Podiatry?

[neoevolution]

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How does podiatry make a 3 year surgical residency work? Even optho is 4 without fellowship and ortho is 5. What exactly is the surgical scope?

 

[GypsyHummus]

Actually, as a first year Pod student at WesternU, our curriculum is intimately integrated with the WesternU DO program. We take all of the same core classes including Gross Anatomy, Neuro, Renal, Derm, Cardio, etc. We attend the same lectures in the same room and sit next to our DO counterparts to take the exact same exams. Most of our classes include multiple clinical cases pertaining to the class we are in that we complete with integrated small groups. These small groups consist of 2 or 3 podiatry students grouped with 5 to 7 DO students. We work together to complete assignments and quizzes, basically to test our knowledge of the subject matter. We do also have our own podiatry core classes additional to the DO core classes. The DO students take OMM and ISSM (essentially an ongoing general health and intro to medicine class) that the pod students do not take. It seems to be partially true that the programs with a 'podiatry only' curriculum may have less of an emphasis on subjects not pertaining specifically to podiatry, but this is not the case at the podiatry program here at WesternU.

I believe it's important as a medical professional and as a surgeon (all podiatrists are surgically trained in the foot and ankle) to have as complete of a medical education as possible to ensure the best patient care. Podiatrists will perform surgeries similar to orthopedic surgeons who specialize in the foot and ankle, so it makes sense that we would need an excess of training to ensure the best outcomes. Also, just as an example, many podiatrists are specialists in diabetes due to the effects of diabetic retinopathy, ulcers, limited healing, and amputations on the foot. Diabetes, as most people know, is a systemic disease with many symptoms that are not limited to the foot. Having the education and training associated with the entire body will likely lead to a better understanding of all the potential effects diabetes can have on a patient. At the very least, this additional knowledge will allow a podiatrist to recognize early signs of other potential conditions and refer patients to the proper specialist, therefore reducing overall health care costs and better yet, yield a healthier outcome in the long run for patients.

These are my personal opinions mixed with facts, so I'd welcome any further questions about podiatry or WesternU.

Are there people in the pod program that ever transfer over to the DO program or vice versa?

 

[Frazier]

How does podiatry make a 3 year surgical residency work? Even optho is 4 without fellowship and ortho is 5. What exactly is the surgical scope?

Everything below the ankle... from clipping toenails to amputations.

 

[bobtheweazel]

How does podiatry make a 3 year surgical residency work? Even optho is 4 without fellowship and ortho is 5. What exactly is the surgical scope?

"Surgical residency" is a commonly used, but misleading term. It's really a podiatric medicine and surgery residency (PMSR). And like any other doctor, podiatrists work well outside of their scope during residency. For all that, three years isn't too long at all, but it's probably just about right. A handful of programs have even started 4 year residency positions, but 3 year positions are still the overwhelming majority.

The residency includes rotations through anesthesiology, dermatology, emergency department, internal medicine, infectious disease, orthopedics, pathology/lab, pediatrics, radiology, rehabilitation, rheumatology, general surgery, trauma, vascular surgery. Of course the specifics of these rotations depends on the hospital, but most residencies include all but a few of these rotations and some include additional rotations (like psychiatry).

Then of course there are all of the foot and ankle cases done through podiatry, orthopedics, or whatever various other departments (surgical and nonsurgical).

In regards to surgical scope of practice, that depends on the state. There are still a few states in which podiatrists can only operate on the foot, below the ankle. In most states they can operate up to and around the ankle. Many states also include the leg (below the knee) in their surgical scope. And in a few states you can technically do some procedures on soft tissues of the thigh, but I think they mostly just use this for autografts or to treat varicose veins. The actual surgery could be on bone, on blood vessels, on nerves, on muscles, on tendons, on ligaments, etc. It's a regional specialty, not a system based specialty, so literally any piece of tissue below the knee (or ankle) is fair game—including amputations of toes or parts of the foot.

For medical scope it's mostly limited to treating local pathologies and local manifestations of systemic pathologies—a lot of conservative orthopedic stuff and a lot of lower extremity dermatology. Of course in many cases treatment may involve prescribing medications that have systemic effects (pain meds, gout medication, etc), but as long as the primary pathology is within the foot or leg then it's all good.

 

[W19]

@PashaOdesit Welcome to the real world!