I heard that most of them end up working for regional companies who just do nursing home care…
More like 99.9999%Just remember that to 90% of your future patients, where you did residency doesn’t mean beans.
Yeah this is accurateMore like 99.9999%
Yes, this is 100% correct. You always want the max training. It is foolhardy to limit yourself.Nobody cares where you did your residency. You are still a podiatrist.
The only thing that matters from residency is if you got good enough training to do everything possible from conservative care to a surgical reconstruction of foot, ankle, leg.
If you did then your practice will have no limit allowing you to earn as much money as possible. That is the name of the game. Those with limited training limit their earning potential. PROVE ME WRONG
Just remember that to 90% of your future patients, where you did residency doesn’t mean beans.
Yes, this is exactly what it is:... it will probably depend on a specific Podiatrist at a specific facility if they’re discriminating against people based off of where they did their residency...
Great post Feli. No more IHS??Yes, this is exactly what it is:
It is business owners/partners in podiatry PP, hospital DPMs, ortho group DPMs, MSG DPMs, etc who are generally in charge of the hiring.
However, it is not specific facilities and is not the minority... it is the majority of groups/facilities. Also, it's not discrimination; it is merely preference to metrics and considering historical success of training since they're trying to predict success from the hire. It would be just like if you were hiring an office manager for a large podiatry group... if you had some candidates with training from Wharton or Brown or Harvard... and some without, which would you prefer? If you had some with exp in running other large medical or even podiatry groups and others without, which would you prefer? If some had their MBA or CPC or BA while others didn't, which would you prefer? It is not discrimination... it's simply about finding the person who is likely to do the best at the job.
I have had plenty of jobs where I was knocked out of the interviewing at some point in the process for the same reasoning (not enough exp, not BC yet, other candidates with better residency/fellowship than me or same training place as the hiring DPM, they picked a candidate who grew up in the city, not enough published research, etc). Likewise, I have discarded dozens of applications for spots at my past PP and MSG jobs for the same reasons when I am helping them screen for interviews of the ones that are most likely to get full area hospital privileges, will have maximal patient offerings, and do well in the group. There is simply no way or desire to interview them all, and there will always be filters. Sure, you will see primary care DPMs, minimally trained, etc in hospitals/MSG... but you have to realize many of those weren't hired to that situation... they were already there when the group was bought out by the supergroup or hospital.
The same logic goes for hospital privileging: it will almost invariably be a DPM gatekeeper who is fairly well trained - or at least delegates the credentialing to one who is. The hospital part can get a little more complex in some competitive places where even somebody who did UPMC residency and Cottom fellowship still won't get ankle privi or ankle referrals just because of the area and politics or because they're DPM not MD, but those are getting a little more rare.
...I say it all the time, but it is not a death blow to do an average or even poor residency. It is fairly restrictive to fail ABFAS, though. If a DPM ends up in one or both of those situations, they just have to get more creative. Solo practice typically becomes the best option (since the other main road is the associate mills). Most hospitals and MSG are off limits (for gatekeeper reasons above), but they can keep trying and trying and look for one that has never had a DPM before or one that has trouble finding/keeping a podiatrist (usually rural or VA/IHS). You will find the occasional group that is expanding fast and just needs bodies. They can try to play the hometown card in their home state or near their residency area, they can network and network and network more to find a group that might need their skill set, or they can even try to undercut on salary to see if a group will bite despite subpar CV. Those methods can work, and I have seen it done with success many times. It is sometimes just a matter of being in the right place at the right time. No doubt. The guy who trained at Coney Island and is working in an ortho group (doing surgery, not just orthotics and injects) is definitely the exception and not the rule, though. So, in the end, it is always better to never put yourself into that uphill battle to begin with... and Inova is one of the programs that will ensure you don't start off with one hand tied behind your back.
I tend to agree with you. In my experience even many pod attendings aren't up to date on which programs are good. I went to a historically very strong program that was below average to terrible in a lot of ways during my time there. The vast majority of the pods I interviewed with assumed my program was still as amazing as it was in the 80/90's and especially the older pods immediately assume my training was the best. Even alumni from my program had no idea how far it had fallen.Inova has been producing strong DPMs for a long time. I would rank the program if its a good fit.
If I were in charge of hiring our next DPM and an Inova grad put their name in the bucket they are getting an interview. But thats because I know several Inova grads and I respect all of them. I know they trained well.
If I were a non podiatrist hiring it wouldnt matter because I have no idea and I would pick the yale DPM grad for the interview.
In my experience even many pod attendings aren't up to date on which programs are good.
Ya, it wasn't for me.Great post Feli. No more IHS??
Yes, this is a very key point.I tend to agree with you. In my experience even many pod attendings aren't up to date on which programs are good. I went to a historically very strong program that was below average to terrible in a lot of ways during my time there. The vast majority of the pods I interviewed with assumed my program was still as amazing as it was in the 80/90s...
Don't get me started on this crap. I graduated from a good program. Have close to 5 years of experience. Done thousands of cases from toes to TARs. Board certified in foot and ankle/rearfoot. Built a program at hospital from nothing to a 1000 RVU a month practice.Same idea applies with a fellowship, a pod with a fellowship is immediately superior to a pod without one, to some in the non podiatry world.
He is just talking about non-DPMs evaluating podiatry CVs. The majority of them will be intrigued by a fellowship.Don't get me started on this crap. I graduated from a good program. Have close to 5 years of experience. Done thousands of cases from toes to TARs. Board certified in foot and ankle/rearfoot. Built a program at hospital from nothing to a 1000 RVU a month practice.
Please tell me how a fellowship trained DPM is superior to me? The answer is........they are not.
Was not feeling attacked. Just saying that fellowship trained DPMs are not special. And they are not more experienced or better surgeons than 3 year trained DPMs who did a solid residency, board certified, and have significant clinical and surgical experience in practice.He is just talking about non-DPMs evaluating podiatry CVs. The majority of them will be intrigued by a fellowship.
He wasn't attacking you though... simply saying that Joe Blow, HR MBA might think Suzanne Ivy who did "Harvard" residency 3yrs and then a 1yr fellowship is better than Becky Plain who went to Swedish residency 3yrs and direct to practice. Sure, anyone in podiatry with half a brain would give strong preference or higher offer to the latter, but that's not the case for MD/HR types - and even some DPMs who are out of touch with training.
And yes, fellowships are bogus... we all know that. The very fact the the majority of fellowship directors are 2 or 3yr trained with no fellowship themselves tells you that fellowships are superfluous. The only couple dozen fellowship spots worth doing are taken by graduating residents who don't need them (already did name programs... already very good surgeons... already highly competitive for good jobs) just to pad CV and compete best for ortho/univ/lecture jobs. The other remaining fellowships are not too useful and basically only for people who did a subpar residency to get more cases or wanting "fellowship-trained" on the CV.
My residency class in 2012 was the second-to-last to not even apply for fellowships. We had one of the longest running good surgical programs 40+ years where nobody had done a fellowship afterwards (besides some mini-AO). Nobody needed to. Soon after that, some people from my program caved in to the trend and were doing fellowship, some residents I trained from other very good Michigan programs were doing them and asking me for fellowship rec letters, etc. l honestly think that, for many of them, they didn't find a job they wanted and just took a fellowship to network more and beef the CV. I know of a couple where one did a specific fellowship to try to get a job with the group that runs the fellowship. That is crazy to me... basically a one-year job internship?!?! Now, don't get me wrong, if I were an immortal vampire living 1000yrs+, then I might do one of the fellowships with a real elite surgeon I like who has a diverse refer base just to see cool stuff and for my academic interest. But we don't live forever, the training at good programs is plenty good, you can always watch videos or read articles on the oddball cases, and you have to take the training wheels off sometime.
That still doesn't change the fact that the average non-DPM might think 4yr Wycoff >> 3yr Jewish... or fellowship >> non-fellowship. Doing interviews in my last year of residency, I seriously had one southern hospital tell me that they had another candidate who did a *podiatric dermatology* fellowship and ask why I didn't do or plan to do a fellowship! No joke. I had to try to keep my composure as I explained to them that I can do anything the patients might need (and left our why that candidate was almost surely a wound wizard or derm diva who is unlikely to be able to even do a gastroc or 5th met fx well). Now, in fairness, I think that was CPME and not ACFAS fellowship, but the point is simply they don't know and like the "additional training" when doing the screening interviews and narrowing down the candidates.
another candidate who did a *podiatric dermatology* fellowship
I guarantee you that was someone from the programs who send residents to GA to sit around the Bako offices for 2 weeks. I’ve seen multiple people who have done that listing “Podiatric dermatology fellowship” on their CVs/Bios.
They aren’t “fellowship trained,” they hung out with Brad for 2 weeks. Probably partied. Maybe did coke. Either way I’m sure it was a good time. And nowhere near a “fellowship,” which is what any random hospital CMO or admin would assume. You put fellowship somewhere and they are going to have a traditional allopathic 1+ year fellowship in their heads. They have no idea and probably didn’t even bother asking the candidate to explain it.
Brad made me take care of his dog.
Then he made me feel like I owed him for being there. Instead of teaching me he talked about how much he hated his ex wife and how much money he’s made in his career, his Tesla, and talked about his boat.
He invited me to go on his boat but the day we got there it was in maintenance and he proceeded to have a melt down and scream obscenities on the dock like a child.
Then he made me anesthetize myself with local and perform a skin biopsy on myself while he watched.
Alpharetta, GA sucked terribly.
“Great experience”
That's about par for the course from what I've heard. Why would anyone subject themselves to that? No need to have be around that.