Studying for ABPM Cert

[Hybrocure]

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Gonna take the test this year.

For those who have done it recently what did you use? It seems they have some practice case work up sims through the main site but I can’t find a lot of stuff for the multiple choice other than the recommendation that they post a question every week on social media. Some of the questions through there are relevant others are really out there.

Please tell me this isn’t on the exam

 

[Retrograde_Nail]

Everyone passes. Stop

 

[Adam Smasher]

I can honestly say I put in twice as many hours studying for ABPM cert as I did studying for APMLE step 3

 

[air bud]

Gonna take the test this year.

For those who have done it recently what did you use? It seems they have some practice case work up sims through the main site but I can’t find a lot of stuff for the multiple choice other than the recommendation that they post a question every week on social media. Some of the questions through there are relevant others are really out there.

Please tell me this isn’t on the exam

Sounds like you should have done a fellowship. Or maybe a double fellowship.

 

[Flip-flop-flerpity]

I had to squint to read this post from my ivory high abfas tower

 

[Sole Badguy]

Yeah...I remember them asking 1-2 shoe-based questions that I don't think a majority of us know as it isn't really formally taught in any curriculum (school, residency, or elsewhere as far as I know). Luckily that's not the majority of the test. Just draw from your wells of practical knowledge from residency and formal knowledge from your gold-standard reference materials and you will pass. Simple, straightforward, yet effective - and best of all, no need to pay the Bored Wizards to practice how to take a crappy CBPS test either. You got this 👍

 

[air bud]

Sir, please study up on shoe construction.

 

[Bored Snorlax]

I can honestly say I put in twice as many hours studying for ABPM cert as I did studying for APMLE step 3

Dedication.

 

[HaimFeldman]

I can honestly say I put in twice as many hours studying for ABPM cert as I did studying for APMLE step 3

Is there a "multiples of zero are still zero" punchline at the end of this?

 

[Adam Smasher]

Is there a "multiples of zero are still zero" punchline at the end of this?

you did it so I didn't have to

 

[diabeticfootdr]

The exam is based on the residency curriculum. So you studied for 3 years already. Which is the way it should be.

 

[Hybrocure]

The exam is based on the residency curriculum. So you studied for 3 years already. Which is the way it should be.

Agreed! Been going through some of the question banks on the website and I’m feeling more comfortable

 

[air bud]

The exam is based on the residency curriculum. So you studied for 3 years already. Which is the way it should be.

Well since we have such standardization of training across residency.....should be a piece of cake.

 

[diabeticfootdr]

Residency training IS standardized. Everyone must meet the standards in CPME 320 to graduate. But I agree that all programs aren’t equivalent. Some train you at the standard, some much higher.

I have some disagreements with the standards too. I advocate for improvements at the 320 re-write meetings (attached). But as long as these are the written standards, that’s what we test. It’s only fair. Board certification shouldn’t be a trick.

 

[Hybrocure]

. Board certification shouldn’t be a trick.

Agree completely. The idea we are free to operate for years after residency then not getting ABFAS all of a sudden makes you not able to operate is an asinine way to do things.

 

[DYK343]

Everytime I look at R/Bunion I realize half of us should not be operating.
The under corrected lapidus with 1st MPJ implant literaly hurt my soul.

 

[Hybrocure]

Everytime I look at R/Bunion I realize half of us should not be operating.
The under corrected lapidus with 1st MPJ implant literaly hurt my soul.

Yet there are plenty of board certified orthos doing horrible bunions as well

The link you sent was an orthopedist

 

[DYK343]

Yet there are plenty of board certified orthos doing horrible bunions as well

Doesnt change my opinion that half of us should not be operating.

I've fixed a lot of other DPM bad decisions in my relatively short career.

Ive rarely fixed ortho bad decisions.

 

[Hybrocure]

Doesnt change my opinion that half of us should not be operating.

I've fixed a lot of other DPM bad decisions in my relatively short career.

Ive rarely fixed ortho bad decisions.

It’s also surgery dependent though. Plenty of podiatrists are able to debride, amputate, remove foreign bodies, excise neuromas etc but the standard for board cert w ABFAS is based on use of hardware. This leads to docs doing crappy work on cases they’re not good at because they feel they “need” to just to get that board cert to keep working. The further irony is most of the surgical pod demand is for cases that don’t require hardware or non elective cases.

 

[heybrother]

It’s also surgery dependent though. Plenty of podiatrists are able to debride, amputate, remove foreign bodies, excise neuromas etc but the standard for board cert w ABFAS is based on use of hardware. This leads to docs doing crappy work on cases they’re not good at because they feel they “need” to just to get that board cert to keep working. The further irony is most of the surgical pod demand is for cases that don’t require hardware or non elective cases.

There's no shortage of surgical demand for bunions which is all you have to do to acquire ABFAS Foot.

You can pass on every scope, Charcot, triple, and lisfranc and still get it.

 

[Hybrocure]

There's no shortage of surgical demand for bunions

Oversaturation of podiatrists would beg to disagree

 

[shadesofgrey]

The link you sent was an orthopedist

Sadly incorrect. If you scroll down on the post the original poster says it was a podiatrist, although she does state that the pod was:

"board certified foot and ankle surgeon....D.ABFAS if that makes a difference."

That reddit bunion page is tough to look at, makes me feel better about my screw ups. I mean at least they didn't end up on a reddit page.

 

[Hybrocure]

Sadly incorrect. If you scroll down on the post the original poster says it was a podiatrist, although she does state that the pod was:

"board certified foot and ankle surgeon....D.ABFAS if that makes a difference."

That reddit bunion page is tough to look at, makes me feel better about my screw ups. I mean at least they didn't end up on a reddit page.

You’re right I just saw the comment where she called the doc an orthopedist.

I don’t like the Reddit foot pages or the Facebook ones etc. Its almost always neurotic patients giving other neurotic patients advice and rarely ever any docs actually commenting

 

[Adam Smasher]

When I took the ABPM MOC self assessment a few years ago, I absolutely bombed the internal medicine questions. IM was my worst rotation in residency and my worst month in school. I forget what % of the questions are IM but I know it's small. I understand why you need to ask  something but it's such a broad and complex content area so it's easy from the view of test-taking strategy to just neglect it all and pass the rest of the test and still come out ok.

 

[Hybrocure]

When I took the ABPM MOC self assessment a few years ago, I absolutely bombed the internal medicine questions. IM was my worst rotation in residency and my worst month in school. I forget what % of the questions are IM but I know it's small. I understand why you need to ask  something but it's such a broad and complex content area so it's easy from the view of test-taking strategy to just neglect it all and pass the rest of the test and still come out ok.

That’s interesting because the practice questions seem to veer toward more IM questions than pod stuff

 

[shadesofgrey]

You’re right I just saw the comment where she called the doc an orthopedist.

I don’t like the Reddit foot pages or the Facebook ones etc. Its almost always neurotic patients giving other neurotic patients advice and rarely ever any docs actually commenting

True, but as soon as I saw that pic, I just kept saying to myself, "please don't be a pod, please don't be a pod". Unfortunately, some part of me immediately knew it was a podiatrist. No ortho would be dumb enough to do that, or maybe it was just that I've just never seen ortho use a 1st MPJ implant (not necessarily bashing, just honestly never seen a ortho use them).

There was a kernel of redemption in the post in that it was a ABFAS doc, hell maybe that doc even failed me on my first case review!!! I feel I can say this as someone certified by both, but highly critical of the ABFAS process.

 

[Hybrocure]

True, but as soon as I saw that pic, I just kept saying to myself, "please don't be a pod, please don't be a pod". Unfortunately, some part of me immediately knew it was a podiatrist. No ortho would be dumb enough to do that, or maybe it was just that I've just never seen ortho use a 1st MPJ implant (not necessarily bashing, just honestly never seen a ortho use them).

There was a kernel of redemption in the post in that it was a ABFAS doc, hell maybe that doc even failed me on my first case review!!! I feel I can say this as someone certified by both, but highly critical of the ABFAS process.

I’ve seen silastic implants it’s been a good minute since I’ve seen someone use a metal one. From my experience mpj implants have been from guys using them close to retirement where they’ll be long gone before they have to deal with the complications

 

[DYK343]

close to retirement where they’ll be long gone before they have to deal with the complications

Sad

 

[Hybrocure]

Sad

This is the way. (But a mustache podiatrist instead of the Mandalorian).

 

[Utvolsdpm]

True, but as soon as I saw that pic, I just kept saying to myself, "please don't be a pod, please don't be a pod". Unfortunately, some part of me immediately knew it was a podiatrist. No ortho would be dumb enough to do that, or maybe it was just that I've just never seen ortho use a 1st MPJ implant (not necessarily bashing, just honestly never seen a ortho use them).

There was a kernel of redemption in the post in that it was a ABFAS doc, hell maybe that doc even failed me on my first case review!!! I feel I can say this as someone certified by both, but highly critical of the ABFAS process.

Wouldn’t have been too horrible except for the giant non union with no compression across the TMTJ.

 

[DYK343]

Wouldn’t have been too horrible except for the giant non union with no compression across the TMTJ.

Should have been a MPJ fusion and done with it....
Its.... bad....

Also I must admit I have never used lapiplasty (too expensive...) but pretty sure its not designed to have an interfrag screw.

 

[Hybrocure]

Should have been a MPJ fusion and done with it....
Its.... bad....

I’m guessing the Redditor wanted to “keep mobility of the toe” and didn’t like the idea of a “fusion”

 

[Calogero]

Doesnt change my opinion that half of us should not be operating.

I've fixed a lot of other DPM bad decisions in my relatively short career.

Ive rarely fixed ortho bad decisions.

Unfortunately this is true for me as well. In my area I had an older pod who suddenly started doing lapifuse and lapiplasty. I revised several and discussed revising several more. I've been out under 7 years and I have revised only one subacute (within 2-3 years) surgery from the local orthos, and they were hammertoes. I've asked the local orthos for help on a couple of cases of my own that were not going well. When you are on an island in private practice sometimes the best thing you can do is find a friendly ortho who won't throw you under the bus but will help you when things are tough.

 

[Utvolsdpm]

Also I must admit I have never used lapiplasty (too expensive...) but pretty sure its not designed to have an interfrag screw.

Because podiatry… lol

I’m sure expert witnesses love these cases

 

[DYK343]

Because podiatry… lol

I’m sure expert witnesses love these cases

Dayton/podiatry was a big part of the lapiplasty design but also a lot of MDs were on the design team.
The lapiplasty jig also provides compression.



Deheer just posted a social media post regarding interfrag screws for 1st MPJ fusion
Was interesting to read. Obviously we are talking about lapiplasty and not 1st MPJ fusions.
But the articles are interesting to read.

https://www.mdpi.com/2673-4095/6/3/47

First metatarsophalangeal fusion with dorsal plate: clinical outcomes - PubMed

We present a retrospective study; all patients enrolled were retrospectively registered.

pubmed.ncbi.nlm.nih.gov

 

[Utvolsdpm]

Dayton/podiatry was a big part of the lapiplasty design but also a lot of MDs were on the design team.
The lapiplasty jig also provides compression.

Exactly! Podiatry trying to reinvent carpentry.
Might want to go back to the drawing board on that one if that’s all the compression you get.

 

[air bud]

Dayton/podiatry was a big part of the lapiplasty design but also a lot of MDs were on the design team.
The lapiplasty jig also provides compression.



Deheer just posted a social media post regarding interfrag screws for 1st MPJ fusion
Was interesting to read. Obviously we are talking about lapiplasty and not 1st MPJ fusions.
But the articles are interesting to read.

https://www.mdpi.com/2673-4095/6/3/47

First metatarsophalangeal fusion with dorsal plate: clinical outcomes - PubMed

We present a retrospective study; all patients enrolled were retrospectively registered.

pubmed.ncbi.nlm.nih.gov

Compression is awesome with lapiplasty, that's why those dinky little biplanar plates work. That stupid screw people put in to bill a double arthrodesis has no effect on fusion.

Good study and one hundred percent true. Normal 1st MPJ fusion other than a fatty a plate is all you need and WB ASAP. Unless you want to be Feli and be 45 going on 85 and do 2 crossing screws because he is trying to save the hospital that he doesn't work for money.

 

[Feli]

... Unless you want to be Feli and be 45 going on 85 and do 2 crossing screws ...

I'm only 44.
And k-wires never did nuffin to you.

 

[air bud]

I'm only 44.
And k-wires never did nuffin to you.

They didn't get me a Delmonico's Ribeye

 

[BubbaWub]

I'm only 44.
And k-wires never did nuffin to you.

You're a spring chicken! A podiatrist near me retired at the ripe age of 83. Another one my friends is 64 and plans on working another 10 years. I would say you have approximately 30 years of practice left. The retirement age in this country continues to get higher with each passing day. Podiatry is certainly not immune to this.

I would say I still have approximately 40 years left of service until my monetary obligations are fulfilled. These new rules with all the student loans fiasco don't help me. Even with most of my years in practice, I still have some loans left, hopefully not for long.

Thank you!

 

[Adam Smasher]

Imagine dying on the job while you're treating a patient. Imagine getting that heart attack mid-clip.

 

[shadesofgrey]

This is gonna be me thanks to my student loans.

96 year young Podiatrist working 6 days a week – United Podiatry Inc

96-year-old podiatrist still doing surgery View original article here – Sun Sentinel: Video interview included Would you trust a 96-year-old surgeon to put you under his knife? In Fort Lauderdale, there’s no shortage of patients for Dr. Albert R. Brown, a podiatrist who has spent more than six...

unitedpodiatry.com

 

[Feli]

This is gonna be me thanks to my student loans.

96 year young Podiatrist working 6 days a week – United Podiatry Inc

96-year-old podiatrist still doing surgery View original article here – Sun Sentinel: Video interview included Would you trust a 96-year-old surgeon to put you under his knife? In Fort Lauderdale, there’s no shortage of patients for Dr. Albert R. Brown, a podiatrist who has spent more than six...

unitedpodiatry.com

It won't.

Just don't do the lifestyle creep.
There are plenty of docs making $300k+ who are underwater on various debt and high lifestyle vaca/toys/big house/sahm/etc.
If you are living on any kind of loans/credit for personal stuff, you're out-spending your means (possible exception house you live in).
Even if you think your income is rising, it's a dangerous path. Buy stuff cash, wait to until you can, or just skip it and invest or pay debts.
It's hard to say you can't or shouldn't or won't get something, but it gets easier and easier. Materialism's a game you can't win.
("if you can't buy it twice, you can't afford it once" -Jay-Z)
Biz loans are different as you can easily outpace the interest on them with growth... but those should still be minimized.
Student loans are painful but not impossible. They need to be attacked hard and head on. It can be done.

And, as usual: get a high income partner. 🙂

 

[Homo sapien]

Residency training IS standardized. Everyone must meet the standards in CPME 320 to graduate. But I agree that all programs aren’t equivalent. Some train you at the standard, some much higher.

I have some disagreements with the standards too. I advocate for improvements at the 320 re-write meetings (attached). But as long as these are the written standards, that’s what we test. It’s only fair. Board certification shouldn’t be a trick.

A lot of those standards aren't met in reality, especially surgically. People graduating from programs where they met numbers in theory but attendings had them as retraction monkeys rather than doing the surgeries. It gives a false premise of capability

 

[Bluecollarmed]

It won't.

Just don't do the lifestyle creep.
There are plenty of docs making $300k+ who are underwater on various debt and high lifestyle vaca/toys/big house/sahm/etc.
If you are living on any kind of loans/credit for personal stuff, you're out-spending your means (possible exception house you live in).
Even if you think your income is rising, it's a dangerous path. Buy stuff cash, wait to until you can, or just skip it and invest or pay debts.
It's hard to say you can't or shouldn't or won't get something, but it gets easier and easier. Materialism's a game you can't win.
("if you can't buy it twice, you can't afford it once" -Jay-Z)
Biz loans are different as you can easily outpace the interest on them with growth... but those should still be minimized.
Student loans are painful but not impossible. They need to be attacked hard and head on. It can be done.

And, as usual: get a high income partner. 🙂

I honestly get more excited about the extra cash each month going to investments rather than stuff. Nothing makes me happier than moving money from my spendy SAHM's grasp into low cost ETFs lol

 

[diabeticfootdr]

A lot of those standards aren't met in reality, especially surgically. People graduating from programs where they met numbers in theory but attendings had them as retraction monkeys rather than doing the surgeries. It gives a false premise of capability

Maybe you misunderstand the standards. Here is the standard for resident activity during surgeries from CPME 320:

So you might disagree with the language of the standard, but they are meeting the standard.

 

[Sendin_Toes_2market]

Maybe you misunderstand the standards. Here is the standard for resident activity during surgeries from CPME 320:
View attachment 406350

So you might disagree with the language of the standard, but they are meeting the standard.

I saw residents at prestigious programs double logging first assists. I also saw residents PGY3 completely making up surgeries, because they didn’t log any at a program I was visiting. Maybe we need more audits.

 

[diabeticfootdr]

I saw residents at prestigious programs double logging first assists. I also saw residents PGY3 completely making up surgeries, because they didn’t log any at a program I was visiting. Maybe we need more audits.

You can't double log a first assist in a procedure in PRR.

If you make up surgeries ... I don't know what to say.

 

[Sendin_Toes_2market]

You can't double log a first assist in a procedure in PRR.

If you make up surgeries ... I don't know what to say.

-Yes you can. If resident A and B both log it as a first assist it doesn’t get caught. They can log the same code, day and patient.

-It happens and is sad.

Why I think audits are important…

 

[Bluecollarmed]

Is there any oversight or way to look at a programs volume of surgical cases versus number of residents and say you only qualify for x number of spots based on your production. I get there's a minimum requirement of cases and diversity in cases which should kind of dictate that but the minimum requirement is laughably low. It would decrease the number of resident slots, absolutely, but would lead to better training and decrease some of this first/second assist nonsense with multiple residents scrubbing cases.