projected residency shortage for 2011

[arez10]

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I just checked my email and saw the following stats in the PM News newsletter:

With 3 months until the CASPR/CRIP match, the APMSA alerts the profession of the current projected residency data as of 11/15/2010:

Class of 2011 Applicants: 534
Prior graduate applicants: 42
Approved CPME positions: 525
Active positions in CASPR: 501
Projected shortage: 75 positions

When they report these kinds of stats, do they include or not include people who need to pass Step II? Is 14% of applicants not receiving a residency better or worse than the last couple of years?

 

[cool_vkb]

lets say that average loan is $150K

75 X $150000 loan = $11250000

I think Sallie Mae and other loan companies should start getting worried. There is no freaking logical way that these people will pay this loan if they are left without residency. its beyond affordability.

But then again if we think about it what does the loan company has to fear.These loans are backed by the dept of education.So basically its the US tax payer who will get screwed in the end.

 

[hematosis]

Does anyone know if any new residency programs are being created? What will happen to these 75 students. This is simply absurd and unethical. How can schools increase class size when the residency spots are not increasing?

 

[347932]

The APMA, COTH and the CPME are hard at work to help those of us interested in creating new residencies and new residency positions.

It is VERY difficult to do this and the numbers fluctuate year to year, so to have schools base their admissions on residency positions is virtually impossible.

Several years ago there was a shortage of graduates and some positions were left unfilled. When this happens, funding can become in jeopardy for the unfilled position and this becomes a trickle down effect to some residencies losing some slots and now there is a shortage of slots.

It is a constant see-saw situation and once again, is virtually impossible to anticipate.

There are people out there in our profession very sensitive to this issue and making a huge concerted effort (volunteer effort I might add) to correct this deficit.

Its very high on the priority list, but unfortunately, these types of things don't happen overnight and may not even happen in one graduation year.

Also, before someone points out the number of students taken in every year, and why that isn't used as a number for residency positions, well, the numbers of admissions rarely has anything to do with the numbers that actually graduate with their class. That makes it even harder to calculate the needed numbers.

I know this may not be much of an assurance, but I'm just trying to offer some explanations.

 

[cool_vkb]

How about 1 yr perceptorships. Folks can make a good money doing pallitative care.

 

[darazon]

EDIT: What I am really afraid about is seeing what the residency shortage numbers will be once Western starts graduating their classes. Then we will have an even more serious problem on our hands.

Dr. Harkless is busy setting up residencies in Southern California -adding more positions to existing residencies and opening up new residencies altogether. There are almost to their goal of a new residency position for every graduating student by 2013.

There is also talk of working jointly with Dr. Page from Midwestern to open up more residencies.

I wouldn't worry about Western's 30 students (might be less by 2013 b/c some are in the DPM/MSHS program) contributing to the residency shortage.

 

[KaTrInAtF4]

Perhaps either OCPM or NY should be closed down - that will solve the problem 😀

 

[darazon]

If they are close to their goal then maybe they should share their magic formula with the rest of the profession. Also, who is say that each of these graduating students will accept a "Western only" residency spot. These students have the best of both worlds...security and a chance to take a spot away from another podiatry student. Why didn't I go to Western???

I think it comes down to Dr. Harkless realizing that we can't just sit around and wait for the APMA to do something. Yes, the APMA is hard at work at it, but he felt he could do something as well. For example, he has gotten privileges at a few of the local hospitals that do not currently have residencies (Arrowhead, Riverside) Riverside will probably be a residency by 2013 and maybe even Arrowhead (we are rotating at Arrowhead next year).

A lot of our podiatry professors are either former residency directors or current residency directors -so thats helps a lot as well. Also, podiatry is very well respected in Southern California. Western has done a excellent job at marketing us in the medical community.

I hope Dr. Harkless's example will spread to the Deans at other schools and they will realize that they can do something about the shortage as well. I know Dr. Page is actively involved now as well.

You're right though, not every Western student will stay in Socal, but then that means that his/her spot that was "made" for them will be open to another student from another college.

 

[347932]

I think it comes down to Dr. Harkless realizing that we can't just sit around and wait for the APMA to do something. Yes, the APMA is hard at work at it, but he felt he could do something as well. For example, he has gotten privileges at a few of the local hospitals that do not currently have residencies (Arrowhead, Riverside) Riverside will probably be a residency by 2013 and maybe even Arrowhead (we are rotating at Arrowhead next year).

A lot of our podiatry professors are either former residency directors or current residency directors -so thats helps a lot as well. Also, podiatry is very well respected in Southern California. Western has done a excellent job at marketing us in the medical community.

I hope Dr. Harkless's example will spread to the Deans at other schools and they will realize that they can do something about the shortage as well. I know Dr. Page is actively involved now as well.

You're right though, not every Western student will stay in Socal, but then that means that his/her spot that was "made" for them will be open to another student from another college.

Those of that are interested in helping, are. The APMA is doing the best they can. One of the reasons Larry is so successful with this is he has a deep reach and can tap some potential funding sources to create these positions. Its about funding here folks, and believe it or not, its not that easy to come by.

Hospitals have to fund these new positions/programs and in today's economy, they are ALL cutting corners.

The CPME and COTH have MUCH more to do with this issue than the APMA and they are also helping a great deal. It takes time and resources to make this happen. Also, a few years ago there was a shortage of graduates which may have indirectly caused this shortage of programs. Its a balancing act. It really is.

 

[347932]

That's rather hard to believe. Who would take the chance on applying blindly to a program that was made for a Western student? Are students from other schools allowed to extern at these Western residencies? I doubt it or else this whole Western-specific residency plan doesn't really make any sense.

If a Western-only spot goes unfilled is this program really going to take a chance and accept someone who is scrambling? Doesn't seem like that would be an ideal situation for a newly created program.

Depending on how these positions are funded, the positions may ONLY be for graduates of that school.

Back in my day some residency slots were left unfilled, because the spots were funded specifically for students from one school or another and no one from that school had applied to that program. I hope that is not the case anymore, but it could be. It might be worth finding out.

 

[darazon]

That's rather hard to believe. Who would take the chance on applying blindly to a program that was made for a Western student? Are students from other schools allowed to extern at these Western residencies? I doubt it or else this whole Western-specific residency plan doesn't really make any sense.

If a Western-only spot goes unfilled is this program really going to take a chance and accept someone who is scrambling? Doesn't seem like that would be an ideal situation for a newly created program.

I'm not exactly sure how it will work. For example, Rancho Specialty residency says they are affiliated with Western right now. I have heard that they are going to change their name to Western University/Rancho Specialty or something like that. Does that mean only Western students can go?? I think preference will be for Western students, but I don't think that can outright say "only Western students allowed to apply". JMO.

 

[347932]

I'm not exactly sure how it will work. For example, Rancho Specialty residency says they are affiliated with Western right now. I have heard that they are going to change their name to Western University/Rancho Specialty or something like that. Does that mean only Western students can go?? I think preference will be for Western students, but I don't think that can outright say "only Western students allowed to apply". JMO.

Sure they can. If the funding for the positions is a grant through the School, that's exactly how it will be. Or at least that's how it used to be back when.

 

[janV88]

Here is the rest of the email...

This data includes:
Students that have failed NBPME part I

This data does not include:
Students that will not pass NBPME part II
The total number of CASPR applicants (application does not close until December 29th and we can not project students dropping out of CASPR)
The addition of new positions provided by CPME
Current position withdrawing from CASPR
Programs not entering the scramble process

 

[dyk343]

When an APMA representative came to my school to speak I immediately badgered him about this issue. He just basically said that it will be fixed by the time I graduate (2014), its easier to start pod residencies because they do not count towards medicare cap numbers for hospital residents (extra cash for hospitals for using their surgery centers), and that lots of positions are currently being set up...

Was he just blowing smoke up my @#$? Maybe. But I hope this issue is solved ASAP. Its an ugly mark on the profession and its scary to know that I could be 200K in debt with no residency. Chances of that happening are slim, but its still nerve racking to know that it *could* happen. I feel really really bad for those people that did not get a residency. They are screwed.


This is by word of mouth and I have no "numbers" to back this up, but I heard that there was an abnormally low amount of applicants this past cycle and the class sizes are smaller than usual...

 

[cool_vkb]

Sure they can. If the funding for the positions is a grant through the School, that's exactly how it will be. Or at least that's how it used to be back when.

Illinois Masonic in Chicago only accepts Scholl grads.

 

[347932]

When an APMA representative came to my school to speak I immediately badgered him about this issue. He just basically said that it will be fixed by the time I graduate (2014), its easier to start pod residencies because they do not count towards medicare cap numbers for hospital residents (extra cash for hospitals for using their surgery centers), and that lots of positions are currently being set up...

Was he just blowing smoke up my @#$? Maybe. But I hope this issue is solved ASAP. Its an ugly mark on the profession and its scary to know that I could be 200K in debt with no residency. Chances of that happening are slim, but its still nerve racking to know that it *could* happen. I feel really really bad for those people that did not get a residency. They are screwed.


This is by word of mouth and I have no "numbers" to back this up, but I heard that there was an abnormally low amount of applicants this past cycle and the class sizes are smaller than usual...

LOL you shouldn't badger any of your representatives.

There are no guarantees in life. He wasn't blowing smoke, but things can change virtually overnight with these things. Yes there is no medicare cap, but any program has to fully fund the first year of a new position or a new program and then retroactively get (some of) the funding back. If they made a profit from it, great. But some programs don't and no one wants to lose money. So they have to foot the bill FIRST.

One thing to realize is that this happens to MD students as well. Yes they are guaranteed a residency of some kind, but they graduate with the same debt we do and some of them who have stars in their eyes and want the "money making" specialties and then get stuck in a Family Medicine residency, believe me, they are none too happy. FP Docs don't really make that much, and every year the money they make seems to go down, just like ours. This isn't to justify the system you are faced with, but merely to say that others are in similar shoes even if it seems like they are not.

 

[347932]

What are you talking about???? Some pod graduates get NO residency positions while MD/DO can always resort to family medicine, internal medicine, or hell they can even do a 1 year transitional year program to increase their credentials to get accepted to a more competitive specialty.

Case in point...friend of mine graduated DO school. He wanted ENT and wasn't competitive for it. He did a 1 year transitional year program where he was paid a normal resident salary. After that program he was able to get into emergency medicine...not too shabby.

NEVER did he have to sit around and wait for a year to reapply. He had a job and was bring money in to pay his bills, etc. Podiatry does not have this option for its graduates and prob never will. Moral of story is that MD/DO students always have an option...it may not be their first choice but a job in medicine is waiting for them ANYWHERE in the US.

Trying to associate our residency shortage issues with the MD/DO profession is preposterous.

There are still parts of this country where a residency is not required to be able to practice podiatry in that state. There are also some areas where surgical residency is not required to get hopsital privileges and if you align yourself with a podiatrist who does surgery in that hospital, they can help you get enough cases to get surgical privileges.

No its not ideal, but it can be done.

I think you also missed my point. Some MDs go into school thinking they are going to score that big residency where they will make $500K a year, and then are shocked when all they get is a FP residency and can barely pull in $100K. This is a heartbreaking realization for some and I've known some to abandon medicine because of it. BTW, there is substantial salary difference between ENT and ED. Was your friend prepared for that? The other point I was making was that there are no guarantees.

I can deal with a disagreement, but no need to get so fiesty lol.

 

[janV88]

There are still parts of this country where a residency is not required to be able to practice podiatry in that state. There are also some areas where surgical residency is not required to get hopsital privileges and if you align yourself with a podiatrist who does surgery in that hospital, they can help you get enough cases to get surgical privileges.

Isn't it only a hand full of states that don't require a residency?

BTW, there is substantial salary difference between ENT and ED. Was your friend prepared for that?

This is off topic but many don't know that only a few specialties can match ER on a per hour basis. One of the alumni of my brother's residency is 4 years out, is now partner, and making 400k per year...working 32 hours a week...

 

[347932]

Isn't it only a hand full of states that don't require a residency?

You are correct. As I mentioned, it is not an ideal situation, but still CAN be done.


This is off topic but many don't know that only a few specialties can match ER on a per hour basis. One of the alumni of my brother's residency is 4 years out, is now partner, and making 400k per year...working 32 hours a week...

That's a lot more than the ED guys make around here. The ENT docs around here make about double what the ED guys do.

 

[dyk343]

LOL you shouldn't badger any of your representatives.

"badger" maybe wasnt a great term to use since I did asked the question respectfully. But this crisis needs to get fixed immediately. Your comparison with MD's getting a residency they do not want doesnt hold weight. They still get a job. The pods that didnt get a residency are screwed. $200K debt with very few options on the table.

Even if you move one of the very few states (Penn and Alaska are the only two I know of without researching) that do not require a residency to practice, the reimbursements are very low... correct?

With the amount of loans pod students take out and the unfilled residencies that will keep compounding year after year, we deserve to be in the know about what is going on with the APMA and this issue.

 

[krabmas]

This was posted in the PM news email this evening...

We are writing this letter in response to the Urgent Request published yesterday by Zackary B. Gangwer, APMSA President.
First, we want to assure all of the students in each of the nine schools that the profession is aware of this residency crisis and that the profession is moving in a coordinated manner on the immediate and the long term fronts to eliminate the shortage that the ASPMA President described.

The message that we want to convey to the APMSA is that the Goldfarb Foundation, the APMA, the AACPM, COTH, CPME, ACFAOM, PMAP and each and every state podiatric medical association have an acute understanding of the shortfall and its impact on the students. All of the stakeholders know that you are our collective future in that you are the continuation of our profession.

The final tally of residency shortage was defined at an October 1, 2010 at a meeting of the American Association of Colleges of Podiatric Medicine’s (AACPM) Ad Hoc Committee on Balance between Graduates and Residency Positions (Balance Committee). At that meeting, the Goldfarb Foundation proposed the creation of a residency genesis facilitator.

This proposal called for the employment of a full time podiatric physician whose job is to work with doctors who contact the AACPM or the COTH or the APMA Residency Hotline. The facilitator fields the call, solicits information about the hospital, coordinates discussion between the hospital and the potential residency director, provides the hospital with financial information related to podiatric residency operation, and works with the proposed director and hospital in creating the Form 309 for the initiation of the residency program.

This is a full-time position for which the Goldfarb Foundation, Podiatric Medical Assurance of Pennsylvania (PMAP) and the Pennsylvania Podiatric Medical Association initiated partial funding in September. After the October Balance Committee Meeting, the Foundation went out to all state component associations of APMA and requested that they participate in funding this program through a Grant. As of this date, The New Hampshire Podiatric Medical Association, the Georgia Podiatric Medical Association, the Washington Podiatric Medical Association and the Utah Podiatric Medical Association have responded with Grant commitments. In addition the AACPM and ACFAOM have committed to funding a portion of the cost.

The good news is that within the first forty days of the program, with virtually no promotion, the facilitator is working with two program in Pennsylvania, six programs in New Jersey, three programs in Florida, two programs in Illinois, and one program each in New York, Washington, Virginia, New Hampshire, California, Arkansas, and Maryland. Each of these programs represents a minimum of two residency positions.

On November 16th a Grant Request was solicited by APMA and sent to President Stone and the Board. APMA has begun its publication of calls for service to potential residency programs and the expansion of its solicitation of Hotline callers. Eight additional state associations have indicated that they are considering joining in the funding of this facilitator program. Presently the CPME is also determining what immediate steps stakeholders can take to help address the shortage.

We will forward, to your President, the Foundation reports on Residency Genesis. We applaud your acts in bringing your voice to the debate of this problem and we solicit your continued involvement.

Thank you,

Thomas Ortenzio, DPM, General Chairman, The Goldfarb Foundation

John Marty, DPM, President, The Goldfarb Foundation


I think it is too little too late. When I was involved with APMSA as a student in 2005(ish) we asked at every meeting what was being done to avert this looming crisis. The year I graduated had one of the lowest number of graduates in podiatry history (about 300 across the country) we had extra residency spots, but we as students saw this train wreck miles ahead. We asked, we asked and we asked what the plan was. We were told to trust the APMA, CPME... to handle the situation. They said they were working on it.

Well...

If the shortage has come and they still are working on a solution I can't imagine they were working that diligently.

Harkless is right to go out and protect his students. Scholl used to do it, they may still have their own residencies that are only for scholl students.

When you mention that certain schools should close becuase of numbers don't forget to lump in there scholl and temple. They also have large classes and all the schools have substandard students. NYCPM and ohio do not own the exclusive rights to them. I went to NYCPM and there were many times I thought the school should cease to exist. I don't feel that way anymore, b/c I would not have a degree without them. I'd have an education, but not the degree. As mentioned in thread after thread: it is not the school that makes the student, it is the student that puts forth the effort and educates themselves with what is provided.

 

[jonwill]

I think it is too little too late. When I was involved with APMSA as a student in 2005(ish) we asked at every meeting what was being done to avert this looming crisis. The year I graduated had one of the lowest number of graduates in podiatry history (about 300 across the country) we had extra residency spots, but we as students saw this train wreck miles ahead. We asked, we asked and we asked what the plan was. We were told to trust the APMA, CPME... to handle the situation. They said they were working on it.

Well...

If the shortage has come and they still are working on a solution I can't imagine they were working that diligently.

Yea, I remember being right there with you Krab. We consistently asked these people multiple times and definitely pressed the issue in a professional manner. And as I'm sure you remember, it quickly became clear that no one had any idea what was going on. We were told by organization "A" that organization "B" was watching the situation closely. Then, organization "B" would come and say the same thing about organization "A".

It IS a complex issue and I can empathize in that aspect but because it is a complex issue, it will take longer than a year or two to fix and that should have been realized a long time ago. Obviously at this point, there is no quick fix.

 

[UW66]

I believe Scholl has two residency programs that have 4 spots each (8 total) that are ONLY for Scholl students.

Other than advocate whats the other program that accepts only scholl students?

 

[UW66]

I have no idea. I know about yoraths program and thats it.

 

[dtrack22]

1) We all know that Scholl can do no wrong so I don't know why they were brought up

2) jonwill alluded to maybe the biggest problem. What students don't realize is that the APMSA had to go to all of the different organizations and compile the data. I don't get how you can expect the APMA, CPME, COTH, AACPM and NBPME to solve any problem when they don't communicate with one another.

3) The one thing that we should be happy about is that the powers that be appear to be addressing the funding issue. There are already 24 positions ready to go that are stuck in limbo without the necessary $$$. We could have 100 individuals decide to open up programs, and the CPME could approve all of the positions, but none of that matters if nobody ponies up.

4) we do need a few more programs. But more than anything we need a larger applicant pool. Our profession doesn't have the luxury of "selection" trough the application process like allo schools. No, we have to weed out students through attrition and residency placement. Last year there were open residency spots...so who cares that there were students without a position. They had the opportunity and those programs decided they would rather go unfilled than work with said students.

 

[krabmas]

I have no idea. I know about yoraths program and thats it.

What a wonderful man! If you have the benefit to work with Dr. Yorath, appreciate every moment of it and take advantage of it.

 

[densmore22]

Yea, I remember being right there with you Krab. We consistently asked these people multiple times and definitely pressed the issue in a professional manner. And as I'm sure you remember, it quickly became clear that no one had any idea what was going on. We were told by organization "A" that organization "B" was watching the situation closely. Then, organization "B" would come and say the same thing about organization "A".

It IS a complex issue and I can empathize in that aspect but because it is a complex issue, it will take longer than a year or two to fix and that should have been realized a long time ago. Obviously at this point, there is no quick fix.

I've said it before, but from '06-'10 I asked the same questions (I tried to do it tactfully and approach the APMA representative one on one) with the exact same answers. The default answer was "Wait until 2015" or "We're well aware of the situation, we appreciate your concern." What I think the APMA fails to realize is how upset the students are a whole with this. And the urgency of the situation. I hated the "2015" answer, what about 2010, 2011, 2012, 2013, 2014? That's great that from 2015 on, there will be (hopefully) a long term solution to this problem, but there's 5 years of 40+ graduates not getting residency spots (I think 2010 was something like 15-30, in that range, can't remember anymore), that's a lot of pissed off Podiatrists (yes, most, graduated and hold the DPM degree) that can't use it. This is why I have such little respect for the APMA. I hope they can rally over these next few months and years to come up with a viable solution.

I will also pose this, opening spots just for the sake of opening spots, although superficially, it makes the student/resident feel good because they have a spot, it may not be so. My program is budgeted for 4 spots, but I can tell you if we took 4 residents/year, it would be a horrible program. 2/year is just right, even 3 would push us to the point where our numbers would be drastically reduced and there would be a lot of wasted time and frustration. So just because there is spots opened up doesn't mean it's good for the profession. I know I will get flack for this, but you want QUALITY training, not just a spot for the sake of a spot. After seeing varying amounts of students over this past few months, I can say that I know why certain students match and certain students don't. Just as was said above, the students need to take some of the responsibility for their own actions and evaluate themselves because at the end of the day, it's up to them on how hard they are willing to work to get a spot. I can tell you that students with baseline knowledge, but absolutely work their butt off for a month will always be considered more highly over a student with a 4.0 GPA, but they're lazy. I know I'm beating a dead horse, but as stated, it's a complex issue. Yes, every student SHOULD have a spot available to them, but I know that even when that day arrives, there will be students who passed part 1, passed part 2 and still will not have matched (different situation though). I don't actually know if this post has contributed to the argument at hand, but I feel better for writing it.

 

[krabmas]

Out of curiosity, Krabmas did you extern at Advocate or did you meet Dr. Yorath at a conference, etc?

EDIT: It doesn't make sense if you externed at SCPM only residency program so you must have came across Dr. Yorath through some other means.

I met him in Africa.

 

[MarquetteGuy]

I've said it before, but from '06-'10 I asked the same questions (I tried to do it tactfully and approach the APMA representative one on one) with the exact same answers. The default answer was "Wait until 2015" or "We're well aware of the situation, we appreciate your concern." What I think the APMA fails to realize is how upset the students are a whole with this. And the urgency of the situation. I hated the "2015" answer, what about 2010, 2011, 2012, 2013, 2014? That's great that from 2015 on, there will be (hopefully) a long term solution to this problem, but there's 5 years of 40+ graduates not getting residency spots (I think 2010 was something like 15-30, in that range, can't remember anymore), that's a lot of pissed off Podiatrists (yes, most, graduated and hold the DPM degree) that can't use it. This is why I have such little respect for the APMA. I hope they can rally over these next few months and years to come up with a viable solution.

I will also pose this, opening spots just for the sake of opening spots, although superficially, it makes the student/resident feel good because they have a spot, it may not be so. My program is budgeted for 4 spots, but I can tell you if we took 4 residents/year, it would be a horrible program. 2/year is just right, even 3 would push us to the point where our numbers would be drastically reduced and there would be a lot of wasted time and frustration. So just because there is spots opened up doesn't mean it's good for the profession. I know I will get flack for this, but you want QUALITY training, not just a spot for the sake of a spot. After seeing varying amounts of students over this past few months, I can say that I know why certain students match and certain students don't. Just as was said above, the students need to take some of the responsibility for their own actions and evaluate themselves because at the end of the day, it's up to them on how hard they are willing to work to get a spot. I can tell you that students with baseline knowledge, but absolutely work their butt off for a month will always be considered more highly over a student with a 4.0 GPA, but they're lazy. I know I'm beating a dead horse, but as stated, it's a complex issue. Yes, every student SHOULD have a spot available to them, but I know that even when that day arrives, there will be students who passed part 1, passed part 2 and still will not have matched (different situation though). I don't actually know if this post has contributed to the argument at hand, but I feel better for writing it.

Dens,
I couldn't agree more. This is certainly a problem that needs to be dealt with, but simply adding more spots to current programs only dilutes that particular program. We just went through this as well...we are approved for 6 spots, but we're not budging from our 1 resident per year. No one here wants to sacrifice our current standards/numbers. Sure we are running ragged and getting our butts kicked, but why would you want it any other way? Isn't that why you choose/want these particular programs in the first place? There is no place for laziness in residency. It needs to be quality over quantity. So, as you already know, you won't get any flack from me, but we may be in the minority on that viewpoint.

 

[krabmas]

Dens,
I couldn't agree more. This is certainly a problem that needs to be dealt with, but simply adding more spots to current programs only dilutes that particular program. We just went through this as well...we are approved for 6 spots, but we're not budging from our 1 resident per year. No one here wants to sacrifice our current standards/numbers. Sure we are running ragged and getting our butts kicked, but why would you want it any other way? Isn't that why you choose/want these particular programs in the first place? There is no place for laziness in residency. It needs to be quality over quantity. So, as you already know, you won't get any flack from me, but we may be in the minority on that viewpoint.

you are certainly not in the minority if you poll current residents or recently graduated residents.

If you poll the APMA, CPME... or students you'll get a different answer, but as usual they don't know what they are talking about, and just want a quick fix, not a well thought out solution.

 

[that1guyfromFL]

So what do you say to those unfortunate souls who passed all their classes, passed the boards, and satisfied all the requirements for graduation at their respected podiatry school that did NOT match?

I would say this, but dtrack already did..

Last year there were open residency spots...so who cares that there were students without a position. They had the opportunity and those programs decided they would rather go unfilled than work with said students.

Unfortunate souls? When spots remain unfilled after the scramble, are those without a program the kind of students we want representing our profession as colleagues?

We need to address the quality of students being accepted and hustled through the system. That responsibility falls on schools, not residencies.

 

[dtrack22]

Ankle Breaker is right. But it isn't the APMA's responisibility IMO. The AACPM needs to get together and figure something out.

I get that programs like Ohio and NYCPM need the money (since pod students is their only source of income), but collectively all schools need to be a little more responsible. But, when there's money to be made...

The problem is that in a year or two it looks like there might be students who miss out on residency NOT because they were idiots, but because there really aren't enough spots. This is what the APMA needs to focus on. We just need a handful of good programs to open up (on top of the projected 525) and we should be fine. All the while focusing on marketing the profession to undergrads so that we can have a legitimate applicant pool.

 

[krabmas]

Ankle Breaker is right. But it isn't the APMA's responisibility IMO. The AACPM needs to get together and figure something out.

I get that programs like Ohio and NYCPM need the money (since pod students is their only source of income), but collectively all schools need to be a little more responsible. But, when there's money to be made...

The problem is that in a year or two it looks like there might be students who miss out on residency NOT because they were idiots, but because there really aren't enough spots. This is what the APMA needs to focus on. We just need a handful of good programs to open up (on top of the projected 525) and we should be fine. All the while focusing on marketing the profession to undergrads so that we can have a legitimate applicant pool.

Again, get your facts straight. Scholl and Temple have large class sizes as well. They get money from other matriculating students in medicine... so why are their pod classes so big? I blame these 2 schools more since they could survive with less students but choose not to.

 

[dtrack22]

Again, get your facts straight. Scholl and Temple have large class sizes as well. They get money from other matriculating students in medicine... so why are their pod classes so big? I blame these 2 schools more since they could survive with less students but choose not to.

That was exactly my point. I understand why programs like Ohio and NYCPM NEED to accept large class sizes. It is their largest source of income (as a % of total income). Those programs probably can't afford to cut down on the number of students they accept. You are right, Scholl and Temple have no excuse since they are both part of larger and wealthier medical systems. I thought my point was implied...apparently not.

Scholl's tuition increased by 2K from last year. Why? I don't know for sure but I would say it was to help fund the construction for the new pharmacy school at RFUMS (yet another pharmacy school in an overly saturated field to bring more $$$$ to RFUMS). Again, this is all hearsay and the above comments are not facts.

I would venture to say you're right. This seems like another example of admins/adcoms thinking we are all idiots and won't put two and two together. You would think they would tell you why tuition was raised, but I'm guessing you all never got that email?

 

[air bud]

I agree with this wholeheartedly. I refer to them as unfortunate because technically they did everything right but are now completely screwed. Its possible that students who fall in this niche are not the quality of student certain residencies are looking for. Does that make it fair though? A crappy MD/DO student can still get a job in a less competitive area of medicine. I agree with you that its prob for the best if these students never get training so they can't represent the profession. But again, is that really fair though?

Why does podiatry school X get off the hook while this person's life is prob ruined? Podiatry schools do whatever the hell they want. Overall, podiatry schools also have a habit of keeping students in school after they failed multiple classes. The student should be kicked out and not allowed to repeat the year. It really all comes down to milking more tuition out of these students though doesn't it? The APMA needs to further regulate the podiatry schools and hold them responsible...but they won't. Cutting the number of matriculating students is not enough...

First of all, I would venture to guess that many of these students do closer to the bare minimum as opposed to "everything right."

You guys are all naive as to the way the real world works. Life is not fair. You are not entitled to anything in life. Does the home builder who used borrowed money from the bank to build a spec home, only to have the market crash, then go to the bank and say "this isn't fair"? Is the small business owner who invested their own profits into a second location entitled to customers even though the large store in the strip mall went out of business and nobody comes there?
Exactly. All of you guys who complain about "life isn't fair" have just come out of undergrad/candyland. Ask Kidsfeet or PADPM if they win a reimbursement case after being denied by putting down "this isn't fair, I did the procedure and it turned out okay, even if I didn't fill things out properly."
So quit with all this crap. People are responsible for their own education. Grow a pair and be accountable for your choices in life. Things may not always work out for the best, or maybe they will.

 

[dyk343]

If a student passes their classes, passes boards, and have a clean background check they deserve a residency.

 

[Podfather]

The issue is multifactorial. Yes the schools accept people who would have trouble in any career they selected. Simply put they should not be in professional school. They would have trouble matching for a position(or pass part 1 and 2 boards) even during a residency surplus. We have left positions unfilled rather than take a poorly qualified student. A bad resident can destroy a program or at the very least create problems.

Case volume is down at most residencies (not just foot and ankle) and the CPME is running around trying to increase positions. They sent us a letter and said we could double our positions and we chose not to because we felt it would dilute our training. In addition hospital reimbursement is on a rolling average of FTEs and therefore the hospital would have taken a hit for several years. New positions that may take away cases from exisiting programs are the wrong way to go and new programs should only be developed in geographic areas that currently have no residency training.

We have mandated residency training for almost all states to get a license. IMO it is a huge problem if someone did pass their classes, boards, and just did not match. There needs to be some venue for these individuals to sit for a year or 2.

Next we will see the cycle continue: Bright students will not apply to DPM schools because they are not willing to risk high debt with the chance of not matching for a residency. Positions will be left unfilled by programs as the quality of student drops and positions will close. The constant headaches of changing residencies with the paperwork and confusion it brings will mean some programs will throw in the towel. Even the MD/DO reject pool will seek out other careers with better stability. For example off shore medical schools or ANP.

So what do we do? First all schools need to raise admission requirements, CPME needs to cap accepted students at a number that is calculated on current residency positions and expected attrition. When a residency/hospital closes they should then focus on replacing that number of positions (an easier process). They also need to quit being schizophrenic and settle on a training model and stick with it for decade or two with small modifications as needed. PSR to PMS and now PMSR only creates more confusion both intra and inter professionally. When we identify good programs who turn out successful graduates year after year quit screwing with them and use them as a model rather kill the training with constant changes. Finally, we need to finally decide what we want to be. The profession wants parity but we want to keep our identity? Seems crazy to me. I have and will always be a dental model kind of guy. Everyone gets similar training for a year or two post graduation then we offer additional training in surgery, wound care, biomechanics etc. But at least prior to that split we all are the same. Heck we have enough spots for the 2 year rotational model at VAs and numerous hospitals across the US now

 

[PADPM]

The issue is multifactorial. Yes the schools accept people who would have trouble in any career they selected. Simply put they should not be in professional school. They would have trouble matching for a position(or pass part 1 and 2 boards) even during a residency surplus. We have left positions unfilled rather than take a poorly qualified student. A bad resident can destroy a program or at the very least create problems.

Case volume is down at most residencies (not just foot and ankle) and the CPME is running around trying to increase positions. They sent us a letter and said we could double our positions and we chose not to because we felt it would dilute our training. In addition hospital reimbursement is on a rolling average of FTEs and therefore the hospital would have taken a hit for several years. New positions that may take away cases from exisiting programs are the wrong way to go and new programs should only be developed in geographic areas that currently have no residency training.

We have mandated residency training for almost all states to get a license. IMO it is a huge problem if someone did pass their classes, boards, and just did not match. There needs to be some venue for these individuals to sit for a year or 2.

Next we will see the cycle continue: Bright students will not apply to DPM schools because they are not willing to risk high debt with the chance of not matching for a residency. Positions will be left unfilled by programs as the quality of student drops and positions will close. The constant headaches of changing residencies with the paperwork and confusion it brings will mean some programs will throw in the towel. Even the MD/DO reject pool will seek out other careers with better stability. For example off shore medical schools or ANP.

So what do we do? First all schools need to raise admission requirements, CPME needs to cap accepted students at a number that is calculated on current residency positions and expected attrition. When a residency/hospital closes they should then focus on replacing that number of positions (an easier process). They also need to quit being schizophrenic and settle on a training model and stick with it for decade or two with small modifications as needed. PSR to PMS and now PMSR only creates more confusion both intra and inter professionally. When we identify good programs who turn out successful graduates year after year quit screwing with them and use them as a model rather kill the training with constant changes. Finally, we need to finally decide what we want to be. The profession wants parity but we want to keep our identity? Seems crazy to me. I have and will always be a dental model kind of guy. Everyone gets similar training for a year or two post graduation then we offer additional training in surgery, wound care, biomechanics etc. But at least prior to that split we all are the same. Heck we have enough spots for the 2 year rotational model at VAs and numerous hospitals across the US now

I agree 100% with your post. I also am a proponent of the dental model, but am afraid of the reality of whether it would truly work in our profession. In dentistry, most dental students enter the profession with the realization that only a few will land residency training in oral/maxilofacial surgery or programs in endodontics, peridontics, etc., and know they will practice "general dentistry". In our profession, I believe the great majority won't be content unless they receive a residency in surgery, and believe when they enter school they WILL eventually be performing surgical procedures. If post graduate residency training focuses on more specialty training similar to dentistry, on wound care, biomechanics, etc. in addition to surgery, it has the potential to completely change the complexion of the profession and the applicants.

 

[densmore22]

So what do you say to those unfortunate souls who passed all their classes, passed the boards, and satisfied all the requirements for graduation at their respected podiatry school that did NOT match?

I may not be a resident but I do understand what yourself, marquetteguy, and densmore are saying...but don't you think students who fit the above description deserve a chance to get post-graduate training?

If the shortage continues to get worse I can see more students like this getting hung out to dry and thats not only unfortunate for them but it looks terrible on the profession. Any chance of increasing admissions standards to podiatry school also goes out the door. Why would more students want to apply if there is a chance all this schooling could lead to a dead end and an insurmountable of debt?

I say that's unfortunate, but it's life. Every once in awhile, you here about a legit student who ranked programs, but didn't match for whatever reason. That same student also seems to have luck on his/her side and scramble into a program. Rarely do you hear about a legit student that doesn't match or scramble, I know it happens, but BELIEVE me, there's a reason why students don't match/scramble. What you guys fail to realize is that once a student gets labeled as lazy or weak or whatever, it's a tag that stays with them and it gets hard for them overcome that. Often times the students that scream the loudest are the ones that have the most deficincies. Showing up late, still can't write a simple SOAP note (we're in December mind you), weak presentation, sucking up, asking to go home, whatever it is, these things are remembered by residents. If you make mistakes (which is ok) and you're trying hard and working hard, then no problem. I asked a student in our clinic once about why a patient was here, he just shrugged his shoulders and said, "I guess it's for foot pain." Do you honestly think that leaves a good impression? When I ask you to go in and see a pt then come out and present and that's all you tell me, then you've just killed yourself at my program. We expect a lot out of you here, but you by no means have to be the smartest person, you just need to show some promise and show you're willing to go above and beyond. To be a resident at my program, that effort is required EVERYDAY you are here, not a week, not 3 weeks, from day 1 to the day you go home. A lot of students don't want to work that hard or think that's bs, then go to a program that doesn't care, but don't come whining to me when you rank us 1 and you're unranked by us. The other thing, everyone is watching all the time, you're actions speak louder than words. Airbud says it well, take some personal accountability and actually show you care to be there. Residency is not guaranteed and you need to prove to us that you want to be there. If you find along the way we don't have the mentality or whatever for you, then that's just as well. I do talk to my friends at other programs, we do talk about students. Residency directors do talk to one another and ask about other students, so don't think for a moment that doesn't happen. I'm so tired of podiatry (the profession) holding the hands of our students. We are way too easy on them and it's only making for lazy 4th years/residents. No where will you ever see an allo/osteopathic student getting their hand held for not knowing some basic info when pimped, in fact, you'll see them get their a**es chewed for not knowing basic info, but we sit here and we're so apologetic to our students because they don't know the 7 causes of hallux varus or the steps in performing an Austin. I'm tired of it and I personally have made an effort to be a d*ck, but at least a student knows their **** when they leave my program and impresses at other programs. I'd rather have the a**hole tag on me than someone who takes it easy and expects our students to coast by. I pimp for the sake of learning. A lot of pimp questions I may not even know the answer too, but I do it to get the student thinking and get their reasoning skills up. At interviews, programs want to know how you reason through things, it's less about getting a right answer and more about how you can come up with a logical solution to a complex problem. My philosophy was to make every program want me as a resident, it doesn't work out that way (rarely, I'd guess), but if you go in with that mentality, then you should be ok.

There's so many aspects of the shortage that need to be addressed. Schools need to start taking accountability for the amount and quality of students they accept. Consistently going the 10 or 20% over the cap every year is just not the right thing that needs to happen. APMA needs to step up and actually do something. Students need to realize that 4th year isn't a vacation, it's the time when you should be working the hardest in your academic career. It's very difficult to just point at one thing and say, this will fix our problem. Many things need fixed and I don't hear/see a solution to it anytime soon.

 

[PADPM]

I'll agree with a lot of what you have to say, but after being involved with teaching/training students and residents for a very long time, I can't agree with your philosophy of being a "d-ck" and an "a-hole". I know that in your mind you are doing the students a favor by stimulating their knowledge and lighting a spark under their behinds, but after many years I can assure you there are much more effective ways to accomplish this than being a "d-ck" or an "a-hole".

Think about the docs that taught you the most and influenced you the most, and the chances are that although they were probably tough on you, they also treated you with respect and guided you (without holding your hand) and didn't act like a d-ck or a-hole.

If a student is a "loser" and is going nowhere, simply don't waste your time and effort on him/her. Channel your efforts to those who are worthy. You're not going to make chicken salad out of chicken sh-t.

Just my opinion based on a "few" years of experience.

 

[densmore22]

I'll agree with a lot of what you have to say, but after being involved with teaching/training students and residents for a very long time, I can't agree with your philosophy of being a "d-ck" and an "a-hole". I know that in your mind you are doing the students a favor by stimulating their knowledge and lighting a spark under their behinds, but after many years I can assure you there are much more effective ways to accomplish this than being a "d-ck" or an "a-hole".

Think about the docs that taught you the most and influenced you the most, and the chances are that although they were probably tough on you, they also treated you with respect and guided you (without holding your hand) and didn't act like a d-ck or a-hole.

If a student is a "loser" and is going nowhere, simply don't waste your time and effort on him/her. Channel your efforts to those who are worthy. You're not going to make chicken salad out of chicken sh-t.

Just my opinion based on a "few" years of experience.

So let me clear this up. Those words were mine, just my perception of myself. I'm not really that hardcore. By "being a d*ck or an a**hole" I really mean that I challenge students more than most of my co-residents/attendings. I feel that watching a bunion is more beneficial if you get asked questions about all aspects of said surgery instead of just sitting in the corner being bored, watching. That's more my style. I have not and will not ever berate or belittle a student for their lack of knowledge. I do spend more time with the ones that show promise/want to learn than those that do not, but ultimately, my residency director feels very strongly that we must educate all students that come through, no matter how great or poor they are.

I, personally, responded more to the attendings that were "d*ck's" to me throughout my education purely based on the fact that I wanted them to shut up when I could rattle off whatever they were challenging me on during rotations, but that's my personality and I acknowledge that not everyone is like that. My point is that we are way too lax on our students compared to students of other medical professions and I'm choosing to be tough, but fair and nice about it in the hopes that the select few that want to challenge themselves will. I know everyone has different learning styles, but such is true with teaching styles as well. I'm sure it's a process that will be modified and reformed many times throughout my professional career, this is just how I see fit to teach the students that I'm responsible for.

I know you quoted it above, but I would never call a student a "loser." Again, I may be tough, but I'm professional and respectful about it. How I wrote it above was purely some frustration coming through and not a true reflection of how I am towards students. I'm way tougher on myself than on anyone else.

I appreciate your post and it definitely will give me some insight and thought into how to better interact with our students.

 

[krabmas]

We are way too easy on them and it's only making for lazy 4th years/residents. No where will you ever see an allo/osteopathic student getting their hand held for not knowing some basic info when pimped, in fact, you'll see them get their a**es chewed for not knowing basic info, but we sit here and we're so apologetic to our students because they don't know the 7 causes of hallux varus or the steps in performing an Austin. I'm tired of it and I personally have made an effort to be a d*ck, but at least a student knows their **** when they leave my program and impresses at other programs. .

I agree with most of what you said about why students don't match. I think this will get worse before it gets better, not because the numbers of students will increase, but because we live in such a "me,mine,now" world and the students were raised where everyone gets a trophy or they stopped keeping score all together.

I cannot agree with the part about allopathic/other medical specialties are harder on their residents. Some may be, but certainly not all. I felt the exact oppisite at my program, maybe it is the exception to the rule, dunno. But the MD (all specialties) attendings treated the MD/DO residents and the pod residents like collegues and people. I do not feel the same of my pod attendings.

I'll agree with a lot of what you have to say, but after being involved with teaching/training students and residents for a very long time, I can't agree with your philosophy of being a "d-ck" and an "a-hole". I know that in your mind you are doing the students a favor by stimulating their knowledge and lighting a spark under their behinds, but after many years I can assure you there are much more effective ways to accomplish this than being a "d-ck" or an "a-hole".

Think about the docs that taught you the most and influenced you the most, and the chances are that although they were probably tough on you, they also treated you with respect and guided you (without holding your hand) and didn't act like a d-ck or a-hole.

If a student is a "loser" and is going nowhere, simply don't waste your time and effort on him/her. Channel your efforts to those who are worthy. You're not going to make chicken salad out of chicken sh-t.

Just my opinion based on a "few" years of experience.

I agree with this. Students that don't want to learn will continue to not learn whether you are nice, nasty or ignore them. I try really hard to not give up on students, but it is very difficult when they show up day after day with no answers to the questions from the day before, 2 days, ago, 3 days, ago...

I responded to anyone that I felt like wanted me to learn. I especially appreciated the ones that came out and would say that they were not trying to be a d*ck, but thought this was info we should know, and did not let up or give up.

Regardless, when you (students) are on externships, in your school clinic... it doesn't matter how the attending treats you. If you don't learn something because they were mean and to spite them... it only hurts you, and one day your patient. Don't forget all this work is not just about you, you are doing it to treat patients one day. and imagine that all the patients you wil see are your grandparents, mothers, siblings, children... Do you want to treat these near and dear to you with only half a book?

 

[densmore22]

I agree with most of what you said about why students don't match. I think this will get worse before it gets better, not because the numbers of students will increase, but because we live in such a "me,mine,now" world and the students were raised where everyone gets a trophy or they stopped keeping score all together.

I cannot agree with the part about allopathic/other medical specialties are harder on their residents. Some may be, but certainly not all. I felt the exact oppisite at my program, maybe it is the exception to the rule, dunno. But the MD (all specialties) attendings treated the MD/DO residents and the pod residents like collegues and people. I do not feel the same of my pod attendings.



I agree with this. Students that don't want to learn will continue to not learn whether you are nice, nasty or ignore them. I try really hard to not give up on students, but it is very difficult when they show up day after day with no answers to the questions from the day before, 2 days, ago, 3 days, ago...

I responded to anyone that I felt like wanted me to learn. I especially appreciated the ones that came out and would say that they were not trying to be a d*ck, but thought this was info we should know, and did not let up or give up.

Regardless, when you (students) are on externships, in your school clinic... it doesn't matter how the attending treats you. If you don't learn something because they were mean and to spite them... it only hurts you, and one day your patient. Don't forget all this work is not just about you, you are doing it to treat patients one day. and imagine that all the patients you wil see are your grandparents, mothers, siblings, children... Do you want to treat these near and dear to you with only half a book?

I was referring to allo/osteo students and less about residents. I have yet to have a really negative experience in residency. The allo students that rotate with IM/FM/Gen Surg/etc get reamed pretty good for answers that I know (and they answered wrong) so I'm assuming it's pretty basic stuff, since they should have much more acumen with that stuff then I do. Regardless, as a resident, from my R2's and R3's have heard that everyone is treated with great respect. Sorry to imply that, wasn't what I was going for.

 

[krabmas]

I was referring to allo/osteo students and less about residents. I have yet to have a really negative experience in residency. The allo students that rotate with IM/FM/Gen Surg/etc get reamed pretty good for answers that I know (and they answered wrong) so I'm assuming it's pretty basic stuff, since they should have much more acumen with that stuff then I do. Regardless, as a resident, from my R2's and R3's have heard that everyone is treated with great respect. Sorry to imply that, wasn't what I was going for.

I didn't see MD/DO students treated poorly either. I know it happens, but usually by older/old school profs that have not kept up with the trends in education or how to effectively educate.

 

[emericana]

I didn't see MD/DO students treated poorly either. I know it happens, but usually by older/old school profs that have not kept up with the trends in education or how to effectively educate.

Hey guys... I am going to be applying very soon (jan 29th when i take mcat) to pod schools.

Obviously, I do not want to be in the situation where I am 200k in the hole and no residency.

I am a good student. My undergrad gpa was sci 3.1 . The only reason it is that low is because I partied too much my first two years. The second I got my act together I earned nearly straight A's (brought my gpa up from a 2.4 to a 3.1) in upper division science classes (molec bio major).

So essentially, I plan on working my butt off when i get into pod school.


What I want to know is am i taking the same risk now at going to podiatry school as I would be if I am going to the carib for a MD program?

As you know, the carib MD schools do not guarantee placement for their students as well.

Would I have a better shot of getting a residency going for a MD at the carib versus podiatry?

Now I would rather be a Pod (eg I am not just using this as a backup because my GPA was too low.. could easily do a SMP), but most importantly I want to be a physician, and MOST importantly I want a residency.

 

[bonvivant07]

Are they doing anything to address the shortage? From my understanding, there was a few shortages throughout Pod history, most notably back int he 90's.

Are schools accepting too many students for the tuition and letting student fight it out for the top spots?

I guess it is similar to dentistry where obviously not everyone gets into a residency and there are a lot of dentist who are General dentists. But the thing is, most OMFS, Ortho etc won't see a normal filling since it is not worth their time or money. Whereas, I feel like in POD, there is only so much business to go around that even a POD with 3 year residency and more training will see a ingrown toenail, thus leaving essentially nothing for the POD that didn't go to residency. Is that true?

 

[arez10]

I guess it is similar to dentistry where obviously not everyone gets into a residency and there are a lot of dentist who are General dentists. But the thing is, most OMFS, Ortho etc won't see a normal filling since it is not worth their time or money. Whereas, I feel like in POD, there is only so much business to go around that even a POD with 3 year residency and more training will see a ingrown toenail, thus leaving essentially nothing for the POD that didn't go to residency. Is that true?

It's not that you are left with nothing. You cannot legally practice in all but a few states without residency training. So unfortunately, it's much worse than dentistry.

 

[doc1107]

This shortage is the number one reason why many people do not even consider Podiatry.

If you can't get a residency, you are left with cutting toe nails the rest of your life.

Whereas in other heath professions, you have other options:

Dentists- most don't go into residency and don't need residency if you just want to be a general dentist.

Doctors- At the very least, you can do some common place residencies such as General Practitioner or Internal med.

Eye doctor- do not need residency as far as I know

Pharmacist- no residency required, unless you want to go into more advances pharm such as nuclear medicine. That is the exception, since most Pharmacy students simply go and work.

Psychologist- no residency needed

Yes, it is great that all residency is 3 years now. But there is not enough spaces! At least back in the old system, one can do a 12 month or a 24 month residency.

 

[krabmas]

If you can't get a residency, you are left with cutting toe nails the rest of your life.

.

you can only do this with a license. Most states require a residency of at least a year to get a license. You can open up a nail salon and charge cash, but you cannot advertise that you are a doctor/DPM or bill insurance since you will not have a license to practice, it would be considered practicing without a license.

 

[podpal]

you can only do this with a license. Most states require a residency of at least a year to get a license. You can open up a nail salon and charge cash, but you cannot advertise that you are a doctor/DPM or bill insurance since you will not have a license to practice, it would be considered practicing without a license.

In many states, ONLY licensed NAIL TECHNICIANS are permitted to perform services at a nail salon. A Podiatrist is NOT a licensed Nail Technician simply by having gone through podiatry school and is therefore not eligible to service clients as a Nail Technician. 🙁