PSR-24 eligible for rearfoot certification but PM & S-24 not?

[cool_vkb]

I was under the impression that only PM & S-36 grads were eligible for rearfoot & ankle (RRA) boards certification or qualification.

Whats up with PSR-24, why is this one eligible and whats the difference between PSR-24 and the other PM & S-24.

I was looking at last years Scholl class and some people went the PMS-24 route (not PSR but PMS). Why do people still do the 24months residence?

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[Feli]

First off, not everyone wants to do RF procedures. I know every single first year is probably he/she wants to be Mr. bigshot surgeon right now, but by interview time, there's probably more people than you think who don't want to do surgery at all or have just realized it's not their strength. For those individuals, there is really not a ton of sense in doing a heavy surgical program that would make them miserable teaching them a lot of stuff they don't ever plan on utilizing. They might be better off with a pms24 heavy on wound care and office experience if that is what they want to learn well and eventually do as a practitioner.

Some people are also so attached to one geographic area that if they can't get a PMS36 there, they will then accept a 24 in order to stay where they want.

Finally, some (actually most) PMS24 residencies may be up for review and planning on converting to a 36 between now and the time someone who matched/scrambled into them last month will finish their PGY2. The resident could then stay on for the third year and get a 36 certificate at the end. However, despite what a program may tell you during a visit or interview, you really never want to take those conversions for granted until they are official per COTH. "We're gonna add a spot as well as be converted to a PMS36 next December" really means nothing if you match there, sign on, and then they fail to be upgraded. If you know that you want a 36, you should probably only consider programs that are at that status when you interview (or programs that are clearly strong enough to convince you they will be converted).

 

[cool_vkb]

First off, not everyone wants to do RF procedures. I know every single first year is probably he/she wants to be Mr. bigshot surgeon right now, but by interview time, there's probably more people than you think who don't want to do surgery at all or have just realized it's not their strength.

Man you are scaring me now. i just hope i dont end up not like surgery . Plus woudnt our incomes affect significantly if people are not RRA certified or dont do surgery.

And what is the difference between PSR-24 and PMS-24. and why is tat only PSR-24 people can do RRA certification. they both are 24 months right!

 

[jonwill]

Man you are scaring me now. i just hope i dont end up not like surgery . Plus woudnt our incomes affect significantly if people are not RRA certified or dont do surgery.

And what is the difference between PSR-24 and PMS-24. and why is tat only PSR-24 people can do RRA certification. they both are 24 months right!

PSR-24 no longer exists. It is being phased out under the new model (PM&S-24). There may be a few left that have not yet transitioned be they will shortly be gone.

 

[NatCh]

Plus woudnt our incomes affect significantly if people are not RRA certified or dont do surgery.

Not necessarily. Business acumen will have more impact on your income than how many rearfoot surgeries you do.

One of the biggest earners I've ever met ($500K+/year) only does forefoot and had only one year of surgical Residency.

Being RRA Certified is a nice selling point to get people in the door though. I don't know if it makes up a huge percentage of the surgical caseload for those who have it.

Nat

 

[cool_vkb]

Not necessarily. Business acumen will have more impact on your income than how many rearfoot surgeries you do.

One of the biggest earners I've ever met ($500K+/year) only does forefoot and had only one year of surgical Residency.

Nat

500K sweeeeeeeeeeeeeet! wat is he like the only podiatrist sitting in a 200 mile radius area.

And is this true, that rural pods tend to make more money than their city counterparts because of unsaturated market and less competition.

 

[NatCh]

500K sweeeeeeeeeeeeeet! wat is he like the only podiatrist sitting in a 200 mile radius area.

And is this true, that rural pods tend to make more money than their city counterparts because of unsaturated market and less competition.

No, he was in a small city with other docs. He just had remarkable business sense. The amazing thing is that his practice was only one source of income. He also did real estate and had other small businesses. It was impressive.

The only rural pods I knew were not flush with money. The patient load they had either did not have insurance or did not feel as if they should have to pay their bill. Many are on Medicaid, which pays poorly. I guess some of it is whether "rural" means Aspen, Colorado or "rural" means Dirtwater, Mississippi.

 

[dpmgrad]

I was under the impression that only PM & S-36 grads were eligible for rearfoot & ankle (RRA) boards certification or qualification.

Whats up with PSR-24, why is this one eligible and whats the difference between PSR-24 and the other PM & S-24.

Jonwill is correct that PSR-24 / PSR-24+ programs are being phased out and will probably not exist when you are applying for residency programs. PSR-24 (2 year program) / PSR-24+ (3 or more year program) residency program graduates will be able to sit for BOTH ABPS Foot Surgery Board Exam and ABPS Reconstructive Rearfoot Surgery Board Exam, just like the PM&S-36 graduate would. From ABPS perspective, PSR-24 / PSR-24+ is the equivalent of PM&S-36. The main difference between PSR-24 / 24+ and PM&S-36 is that only PM&S-36 graduates can sit for BOTH ABPS and ABPOPPM board exams.

The equivalent for the PM&S-24 in the older model of residency program would be the PSR-12 programs, where the graduates would be eligible to sit for the ABPS Foot Surgery Board exam and not the ABPS RRF exam.

Majority of the PSR-24 / 24+ programs have successfully converted over to PM&S-36. There a few PSR-24 / 24+ programs that were converted to PM&S-24 due to variety of issues.

 

[krabmas]

Man you are scaring me now. i just hope i dont end up not like surgery . Plus woudnt our incomes affect significantly if people are not RRA certified or dont do surgery.

And what is the difference between PSR-24 and PMS-24. and why is tat only PSR-24 people can do RRA certification. they both are 24 months right!

Most surgeries will take place in a surgi center or hospital. You will need to travel to these places even if it is only across the street. Then you will need to play the waiting game and plan to not schedule patients back to back with your surgery schedule. This all equals a loss of money. Then you'll need to see all the surgical patients post op for free in the global period of usually 90 days. Some procedures are charged for in the global period but not many.

Orthotics reimburse very well even thru most insurances. Some pods sell pre-fabs like super feet or powerstep... for $20-$100.

Nail avulsions take about 15 minutes including set-up and numbing. These reimburse pretty high - $100+ plus most patients will pay for the ameri-gel kit for soaking or what ever you tell them you suggest that you sell in the front of the office.

There are many other things in the office that pay well and do not take much time. The above are just the most common example. And people without insurance will pay for the above services out of pocket full price.

This is part of the reason that surgery does not pay as well as people tend to think.

 

[bdaddyjolley]

Man you are scaring me now. i just hope i dont end up not like surgery . Plus woudnt our incomes affect significantly if people are not RRA certified or dont do surgery.

And what is the difference between PSR-24 and PMS-24. and why is tat only PSR-24 people can do RRA certification. they both are 24 months right!

I think a misconception people have is that if you don't do big surgery you can't make a lot of money. A lot of pods I have talked to have stated there is more money to be made in other aspects of podiatry besides surgery because surgery doesn't pay what it use to and you have lots of post ops that take up time that you don't get paid for. Thats not to say that you don't make big money in surgery, but to show that it is not the only way to. Good business sense will make you the most money.