AnonymousPod1205
New Member
Advertisement - Members don't see this ad
I wanted to share some thoughts I originally posted in the pre-podiatry section and start a discussion of what could be in store for the profession in the next 2 decades
Original Post
Student Enrollment Crisis – A Podiatrist's Response
The future?:
Schools have seats to fill. Students will have lower average MCAT scores, GPAs, and other academic metrics over time. This is not an indictment of individual students. Every profession has outstanding physicians who entered with average statistics, and academic metrics alone do not determine who becomes a successful podiatrist. However, when the overall applicant pool becomes smaller, the academic stats of incoming classes will be hard to ignore. The immediate downstream effect may not be obvious because the strongest residency programs will likely continue attracting the strongest graduates. The top residency programs will remain highly competitive for the foreseeable future. The greater challenge lies with the remainder of residency programs, which may find themselves interviewing and matching applicants who, ten or twenty years ago, may never have been matched into those same positions simply because the overall talent pool was larger.
As this transition occurs, residency directors and hiring podiatrists begin asking questions such as, "What happened to the students from NYCPM?" or "Why aren't Des Moines externs as good as they used to be?" The more uncomfortable reality is that the answer may have very little to do with those schools themselves. Schools can only educate the students who choose to accept admission to their institution. “What happened to podiatry?” is going to be the more appropriate question.
If the overall applicant pool continues to weaken, that same cohort will eventually become the public face of podiatry. Many of these pods will be advocating for the "foot and ankle surgeon" identity that organizations such as the ABFAS and ACFAS have worked to establish. That title carries significant expectations from patients, referring physicians, hospitals, and the broader medical community. If there is a decline in the overall preparedness or consistency of graduating podiatrists, the gap between the highest-performing foot and ankle surgeons and the remainder of the profession may become increasingly apparent. The top tier of podiatric surgeons will likely continue to distinguish themselves through exceptional training, surgical volume, outcomes, and academic achievement. However, if the profession does not maintain a strong pipeline of highly qualified docs, the disparity between that top group and the average pod could widen over time, making it more difficult to preserve the credibility and reputation that the pods worked to build since the 2000s (or earlier).
If responsibility and blame is to be assigned, it belongs to the profession's leadership and senior practitioners. The profession expanded educational capacity by opening multiple new schools despite previous experience demonstrating the consequences of rapid expansion. The first wave of expansion contributed to the residency shortage crisis of 2007–2014. The second wave is occurring while conversations about declining applications and student enrollment challenges are becoming publicized on PMNews. Am I the only one that finds that ridiculous?
Would you open four more restaurants in a small town where existing restaurants are already struggling to fill tables, then create a committee to discuss why customer traffic is declining? Would you build apartment complexes in a market with rising vacancy rates, then question why landlords are being forced to lower rent?
Would you solve a residency shortage by creating more residency positions while ignoring the fact that every one of those residents expects to graduate into a competitive job market with opportunities for ownership or career growth to make the time invested and debt acquired/money spent on education worthwhile?
It’s clear that in our profession the left hand doesn’t know what the right hand is doing. When the ABPM introduced a new surgical certification, the ABFAS/ACFAS folks declared war and newsletters were sent q2 weeks. Yet when the CPME allows 4 new podiatry schools to open over two decades despite widespread concerns about saturation, the profession generated far less public debate to prevent this.
Many experienced podiatrists also supported or participated in this expansion ($$ involved of course).
When pods with 25-30+ years of practice ownership prefer to sell to private equity than transition ownership to the associates that have been producing revenue for them for years, they contribute to the problem. When you see these same docs listed on the leadership boards of these private equity groups, their priorities are clear.
This discussion began as a conversation about declining student enrollment, but I wanted to broaden it to encourage a discussion about where the profession is headed. In my eyes future of podiatry will not be determined by the students entering school today. It will be determined by the decisions the leaders in the profession make today. The residency crisis of 15–20 years ago has evolved into today's student enrollment crisis. The next phase we are on track for is the podiatry employment crisis.
I hate to say it, but the profession will rebalance for the better if the enrollment crisis worsens, residency programs begin closing, and older docs continue to retire.
The business models of private equity backed podiatry practices need to be exposed or fail.
If all these events happen, I wouldn't be surprised if starting salaries after residency are today’s equivalent of 250-300K in private practice in 10-20 years.
My next step is to develop an anonymous form that allows pods to share our experiences. The survey will collect information on topics such as post-residency salary, practice type, career satisfaction, partnership opportunities and perspectives on the future of the profession. My hope is that this data will create a more transparent picture of podiatry for both current pods and prospective students. The e-book will be called Podiatry Unfiltered and will be available for anyone to download once we reach a specific number of responses. Send me a DM if you have suggestions for it. Education and exposure are powerful catalysts for change. This data will be pushed to college universities/online pre-health forums etc.
Of note, I think it's important to provide some context myself because it's easy to dismiss criticism by assuming it comes from someone who struggled in school, residency and practice. That is not my story. I was not someone who repeatedly failed board examinations, spent years trying to match into residency, or has been unable to build a successful career. I own what has become one of the busiest podiatry practices in a mid-sized community. Every month, I have the privilege of treating hundreds of patients with a wide variety of foot and ankle conditions. Over the past few years, I've built strong referral relationships with local hospitals where I take call, primary care physicians, specialists, and other healthcare providers throughout the area. I genuinely enjoy what I do, and there is nothing more rewarding than helping patients. However, on the other end, I would never choose a career in podiatry again if I had a choice.
SDN Podiatry Members - What are your thoughts on where podiatry will be in the next 10–20 years? What changes do you foresee for the profession and what do you think today's podiatrists should be doing to shape its future?
Original Post
Student Enrollment Crisis – A Podiatrist's Response
The future?:
Schools have seats to fill. Students will have lower average MCAT scores, GPAs, and other academic metrics over time. This is not an indictment of individual students. Every profession has outstanding physicians who entered with average statistics, and academic metrics alone do not determine who becomes a successful podiatrist. However, when the overall applicant pool becomes smaller, the academic stats of incoming classes will be hard to ignore. The immediate downstream effect may not be obvious because the strongest residency programs will likely continue attracting the strongest graduates. The top residency programs will remain highly competitive for the foreseeable future. The greater challenge lies with the remainder of residency programs, which may find themselves interviewing and matching applicants who, ten or twenty years ago, may never have been matched into those same positions simply because the overall talent pool was larger.
As this transition occurs, residency directors and hiring podiatrists begin asking questions such as, "What happened to the students from NYCPM?" or "Why aren't Des Moines externs as good as they used to be?" The more uncomfortable reality is that the answer may have very little to do with those schools themselves. Schools can only educate the students who choose to accept admission to their institution. “What happened to podiatry?” is going to be the more appropriate question.
If the overall applicant pool continues to weaken, that same cohort will eventually become the public face of podiatry. Many of these pods will be advocating for the "foot and ankle surgeon" identity that organizations such as the ABFAS and ACFAS have worked to establish. That title carries significant expectations from patients, referring physicians, hospitals, and the broader medical community. If there is a decline in the overall preparedness or consistency of graduating podiatrists, the gap between the highest-performing foot and ankle surgeons and the remainder of the profession may become increasingly apparent. The top tier of podiatric surgeons will likely continue to distinguish themselves through exceptional training, surgical volume, outcomes, and academic achievement. However, if the profession does not maintain a strong pipeline of highly qualified docs, the disparity between that top group and the average pod could widen over time, making it more difficult to preserve the credibility and reputation that the pods worked to build since the 2000s (or earlier).
If responsibility and blame is to be assigned, it belongs to the profession's leadership and senior practitioners. The profession expanded educational capacity by opening multiple new schools despite previous experience demonstrating the consequences of rapid expansion. The first wave of expansion contributed to the residency shortage crisis of 2007–2014. The second wave is occurring while conversations about declining applications and student enrollment challenges are becoming publicized on PMNews. Am I the only one that finds that ridiculous?
Would you open four more restaurants in a small town where existing restaurants are already struggling to fill tables, then create a committee to discuss why customer traffic is declining? Would you build apartment complexes in a market with rising vacancy rates, then question why landlords are being forced to lower rent?
Would you solve a residency shortage by creating more residency positions while ignoring the fact that every one of those residents expects to graduate into a competitive job market with opportunities for ownership or career growth to make the time invested and debt acquired/money spent on education worthwhile?
It’s clear that in our profession the left hand doesn’t know what the right hand is doing. When the ABPM introduced a new surgical certification, the ABFAS/ACFAS folks declared war and newsletters were sent q2 weeks. Yet when the CPME allows 4 new podiatry schools to open over two decades despite widespread concerns about saturation, the profession generated far less public debate to prevent this.
Many experienced podiatrists also supported or participated in this expansion ($$ involved of course).
When pods with 25-30+ years of practice ownership prefer to sell to private equity than transition ownership to the associates that have been producing revenue for them for years, they contribute to the problem. When you see these same docs listed on the leadership boards of these private equity groups, their priorities are clear.
This discussion began as a conversation about declining student enrollment, but I wanted to broaden it to encourage a discussion about where the profession is headed. In my eyes future of podiatry will not be determined by the students entering school today. It will be determined by the decisions the leaders in the profession make today. The residency crisis of 15–20 years ago has evolved into today's student enrollment crisis. The next phase we are on track for is the podiatry employment crisis.
I hate to say it, but the profession will rebalance for the better if the enrollment crisis worsens, residency programs begin closing, and older docs continue to retire.
The business models of private equity backed podiatry practices need to be exposed or fail.
If all these events happen, I wouldn't be surprised if starting salaries after residency are today’s equivalent of 250-300K in private practice in 10-20 years.
My next step is to develop an anonymous form that allows pods to share our experiences. The survey will collect information on topics such as post-residency salary, practice type, career satisfaction, partnership opportunities and perspectives on the future of the profession. My hope is that this data will create a more transparent picture of podiatry for both current pods and prospective students. The e-book will be called Podiatry Unfiltered and will be available for anyone to download once we reach a specific number of responses. Send me a DM if you have suggestions for it. Education and exposure are powerful catalysts for change. This data will be pushed to college universities/online pre-health forums etc.
Of note, I think it's important to provide some context myself because it's easy to dismiss criticism by assuming it comes from someone who struggled in school, residency and practice. That is not my story. I was not someone who repeatedly failed board examinations, spent years trying to match into residency, or has been unable to build a successful career. I own what has become one of the busiest podiatry practices in a mid-sized community. Every month, I have the privilege of treating hundreds of patients with a wide variety of foot and ankle conditions. Over the past few years, I've built strong referral relationships with local hospitals where I take call, primary care physicians, specialists, and other healthcare providers throughout the area. I genuinely enjoy what I do, and there is nothing more rewarding than helping patients. However, on the other end, I would never choose a career in podiatry again if I had a choice.
SDN Podiatry Members - What are your thoughts on where podiatry will be in the next 10–20 years? What changes do you foresee for the profession and what do you think today's podiatrists should be doing to shape its future?
