Since I'm the most qualified...

Discussion in 'Clinicians [ RN / NP / PA ]' started by drmoon, Mar 8, 2002.

  1. drmoon

    drmoon Senior Member

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    Let me help you guys out.

    I started this thread some time ago and happened upon it today.

    In my opinion, podiatrists occupy a "netherworld" of doctors. As my good friend in podiatry school put it, we're the "bastard children of medicine". It seems like a lot of posters here have varying definitions of what a doctor or physician is. Frankly, since I've started pod school, I've grappled with this very question. I agree that podiatrists do not have to endure the the same, exact brutal 3rd and 4th years that med students do (the on-call stuff, delivering the babies, etc.) We have our own 3rd and 4th years, which isn't as taxing and pretty much is a mixture of didactic, externships and rotations. They are pretty far away from what MD and DO students do. In this respect, I believe that we are shorted on our education to become doctors. (And, by the way, the 1st two years are essentially identical to MD/DO school as has been shown to be so in a report written in 1995 by an MD named Franklin Medio). The 3rd and 4th years are not comparable, but you also have to realize that we are (still) concentrating on pathologies of the lower extremity. MD and DO students pretty much know squat about the lower extremity at this point.

    I feel that our education falls somewhere between dentistry and MD/DO school. Dentists are not responsible for the extensive pathology that we see nor are they required to know so much about internal and emergency medicine, etc.. Not to downgrade what a dentist does, but they do not have the same level of training. Now, compared with DO's and MD's, podiatrists are responsible for the same type of knowledge of the human body (with the exception of psych and OB/GYN) and do residencies just like MD/DO's. But, like I said, we don't get to have the same clinical exposure (and only part of the didactic). The residencies are the same in some respects, but different in others. For pods, residencies can last anywhere from 1 to 4 years and for the years 2-4 are basically focused on foot and ankle surgery. If you opt for a one year residency it usually encompasses about 6-8 months of rotations in a regular hospital setting which are done in concert with MD and DO interns. We are responsible for the same level of care and take care of our own patients. There's no difference.

    I did a one year residency at L.A. County in 1999. Just to give you an idea of what was expected of me I was treated like any other intern and more. I had my own very sick patients in internal medicine (2 months) who suffered from end-stage AID's, lung cancer, CHF, etc. I did 4 months of orthopedic trauma and infection and once did a complete skin graft surgery on my own (an entire arm) with only a PGY-1 by my side who had never seen one done. Bottom line is that we were treated just like everyone else and were expected to tow the line. We were also required to have more than a modicum of knowledge about medicine and surgery.

    What I will concede on is the patchy 3rd and 4th years that we go through and the overall lack of didactic and clinical training that other med students go through. I will say that pods are not complete physicians like MD's and DO's and should not be called as such. However, anyone who has earned a D.E.A license that allows them to prescribe the same things that MD's and DO's do, anyone who can autonomously perform recon foot and ankle surgery (and have that patient admitted and discharged as any doctor would) and gets reimbursed just like any ortho would is a doctor in my book. Just not a complete physician.

    This is part of the reason why I'm planning to go back to get my MD or DO. I set out to become what I believe is a physician and, as a podiatrist, I haven't reached that goal. I've learned and done many things in my pod time that would parallel any med student or resident experience, but it has fallen short for me.

    It's hard to define what a podiatrist is, but I believe that they are certainly more doctors than not. I can still carry on a conversation with any MD or DO about general medicine because, while I didn't really get too much real life exposure, I had to take the same courses.

    Hope this helps.
     
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