PMSR vs PMSR/RRA

[Reverdin green]

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I am first year resident and I recently found out I was only taken for PMSR even though I applied PMSR/RRA position. Will just PMSR limit me or should I transfer to another program for PMSR/RRA? Will I Ben able to do everything with just PMSR? Thank you and I look forward to your counsel.

 

[Adam Smasher]

should I transfer to another program for PMSR/RRA?

In a word, yes

 

[Reverdin green]

In a word, yes

Thank you!

 

[billBOB213]

Have you brought this up to the director? I would see what happened, could be the old bait n switch [emoji3081]

 

[Pronation]

In a word, yes

How about in two words?

 

[DogSnoot]

I am first year resident and I recently found out I was only taken for PMSR even though I applied PMSR/RRA position. Will just PMSR limit me or should I transfer to another program for PMSR/RRA? Will I Ben able to do everything with just PMSR? Thank you and I look forward to your counsel.

I know eleven spots are listed on AACPM.org.
I’d wait till the end of the year and see if anything good opens up, transfer out.

 

[Adam Smasher]

How about in two words?

He should

 

[Reverdin green]

Can someone explain to me how exactly PMSR limits you after residency? Does it mean you don’t ever do rear foot cases?

 

[Adam Smasher]

Fine, more than 2 words.

What you cover and what you don't cover will be up to your director and your seniors. Where this limits you on paper is that you will never have an RRA credential, you will be ineligible to sit for ABFAS RRA boards, and that locks you out of certain employment opportunities down the road. You'll still be able to apply for "core podiatry" privileges at hospitals/surgery centers and do forefoot work. If calcaneal osteotomies and ankle fractures, etc are within your delineation of privileges, you can even do that, provided you have the skill for it, if not the training.

 

[Boba Foot]

Fine, more than 2 words.

What you cover and what you don't cover will be up to your director and your seniors. Where this limits you on paper is that you will never have an RRA credential, you will be ineligible to sit for ABFAS RRA boards, and that locks you out of certain employment opportunities down the road. You'll still be able to apply for "core podiatry" privileges at hospitals/surgery centers and do forefoot work. If calcaneal osteotomies and ankle fractures, etc are within your delineation of privileges, you can even do that, provided you have the skill for it, if not the training.

In addition to what just PMSR physically limits you to, it will limit your job opportunities. It’s hard enough competition out there, you don’t want to be the absolute bottom of the barrel with just a PMSR credential competing against everyone with PMSR/RRA + whatever board cert/qual.

Residency directors are shady and will try to trick people into taking that spot. Sorry they did that to you. Transfer out as soon as you can, though they probably won’t release you until the end of the PGY year.

 

[GreenHousePub]

it will limit your job opportunities

Honestly, as someone who has the RRA cert, not really.

 

[HardRoadPaved]

I think it depends if you feel like looking up from nail dust to see if there are signs of ankle OA

 

[GreenHousePub]

Truth be told the vast majority of jobs are going to be looking for a "board-certified" podiatrist. The general public doesn't know the difference between our boards and despite the chants that there are podiatry gatekeepers screening these "lucrative" hospital jobs, those jobs are only going to offer 250-280k a year.

Opening your own practice, which has been the tried and true method since the dawn of our profession, is going to be the best bet for making good money and does not require the RRA cert. Nor will you want to do a lot of RRA anyways since 1) it doesn't pay well 2) it's too time consuming for aftercare to be worth it.

 

[Pronation]

these "lucrative" hospital jobs, those jobs are only going to offer 250-280k a year.

wat

250ish is just the base. If you’re busy it’s pretty easy to bonus another 50-100k. There’s a reason why every time a hospital job goes up that they get over 100 applicants instead of these people just opening up their own practice.

 

[heybrother]

I am first year resident and I recently found out I was only taken for PMSR even though I applied PMSR/RRA position. Will just PMSR limit me or should I transfer to another program for PMSR/RRA? Will I Ben able to do everything with just PMSR? Thank you and I look forward to your counsel.

(a) What happened to you is supposedly a NYC game that some of the programs play ie. playing favorites, making people fight to be the RRA vs the PMSR resident. There's only 1 program outside NYC that is PMSR anymore.

(b) Presumably, you are PMSR because there are only so many cases to be done ie - they have enough RRA cases for some residents, but not for you. Probably they simply don't have enough cases to begin with. PMSR to me screams the hospital has plenty of work but not enough surgery. You may feel differently but you should remember it only takes 50 cases to meet the RRA requirement.

(c) The time to limit your education and opportunities is not as a first year resident.

(d) Established people can say and believe whatever they want, but when it comes to hiring - you are setting yourself up to be apart of a tinier and tinier group. Everyone else will at least have RRA training even if they aren't RRA certified. I'm skeptical that the only thing missing in your training will be the cases.

(e) No one else in the country thinks PMSR should exist other than Albama. It screams NYC.

Anyway. Your residency is screwing you and setting you up to be a second class citizen for the rest of your career. They were supposed to be your advocates. Transfer.

 

[Boba Foot]

PMSR to me screams the hospital has plenty of work but not enough surgery

Correct.

 

[Reverdin green]

(a) What happened to you is supposedly a NYC game that some of the programs play ie. playing favorites, making people fight to be the RRA vs the PMSR resident. There's only 1 program outside NYC that is PMSR anymore.

(b) Presumably, you are PMSR because there are only so many cases to be done ie - they have enough RRA cases for some residents, but not for you. Probably they simply don't have enough cases to begin with. PMSR to me screams the hospital has plenty of work but not enough surgery. You may feel differently but you should remember it only takes 50 cases to meet the RRA requirement.

(c) The time to limit your education and opportunities is not as a first year resident.

(d) Established people can say and believe whatever they want, but when it comes to hiring - you are setting yourself up to be apart of a tinier and tinier group. Everyone else will at least have RRA training even if they aren't RRA certified. I'm skeptical that the only thing missing in your training will be the cases.

(e) No one else in the country thinks PMSR should exist other than Albama. It screams NYC.

Anyway. Your residency is screwing you and setting you up to be a second class citizen for the rest of your career. They were supposed to be your advocates. Transfer.

Would you advise to transfer now or wait until end of first year to transfer out?

 

[Adam Smasher]

Would you advise to transfer now or wait until end of first year to transfer out?

Look around for open positions. If you can knock out your off-service rotations first year then it won't matter as much. Obviously if a good thing materializes, you'll want to move on sooner.

 

[heybrother]

Would you advise to transfer now or wait until end of first year to transfer out?

We are essentially asking you to move heaven and earth. I don't know if you can transfer. I don't know if you can find a spot. I don't know if doing this will result in you have to repeat a year. But it has to be done. Most people try to complete a year in the hope that they can transfer and start as a PGY-2. All I can say is - do what you have to do. I'm personally of the opinion that a lot of programs have the RRA and are still meh, but those letters could open doors in your future.

This whole thing is very distasteful to me because a few years ago - none of the PMSR programs could really fill their spots. One of the notorious mixed programs in NY literally filled like ..2 of the RRA spots and nothing else they had. It felt like a brighter future, but only for a moment. The closer the graduating class size is to the number of residency spots the more likely someone is to get screwed.

 

[dtrack22]

This whole thing is very distasteful to me because a few years ago - none of the PMSR programs could really fill their spots. One of the notorious mixed programs in NY literally filled like ..2 of the RRA spots and nothing else they had. It felt like a brighter future, but only for a moment. The closer the graduating class size is to the number of residency spots the more likely someone is to get screwed.

The question people should be asking is, why does CPME allow for PMSR spots to exist in 2023?

There is an accrediting body who could get rid of them and then none of this would be an issue.

 

[podiatryresident]

Would you advise to transfer now or wait until end of first year to transfer out?

Transfer asap!

 

[newfeet]

I am first year resident and I recently found out I was only taken for PMSR even though I applied PMSR/RRA position. Will just PMSR limit me or should I transfer to another program for PMSR/RRA? Will I Ben able to do everything with just PMSR? Thank you and I look forward to your counsel.

If you want the RRA you should transfer. I have only the PMSR but I also applied for a pms-24 program and chose to stay for the
PMSR. I’m content. You might not be.

 

[DYK343]

Depends on what you want.
If forefoot cases and chip and clip is what you want to do then it (this can be insanely profitable in the right setting).
Bunions and HT's are easy. No call and off at 5pm every day.
Dont need an over the top residency for this.


That's a good life. Sometimes i'm jealous of my colleagues who live this life.

 

[DarkPathMedicine]

It really depends on what you want to do and your future goals. Credentials with RRA can open you the doors to different opportunities, but doesn't necessarily mean it's better. Better for some, not better for others. I have colleagues who are also PMSR/RRA and they aren't doing any ankles/rearfoot stuff and are happy with just forefoot stuff. Success in this field is not based on your credentials as people with PMSR can do really well too. Sure, RRA opens more doors, but what doors are you really looking for? It all depends on what you want to do with the RRA.

 

[Hybrocure]

It really depends on what you want to do and your future goals. Credentials with RRA can open you the doors to different opportunities, but doesn't necessarily mean it's better. Better for some, not better for others. I have colleagues who are also PMSR/RRA and they aren't doing any ankles/rearfoot stuff and are happy with just forefoot stuff. Success in this field is not based on your credentials as people with PMSR can do really well too. Sure, RRA opens more doors, but what doors are you really looking for? It all depends on what you want to do with the RRA.

Agreed. I am PSMR/RRA and don’t bother with anything proximal to the TMTJ in practice. It’s just what I want to do. I make zero use out of my RRA and don’t plan to ever use it.

 

[DarkPathMedicine]

I sometimes feel like they should get rid of PMSR altogether or shorten it to just 2 years, while keeping PMSR/RRA to 3 years. Podiatry residency doesn't need to be long, IMO. It can actually be reduced down to 2 rigorous years, that is, with less graduates and really quality candidates. Definitely it should not have any 4 year RRA programs like some dumb NY programs that we still see today. I'm amazed something like this still exists even today.

 

[podiatryresident]

If you want the RRA you should transfer. I have only the PMSR but I also applied for a pms-24 program and chose to stay for the
PMSR. I’m content. You might not be.

you saved 1 year! good trade

 

[msion]

PMSR only means you will be a second class citizen in the residency program. You definitely don't want to be a second class citizen in an already second class citizen profession.
In the real world how much of a difference it would make? Not much IMHO. But you want to be exposed to all aspects of podiatry during training, and then selectively practice your skills in the real world.
Times are different. You won't be able to learn to do rearfoot/ankle cases on the job like how Shuberth learned to do TARs by trial and error.

 

[FutureDPM323]

You already have slim opportunities as it is. Don’t have a bunch of doors close on you because of the training you got. Sure you’ll probably be fine with just PMSR but why risk it or chance it? Transfer programs.

 

[DarkPathMedicine]

Back in the days when there was a shortage of residencies available, PMSR positions were competitive and usually filled. Candidates didn't have a choice. I believe that's no longer the case and there are more graduates than needed and an excess numbers of residency positions available. You should aim for RRA if possible as there should be excess positions available. Depending where you go, it's still 3 years to complete. Transfer if you can, assuming that's what you want to do.

 

[diabeticfootdr]

I am first year resident and I recently found out I was only taken for PMSR even though I applied PMSR/RRA position. Will just PMSR limit me or should I transfer to another program for PMSR/RRA? Will I Ben able to do everything with just PMSR? Thank you and I look forward to your counsel.

DM me, if you were promised a different program or didn’t apply for it, you should complain to CPME.

 

[diabeticfootdr]

Fine, more than 2 words.

What you cover and what you don't cover will be up to your director and your seniors. Where this limits you on paper is that you will never have an RRA credential, you will be ineligible to sit for ABFAS RRA boards, and that locks you out of certain employment opportunities down the road. You'll still be able to apply for "core podiatry" privileges at hospitals/surgery centers and do forefoot work. If calcaneal osteotomies and ankle fractures, etc are within your delineation of privileges, you can even do that, provided you have the skill for it, if not the training.

To the OP: Not only that, you’d never be able to do ankle surgery in Oregon. And probably a number of other states if they start adopting similar administrative rules. This is regardless of your board certification.

 

[diabeticfootdr]

Would you advise to transfer now or wait until end of first year to transfer out?

I would wait. Because the programs left are probably not the best. But a 2/3yr spot might open at a good program for any number of reasons.

CPME really needs to publicize a list of these, but they don’t.

 

[newfeet]

you saved 1 year! good trade

No I did the 3rd year. I was the first one to do it at my program.

 

[Reverdin green]

I really appreciate you guys taking out your time to offer counsel.

 

[DogSnoot]

I would wait. Because the programs left are probably not the best. But a 2/3yr spot might open at a good program for any number of reasons.

CPME really needs to publicize a list of these, but they don’t.

How do residents in this position find out about open spots ? I assume just by cold calling and asking friends?

 

[Reverdin green]

How do residents in this position find out about open spots ? I assume just by cold calling and asking friends?

I emailed some of the programs I interviewed at if they got open spots for RRA. So far only heard from one program.

 

[Weirdy]

I emailed some of the programs I interviewed at if they got open spots for RRA. So far only heard from one program.

Reach out to your classmates if you're on good terms with them.

 

[diabeticfootdr]

How do residents in this position find out about open spots ? I assume just by cold calling and asking friends?

That’s what I meant about CPME needs to publish a list. Because … yes … word of mouth [emoji2359]