp, burr, saw, throw screws, etc blind... not ever wise to use power instruments and cut instruments blindly. A bit better to consider MIS if the surgeon has done the procedure open? Yeah, but again... why? No real need for bone surgery. Perc TALs in diabetics, perc FDL tendonotomies, etc might be the only real "MIS" application in my eyes.

Same logic applies to those stupid shark bite trauma attempts with a bunch of stab incisions up and down the plate, perc Achilles ruptures, Lapidus with two incisions, etc... heals same rate anyways, looks worse than just a nice curvilinear incision, likely to cause heavy retraction on small incisions and bad scars or wound issues/necrosis.

You sure don't see plastic surgeons doing "MIS"... they just use what exposures they need with good handling and good closure. It is much more about handling edges and tensions than length of incisions.

You will find F&A surgery trends come and go in podiatry... definitely don't pick a residency based on "up to date" that may crash and burn soon after:
Austin popularized = yeah, for bunions mild and not hypermobile
First MPJ implants = junk
Arthroeresis = not too useful or effective
Ex-fix craze = no way... very narrow indications
Brostrom and ropes to replace sacrificing peroneals for lateral ankle = for sure
EPFs = why?
Ankle scopes = yes
STJ and MPJ1 scopes = nope
Gastroc recessions = yeah, usually good if indicated
Lock plates = awesome for many things
Lapidus rebirth = fantastic (way better long term if done well vs met osteotomies)
Wound goops and grafts = not sure why people do this$$$s
Nerve surgery and releases = kidding right?
TAR = make up your own mind (I say not wise, needs long term... which likely won't be good, just like MPJ1 replace results)
MIS = seen that movie before
 
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Feli said:
For residency, same as it ever was... choose mainly on volume and teachers (many RRA cert attendings, etc).

I would say priorities are:
1 - case volume and diversity (OR every day, first assist from early in training, RRA, 3x numbers, etc)
2 - good attendings and many of them (RRA cert, successful, various backgrounds.. not too inbred backgorund/thinking)
3 - lack of BS (excessive hours, call, academics, "heirarchy" crap, much mandatory research, etc... unless you like that)
4 - trauma for podiatry (via ER, many attendings' offices bringing, etc... need to know it for practice, boards, etc)
5 - office rotations (at least some basic billing, chances to hang out in attendings' PP clinics, etc)

Watch out for the many new and 'up-and-coming' programs with one awesome attending (usually director) but little or no 'depth chart'... that's a recipe for huge problems if something happens to that doc or if there are too many mouths to feed and double/triple scrubbing. Those programs are also usually in trouble for office rotations as that director will be doing hospital/complex stuff and not much bread-n-butter where you learn how to code, make money, talk to patients, market and get refers, etc. You need various perspectives and teachers.

ER is a must. What are you going to do after training if a calc fracture comes in? A bimall? A lisfranc? Jones fx? ...Poop your pants?
I get fractures daily from ER and Urgent Cares even though I am now as "real world podiatry" as can be. You can always choose not to do it, but you want exposure so you have those skills and basic understandings to at least recognize it, dx it, and treat it appropriately.

This is why you take the historically strong programs if you can get one. They have generally fixed these problems while the next teir residencies are trying to hash them out... and the crap programs have major holes for volume, case diversity, attendings depth and training, quality of residents, way too much C&C and wound basics, etc. Good resident/student will do well almost anywhere, but more reps and good co-residents and attendings to push you and mentor from makes it much easier.


Concur. ^^

MIS was dumb years ago in podiatry ("Shannon burr"), and it's still fairly dumb now - even though we have cannulated screws. A 5mm incision and a 15cm incision heal same rate. If one won't heal, the other won't either (person has PAD)... just use good tissue handling and proper pt selection, pt education, and get adequate exposure. Use lido epi to see the structures in good contrast color, prevent edema and pain without cuff, and do plastics closures if you like (I do all of those for most elective). It is better to get adequate room for instruments or visualizations than to try retract hard on flaps and rasp, burr, saw, throw screws, etc blind... not ever wise to use power instruments and cut instruments blindly. A bit better to consider MIS if the surgeon has done the procedure open? Yeah, but again... why? No real need for bone surgery. Perc TALs in diabetics, perc FDL tendonotomies, etc might be the only real "MIS" application in my eyes.

Same logic applies to those stupid shark bite trauma attempts with a bunch of stab incisions up and down the plate, perc Achilles ruptures, Lapidus with two incisions, etc... heals same rate anyways, looks worse than just an nice curvilinear incision, likely to cause heavy retraction on small incisions and bad scars or wound issues/necrosis.

You sure don't see plastic surgeons doing "MIS"... they just use what exposures they need with good handling and good closure. It is much more about handling edges and tensions than length of incisions.

You will find F&A surgery trends come and go in podiatry... definitely don't pick a residency based on "up to date" that may crash and burn soon after:
Austin popularized = yeah, for bunions mild and not hypermobile
First MPJ implants = junk
Arthroeresis = not too useful or effective
Ex-fix craze = no way... very narrow indications
Brostrom and ropes to replace sacrificing peroneals for lateral ankle = for sure
EPFs = why?
Ankle scopes = yes
STJ and MPJ1 scopes = nope
Gastroc recessions = yeah, usually good if indicated
Lock plates = awesome for many things
Lapidus rebirth = fantastic (way better long term if done well vs met osteotomies)
Nerve surgery and releases = kidding right?
TAR = make up your own mind (I say not wise, needs long term... which likely won't be good, just like MPJ1 replace results)
MIS = seen that movie before
Click to expand...
Yup this. Learned from my ortho mentors. They don’t use tourniquets for knee replacements because you wouldn’t use one for a hip replacement either. If you follow sound anatomical dissection, you should be avoiding most major veins and arteries otherwise you probably should retake a course on the layers of skin. Another thing I see too often - people retracting the living hell out of tissues with senn/ragnell/army navy when you can just extend your incision to make life easier.

But then again we have brand new fellows trying to teach MIS courses with their limited sample size. Go figure.
 
Agent9 said:
Good posts above.

Number of attendings is an interesting topic with positives and negatives associated with each. Lower number of attendings (4-5) does limit your exposure to numerous ways to bake a cake but also allows you to develop a more personal relationship with the attending and understand the "why" behind the surgery rather than just showing up to an ASC and operating on a patient you have no background or familiarity with which can sometimes happen with these 40+ attending programs. With that said, there is certainly a lot of learning that can be done with the amount of surgical volume that comes with these larger attending programs and leaving a program with easily over 1K cases and 2-3K procedures can make a huge difference. The other thing to consider is that just because there are 40+ attendings, doesn't mean that all will know you and trust you enough to let you go skin to skin. Long story short, go to the place that has good surgical volume and diversity and where attendings will let you fly. Programs that just let residents do parts of cases or just drill and fill are a no go, you need the hands on experience skin to skin.

Lastly I will say that when possible I would advise going to programs that are well known and have attendings that are active in our field and well connected. Connections go a long way in this small profession and while they won't do the work for you, they can certainly open some doors. In the same light going to programs in certain regions or with certain poor reputations can be limiting even if you are an excellent resident. Im sure there are many that will disagree and have made lemonade out of lemons, but at this point in your career when you have the choice it makes sense to get in with the right people early on.
Click to expand...
I don’t think the pros and cons match up here. Doing residency with 4-5 attendings is a terrible idea. Expect 1-3 to be garbage. Maybe one RRA guy. not enough variety. you will not be good. The “why” behind a surgery can be explained with good academics associated with the program.
 
The 5 most important things:

1. Volume. By far… if you aren’t getting cases and just meeting the minimums.. you will suck.
2. Quality and quantity of attendings. How can you be good if they suck? How can you be well rounded if you only work with one or two attendings?
3. Autonomy. How much does this program trust the residents to handle business by themselves (within reason.. you never want to be left alone. But a good program let’s you do your thing).
(huge gap)
4. Exposure to different patient populations. A good program will have you seeing the moms in the suburbs and the underserved. You have to treat these different.
5. Lifestyle. Arguably should be higher. Yeah you want to be well trained, but also don’t be abused. Some programs who are “top tier” are just flat out mean, rude, and abusive. I would call them out but we know who they are. Funny thing is these militant programs have fallen behind and aren’t so top tier anymore. Thankfully I went to a program where it was great training and everyone was nice. But I remember being an extern and feeling unwelcomed. I also remember residents on externships who I saw being treated poorly. My question is why? We all have to start from somewhere.
 
ToeFather said:
The 5 most important things:

1. Volume. By far… if you aren’t getting cases and just meeting the minimums.. you will suck.
2. Quality and quantity of attendings. How can you be good if they suck? How can you be well rounded if you only work with one or two attendings?
3. Autonomy. How much does this program trust the residents to handle business by themselves (within reason.. you never want to be left alone. But a good program let’s you do your thing).
(huge gap)
4. Exposure to different patient populations. A good program will have you seeing the moms in the suburbs and the underserved. You have to treat these different.
5. Lifestyle. Arguably should be higher. Yeah you want to be well trained, but also don’t be abused. Some programs who are “top tier” are just flat out mean, rude, and abusive. I would call them out but we know who they are. Funny thing is these militant programs have fallen behind and aren’t so top tier anymore. Thankfully I went to a program where it was great training and everyone was nice. But I remember being an extern and feeling unwelcomed. I also remember residents on externships who I saw being treated poorly. My question is why? We all have to start from somewhere.
Click to expand...
^This x100000
 
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1) Number of attendings. More attendings equals more cases and more diversity

2) Number of residents. If the program has a ton of attendings but accepts 4-5 residents a year then this will hurt your training. There will be a lot of double scrubbing. If the program does not have a ton of attendings and the program accepts 4-5 residents a year then do not consider doing your residency training there

3) Resident clinic. Logging cases is paramount but having decent follow up with your inpatients is critical for further learning and seeing the big picture

4) Work life balance. Unpopular opinion but work life balance should not exist in residency. You are there to train. If you have too much free time then you should be double scrubbing or make friends with your ortho or vascular attendings and ask if you can scrub their cases. Only after you have done that should you truly enjoy your free time. Residency is your time to learn and hone your skills before you practice in the real world which is filled with doctor reviews on the internet, litigation, earning respect from ortho. If you suck then you suck. All the surgery in the world while you are an attending will not make up for what you should have learned in residency.

5) Name of the residency program. This means NOTHING. Nobody in the MD/DO world knows about the historically strong podiatry programs and their attendings nor do they care.....AT ALL. The only names they will recognize are podiatry programs affiliated with larger well known hospital systems that have strong residency programs in other specialties.
 
Feli said:
TAR = make up your own mind (I say not wise, needs long term... which likely won't be good, just like MPJ1 replace results)
Click to expand...
Not the same anatomy. Different biomechanical forces through the joint. TAR systems are more anatomic than they have ever been before with robust salvage implants in case there are complications. I think if the correct patient is chosen and the procedure is executed correctly the chance of long term positive outcomes are rather high these days.
 
CutsWithFury said:
1) Number of attendings. More attendings equals more cases and more diversity

2) Number of residents. If the program has a ton of attendings but accepts 4-5 residents a year then this will hurt your training. There will be a lot of double scrubbing. If the program does not have a ton of attendings and the program accepts 4-5 residents a year then do not consider doing your residency training there

3) Resident clinic. Logging cases is paramount but having decent follow up with your inpatients is critical for further learning and seeing the big picture

4) Work life balance. Unpopular opinion but work life balance should not exist in residency. You are there to train. If you have too much free time then you should be double scrubbing or make friends with your ortho or vascular attendings and ask if you can scrub their cases. Only after you have done that should you truly enjoy your free time. Residency is your time to learn and hone your skills before you practice in the real world which is filled with doctor reviews on the internet, litigation, earning respect from ortho. If you suck then you suck. All the surgery in the world while you are an attending will not make up for what you should have learned in residency.

5) Name of the residency program. This means NOTHING. Nobody in the MD/DO world knows about the historically strong podiatry programs and their attendings nor do they care.....AT ALL. The only names they will recognize are podiatry programs affiliated with larger well known hospital systems that have strong residency programs in other specialties.
Click to expand...
nailed it except for #4. 40 hour work week in residency is bad. but avoid the consistent 80-100 hour ones.
 
ToeFather said:
nailed it except for #4. 40 hour work week in residency is bad. but avoid the consistent 80-100 hour ones.
Click to expand...

There were numerous weeks which I logged >120 hours - in the ER from night to morning, in the OR straight from Friday to Monday with minimal rest, stayed for add on cases even though I wasn’t on call, running a full day of clinic and then more cases after. This made my transition into real world practice very easy for me.
 
wakaflocka88 said:
There were numerous weeks which I logged >120 hours - in the ER from night to morning, in the OR straight from Friday to Monday with minimal rest, stayed for add on cases even though I wasn’t on call, running a full day of clinic and then more cases after. This made my transition into real world practice very easy for me.
Click to expand...
I mean that is true. it is 3 short years.
 
CutsWithFury said:
If you suck then you suck
Click to expand...
Honestly...I agree and wish more people said this to students regarding SURGERY. This is something people just don't understand. But let me expand.

When entering podiatry you have NO CHOICE except to do surgery during school and residency starting day 1. In MD school you spend months in surg rotations deciding if you like it or not then decide. But it's just not for everyone. Every single student DOES NOT NEED TO DO SURGERY. Many people just suck at it. Bad hand eye coordination. Bad hands. Bad decision making in OR. Poor training. Most people don't give a crap about fixing hammer toes and bunions or debridements.

There are plenty of ways to make tons of money without ever going to the OR. Don't feel like you HAVE to do surgery. It's a requirement for residency but if all you do is scrub cases and you hate it then you wasted 3 years when you could have spent time studying and being in clinic. Being efficient and building communication skills, billing, treating non operatively. This also means not wasting your time scrubbing vascular or Ortho cases. Who cares.

Read papers. Learn your fundamentals and create algorithms for everything so when your in practice your good.

I've seen plenty of residents that suck at surgery. It's okay. Your not a bad "doctor" or dumb because surgery wasn't your thing.
 
podwho said:
Honestly...I agree and wish more people said this to students regarding SURGERY. This is something people just don't understand. But let me expand.

When entering podiatry you have NO CHOICE except to do surgery during school and residency starting day 1. In MD school you spend months in surg rotations deciding if you like it or not then decide. But it's just not for everyone. Every single student DOES NOT NEED TO DO SURGERY. Many people just suck at it. Bad hand eye coordination. Bad hands. Bad decision making in OR. Poor training. Most people don't give a crap about fixing hammer toes and bunions or debridements.

There are plenty of ways to make tons of money without ever going to the OR. Don't feel like you HAVE to do surgery. It's a requirement for residency but if all you do is scrub cases and you hate it then you wasted 3 years when you could have spent time studying and being in clinic. Being efficient and building communication skills, billing, treating non operatively. This also means not wasting your time scrubbing vascular or Ortho cases. Who cares.

Read papers. Learn your fundamentals and create algorithms for everything so when your in practice your good.

I've seen plenty of residents that suck at surgery. It's okay. Your not a bad "doctor" or dumb because surgery wasn't your thing.
Click to expand...
This is a defining problem with podiatry. And one of the reasons I was attracted to it. I didn't want to risk being non-op going DO. So I said cool will do Podiatry and do surgery. Looking back would have done DO EM and worked locums.
 
Surgery is an ego thing for some pods. They extra emphasize that they can do surgery out of some inferiority complex...Actually with these types they don't even like using the word podiatrist. They want to be called Foot and Ankle surgeons and are ashamed to be called podiatrists LOL. I've noticed it's very common with residents. And then they get out into the real world and realize none of that matters, you just need to figure out how to start bringing money in to survive and build a life.
 
Hungry_Anxiety8703 said:
Surgery is an ego thing for some pods. They extra emphasize that they can do surgery out of some inferiority complex...Actually with these types they don't even like using the word podiatrist. They want to be called Foot and Ankle surgeons and are ashamed to be called podiatrists LOL. I've noticed it's very common with residents. And then they get out into the real world and realize none of that matters, you just need to figure out how to start bringing money in to survive and build a life.
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Just look at all the LinkedIn accounts for these residents... rarely is “podiatry” mentioned.
 
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Hungry_Anxiety8703 said:
Surgery is an ego thing for some pods. They extra emphasize that they can do surgery out of some inferiority complex...Actually with these types they don't even like using the word podiatrist. They want to be called Foot and Ankle surgeons and are ashamed to be called podiatrists LOL. I've noticed it's very common with residents. And then they get out into the real world and realize none of that matters, you just need to figure out how to start bringing money in to survive and build a life.
Click to expand...
Certainly there are inferiority complexes within our profession which drive some to abandon the use of podiatrist versus F&A surgeon, but I would argue that many may also use this in terms of marketing. When entering areas where podiatrist/podiatry = RFC only, marketing yourself as a surgeon is often necessary to market your services if you are trying to grow a surgical practice in an area where patients are unaware of the surgical aspect of podiatry. Often orthopaedic groups will purposefully market podiatrists in this way as well.
 
But you could just as easily call yourself a podiatric surgeon. They won’t do this. They don’t like the association. We didn’t go to “Foot and Ankle Surgery School”. We went to Podiatry school. It’s just tacky imo to hide from it
Agent9 said:
Certainly there are inferiority complexes within our profession which drive some to abandon the use of podiatrist versus F&A surgeon, but I would argue that many may also use this in terms of marketing. When entering areas where podiatrist/podiatry = RFC only, marketing yourself as a surgeon is often necessary to market your services if you are trying to grow a surgical practice in an area where patients are unaware of the surgical aspect of podiatry. Often orthopaedic groups will purposefully market podiatrists in this way as well.
Click to expand...
 
Hungry_Anxiety8703 said:
Surgery is an ego thing for some pods. They extra emphasize that they can do surgery out of some inferiority complex...Actually with these types they don't even like using the word podiatrist. They want to be called Foot and Ankle surgeons and are ashamed to be called podiatrists LOL. I've noticed it's very common with residents. And then they get out into the real world and realize none of that matters, you just need to figure out how to start bringing money in to survive and build a life.
Click to expand...
Sure, it can be partially an ego thing.
I will tell you that it is not just about the surgery, though... it is MUCH more about being able to treat everything comprehensively.
Personally, I use "podiatry" often (since ppl know what that is), but I tend to promote the inpatient/surgery/complex skill more often among the local medical community... the easy stuff finds me no matter what. I tend to communicate more or send pts back to PCP with before/after results on the surgery, inpatient, etc. I want the pt PCP, network, etc to know I'm available for much more than orthotics and toenails if I can help someone else they may refer.

It is annoying to have to explain to PCPs that you can fuse an arthritic ankle... and they're confused since the prior doc just kept injecting a bunion since they couldn't even do that surgery. ER is understandably confused when one DPM is almost scared of ankle sprains and can't do much more than brace or Rx PT for them (which a PCP could do)... and yet another DPM can ORIF a high energy calc fx, do ankle sprain all the way to scope lat stab if needed, etc etc.

Can a DPM do bunion surgery? Treat ankle fracture? Do amputation for osteomyelitis? Do they do flat foot surgery if brace doesn't work?
The answer is "it depends" for many, many, many things podiatry. That's a major problem in perception by public and overall medical community.
And you don't really see any of that in other specialties. Can an ENT do ear tubes? Can a neuro work up Parkinsons? Can an Endo do thyroid biopsy? Can a plastic surgeon revise a c-sec scar? Can a GI do a scope biopsy? Those are universally a yes... due to standardization.
 
Feli said:
Sure, it can be partially an ego thing.
I will tell you that it is not just about the surgery, though... it is MUCH more about being able to treat everything comprehensively.
Personally, I use "podiatry" often (since ppl know what that is), but I tend to promote the inpatient/surgery/complex skill more often among the local medical community... the easy stuff finds me no matter what. I tend to communicate more or send pts back to PCP with before/after results on the surgery, inpatient, etc. I want the pt PCP, network, etc to know I'm available for much more than orthotics and toenails if I can help someone else they may refer.

It is annoying to have to explain to PCPs that you can fuse an arthritic ankle... and they're confused since the prior doc just kept injecting a bunion since they couldn't even do that surgery. ER is understandably confused when one DPM is almost scared of ankle sprains and can't do much more than brace or Rx PT for them (which a PCP could do)... and yet another DPM can ORIF a high energy calc fx, do ankle sprain all the way to scope lat stab if needed, etc etc.

Can a DPM do bunion surgery? Treat ankle fracture? Do amputation for osteomyelitis? Do they do flat foot surgery if brace doesn't work?
The answer is "it depends" for many, many, many things podiatry. That's a major problem in perception by public and overall medical community.
And you don't really see any of that in other specialties. Can an ENT do ear tubes? Can a neuro work up Parkinsons? Can an Endo do thyroid biopsy? Can a plastic surgeon revise a c-sec scar? Can a GI do a scope biopsy? Those are universally a yes... due to standardization.
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I agree it is a much more common issue for podiatry, but it might be more common than you would expect for solo doctors in other specialties. One of the advantages to larger groups is that they are more likely to be one stop shopping for referrals from PCPs.
 
MusicManMike said:
Just look at all the LinkedIn accounts for these residents... rarely is “podiatry” mentioned.
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Chiropodist, Podiatrist, Podiatric Surgeon, Foot and Ankle Surgeon......before my time the word Laser was worked in there somehow

I see both sides on this issue and once ABPS went to ABFAS I started going with Foot and Ankle Surgeon over Podiatric Surgeon when marketing.

Got tired with the term Podiatric Surgeon on my old white coat also and people thinking I operated on kids.

Some do go to great lengths to never use the word podiatrist or DPM from an inferiority complex for sure and they absolutely despise being grouped together with the podiatrists doing mainly nail care......for them Dr. and Foot & Ankle Surgeon only......you will never, ever see podiatrist or DPM.

When I meet someone new socially 99 percent of the time I still tell them I am a podiatrist as I still consider that my profession. Next question is always do you do surgery, so even with this I can understand using Foot and Ankle Surgeon which makes it easier to understand.

The general public does still tend to associate the word podiatry more so with chiropody, but from an ego standpoint I could care less.
 
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I would say
1- Numbers, single scrub, cases done by the end of 2nd year
2- As much as I hated it, educational meetings etc. I knew they would be good for me.. My work life really wasnt that terrible, depending on the rotation and time of year. Long days and early mornings were common but I rarely felt burnt out
3- Clinic.. that is where you will spend most your time in the real world and thats what gets you to the OR
4- The residents coming out were really good which meant I would be too if I did what I was suppose
5- I don't know.. I could get in?

Location to be meant nothing I was leaving when I was done unless I got a good offer.
Up to date on MIS.. Wasn't really a big thing at that point. Reps are always willing to send you to training etc if you want.
 
I found pickling in residency to be very beneficial. I prefer lactofermented style pickles as these have just wonderful flavor. That’s really about the time when my fermentation addiction started. Anyway, thanks for reading.
 
The skill and diversity of attendings was the most important to me. It’s super important to learn from the very best; you can learn exactly how you should operate, what you are trying to accomplish and why, and eventually get your hands to do exactly what you know they’re supposed to do, in an efficient manner. A wet lab really, really helps. I thought it was also helpful to scrub with the really bad surgeons to figure out how to NOT do surgery.

Diversity of pathology was also super important. One program that had a great reputation was bunions, ankle fractures and diabetic foot infections I swear about 95% of the time. Those residents (and attendings) couldn’t reconstruct a cobb salad much less a foot. Maybe I was just there on a bad 3 months
 
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