Residencies

[podwife]

I am the wife of a fourth year podiatry student at DMU and my husband just started his first clerkship. I wanted to know more about what residencies are considered the "good" ones. I've seen that if you're not in a top residency that your first "job" will consist of slave labor clip-and-cut kind of work. (I've read a lot of depressing stuff on this issue) Can anyone fill me in on the top residencies? I realize that we've already set up our clerkships but we have time till we apply for residencies.

Also, is it safe to buy the practice of a retiring podiatrist? That is an option for us but I want to be guaranteed patients and some money. I don't want my husband to be stuck doing nursing homes for years and years.

Any comments would be appreciated.

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[HenryH]

I am also curious about this issue...if a podiatry student doesn't complete a top, hot-shot residency, are they essentially screwed when it comes to getting a good, six-figure job after residency? I would hate to graduate from a not-highly-touted 3-year residency program, learn all those surgical skills, and then be stuck making $60-70k doing "palliative care" or whatever.

Is it like business school, where only the students graduating from the top 10-12 programs are privy to the big-bucks investment banker, etc. jobs?

 

[Feli]

...Can anyone fill me in on the top residencies? ...

Over the past few years, there have been a fair number of threads on this if you try searching in the pod forums. Here's a couple of them...

http://forums.studentdoctor.net/showthread.php?t=306230http://forums.studentdoctor.net/showthread.php?t=306230&highlight=residencies+west+penn
http://forums.studentdoctor.net/showthread.php?t=486427

...if a podiatry student doesn't complete a top, hot-shot residency, are they essentially screwed when it comes to getting a good, six-figure job after residency...

Residency (+/- fellowship) surely helps, but, just like going to a good college, it really doesn't guarantee anything. It will come down to the person... lazy or hardworking? Gregarious or diffident? etc

Graduating from a prestigous residency usually does help in terms of getting better initial job offers right out of residency, but you are still working for someone else. Eventually, just as in any carer, many of the richest pods are working for themselves (private practice ownership). You need skills, but it's more of a game of smart billing, networking, and marketing if your goal is to really reach the elite levels of DPM income range.

We are very fortunate that the vast majority of PMS-36s available now will give their grads the experience, resources, and surgical experience that they need to pass all of the forefoot and rearfoot boards that a DPM will need to get on hospital/clinic staff at most places. "High powered" programs are probably still the best way to go if you have the grades/smarts and can hack the rough hours. Completing a well known program or getting elite skills is likely to give you more options and set you up well to go into academic roles after training (which are usually undertaken more due to interest than riches). It all depends on what the individual's ultimate goal is, though. As a 4th year student myself, if I were out to make as much $ as I can after training (I'm really not), I'd probably be looking for a middle of the road program that would give me adequate surgical skills and a ton of experience at successful private offices.

 

[HenryH]

Over the past few years, there have been a fair number of threads on this if you try searching in the pod forums. Here's a couple of them...

http://forums.studentdoctor.net/showthread.php?t=306230http://forums.studentdoctor.net/showthread.php?t=306230&highlight=residencies+west+penn
http://forums.studentdoctor.net/showthread.php?t=486427


Residency (+/- fellowship) surely helps, but, just like going to a good college, it really doesn't guarantee anything. It will come down to the person... lazy or hardworking? Gregarious or diffident? etc

Graduating from a prestigous residency usually does help in terms of getting better initial job offers right out of residency, but you are still working for someone else. Eventually, just as in any carer, many of the richest pods are working for themselves (private practice ownership). You need skills, but it's more of a game of smart billing, networking, and marketing if your goal is to really reach the elite levels of DPM income range.

We are very fortunate that the vast majority of PMS-36s available now will give their grads the experience, resources, and surgical experience that they need to pass all of the forefoot and rearfoot boards that a DPM will need to get on hospital/clinic staff at most places. "High powered" programs are probably still the best way to go if you have the grades/smarts and can hack the rough hours. Completing a well known program or getting elite skills is likely to give you more options and set you up well to go into academic roles after training (which are usually undertaken more due to interest than riches). It all depends on what the individual's ultimate goal is, though. As a 4th year student myself, if I were out to make as much $ as I can after training (I'm really not), I'd probably be looking for a middle of the road program that would give me adequate surgical skills and a ton of experience at successful private offices.

The excerpt I bolded above describes me, so I guess I will look into applying to...

"a middle of the road program that would give me adequate surgical skills and a ton of experience at successful private offices"

...if I decide to apply to podiatry school.

Do you ever talk to residents of 36-month programs that accept offers for less than $100k? I'm not trying to bash anyone, but honestly -- if I am going to be trained and licensed to reconstruct somebody's ankle and be *the* go-to authority on lower-extremity health, I want to at least earn six-figures. I mean, I'm sure the ortho F&A guys don't even consider sub-six figure offers, and since PMS-36 trained podiatrists are licensed to do the exact same procedures, why should they?

One other thing -- for a good chance at being accepted to a residency program that will enable me to make the "connections" needed to start out with a bang, what minimum GPA would you suggest?

 

[jonwill]

I am the wife of a fourth year podiatry student at DMU and my husband just started his first clerkship. I wanted to know more about what residencies are considered the "good" ones. I've seen that if you're not in a top residency that your first "job" will consist of slave labor clip-and-cut kind of work. (I've read a lot of depressing stuff on this issue) Can anyone fill me in on the top residencies? I realize that we've already set up our clerkships but we have time till we apply for residencies.

Also, is it safe to buy the practice of a retiring podiatrist? That is an option for us but I want to be guaranteed patients and some money. I don't want my husband to be stuck doing nursing homes for years and years.

Any comments would be appreciated.

I think the "horror stories" that you are referring to are from a different era. I think to some extent, it really used to be like that. However, as training has greatly increased across the board, this is no longer the case. Yes, I have many friends at the "high power" programs and those residents do very well. However, I am also aware of many that have come from far less known programs that start out very well.

I think anyone that buys a practice out of residency is crazy!!! But seriously, there are plenty of other options out of residency including pod groups, multispecialty groups, ortho groups, and hospitals. Going out on your own immediately after residency would be extremely stressful and risky but then again, people do it.

 

[podwife]

Thanks for all the info and the links were great HenryH, I couldn't find any threads on it myself. I was happy to see a couple of our externships on the lists I saw, WestPenn and St. John North Shore in MI. We are also going to St. Joseph's in IN, MillCreek in OH, and Multicare in WA. (Hubby's core is at the VA in Phoenix but it will be after residency interviews). Has anybody heard anything about those? Are they any good? We tried to pick places we thought looked well-rounded with lots of surgery but I should have been doing more research last year.

Getting into a group practice would be great. I agree, Jonwill, it's too stressful to go right into private practice. Is it hard to get into a group practice? I probably won't want to settle where we do residency and I don't know how hard it is to network into a group some place we don't live. Do hospital's hire DPM's full time? That would shock me but I have to ask because I'm curious.

 

[jonwill]

Thanks for all the info and the links were great HenryH, I couldn't find any threads on it myself. I was happy to see a couple of our externships on the lists I saw, WestPenn and St. John North Shore in MI. We are also going to St. Joseph's in IN, MillCreek in OH, and Multicare in WA. (Hubby's core is at the VA in Phoenix but it will be after residency interviews). Has anybody heard anything about those? Are they any good? We tried to pick places we thought looked well-rounded with lots of surgery but I should have been doing more research last year.

Getting into a group practice would be great. I agree, Jonwill, it's too stressful to go right into private practice. Is it hard to get into a group practice? I probably won't want to settle where we do residency and I don't know how hard it is to network into a group some place we don't live. Do hospital's hire DPM's full time? That would shock me but I have to ask because I'm curious.

It is actually pretty easy to get into some type of group and that is what most guys do directly out of residency. Some brave souls do go out on their own and do just fine as well. Yes, I have seen quite a few hospitals hire podiatrists. In Iowa, Broadlawns and Methodist have multiple pods. Podiatry is a big money maker because it is "procedural" (ie they do many procedures whether in an OR or office which bills very well) so groups/hospitals love us.

 

[dpmgrad]

Do you ever talk to residents of 36-month programs that accept offers for less than $100k? I'm not trying to bash anyone, but honestly -- if I am going to be trained and licensed to reconstruct somebody's ankle and be *the* go-to authority on lower-extremity health, I want to at least earn six-figures. I mean, I'm sure the ortho F&A guys don't even consider sub-six figure offers, and since PMS-36 trained podiatrists are licensed to do the exact same procedures, why should they?

As discussed on the forum previously, salary issue is a rather complex. Yes, ideally, everyone would love to be making 6 figures when they get out of residency. For many PM&S-36 residency graduates in various parts of the country, they are being offered this level of salary. However, there are also many areas in the country that the starting salary will be below 100,000 due to a variety of factors. One needs to evaluate the entire salary package and not just looking at the salary itself. Many of the starting salaries that are below 100,000 usually have an incentive bonus package attached to it. Someone who has a starting salary of 75,000 with a very nice incentive bonus package can potentially make a lot more money than someone with a starting salary with 125,000 with no incentive package or with a bonus structure where level for bonus is too high due to higher starting salary.

 

[podwife]

Dpmgrad, what you shared about salary and incetives was really good to know!! I have been checking other threads out since I joined and am finding good information on this kind of topic. Do most/all offer health insurance? Or does it depend on the group? Do you have to pay overhead or does the group take care of it another way? Is it the same with mal-practice insurance?

Thanks again for all the imput!

 

[cool_vkb]

I mean, I'm sure the ortho F&A guys don't even consider sub-six figure offers, and since PMS-36 trained podiatrists are licensed to do the exact same procedures, why should they?

YOU are not equal to a F &A when it comes to salary. This is the most common misunderstanding many people have.

An F & A orthopod is a full body orthopedic surgeon who does a further specizliation in F & A orthopedics.

A Podiatrist is a foot & ankle specialist.

An F &A orthopod legally can treat entire Musculoskeletal system of body , a DPM has COMPLETE (muscle,nerve,vascular,ortho,etc etc) over just FOOT & ANKLE.

Just because a guy is F & A orthopod, it does not means he is gonna sit whole day just doing foot & ankle cases. If he feels like having an extra income or a busy life. he can treat knee, shoulder, elbow joint problems or fractures or whatever related to bone of anybody. So yeah naturally his salary will be way higher than us.Where as we as Podiatrist are strictly limited to Foot & ankle. i hope you see the difference here in terms of number of surgeries performed, number of patients seen,etc

Ofcourse there are some orthopods who strictly see only one thing (eg knee, hip,anke) but its not like every F & A orthopod you meet is solely surviving on bunions and ankle arthoscopies.they do see patients with other orthopedic conditions. Thats why they have long and tedious hours, high malpractice, and all this means higher salary.

Now we as Podiatrist chose this way of life. We know what we are gettin into, we know our scope of practice and all the good things we can do in it. We can definetly have a debate with an F&A orthopod over treatment/procedures but you simply cannot compare their lifestyle or salary with us as most of them are whole body orthopedic surgeons first and then F&A speciaist! Thats why some hospitals prefer them over us as they can take EM Call for any orthopedic condition where as we will be limited to Foot & ankle. For a hospital , this reduces a lot of work. now they dont have to hire two doctors : one for F&A and one for other bony structures.

there are some DPMs whose salaries or earnings are in 300-400k. i dont know the names. but they are always mentioned once or twice in debates on this forum. do a search, you will find their names.

This also opens a good debate. Since we just spend our entire 4yrs +3yrs solely on F & A, shouldnt we be having more expertise and eyes & hands more skilled when it comes to operating on F & A, compared to someone who spends just 6 months to 1yr.

 

[HenryH]

So it sounds like (once incentive bonuses, etc.) have been factored in, the peak salary for a podiatrist working for someone else is probably in the $130k-$150k range? Of course, podiatrists (hopefully) earn more as practice owners...

 

[spo01]

One other thing -- for a good chance at being accepted to a residency program that will enable me to make the "connections" needed to start out with a bang, what minimum GPA would you suggest?

I see a common theme to a lot of your posts and it's annoying- questions like 'what is the lowest gpa can I have?...' 'what is the lowest MCAT I can score....?' 'what is the least amount of hours I can work and make mad money.....' 'what is the minimum this or that' etc. Don't sell yourself so short. Work hard and do your best in whatever field interests you. I understand your worries man but you must realize there are no guarantees in ANY field. Whether you have MD, DO, DPM, DDS behind your name doesn't mean crap nowadays, you need to know your **** and have good business skills if you want a chance at making bank.

 

[MaseratiGT]

I see a common theme to a lot of your posts and it's annoying- questions like 'what is the lowest gpa can I have?...' 'what is the lowest MCAT I can score....?' 'what is the least amount of hours I can work and make mad money.....' 'what is the minimum this or that' etc. Don't sell yourself so short. Work hard and do your best in whatever field interests you. I understand your worries man but you must realize there are no guarantees in ANY field. Whether you have MD, DO, DPM, DDS behind your name doesn't mean crap nowadays, you need to know your **** and have good business skills if you want a chance at making bank.

 

[cool_vkb]

 

[cool_vkb]

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[cool_vkb]

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[jonwill]

So it sounds like (once incentive bonuses, etc.) have been factored in, the peak salary for a podiatrist working for someone else is probably in the $130k-$150k range? Of course, podiatrists (hopefully) earn more as practice owners...

That depends on your definition of "someone else". Many with hospitals, multipspecialty, and ortho groups start out around there and I've seen higher. If you start out with a small private practice that offers a small base with big incentives, than it all depends on what you do and how much you bring in.

 

[krabmas]

I'm sure the ortho F&A guys don't even consider sub-six figure offers, and since PMS-36 trained podiatrists are licensed to do the exact same procedures, why should they?

One other thing -- for a good chance at being accepted to a residency program that will enable me to make the "connections" needed to start out with a bang, what minimum GPA would you suggest?

the ortho F&A's get >300,000 to start, but they take gen ortho call and gen do general ortho cases as well.

 

[HenryH]

the ortho F&A's get >300,000 to start, but they take gen ortho call and gen do general ortho cases as well.

If I were the APMA, I would focus on getting podiatrists recognized as competent -- and willing! -- on-call physicians; it's too bad they can't take some sort of general call...

 

[cool_vkb]

If I were the APMA, I would focus on getting podiatrists recognized as competent -- and willing! -- on-call physicians; it's too bad they can't take some sort of general call...

Fortunately you are not!

 

[jonwill]

If I were the APMA, I would focus on getting podiatrists recognized as competent -- and willing! -- on-call physicians; it's too bad they can't take some sort of general call...

Podiatrists take call at ER's across the country. But they take foot and ankle call. F&A orthos did a general ortho residency before their fellowship and therefore can take GENERAL ortho call meaning shoulders, hips, spine, etc. That is the big difference between call. Obviously, a pod for an ortho group cannot take general call (even though many of us do as residents while on ortho).

 

[NatCh]

I am the wife of a fourth year podiatry student at DMU and my husband just started his first clerkship. I wanted to know more about what residencies are considered the "good" ones. I've seen that if you're not in a top residency that your first "job" will consist of slave labor clip-and-cut kind of work. (I've read a lot of depressing stuff on this issue) Can anyone fill me in on the top residencies? I realize that we've already set up our clerkships but we have time till we apply for residencies.

Also, is it safe to buy the practice of a retiring podiatrist? That is an option for us but I want to be guaranteed patients and some money. I don't want my husband to be stuck doing nursing homes for years and years.

Any comments would be appreciated.

Podwife, I understand why you'd be anxious at this point, but relax and do not fret. I doubt many graduates get themselves into the slave labor clip and chip work any more (unless that's what they want).

Buying a practice right out of Residency is an option but I think it'd be too scary since your husband won't have much (any?) practice management experience.

One option is to get hired as an "Associate" (employed podiatrist) on a salary in order to safely learn how to run a practice. Just make sure he pays attention to the nuts and bolts of running a practice rather than just collecting the paycheck. Then he can "buy-in" a Partnership share when he's comfortable.

Another option is to hire on as an Associate for a couple of years to learn the ropes, then "buy-out" an established practice elsewhere, or start from scratch.

Either of the above traditional scenarios have been available to "average" Podiatrists for years, and most of us do quite well financially. Of course everyone wants to leave school and Residency above average and as a top-notch podiatrist, but if your husband does not find himself a candidate for the Podiatry Hall of Fame, he can still make a great living.

I can tell a lot of the regular posters on this board are destined for greatness, and those who become the most highly trained are likely to make big incomes and advance the profession, but ask your husband how many "big names" in the profession he can recognize. I might be able to recognize maybe a hundred. He might recognize a couple hundred or even a few hundred? What about the other "average" 15,000 of us, out in our communities, knocking down bunions and ingrown nails one at a time? I guarantee you we're not all starving. If we were, then our national average income wouldn't be what it is.

Relax. Tell your husband to do his best. Be supportive and optimistic. You all are going to be fine.

Nat [never heard of me, but doing quite well]

p.s., Although our average income is less than that of Orthopods, our malpractice is a fraction of theirs. My brother-in-law is an Orthopod and he pays close to $300,000 per year for malpractice. Ouch. Mine's a mere $7200. Pffft. He takes call Q4 whereas I answer my cellphone a couple of times a month. He's stressed out as can be and I'm not, and I wouldn't trade places. I quit comparing professions years ago once I realized I was happy.

 

[cool_vkb]

My brother-in-law is an Orthopod and he pays close to $300,000 per year for malpractice. Ouch. Mine's a mere $7200. Pffft. He takes call Q4 whereas I answer my cellphone a couple of times a month. He's stressed out as can be and I'm not, and I wouldn't trade places. I quit comparing professions years ago once I realized I was happy.

OMG! $300K just in malpractice.wow! How much does he makes in average to pay such a humongous amount in malpractice.wow!

 

[podwife]

I see you can sense my anxiousness. As a wife, it's hard not to want to jump in and help your spouse (while not overstepping it). It's difficult to know what to do beyond "supporting him." The replies are very informative though.

As far as state licensing goes, how hard is it to get licensed in other states? Is it just a written test or something?

Although our average income is less than that of Orthopods, our malpractice is a fraction of theirs. My brother-in-law is an Orthopod and he pays close to $300,000 per year for malpractice. Ouch. Mine's a mere $7200. Pffft. He takes call Q4 whereas I answer my cellphone a couple of times a month. He's stressed out as can be and I'm not, and I wouldn't trade places. I quit comparing professions years ago once I realized I was happy.

That was one of the perks for us!!! SO many docs/future docs are afraid of malpractice costs (that's why there are so few OBGYN's now). Hopefullt that will help us sleep better at night.

Knowing we can have a confortable life is really all we want, with a muscle car and a boat. Too much to ask for? I hope not.

HenryH- I agree with the others, stop stressing yourself out, you'll get an ulcer. YOu seem really ambitious and that's a good trait to have, I'm sure you'll do fine. Wait, sorry, I meant you'll do great!

 

[IPODiatrist]

so as far as when youre doing your residency, how hand to mouth is it/can it be when you are paying your loans off? how are you guys managing your debt? how are others handling it? how soon do you realistically expect to be done paying? what is your opinion on the best way to repay? just curious to see how different folks are handling this issue.

 

[dpmgrad]

Dpmgrad, what you shared about salary and incetives was really good to know!! I have been checking other threads out since I joined and am finding good information on this kind of topic. Do most/all offer health insurance? Or does it depend on the group? Do you have to pay overhead or does the group take care of it another way? Is it the same with mal-practice insurance?

Thanks again for all the imput!

Most of the group practices do offer a variety of benefits package, which usually includes health insurance, malpractice insurance, membership dues, and CME courses/conferences. Some might even include relocation benefits, sign on bonuses, loan repayment, etc... For me, since I joined the podiatry group via income guarantee contract through a hospital, the hospital is paying off 10% of my student loans for each year I work under the contract. Health insurance and medical malpractice are usually picked up by the group practice if you are working for them full time. Most of the people working for a group as an independent contractor may not get these benefits. Sadly, I do know a few podiatry groups that do not offer health insurance and medical malpractice insurance coverage to their associates. As for the overhead expenses, it is usually paid by group. Since I am an associate at my group practice, the overhead cost really does not affect me as much as the partners in the group since I am paid out a salary with a bonus structure. If the overhead cost does increase, it might affect the bonuses that the partners get at the end of the year.

As for malpractice cost, it will vary from location to location. As NatCh posted, he is paying around 7000 a year for his malpractice. In my area (Philadelphia), the average Podiatric Surgeon pays about 12000 - 15000 a year for surgical Podiatry medical malpractice coverage. If I were to go over to Camden, NJ (which is right across the river from Philadelphia), the medical malpractice cost will drop to 6500 a year.