Shorter Medical Degree Programs Just as Good

[Adam Smasher]

Shorter Medical Degree Program Outcomes Just as Good

NYU finds its accelerated program matches the traditional program on key measures

www.medpagetoday.com

NYU figured out how to confer a MD degree in just 3 years. Those are doctors studying the entire body. This proves you don't need 4 years to figure out the foot.

CPME lurkers, take note. We are overtrained.

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[heybrother]

Shorter Medical Degree Program Outcomes Just as Good

NYU finds its accelerated program matches the traditional program on key measures

www.medpagetoday.com

NYU figured out how to confer a MD degree in just 3 years. Those are doctors studying the entire body. This proves you don't need 4 years to figure out the foot.

CPME lurkers, take note. We are overtrained.

Its a fascinating line of inquiry, but my preference for changing podiatry schools is to target the common line "podiatry students devote themselves to the foot and ankle from day 1 for 4 years." In fact most podiatry students receive essentially a superficial textbook type education* with insufficient focus on hand skills/surgical technique, far too much nail cutting as opposed to a focus on actual pathology, and far too much separation of anatomic training from surgical training. *I am willing to admit that the quality of teaching may be evolving because my own podiatry school has been hiring more people with actual surgical training who were employed at hospitals and what not.

I recall one surgical laboratory near the end of 3rd year where a group of 4 students sharing a cadaver attempted to perform some variation of an Austin, a closing base wedge, and a lapidus on a foot. We had some other interesting labs like building a circular frame, but the above is the only laboratory I can specifically recall that involved a cadaver human foot. I don't remember any focus or training on joint preparation or the use of a saw. I don't recall working on anatomic targeting with kwires and fluoro in combination. We threw some screws at some point, but not into bone. Anatomy contained far too much focus on the specific shapes of metatarsal bases and far too little incorporation of relevant surgical anatomy into our lower extremity cadaver labs. I've said this before - working on pigs feet in residency - not suturing, but focusing on tissue handling, dissecting periosteum, preparing joints with a rongeur etc - amped my game.

I get it. The podiatry schools are never going to be a trauma center. They can only treat the pathology that comes in. But in my experience, almost all students leave podiatry school essentially with a reasonable starting knowledge base, but almost no hands on skills. Far too often they show up at residencies where attendings don't pass the blade for at least a year. If there is any point in the podiatric schooling where the training is ripe for upgrading its 3rd year. Increasing student hand skills asap, might actually increase attending confidence in them and improve the likelihood they start cutting sooner.

Not all surgical equipment is expensive. I priced an MIS set at one point that came with a bit of everything and it was $4K

 

[Adam Smasher]

Once again, this is where I deviate from the conventional wisdom on sdn. Here, the general tone is, reduce enrollment, improve academic rigor at the school level, improve case volume/diversity per trainee at the residency level.

My attitude is, academic rigor in school is just fine because 90% of podiatry is pretty damn simple, don't waste everyone's time acting like it's not, shorten the number of years in school and/or residency, and let pre-health students look at the job market and decide collectively what enrollment should be.

 

[Bored Snorlax]

I don’t agree for MD/DO programs, but for podiatry, a 3-year completion might be adequate at certain schools.

 

[Retrograde_Nail]

Shorter Medical Degree Program Outcomes Just as Good

NYU finds its accelerated program matches the traditional program on key measures

www.medpagetoday.com

NYU figured out how to confer a MD degree in just 3 years. Those are doctors studying the entire body. This proves you don't need 4 years to figure out the foot.

CPME lurkers, take note. We are overtrained.

Are these students going primarily into primary care? This makes sense to entice more people to go into general practice so we don't have to rely on PAs and NPs for medical care.

 

[Adam Smasher]

Are these students going primarily into primary care? This makes sense to entice more people to go into general practice so we don't have to rely on PAs and NPs for medical care.

The school website says you get conditional acceptance into the IM residency at NYU Langone. Basically they acknowledge that doing a 4th year full of clerkship simply to have a broad exposure into different specialties is not a productive use of students' time, especially if you already know how you want to specialize, so let's fast-track you onto residency.

Obviously, the biggest difference is that the residency match for them is "ho hum, I'm going to get good training no matter where I land so might as well get this degree over with." By contrast, in podiatry, there's inconsistent quality both on the applicant side and the residency side, so 4th year clerkships are basically a tax on students both to get information on which programs are legit and to prove their own legitimacy.

 

[Robin-jay]

A 3 year residency for podiatry is what blows my mind.

All this incentivizes is that Attendings use residents for scut work as much as possible.

2 years should be the max, and doing surgeries should be 80% of the focus.

I couldn't imagine how much scut work a resident would be forced to do if residency was 4+ years (which I know a couple pod residencies are 4 years already).

 

[Feli]

A 3 year residency for podiatry is what blows my mind.

All this incentivizes is that Attendings use residents for scut work as much as possible.

2 years should be the max, and doing surgeries should be 80% of the focus.

I couldn't imagine how much scut work a resident would be forced to do if residency was 4+ years (which I know a couple pod residencies are 4 years already).

Yes and no.
For general podiatry (RFC, insoles, injects, derm stuff, wound care, etc), 3 years is too long. For sure.
However, for surgical podiatry (ORIFs, recons, etc), 3 years is a minimum for any MD that does proc/surgery... so even with pod school focused, podiatry should probably be 4yr for surgery.
But we missed our chance to do that dent model, and we have what we have: everyone's a 3yr residency "foot and ankle surgeon" (except some have a joke VA or baby hospital RFC residency, and others have pretty solid volume and skills in a legit teaching program with good DPM attendings).

...Either way, it's a moot point. That study in OP is obviously biased (study by the school doing 3yr), and it can't be seen as any help for real insight.

And at the end of the day, follow the money. If podiatry school was 3yr and not 4yr, that means the schools then need 25% more students/matriculants to have the same tuition profits. That won't happen. It'll stay 4 years (or 5yr, 6yr, 7yr, etc if they can string some students who should've flunked along for remediation cla$$es). 🙂