trouserz

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i cannot even ponder why anyone would want to look at just feet their whole life.
 

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For the same reason that I can't ponder why you as a nursing student are willing to clean up somebody's **** for the rest of your life. If your lucky you might be able to go for a grad degree in anestesia, but I've been hearing that the MD's are closing that space up since there are too many nurses that accidentally kill their patients. I have looked at some of your recent posts and doubt that you even go to college. Tell me,"Genius," what do you think a denstist, cardiologist, and proctologist look at all day? This is not cutting on nurses at all, but just pointing out how stupid you really are. Healthcare is not a "palm reading" field. Most of us get down and dirty. Just make sure you prep those feet for me before I do surgery!
 

efs

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Personally I cannot ponder why anyone would want to spend their lives in an office or a cubicle or slaving over a computer. The long term effects and gains of this type of work just boggle my mind. Being able to see a patient who will likely walk out of the office with less paint han they came in iwth is definately gratifying. Being able to see the results of our efforts immediately is satisfying. Being able to do some good is worthwhile.

I worked as a nurse for a while before I decided to do this, and I definately feel good about my decision to pursue this line of work instead. Much better.

Glad to answer questions.

P.S. I also spend a few years working as a medic in an infantry battalion. Saw lots of feet then, but mostly only palitative care. With what I know know, I think I could have made many more lasting benefits for a lot of people.
Podiatry offers me a lot of what I want and avoids much of what I do not want.
If you are interested I can expound.
 
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efs

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trouserz - You obviously don't have any idea what you are talking about.
 

efs

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You really ought to feel ashamed of yourself for that comment.

Sort of like DO = Chiropractor.

Being a student at DMU, I would expect you have had an opportunity to interact with the DPM students in your classes. You ought to know better. In fact, why don't you find out a bit more? I think you may be able to arrange doing a rotation with Podiatry. It's an opportunity not available at other schools. You might find it interesting. (I think you'll have to wait a year or two though, until you know enough to work in the clinics.)

Study hard. But take the time to look around you also.
 

vietcongs

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I was just playing, efs! No need to take offense. I love DPMs, I go to class and interact with them every day. I was just being silly. Sorry if you took it the wrong way.
 

efs

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vietcongs

I have thick skin, and the comments don't bother me at all personally. I take a lot more than that into consideration.
However, this is a public forum, and I do not know how others would respond to such comments. I just felt it was inappropriate.

:)
 

John DO

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Sorry to trespass on your forum, but a friend just decided to go to DPM school, so I was curious. I am unsure about why the feet warrant a special degree of medicine that is not funneled through unlimited practitioners. Every other specialty requires first attending medical school, then specializing (except pseudo-doctorates like chiropractic or optometry--that's gonna ruffle some feathers). Since podiatry entails surgery, i would think the practitioner would require a background in general medicine. Do you obtain the cliffs notes version of medicine while in school? If not, how in the world can you study feet for 4-6 years, or however long it is? They are feet; what can you possibly be learning about them for THAT long?
 

efs

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Good questions. I'll try to give you the short answers.

Why do we have podiatry outside of "regular" medicine? For similar reasons to why dentists fall outside of the "regular" paths. Years and years ago, the "Doctors" did not want to deal with the feet, or the teeth. For that matter, they did not do surgery either. So we had barber-surgeons who did the "surgery" (mostly minor, since there was no anesthesia), pulled teeth and treated corns and other foot ailments. Over time, these developed into dentistry, and chiropody. With developments in anesthesia and aseptic techniques the MD types found that acceptable surgical results could be had. The history on some of this doesn't go back as far as you might think. Antibiotics weren't really seen until World War II. Modern orthopaedic surgical techniques were established in the late 1950's by the AO (Arbeitsgemeinshaft fuhr Osteosynthesfragen). Chiropodists began their national organization just after the turn of the century (before the Flexner Report on medical schools). The decision to formally change the name to podiatry was in the 1950's.

Hopefully that gives you a little to consider.

Since podiatry entails surgery, i would think the practitioner would require a background in general medicine. Do you obtain the cliffs notes version of medicine while in school? If not, how in the world can you study feet for 4-6 years, or however long it is? They are feet; what can you possibly be learning about them for THAT long? ••

Don't take my answers to this in the wrong way, but I do like to use sarcasm.
Your thinking in the first sentence is quite accurate. We do have a general background, but also spend more time with our specific area. I highly doubt that we obtain the cliffs notes version of medicine while in school. At Des Moines University our first year courses are taken with the DO students. There are a couple of differences, we take intro to podiatry and biomechanics 1; they take intro to osteopathy and OMM. A couple of other minor things, but not anything significant. So, unless the DOs are also receiving a cliffs notes version . . .

They are only feet, what could possible take 4-6 years to study them. How long does it take a cardiologist to learn about the heart? How long does it take the dentist to learn about the teeth? How long does it take the optometrist to learn about the eye? For that matter, why should we need ophthalmologists? Aren't they just doing the same thing? Many PhD's take longer than 4-6 years, and their topic of study is usually much more specific.

To be more specific:
A fair amount of time is spent on biomechanics. Can you tell me specifically how your foot works during the gait cycle? And why? Now think about an abnormally functioning foot? How is it best treated?
Lower limb anatomy. The course we took with the DOs in the first year was Gross Anatomy. In the second year we cover Lower limb anatomy as a dissection lab course. In much more detail than in gross, not an easy course. Lots of variations. Lots of stuff we did never covered in gross.
Dermatology. There is a bit of this on the feet.
Radiology. Lots of bones in the feet. Also cover things like CT and MRIs. Of course it helps to really know anatomy. Are you looking at a pull-off fracture or an accessory ossicle?
Diabetes. This is a huge area. So it generally gets some attention in every course we take. Neuropathy causes huge problems for these people, among other things. No need to make a list.
Surgery. There are literally dozens of ways to fix a simple bunion. How do you know which technique will work for which patient? Why were all these different techniques developed? Wonder if that biomechanics stuff might have anything to do with it?
Trauma, and emergency medicine. Crush injuries, falls, gunshot wounds, etc.
Sports medicine. Last time I looked, most sports rely on the foot in some manner. Lots of injuries here too. Is it a sprain, or a fracture?
Gerontology. Old people have feet too. Most of them anyway. Know what most old people fear most? Loss of independence. Know a quick way to get to loss of independence? Have a hard time walking?

Essentially everything the podiatrist does can and is done by someone else. Sure, your FP can do a nail avulsion or a matrixectomy. The orthopaedic surgeon can do a bunionectomy. The dermatologist can treat tinea pedis, erythrasma, etc. The ER doc might treat your ankle sprain.

Of course the FP might also deliver a baby, but wouldn't you prefer the Ob-Gyn to do that? The ER doc knows what to do with an MI, but don't these people usually get seen by a cardiologist at some point? Etc.

Hope this gives you a bit to think about.
 

sandj9397

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That is a good question and eric did a great job answering it but the problem is that dentistry had done a helluva better job remaining a distinct profession while podiatry is barely staying afloat. With horrible declining admission numbers and decreasing reimbursement, HMOs find their competitors much more affordable and podiatrists are struggling. The current reality in podiatry is that if you do not complete a surgical residency you will not survive.Why? Becuase no surgical training= no insurance panels= loan default. This stuff truly bothers me when I know first hand how excellent this profession is. They really should find a way to merge with mainstream medicine and medical education(MD or DO)to boost up their admissions(higher qualified students) and complete the equal medical training as any medical specialist would to obtain respect and financial reward that the profession deserves. It is not fair that podiatrist go through 6-8 yrs of training to be lucky to land a job post residency salary over 75,000 which is considered top. This is why podiatrists have the second highest default rates on their student loans behind only chiropractors with MD/DOs far behind.
But of course, merging would mean the loss of jobs and power to those in the APMA and schools. So who knows where the profession is headed. I know merging with a caribbean school to obtain an electronic medical education is not going to help besides perhaps roping in several more unsuspecting students. The profession needs change. Hopefully, for the better.
 
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sandj9397

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You know what is also strange. The length of podiatric medical training has increased over the years( for ex: residencies in podiatry where virtually unheard of 20 yrs ago). But, their scope of practice has remained the same for 30 or more years. This hasnt happened in dentistry. If they were able to do it twenty years ago with just 4yrs ofd school and office preceptorships and do well why is it needed now? It seems to be of no benefit but putting DPMS in a larger financial hole. Sorry for all the rambling guys. Just some of the things that were picking at my mind while i was a student at pod school
 

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Thanks for keeping the forum alive. I know that there are people that are interested, but just dont write. Anyway, I have a problem with the following statement: "This is why podiatrists have the second highest default rates on their student loans behind only chiropractors with MD/DOs far behind," I would like to add that the overall default rate for William Scholl College is like 0.8%, and it has been 0.0% for the last few years........They must be doing something right.

The U.S. Department of Education reported in September that the national cohort default rate on student loans has fallen to the lowest rate ever -- 5.6% for fiscal year 1999 ? and that the Dr. William M. Scholl College of Podiatric Medicine rate stands at 0.0 percent, the lowest in the nation.
"This means that none of our borrowers who entered repayment during the reported period defaulted on their loans," said Carmelita Gee, director of financial aid at Scholl. Last year the college's cohort default rate was among the lowest in the nation at 0.8 percent.
"This exceptional default rate is an indicator that our graduates are doing well," said Dean Terence Albright, noting that our default rate is also the lowest of any college of podiatric medicine. "It also supports all the effort the financial aid staff has put into their default management programs. Default prevention strategies such as ours increase borrowers awareness of their repayment obligations and educate students on the various repayment options available to them."
 

efs

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Glad to hear that.

Hope more of you and your classmates would be more active on this forum. I think it has lots of potential. Especially because this board is active with lots of other students. Our issues deserve to have a broader spectrum. The more people are aware, the better off we all will be.

Thanks.
 

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Well,thats fantastic. Your school should share their secrets because I am positive this not the case for the profession as a whole. These are the HEAL(Health resources and Services Administration) default rates by medical discipline as of 9/30/99:

Osteopathy: 1.9%
Allopathy: 1.9%
Chiropractic: 14.5%
Dentistry: 4.3%
Optometry: 2.6%
Veterinary: 3.1%
Podiatry: 5.8%

Does Scholl have a large endowment. How large are the scholarships awarded at the school. Becuase if their rates are the lowest in the nation, what does that say for the other 6 podiatry schools and their default rates if the national percentage is close to six.
 

efs

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I think the 5-6% number may be a little skewed. With roughly 500-600 graduates between all the schools we are looking at an absolute number of around 25-36 students who default. I think this is about 25-36 too many, but it might put the numbers into perspective.
I have to guess and make up a numbers. Lets say 10,000 MD graduates/year. At about 1.9% the absolute number would be 190.

My point is that there are so few DPMs that the individual characteristics make a greater difference. These things may or may not have anything to do with DPMs as a population. How many of that 5% make poor financial decisions? Would this type of person have made the same mistakes if they were in a different type of program?

As an example, any of your classmates buy a new $30,000 vehicle? Do you htink this type of decision making might impact that individual's potential default rate? That one person makes about a 0.2% difference on the overall rate for DPMs. If it were an MD in this example it would change their group's rate by 0.01%.

Because of our small numbers each individual makes a greater impact on the whole.

I think the individual's characteristics have more impact on default than anything particular to the profession.
 

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Yes, as far as what I know, Scholl has a huge endowment program. I know that the name change from Illinois CPM to Scholl CPM set up a large scholarship program (like $5-$10 million in the early 80's) and this amount gets added to each year. I would say that about 1/4 of my class get half tuition scholarships and the rest may be getting a few bucks here and there, with just a few full rides each year. On a side note, do your schools teach, lecture, or even bring up being in the real world? At Scholl, we do have a practice management course, which at least exposes us to the horror of what we have gotten into. As for individuals, most students have a pretty good head on their shoulders...no new cars etc, but living in downtown Chicago is not cheap. Also, I would say that almost 1/2 of my class is married, with working spouses. And of course, there are a few I feel sorry for, who went to private undergrad schools and have accrued $100k ever before setting foot on campus. Anyway, just my 2-cents.
 

sandj9397

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With a profession as small as this one it is still way too many. Im not sure if this applies to just one graduating class of 500-600 people anyway. Plus with such a small group of graduates each year, podiatry has no excuse allowing 20-30 people to fall in financial ruin with a network of 15,000 to support them. I think its the professions inability to improve the public knowledge of podiatry, and effectively lobby to improve the profession's financial lot. Particularly for those who are not surgical trained. Where is this magical baby boomer money bull**** they put in their propaganda pamphlets?

Eric, I know you are a student who is trying to remain positive and optimistic because this is your future. You have shown a sincere love and willingness to be a podiatric physician. IBut ,I am sure you are aware of the negative trends in podiatry that are not improving anytime soon. There is so much negativity and bashing on the podiatry forum( Network 54) that its scary. There is no surprise that noone is applying to podiatry schools. I just can not believe that anytime someone fails financially in podiatry it is always there fault.WHY DOES NOONE SAY WHAT THE F#$% ARE THOSE IN CHARGE DOING TO IMPROVE OUR FUTURE? or help those who did fault? It has become too cut throat in podiatry and the new pod is pretty much on thier own. It angers me because I know there has to be some solution and noone seems to care. Personally, I believe podiatry should merge with mainstream medicine, increase their training and change or combine their initials with MD/DO. It is not like podiatry is a different "philosophy" Its basically allopathic medicine in many facets.

This section is also quiet, no pre med students seem to have interest in podiatry Especially not the DPM students. Just 2 topics, podiatry's history and someone claiming DPMs have a foot fetish. Hey DPM students, do you guys see anything substantial coming out of that magazine they sent us or from student council meetings. Besides assigning some APMA brass to some bull**** position to address the application crisis.

Sorry, I lost my temper. But with they way the profession does nothing to take care of its own,ex: Brian Gale. How can anyomne sit there and say everything is ok. Maybe it is for those who do well academically and land strong surgical residencies. But what about the lower third who struggles. The third who will not land a surgical residency. What insurance plans will they get on? Perhaps, they should no be in pod school in the first place. Victims,who unknowingly take out thousands of dollars in loans to hungry schools desperate for students. Wheres the morality here? They know some of these students cannot handle a medical school curriculum. But that will not stop them. I have seen students who I would question can handle a basic undergraduate education.
There are so many questiions this profession has too answer. As a student, you are too overwhelmed with your schoolwork to really be aware of the professions status quo. Automatically you will defend the profession and dismiss any negativity as the rantings of those who did not succeed in podiatry.

All you students who have doubts about podiatry's future are not wrong in feeling this way. Please speak to as many podiatrists as possible. They are the best source of information. A school might not be the best idea. Remember, they need you in that seat and your money.
If you still feel comfortable, thats great! Study hard and good luck. You can succeed in podiatry if you are tough , aggressive,lucky and work your ass off. But, if you feel podiatry is no longer for you, then look for other options. Do not feel you HAVE to stay because schools will do everything in their power to keep you. Theres no evil if you decide to leave and pursue other roads in medicine or in life. I know because I was one of those students who decided to leave. A decision fueled with my own desire to want more in medicine combined with the advice of podiatrists.

I might of went a little overboard. Sorry, but no one else is talking besides eric and the message. I know otherpeople read this section of the forum, especially pod students. Someone else must have an opinion or suggestion. Stop hiding and show yourselves. Represent podiatry to the rest of the premedical and medical student community on this site.
 

sandj9397

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Stupod,
NYCPM does not have that type of endowment I am sure. Top students are lucky to obtain 15-20% in scholarship money.
 

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Hey guys,

I was just cruising through here and read your discussions. I must say that podiatry is an important discipline and although I don't know enough to have formulated some sort of informed opinion, it sounds like what is happening is very unfortunate for the profession. I think podiatrists are important because, as efs mentioned earlier, everyone has feet, and if they're not working properly, well...
Sorry I don't have anything insightful to add, but I just thought I'd make my presence (and interest) known about this forum. I look forward to visiting again soon!
 

sandj9397

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Well I am just trying to spark up conversation. I could not agree with you more timmy,podiatry is a great profession that will have to change in some way. I hope for the better. Its not fair that you take out all that money for a medical education and worry about your future and how you will pay back loans. The schools and the APMA have to arrive at an effective plan to revamp podiatry and their educational system. Lets get some american students in these schools too. Stop taking in large numbers of foreigners and foreign trained MDs who could not cut it here into the schools to fill seats. Anyone at NYCPM knows what I am talking about. It looks like Brighton Beach. I am not saying foreigners should be excluded. But when they make up 25-50% of a class' population then that is odd. Oh, who believes a medical degree obtained via the internet will hold any weight in this country. What the hell are they thinking? Try to add a possible combined masters degree in public health or business.
 
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