Thoughts on Fellowship given job market

[HalluxSlicer]

On a serious note though, I believe knowing what to expect in the field of Podiatry should be advertised more. If I were applying to Podiatric Colleges and I was told that majority of your career involves doing "bottom feeding" surgeries such as I&D puss bus, amps, limb salvage, diabetic foot care, while on occasion you take on the big cases like ankles, etc., I definitely would not have chosen this field.

There are student orgs in the Podiatric Colleges like Pediatrics club or Sport smedicine club and I feel bad for them, most especially Pediatrics because the specialty of Podiatric Pediatric is virtually non-existent; fellowship trained pediatric ortho are the ones who specialize in these things. There's this self procliamed pediatric podiatrist called Louis J. DeCaro who heads the ACFAP. His training says "emphasis in pediatrics" but that is interpreted as I prefer seeing pediatric patients and have interest in it. There is no formal speciality training for Pediatric Podiatry.

I do appreciate on behalf of the profession to see young future podiatrists like LordofWaffles and few others looking forward to be in this career field but I could tell you that there are people like myself who is not motivated enough to continue this profession long because of said problems already discussed but also it's just not worth it for us in the end

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[LordofWaffles]

I believe knowing what to expect in the field of Podiatry should be advertised more.

I would say people just need to do their due diligence more. The schools should really enforce shadowing a podiatrist on their applications. They do have the DPM mentors Network, thats how I found the pods I shadowed before I applied. The advice I got when I shadowed was to not get caught up in the surgery. Be good at all aspects in the field and you'll find success. Quoting the pod, "what a mistake I was making when I was referring nails and foot fungus away at first." All while he was bragging about his home theater. I looked at that office recently though, they hired a new associate and brag how he was #2 in his class, etc. Why wouldn't they though. He gets really great reviews, likely because he's overtrained for the position. I suppose thats better than the field being undertrained for the job...

Without a doubt some pods are super fortunate and find themselves in great positions, but have to fight for said spots. Those spots should be everyone's plan A, but you really need to have plan B and C ready to go also. I did witness first hand at one of the programs on externship some pods part of an ortho group. The young director got in, then a couple of others weaseled their way in after he made the case for them. None of them did a fellowship. They just attend the conferences and kept learning after residency. Ain't doing ankle fracture or TAR though, the MD does that. And of course they need to ride the pus train.

 

[Prehealth1011]

On a serious note though, I believe knowing what to expect in the field of Podiatry should be advertised more. If I were applying to Podiatric Colleges and I was told that majority of your career involves doing "bottom feeding" surgeries such as I&D puss bus, amps, limb salvage, diabetic foot care, while on occasion you take on the big cases like ankles, etc., I definitely would not have chosen this field.

In my mind, it's simple. You don't guarantee me 250k-300k? You don't get my 300k in loans

And I don't care if you say "It's not all about money". Professional schools are expensive here in the States and ROI has to be considered

 

[air bud]

I would say people just need to do their due diligence more. The schools should really enforce shadowing a podiatrist on their applications. They do have the DPM mentors Network, thats how I found the pods I shadowed before I applied. The advice I got when I shadowed was to not get caught up in the surgery. Be good at all aspects in the field and you'll find success. Quoting the pod, "what a mistake I was making when I was referring nails and foot fungus away at first." All while he was bragging about his home theater. I looked at that office recently though, they hired a new associate and brag how he was #2 in his class, etc. Why wouldn't they though. He gets really great reviews, likely because he's overtrained for the position. I suppose thats better than the field being undertrained for the job...

Without a doubt some pods are super fortunate and find themselves in great positions, but have to fight for said spots. Those spots should be everyone's plan A, but you really need to have plan B and C ready to go also. I did witness first hand at one of the programs on externship some pods part of an ortho group. The young director got in, then a couple of others weaseled their way in after he made the case for them. None of them did a fellowship. They just attend the conferences and kept learning after residency. Ain't doing ankle fracture or TAR though, the MD does that. And of course they need to ride the pus train.

Wrong mode of transportation bro. We be bussin

 

[Feli]

... The schools should really enforce shadowing a podiatrist on their applications. They do have the DPM mentors Network, thats how I found the pods I shadowed before I applied. ...

Logical, but too bad it doesn't apply...

Need butts in the seats NOW. Read pre-pod threads... LECOM and others accept until last possible minute, shadowing or not.

Can't make time for shadowing in the summer when they need to find an apt and start paying tuition in a month or two.

 

[MicroPod]

It makes me feel silly that I actually worried about being accepted to pod school when I applied and interviewed very early. Also actually had an MCAT score that was good enough to get into MD schools (never applied). The rest of my stats were subpar (gpa, extracurricular, volunteering, etc.) for med school application though. Sometimes I wish I just tried to apply anyway but it was expensive enough applying and flying out to pod schools.

 

[Feli]

It makes me feel silly that I actually worried about being accepted to pod school when I applied and interviewed very early. Also actually had an MCAT score that was good enough to get into MD schools (never applied). The rest of my stats were subpar (gpa, extracurricular, volunteering, etc.) for med school application though. Sometimes I wish I just tried to apply anyway but it was expensive enough applying and flying out to pod schools.

Yeah, I took the MCAT so long ago it was diff scoring, but I was 50th percentile or so in the various sections.

In reality, the point is that any reasonably competitive student for MD schools is in a HUUUUGE power position for podiatry school admiision. They should approach pod school interviews like, "so, who is going to give me the best scholarship???" It's not a matter of getting accepted to pod school, it's a matter of how much tuition + living is, how much scholarship is offered. That's what it comes down to these days - esp with skyrocketing tuition.

Everyone even semi-reasonable gets into podiatry school. Everyone...
People with 5th or 10th percentile MCAT get accepted.... people with no shadowing... ppl who interview a month before classes start... nearly anyone. Are they going to pass pt1 national boards? Many will not. Will they all graduate? Nope. All get a good residency? Heck no.... but they get accepted. Will it always be that way? It nearly always has.. and now they overshot badly on schools/seats. Any decent or strong applicant needs to know that and save themself some $ by getting scholarships from the schools. Even if CPME sits on their hands when schools suck or are asinine to open new schools, the smart pod schools still feel the need to get students who will pass boards and rep them fairly well. Stronger applicants can definitely use the schools' greed agains them and let them bid - especially right now.

 

[icebreaker32]

 

[Feli]

I am surprised that they even published this interview. I'm not sure if you posted it as more of a joke because of the My Feet are Killing Me girl or a legit discuss point.

It's a couple of attendings who are quite good despite the fact they did not do a fellowship (sorry, 4 or 6wks of mini-AO that nearly every good 1990s and early 2000s pod residency grad did doesn't count... that's a glorified rep workshop). They now direct a DPM fellowship, they are pro-fellowship, and they ask the questions. Of course they are pro-fellowship; they get an excellent podiatry PA for $70k/yr or less every year. That's like me saying I'm pro-MA or pro-biller because they enhance my productivity. No-brainer... but it's a very clear conflict of interest.

The panel discussing the issue: three people who did a podiatry fellowship after 3 year residency (Hoboken NJ, Univ Hosp NJ, Aria) and probably more cases in training than the fellowship directors are talking about how fellowship helps with:

• "Pre- and post-op experience" and "working up the patient yourself." (3:45)
• They say (11:00 mark) that fellowship taught them how to bill and code; all three of them credit fellowship with teaching them billing.
• They talk about how fellowship helps with the "transformation" into "being an attending."

Hmm, you know what else makes that being-an-attending transformation? Being an attending!
Pro tip: being an attending is going to happen sooner or later.

Check the part (7:30 mark) where she says she did fellowship to "set myself apart from other applicants for the dream job" [she worked at a podiatry PP for 7 or 8 years after fellowship until getting a Kaiser job this year... a job that plenty of DPMs with no fellowship get right from residency graduation].

...This doesn't seem like the most glowing endorsement to me. Apply now for fellowships, guys. Hidden benefit of podiatry fellowship is that it may also transform you into a TV podiatrist on My Feet are Killing Me (can't make this stuff up... but in ACFAS' defense, I don't think she was on the show yet at the time of this 2021 interview).

They really should've found 3 fellowship grads who did top residency + top fellowship worked ortho jobs or tough-to-get hospital jobs or niche private practice or something. Working in pod PP or being on a TV show or working the big supergroups (Sutter, Kaiser, FASMA, etc) doesn't really need a fellowship that leads to no additional cert or skill. This podcast does a better job of making me sad about our residencies (not getting enough pre/post op, billing, case volume???) than it does excited about DPM fellowships. Yikes.

 

[GreenHousePub]

Wow, the only thing more insufferable than listening to the fellowship directors blab on about themselves is listening to the fellows themselves.

 

[icebreaker32]

I am surprised that they even published this interview. I'm not sure if you posted it as more of a joke because of the My Feet are Killing Me girl or a legit discuss point.

It's a couple of attendings who are quite good despite the fact they did not do a fellowship (sorry, 4 or 6wks of mini-AO that nearly every good 1990s and early 2000s pod residency grad did doesn't count... that's a glorified rep workshop). They now direct a DPM fellowship, they are pro-fellowship, and they ask the questions. Of course they are pro-fellowship; they get an excellent podiatry PA for $70k/yr or less every year. That's like me saying I'm pro-MA or pro-biller because they enhance my productivity. No-brainer... but it's a very clear conflict of interest.

The panel discussing the issue: three people who did a podiatry fellowship after 3 year residency (Hoboken NJ, Univ Hosp NJ, Aria) and probably more cases in training than the fellowship directors are talking about how fellowship helps with:

• "Pre- and post-op experience" and "working up the patient yourself." (3:45)
• They say (11:00 mark) that fellowship taught them how to bill and code; all three of them credit fellowship with teaching them billing.
• They talk about how fellowship helps with the "transformation" into "being an attending."

Hmm, you know what else makes that being-an-attending transformation? Being an attending!
Pro tip: being an attending is going to happen sooner or later.

Check the part (7:30 mark) where she says she did fellowship to "set myself apart from other applicants for the dream job" [she worked at a podiatry PP for 7 or 8 years after fellowship until getting a Kaiser job this year... a job that plenty of DPMs with no fellowship get right from residency graduation].

...This doesn't seem like the most glowing endorsement to me. Apply now for fellowships, guys. Hidden benefit of podiatry fellowship is that it may also transform you into a TV podiatrist on My Feet are Killing Me (can't make this stuff up... but in ACFAS' defense, I don't think she was on the show yet at the time of this 2021 interview).

They really should've found 3 fellowship grads who did top residency + top fellowship worked ortho jobs or tough-to-get hospital jobs or niche private practice or something. Working in pod PP or being on a TV show or working the big supergroups (Sutter, Kaiser, FASMA, etc) doesn't really need a fellowship that leads to no additional cert or skill. This podcast does a better job of making me sad about our residencies (not getting enough pre/post op, billing, case volume???) than it does excited about DPM fellowships. Yikes.

Just put it out there to put it out there.....neither as a joke or to promote fellowships.

They basically said that they felt it gave them 3 years of attending level experience in one year and to get better jobs. They were not really doing it to gain surgical skills.

I suppose the experience part might be true.....but why do most specialties do fine without this extra pre/post op and coding etc experience ? Why do mid levels get paid 6 figures and good benefits when they still have to learn so much on the job?

Most other specialties do a fellowship to focus on a niche within a specialty and get a job where they will be feed those patients their whole career.

As per the job part? We know how the job market is. It will be determined over the next few years just how necessary or unnecessary fellowships are to get a good job. What will it take to get a good job?....big name residency, a fellowship, a few years experience, ABFAS, ABFAS RRA or some combination? Another point worth considering is even if one does not get a good job with a fellowship even getting an above average job in an above average location sets them up to leave for that organizational job a couple years later. Maybe the fellowship did not directly help them get their organizational job but it might have helped get a better than typical first job in a better than typical location.....perhaps reason enough for podiatry's job market.....if true.