Residency Programs

[BuckeyeDoctor]

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I was hoping either current residents or attendings could share some insight on picking a residency program. Specifically,

1) How can you tell if a program is a solid program or not? There are always students talking about certain "elite" programs but if a program isn't your typical West Penn, Inova, Denver, etc. how can you judge it? What questions should one ask to determine the quality of training?

2) Is it worthwhile to call attendings in the area of the program and ask their view on the program and the quality of training?

3) What are some things you wish you knew if you could choose for residency again?

Thanks for any insight you may be able to share!

 

[Feli]

1) I'd judge mostly on recent alumni competence, current resident competence, director and attendings' interest in teaching, and surgical experience per resident...
-Where do some recent program graduates work? If they're local, do they seem to be boarding good rearfoot cases regularly? Are they passing ABPS consistently, are they competent in the OR, on floors, billing in clinic, etc?
-Same analysis of residents: competency, surg skill, ER/floor/clinic skills, general knowledge level, etc. People have different levels of natural ability and coordination, but resident quality will generally have large influence on overall program quality. Some programs consistently attract smart+competent residents while others consistently don't... usually an underlying reason (besides just geographic location) for that.
-Having director/attendings/co-residents who are interested in teaching also plays a big role. A trained monkey could probably do good technical surgery, but you also want to have active lectures, rad conf, journal club, etc to help you think about standards of care and clinical/surgical decision making... maybe research support is also valued if you are interested in that.
-Of prime importance is obviously how much surgery and how many clinic patients does each resident get to do (note the difference between "logging" and "doing") on an individual basis... are most surgeries just a resident +/- a student and the attending, or is it usually 3+ residents scrubbed in with the attending, and maybe students watching? Your logs are probably what will get you privileges for surgery after residency, but some programs/individuals fudge or "enhance" their logs. Competence is really the bottom line... you are what you repeatedly do.

A good sign will usually be letting (competent) students participate frequently in surgery/clinic/ER/etc... that generally shows you there's not much shortage of work and patient/surgery load. On the other hand, if clinic involves a lot of sitting around and residents are bickering over who gets to scrub cases or frequently voicing concerns about "getting numbers," then it might be a program where the experience could be better.

2) Probably not worthwhile, but maybe if they're younger ones. Most community attendings will be outdated on program quality and just tell you that the program where they trained is a good one. Attendings who are more involved in academics and resident teaching probably will be more up to date, but it's then in their best interest to pimp the program(s) which they are involved with.

3) If you read a lot on CASPRCRIP.org, visit a good number of programs, and talk to a lot of residents during your 4th year, then you should have a good handle on the process and what you want from a program. GL

 

[Foot Doc]

1) I'd judge mostly on recent alumni competence, current resident competence, director and attendings' interest in teaching, and surgical experience per resident...
-Where do some recent program graduates work? If they're local, do they seem to be boarding good rearfoot cases regularly? Are they passing ABPS consistently, are they competent in the OR, on floors, billing in clinic, etc?
-Same analysis of residents: competency, surg skill, ER/floor/clinic skills, general knowledge level, etc. People have different levels of natural ability and coordination, but resident quality will generally have large influence on overall program quality. Some programs consistently attract smart+competent residents while others consistently don't... usually an underlying reason (besides just geographic location) for that.
-Having director/attendings/co-residents who are interested in teaching also plays a big role. A trained monkey could probably do good technical surgery, but you also want to have active lectures, rad conf, journal club, etc to help you think about standards of care and clinical/surgical decision making... maybe research support is also valued if you are interested in that.
-Of prime importance is obviously how much surgery and how many clinic patients does each resident get to do (note the difference between "logging" and "doing") on an individual basis... are most surgeries just a resident +/- a student and the attending, or is it usually 3+ residents scrubbed in with the attending, and maybe students watching? Your logs are probably what will get you privileges for surgery after residency, but some programs/individuals fudge or "enhance" their logs. Competence is really the bottom line... you are what you repeatedly do.

A good sign will usually be letting (competent) students participate frequently in surgery/clinic/ER/etc... that generally shows you there's not much shortage of work and patient/surgery load. On the other hand, if clinic involves a lot of sitting around and residents are bickering over who gets to scrub cases or frequently voicing concerns about "getting numbers," then it might be a program where the experience could be better.

2) Probably not worthwhile, but maybe if they're younger ones. Most community attendings will be outdated on program quality and just tell you that the program where they trained is a good one. Attendings who are more involved in academics and resident teaching probably will be more up to date, but it's then in their best interest to pimp the program(s) which they are involved with.

3) If you read a lot on CASPRCRIP.org, visit a good number of programs, and talk to a lot of residents during your 4th year, then you should have a good handle on the process and what you want from a program. GL

what he said

 

[Podfather]

I would look for programs where the graduates have excelled after graduation. Good jobs, involvement at the national level, and a their involvement in education. This shows that a program has the best intentions and promotes their graduates. Seattle programs, Northern Virginia, West Penn Hospital, and West Houston Medical Center (Harris County). All have a whos who of national leaders and place graduates in orthopedic, multispecialty, and large DPM practices. See if their directors are involved at the state and national level which helps with job placement.

 

[XCdude]

I would look for programs where the graduates have excelled after graduation. Good jobs, involvement at the national level, and a their involvement in education. This shows that a program has the best intentions and promotes their graduates. Seattle programs, Northern Virginia, West Penn Hospital, and West Houston Medical Center (Harris County). All have a whos who of national leaders and place graduates in orthopedic, multispecialty, and large DPM practices. See if their directors are involved at the state and national level which helps with job placement.

I agree that going to a well established program might seem to make it easier to excell, but it isn't everything. I personally think that many years ago these were the only places you could get good training, but now there is a much more even playing field. Some of the most successful podiatrists I know went to less than renown residency programs. Being a successful podiatrist comes down to being a nice guy who's competent at what he does. Having attendings who're involved at a national and state level will not get you a job. It gets you involved in politicing...

 

[Podagra]

I would look for programs where the graduates have excelled after graduation. Good jobs, involvement at the national level, and a their involvement in education. This shows that a program has the best intentions and promotes their graduates. Seattle programs, Northern Virginia, West Penn Hospital, and West Houston Medical Center (Harris County). All have a whos who of national leaders and place graduates in orthopedic, multispecialty, and large DPM practices. See if their directors are involved at the state and national level which helps with job placement.

No offense but I think that your list of programs is extremely dated. While those are solid programs I would not say that they are the national leaders nor on the cutting edge of medicine. I would postulate that they appear high b/c many graduates lecture for ACFAS. But that group continues to inbreed. They do not go outside of their group, thus the ACFAS meetings are stagnet. I bet when I go this year, I'll hear the same topics. A perfect example of this is West Penn's special edition of JFAS, a case series of 3 cavus feet. You've got to be kidding me.

I agree with the criteria listed above, but don't get caught on a name or assume that b/c a program was great in 1990 or 2000 that they are still strong. The best thing is to visit. Don't get caught up in numbers too much b/c you need clinical exposure. If you don't learn how to run a clinic as a resident, you'll have to learn as an attending (that means you lose money)

One thing that drives me nuts is the attitude of these old programs, check out West Penn's website.

http://www.wpahs.org/wph/education/wph/graduate/wph_podiatry.html

They use the word podiatry or podiatric 7 times and the term Foot and Ankle 17 times (not including ACFAS). I am happy to be a podiatrist and the term podiatry is nothing to be ashamed of. As posted elsewhere, how will we change things if we continue to go be foot and ankle surgeons. Call a spade a spade, we are podiatrists and we need to be proud.

 

[Podfather]

Look, I wasn't saying their are not other good programs just that these programs seem to do well for post-graduate placement. Many of their graduates get offerred top paying jobs in a variety practice types. As for the "politicing" comment, I feel sorry that you feel that that is what is going on at the ABPS, ACFAS, and now APMA. Most of those involved contribute a lot of time away from their practices and families to help the profession. This is at a loss of income and family time. The networking that the directors and faculty do while putiing in the time permits them to help their graduates find jobs all over the country within podiatry, orthopedics, or multispecialty care.

As far as implying that the information they provide to their residents or the profession is stale, outdated, or inbred mantra, I would argue that many of those people are at the cutting edge of the profession and actually do the work.

 

[templepodnc]

Podfather,

I see where you are coming from. At the same time, I think you might of misread the original post, or maybe I did! I thought the OP was asking how to tell if a program was a solid program besides the usual ones that are always mentioned.

Sure, West Penn, Inova, etc. are great programs, with great attendings, that's not really disputable. But what about "sleeper" programs that may not be pushing the ACFAS research papers 24/7 but give outstanding training. How do you tell when you find a program like that? I think there are about 15-20 programs that everyone would rattle off that give you excellent training and are "big" name programs. But how do you judge the others?

 

[Podfather]

Yes I agree the big names are less of a concern. I took a little offense to the list is outdated, the politicing, the ACFAS meetings are stagnet, etc. IMO those statements are untrue and could mislead someone in not considering those programs when they are gateways to success for the right individuals.

To your point here are some questions to ask yourself or the program:
1. How many surgical cases and what types will you perform over the 2-3 years? Will you only meet the MAVs required for approval or exceed that in numbers and diversity?
2. How many DPMs ACTIVELY work with the residents clinically and academically?
3. How many of the graduates found positions and what was their average starting salary, benefits? What is the pass rate for board qualification? How many have published and are active both scientifically and politically in the profession. How many alumni exist (for placement purposes).
4. What is your involvement in the non-podiatric rotations? Observational or do you participate in care?
5. What are the academics like? A few lectures a month or regular consistent journal clubs, dissection labs, care reviews and are the attendings involved?
6. What is the experience and reputation of the director?
7. How stable is the hospital financially?
8. Is there activities that the residents do that benefit the director or attendings that serve no educational purpose?
9. Does the program have a real clinic (not a palliative care) or office rotation that permits training in patient evaluation, postop care?
10. Any practice management?
11. Has the program been or is it on probation with the CPME and is it approved or on provisional status?

Your sources are the previous and current residents, the CPME, visiting/calling faculty, and if possible visiting the program. Training even with the new models is extremely variable. The solid programs mentioned above are solid because of proven track recirds and consistently putting out solid, competent DPMs year after year. For the rest honest questioning without rationalization is essential. Please do not pick a program purely because of location and pay. Many new graduates seek convenience versus education. After your 3 years then focus on those kind of questions...........

 

[Feli]

Many good points made in the thread. Like I said in my initial reply, I'd look at what recent program grads are doing: what kinds of cases/jobs/etc?

Mainly, you have to realize that many good programs have expanded recently (likely based on CPME/APMA pressures due to increased size of upcoming DPM grad classes). If a program goes from taking 2 residents/yr to taking 3/yr without adding any attendings/cases, then each resident's number of surgical cases, clinic pts, and ER calls dips by one third. Go from 3/yr to 5/yr? you guess it: down 40%... might not even get your minimum surgical reqs anymore. Do progams that take recently began to take 4/yr do that because they added a new hospital and need that many residents to cover their cases/clinic/inpatients/ERs... or do they take that many because it adds more $ for the hospital for each resident they take and because that's the max are allowed to take? That kind of thing can turn a great program into an avg/good program pretty fast, so be very concious of how much double/triple scrubbing is going on and how each resident is actually doing in terms of surgery and pt care when you clerk/visit different programs.

There are some programs that are getting by largely on name, but most are still good programs in their own right. I clerked at basically all "big name," "top 20," etc programs, and while I had likes/dislikes at each, they could all definitely give you what you need in terms of clinic, surgery, etc skills and knowledge to pass boards, get a good job, help patients, etc. When all was said and done, my program was probably the least known "brand name" of the ones I clerked at, but it was the best fit for me and my #1 rank. In the end, residency choice has to fit you for 3yrs, so pick the right one, not just the biggest name (although the two may go hand in hand). The bottom line is just that we are lucky that there are many great PG pod surg training programs with major hospital affiliations nowadays, and if you doubt that, ask any DPM who graduated 10+ years ago what their options were compared to the current CASPR list. 👍

 

[krabmas]

I knew where I wanted to go from day one of 4th year. I decided at the end of my 3rd year and I got very lucky that it worked out, but there are things to look for when you visit.

1. Watch the 3rd year residents doing surgery - are the attendings letting them work? Are the 3rd years confident and compitent? That will be you as a 3rd year if you go to that program. (everyone progresses at a different pace but that will be your level more or less).

2. Are the 3rd years showing the 2nd and 1st years how to do cases? (I think this is a benefit when the attending allows the senior residents to teach the juniors) This is actually a requirement and a level of case logging for AGCME (MD) residencies.

3. Are the 3rd years doing bunions? If so, why? do they need the numbers? Or does that program think that rearfoot is for 1st years and forefoot for 2nd years? There are people out there that subscribe to this theory b/c forefoot is small and fine disection whereas rearfoot is big and easier for new motor skills.

4. Are the residents that are off service still required to go to the pallative care clinic or evening meetings for podiaty or are the allowed to enjoy and imerse themselves in the off service rotation?

5. When off service are the expectations of the pod resident the same as the MD/DO residents? They should be the same.

It is easier to tell these things once at the program. The hard part is deciding which programs to rotate at.

Here is a list of programs that I can think of off the top of my head:

Inova
West Penn
DMC
UMDNJ
(where Feli is? I think St John? in Michigan?)
Denver (PSL)
Scripps
Kaiser consortium in san fran
some other northern cali programs
Kentucky has 2 good programs
There is one in Arizona that the 1st year is spent as a general surgery intern and sounds pretty solid
Presby
Ohio state (sounded good - don't really know)


This list is not inclusive and I am sure I forgot to name several good programs. It is also important that you find an environment that supports your learning style. For example, Inova is good for independent learners. We have academics but mostly we are a pretty motivated bunch and we read lots on our own. We also tend to take advantage of the attendings on other services that do not have residents and scrub cases just to get tissue time.

That is all my advice for now. Hope this helped a bit. If there are programs that you are wondering about just ask and you'll get 5 or 6 oppinions.

 

[templepodnc]

What is the opinion of the two louisville programs? I know Jewish is an excellent program, what's the opinion or general consensus about Norton? Pros, Cons?

 

[Feli]

... The hard part is deciding which programs to rotate at...

Yep^^
Chances are that with bigger and bigger graduating class sizes, programs become more likely to pick their residents from among their clerk students. It's important to apply early and have done your research beforehand. Every program has their emphasis, and strong/weak points which you'll gain the most insight on by visiting and seeing for yourself.

I listed some of the better known programs awhile ago (and you will see basically 100% overlap with krabmas list)...
http://forums.studentdoctor.net/showthread.php?p=6091105#post6091105

Different students want different things, and it helps to figure that out before you pick your clerkships: do you want to do a lot of wound care? a ton of acute trauma and ER call? lots of elective? want to learn total ankles? do you want to go into academics/politics and need to publish a lot during residency to open those doors? The best program for one student might bore another or waste a lot of their time on areas they aren't intending to do much of in practice. Ideally, you'd want to group the programs based on their emphasis...

Trauma = DMC, Palmetto, Jewish, Oakwood, UMDNJ, Orlando, Frankfurt, etc
Advanced RF recon = DeKalb, West Penn, Kaisers, etc
Great outside med/surg rotations = Presby, Inova, Yale, UPMC, etc
High volume elective = Genesys, JFK, StJohn, etc
Diabetic limb salvage = Beth Isreal, UTSA, etc
Academic = West Penn, Oakwood, Swedish, Kaisers, DeKalb, etc

...but despite "emphasis," most of the ones in the link and krab post above are pretty good (or at least adequate) in all areas since they have good residents and many different attendings who will bring in nearly all types of cases at least periodically. I guess that's the reason they're "top programs": they will give you what you need, and you can't really go wrong.

I'd also echo what krabmas said about finding a program that fits your needs: high structure vs more independent, trained more by ortho or more by DPMs for rearfoot, more trauma vs more elective, personalities of fellow residents, etc.

 

[TexPod1]

"Trauma = DMC, Palmetto, Jewish, Oakwood, UMDNJ, Orlando, Frankfurt, etc
Advanced RF recon = DeKalb, West Penn, Kaisers, etc
Great outside med/surg rotations = Presby, Inova, Yale, UPMC, etc
High volume elective = Genesys, JFK, StJohn, etc
Diabetic limb salvage = Beth Isreal, UTSA, etc
Academic = West Penn, Oakwood, Swedish, Kaisers, DeKalb, etc"

😕

How did you narrow your focus? I'm interested in all of these aspects, and having a difficult time deciding which programs to apply for clerkships to!

 

[Feli]

...How did you narrow your focus? I'm interested in all of these aspects, and having a difficult time deciding which programs to apply for clerkships to!

Just think about what kind of pts you enjoy treating and what you'd like see yourself doing 2, 5, 10, 20, etc yrs after residency. Also, you obviously have to consider what makes money to pay off your loans, pay your mortgage, and have a comfortable life.

Like I said, most good programs will give you at least adequate exposure to many types of pts and procedures, but they all have their emphasis. You might get the most out of a program that emphasizes the types of cases and environment you want to do a lot of as an attending. For some students, that's office/elective, some ER/trauma, some wound care/diabetes, some academic research/lecture, etc. It's all individual, and chances are good that you'll be doing at least a fair amount of all those things. Still, it helps to start figuring out what you want from a program... preferrably even before clerkship apps, definitely before you rank them for match.

 

[Foot Doc]

What is the opinion of the two louisville programs? I know Jewish is an excellent program, what's the opinion or general consensus about Norton? Pros, Cons?

from my personal experience from starting at the Norton program for the first 2 months of residency and then moving to and helping start the Jewish program is that we (Jewish) retained most (20 or so of the 23) podiatry attendings, kept University of Louisville affiliation (Norton does not), our director is Dr. Ford (he made KPRP what it was before we moved). Our numbers have not decreased and the Jewish hospital system treats us a LOT better than Norton did.......I'm just sayin'

 

[jonwill]

"Trauma = DMC, Palmetto, Jewish, Oakwood, UMDNJ, Orlando, Frankfurt, etc
Advanced RF recon = DeKalb, West Penn, Kaisers, etc
Great outside med/surg rotations = Presby, Inova, Yale, UPMC, etc
High volume elective = Genesys, JFK, StJohn, etc
Diabetic limb salvage = Beth Isreal, UTSA, etc
Academic = West Penn, Oakwood, Swedish, Kaisers, DeKalb, etc"

😕

How did you narrow your focus? I'm interested in all of these aspects, and having a difficult time deciding which programs to apply for clerkships to!

You can find a lot out by speaking with residents and students in front of you that are at these programs. It is difficult to classify any of the above programs into one category. What you will find is that a lot of programs (especially the ones listed) satisfy many of the categories which is what makes them such great programs and so competitive.

But in the end, you can't visit them all which is what makes it so difficult!

 

[Dr. Gangrene]

what he said

or she said (the office)

 

[SubRosa]

Yep^^

Diabetic limb salvage = Beth Isreal, UTSA, etc

Does anyone have any experience or insight into any of the other ones in the Boston area like Mass Gen, Cambridge, and Beth Isreal?

 

[NormColeman4MN]

Does anyone have any experience or insight into any of the other ones in the Boston area like Mass Gen, Cambridge, and Beth Isreal?

1 spot at Mass General...and I shottied it sorry skippy. Look at cambridge or beth israel. Thanks.

 

[Podagra]

Look, I wasn't saying their are not other good programs just that these programs seem to do well for post-graduate placement. Many of their graduates get offerred top paying jobs in a variety practice types. As for the "politicing" comment, I feel sorry that you feel that that is what is going on at the ABPS, ACFAS, and now APMA. Most of those involved contribute a lot of time away from their practices and families to help the profession. This is at a loss of income and family time. The networking that the directors and faculty do while putiing in the time permits them to help their graduates find jobs all over the country within podiatry, orthopedics, or multispecialty care.

As far as implying that the information they provide to their residents or the profession is stale, outdated, or inbred mantra, I would argue that many of those people are at the cutting edge of the profession and actually do the work.

"The lady doth protest too much, methinks."

While I respect those that sacrifice and give to our profession, you seem too defensive. You cannot deny that certain groups control certain societies. If you disagree please list me young practioners that lecture for ACFAS that did not attend PI, Swedish, West Penn or West Houston. A better response would be like minded people follow similar paths, ie bird of a feather theory.

I would like you to show me where I said they provide outdated information. I stated that I get tired of hearing the same lecture every year with the same pictures of the same cases. As far as cutting edge, I cannot say that many areas of medicine have had ground breaking changes. Most ground breaking research has been in diabetes from Lavery, or Armstrong, or Harkless. Outside of that I would say the last big break that was purely podiatric would be pre-dislocation syndrome.

 

[Podfather]

"The lady doth protest too much, methinks."
I am not defensive but tire of the inbreeding, poltics, good ole boy urban legend

While I respect those that sacrifice and give to our profession, you seem too defensive. You cannot deny that certain groups control certain societies. If you disagree please list me young practioners that lecture for ACFAS that did not attend PI, Swedish, West Penn or West Houston. A better response would be like minded people follow similar paths, ie bird of a feather theory.

Since you asked: Hamilton, Ford, Buddecke, Steck, Boffelli, Steinberg, Treadwell, Grambart. There are many others. Even those you loisted below Harkless,Lavery have been part of the ACFAS program.

I would like you to show me where I said they provide outdated information. I stated that I get tired of hearing the same lecture every year with the same pictures of the same cases. As far as cutting edge, I cannot say that many areas of medicine have had ground breaking changes. Most ground breaking research has been in diabetes from Lavery, or Armstrong, or Harkless. Outside of that I would say the last big break that was purely podiatric would be pre-dislocation syndrome.

The lecture topics will always have many of the same titles since the problems rarely change. The format, speakers, and information has evolved and morphed in style, presenters, and EBM. Cutting edge is what you will find at these meetings and presented by those who really do the work. I have seen the evaluations and the majority of those who attend have a different point of view than you.

 

[Podagra]

"The lady doth protest too much, methinks."
I am not defensive but tire of the inbreeding, poltics, good ole boy urban legend

While I respect those that sacrifice and give to our profession, you seem too defensive. You cannot deny that certain groups control certain societies. If you disagree please list me young practioners that lecture for ACFAS that did not attend PI, Swedish, West Penn or West Houston. A better response would be like minded people follow similar paths, ie bird of a feather theory.

Since you asked: Hamilton, Ford, Buddecke, Steck, Boffelli, Steinberg, Treadwell, Grambart. There are many others. Even those you loisted below Harkless,Lavery have been part of the ACFAS program.

I would like you to show me where I said they provide outdated information. I stated that I get tired of hearing the same lecture every year with the same pictures of the same cases. As far as cutting edge, I cannot say that many areas of medicine have had ground breaking changes. Most ground breaking research has been in diabetes from Lavery, or Armstrong, or Harkless. Outside of that I would say the last big break that was purely podiatric would be pre-dislocation syndrome.

The lecture topics will always have many of the same titles since the problems rarely change. The format, speakers, and information has evolved and morphed in style, presenters, and EBM. Cutting edge is what you will find at these meetings and presented by those who really do the work. I have seen the evaluations and the majority of those who attend have a different point of view than you.

Again, I like many of the people in ACFAS, APMA, ect but you are just proving my point even more. Just a few people you mentioned:

Grambart-Seattle grad
Ford- Seattle grad
Rush - Seattle grad
Steinberg - INOVA grad
Hamiliton - Works with Ford and Schuberth at Kaiser
Buddecke - Good friends with Lee worked together in Des Moines

I am good friends with many of the people in ACFAS and APMA, but I don't deny the fact that there are good old boy networks.

As I said before in my orginal comment, I do not approve of any group that asks ashamed of being a podiatrist. Hiding behind the term foot and ankle surgeon drives my crazy. I understand that podiatry was much different then it is today.

As for the meetings, there are plenty of topics to rotate through. One increase diabetic topics. Two, we discussed Harless, Lavery, Armstrong, why not bring these people to talk? One reason is they used to be part of ACFAS, but why not now? As I state times have changed, this is true in residencies also.

 

[Podfather]

Again, I like many of the people in ACFAS, APMA, ect but you are just proving my point even more. Just a few people you mentioned:

Grambart-Seattle grad
Ford- Seattle grad
Rush - Seattle grad
Steinberg - INOVA grad
Hamiliton - Works with Ford and Schuberth at Kaiser
Buddecke - Good friends with Lee worked together in Des Moines

So now Seattle/INOVA is included with the programs you mentioned. Then Hamilton is an issue since he works with people who trained at Seattle and Buddecke is friends with a West Penn graduate so he is included. You never mentioned Steck, Treadwell or Boffeli? Soon anyone who has the same zodiac sign will be a problem. Look there are scores of people who are younger with EXPERIENCE who lecture at the ACFAS meeting and other CMEs. Those I named are just a few. They are invited to speak because of their knowlege and their weekly experience with the procedures they are lecturing about. They actually do the work. Besides even if there are some programs that have more graduates lecturing than others (often a result of the number of years the program has been around and class size which gives us mor numbers) do actually believe they all practice the same? Attend any panel discussion and you will see alums disageeing with each other and even their own directors at times.

I am good friends with many of the people in ACFAS and APMA, but I don't deny the fact that there are good old boy networks.

As I said before in my orginal comment, I do not approve of any group that asks ashamed of being a podiatrist. Hiding behind the term foot and ankle surgeon drives my crazy. I understand that podiatry was much different then it is today.

I am a podiatrist who is a foot and ankle surgeon. The public needs to know that. They need to know what I do. There are podiatrists who tout themseleves as wound care specialist, peripheral nerve surgeons, biomechanic specialists, and sports medicine docs. They are just informing the public what they do. No one is hiding?????

As for the meetings, there are plenty of topics to rotate through. One increase diabetic topics. Two, we discussed Harless, Lavery, Armstrong, why not bring these people to talk? One reason is they used to be part of ACFAS, but why not now? As I state times have changed, this is true in residencies also.

Check the programs at ACFAS over the last few years and you will see Harkless and others with an interest in diabetic topics are always on the program. It's a surgical seminar so there are a limited number of tracks for the diabetic just like rheumatoid patients. ACFAS had a 2 day learning center time course completely devoted to diabetes just a year ago.

 

[Podagra]

Check the programs at ACFAS over the last few years and you will see Harkless and others with an interest in diabetic topics are always on the program. It's a surgical seminar so there are a limited number of tracks for the diabetic just like rheumatoid patients. ACFAS had a 2 day learning center time course completely devoted to diabetes just a year ago.

You must a liberal because you have an excuse for everything.

You win and you didn't even have to play a race card, just keep Jimmy Carter off my back

 

[Podfather]

You must a liberal because you have an excuse for everything.

You win and you didn't even have to play a race card, just keep Jimmy Carter off my back

Geez. I simply state the facts you make an attack. Trying to poison the well with a label (BTW being a liberal or conservative isn't a bad thing is it?) is a poor way to prove a point. Look there are several great residencies out there. Some are well known and historically proven others are good and produce great graduates without the name recognition. The most important point that has been made is the program must be a good fit both for the resident and the attending faculty. Some programs are intense and require a self driven independent thinking residents, others are structured for someone who needs more direction, and some are laid back. I have seen programs of all types produce great surgeons and doctors and also produce bad ones. Since the program is the same for everyone, I chalk up the differences to poor resident fit. If you need pushed then you need a program that does that. If you push yourself then that type of program may slow you down.

My only gripe with some of your posts was the implication that the historically strong programs are past their prime and inbreed ideas. That the graduates who chose to give back by becoming residency directors, publishing, or lecturing are not on the edge or are there as a result of nepotism/ego is absurd. These individuals (both the recent graduates and those who have contributed for years) should be thanked for the efforts they make for the profession. Their efforts cost them money, time from their families, and are what has helped us enter the mainstream.

I respect ALL ethical, hardworking DPMs regardless of what organizations they support, regardless if they are a "foot and ankle surgeon", wound specialist, or biomechaniclly weighted practitioner.

BTW from now on I will call you gout of the first MPJ rather Podagra since that will be more on the edge and something you should like. I have already started prophylactic allopurinol to prevent getting Podagra or Podagra like thoughts.

I am a moderate BTW and support both Republican and Democratic candidates both financially and with time.......................

 

[Podagra]

Geez. I simply state the facts you make an attack. Trying to poison the well with a label (BTW being a liberal or conservative isn't a bad thing is it?) is a poor way to prove a point. Look there are several great residencies out there. Some are well known and historically proven others are good and produce great graduates without the name recognition. The most important point that has been made is the program must be a good fit both for the resident and the attending faculty. Some programs are intense and require a self driven independent thinking residents, others are structured for someone who needs more direction, and some are laid back. I have seen programs of all types produce great surgeons and doctors and also produce bad ones. Since the program is the same for everyone, I chalk up the differences to poor resident fit. If you need pushed then you need a program that does that. If you push yourself then that type of program may slow you down.

My only gripe with some of your posts was the implication that the historically strong programs are past their prime and inbreed ideas. That the graduates who chose to give back by becoming residency directors, publishing, or lecturing are not on the edge or are there as a result of nepotism/ego is absurd. These individuals (both the recent graduates and those who have contributed for years) should be thanked for the efforts they make for the profession. Their efforts cost them money, time from their families, and are what has helped us enter the mainstream.

I respect ALL ethical, hardworking DPMs regardless of what organizations they support, regardless if they are a "foot and ankle surgeon", wound specialist, or biomechaniclly weighted practitioner.

BTW from now on I will call you gout of the first MPJ rather Podagra since that will be more on the edge and something you should like. I have already started prophylactic allopurinol to prevent getting Podagra or Podagra like thoughts.

I am a moderate BTW and support both Republican and Democratic candidates both financially and with time.......................

I guess sarcasm does not translate well in type. It was a sardonic post only. I guess I need to use one of these things 😱

Also, I said that organizations are inbreed which I still stand by my statement. Residencies are most definately inbreed. Find me a residency that most attendings are not graduates from that program. I think that is true in every program and every specialty. I never comment on this topic or programs producing more residency directors. I never thought about it but that is probably a great way to see the quality of a program. I would imagine good programs produce more directors.

I am just amazed that I can post critizing every program and every attending and every podiatrist including Isachar Zacharie's care of President Lincoln with maybe a total of 250 words.😱 (that means sarcasm) If you are the type that believes everything you are told and never question the status quo, congrats, I am not.

 

[templepodnc]

others are good and produce great graduates without the name recognition.

Anyone care to share what some of the programs may be?

 

[krabmas]

I guess sarcasm does not translate well in type. It was a sardonic post only. I guess I need to use one of these things 😱

Also, I said that organizations are inbreed which I still stand by my statement. Residencies are most definately inbreed. Find me a residency that most attendings are not graduates from that program. I think that is true in every program and every specialty. I never comment on this topic or programs producing more residency directors. I never thought about it but that is probably a great way to see the quality of a program. I would imagine good programs produce more directors.

.

I don't think I care to agree or disagree with either of you but I would like to defend Inova.

We most certainly do not have an inbred program. Of the 25-30 attendings that we work with only 5 of them are graduates of the program and 1 of them we seldom work with.

 

[Podagra]

I don't think I care to agree or disagree with either of you but I would like to defend Inova.

We most certainly do not have an inbred program. Of the 25-30 attendings that we work with only 5 of them are graduates of the program and 1 of them we seldom work with.

Why defend? I see nothing wrong with having alumni serving as attendings. It is the norm. I don't know where this topic came from. I would say that most programs are heavy with alumni so you may be the exception. Of course some areas did not have program years ago or the programs maybe be long gone. Heck some attendings probably did not even do a residency. As I said, I don't understand why this matters?😕

 

[Podagra]

Anyone care to share what some of the programs may be?

Another way to find quality programs is look at who is publishing. See if they are an attending somewhere, see where they trained. Check program websites or check interesting people/attendings websites. A lot of websites have "bios" which have where they trained. Just another resource to evaulate programs.