USMLE

[rayovac]

During our last class meeting there was discussion about implementation of USMLE as the board exam for pods and I think western is the guinea pig for testing this year. Is this true? Just seeing if any western students could chime in. Good luck if this is the case.

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[PatchAdamsFan]

Students in both California schools will take the CBSE (comprehensive basic science examination), not the USMLE. The APMA, which would fund the prep and exam cost, has full ownership of the exam results and can distribute that information as they see fit. I would imagine less than stellar outcomes will be buried. Obviously, it is our best interest that the classes do well... good luck to those taking it!

 

[burritodoc]

I'm part of the guinea pig class. At the CPMA (California Podiatric Medical Association) meeting in Sacramento last March, they mentioned both CSPM and WesternU 2019 students would take the USMLE. Though, I don't believe they are making it mandatory and enforcing it of all students.

No additional information has been provided to us really. We know that the CPMA will pay for the exams and a preparation course that MD/DOs use. I don't think my school has found a place in our schedule to give us adequate preparation time for this type of exam.

Honestly, I don't think many pod students are going to do well. The reason MD/DO students perform well on this exam is because of EXTREME PRESSURE. If they want to get a competitive residency, this is the major obstacle that they must overcome to reach that goal. They go in to medical school on day 1 with their First Aid book in hand and many of my DO friends have spent their summer vacation after the first year studying for USMLE/COMLEX a year in advance. Also, after their second year of school ends, they are (at many schools) given weeks to months to prepare.

The only way to get pod students to do well on exams is to light a fire under their asses. There has to be a legitimate reason for the students to want to kill themselves over an exam that does not pertain to their future career. Yes there are a few things that overlap with APMLE, (so if you study for USMLE you are kinda studying for APMLE too), but not really. The question style and content between the two tests are very different.

The attitude of the old guys who want us to take this test is for their statistics and to compare curriculums, and/or help us prove our parity to MD/DOs if we do well. The CPMA even mentioned that we may not even get our score feedback after taking that exam. But imagine how many students are going to willingly take this test if you can't even see your own results?! Come on

 

[dyk343]

This is everything I would expect from podiatry and the out of date attendings/ DPM administration that cash a paycheck every year for "teaching" at podiatry schools.


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I don't think my education was poor or out of date.

 

[FootAndAnkle]

I'm part of the guinea pig class. At the CPMA (California Podiatric Medical Association) meeting in Sacramento last March, they mentioned both CSPM and WesternU 2019 students would take the USMLE. Though, I don't believe they are making it mandatory and enforcing it of all students.

No additional information has been provided to us really. We know that the CPMA will pay for the exams and a preparation course that MD/DOs use. I don't think my school has found a place in our schedule to give us adequate preparation time for this type of exam.

Honestly, I don't think many pod students are going to do well. The reason MD/DO students perform well on this exam is because of EXTREME PRESSURE. If they want to get a competitive residency, this is the major obstacle that they must overcome to reach that goal. They go in to medical school on day 1 with their First Aid book in hand and many of my DO friends have spent their summer vacation after the first year studying for USMLE/COMLEX a year in advance. Also, after their second year of school ends, they are (at many schools) given weeks to months to prepare.

The only way to get pod students to do well on exams is to light a fire under their asses. There has to be a legitimate reason for the students to want to kill themselves over an exam that does not pertain to their future career. Yes there are a few things that overlap with APMLE, (so if you study for USMLE you are kinda studying for APMLE too), but not really. The question style and content between the two tests are very different.

The attitude of the old guys who want us to take this test is for their statistics and to compare curriculums, and/or help us prove our parity to MD/DOs if we do well. The CPMA even mentioned that we may not even get our score feedback after taking that exam. But imagine how many students are going to willingly take this test if you can't even see your own results?! Come on

Regarding irrelevance to current podiatry students taking the USMLE, I think that the exam actually does pertain to their future career. If podiatric medical students do just as well as MD/DO students on the USMLE, it would be undeniable proof of current educational parity. I don't think you could overestimate the value to our profession that would be - success would be truly historic and a lot of barriers and headaches faced by podiatrists would, in time, be eliminated.

 

[FootAndAnkle]

Could you function like your fellow MD/DO intern counterparts when you started residency (in terms of inpatient management)?

Were you getting exposure and developing a clinical plan (with close oversight from senior residents) with regards to management of an ICU patient on a vent while you did your off-service rotations as a podiatry student?

Answer to those questions are probably no.






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Maybe you had some bad off-service rotations, but my answers would be yes. Also, if you're talking vent settings themselves, that's fairly advanced for any medical student as far as having a good, working clinical knowledge goes.

 

[dyk343]

Could you function like your fellow MD/DO intern counterparts when you started residency (in terms of inpatient management)?

Were you getting exposure and developing a clinical plan (with close oversight from senior residents) with regards to management of an ICU patient on a vent while you did your off-service rotations as a podiatry student?

Answer to those questions are probably no.






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I understand the point of this thread and preparing for the USMLE. I agree with above posters that taking the USMLE is not what our education is tailored towards. But your generalized comment about our education being poor and out of date is not true (IMO). Because we are podiatrists our education is tailored to the foot and ankle. Its not poor or out of date. Its specialized. I feel my school did a good job of preparing me for residency.

As a student, I did have much less medicine classes/rotations than a MD/DO student but I felt my medicine classes and rotations were top notch. I always felt well integrated into the system.

I did spend a month in the ICU as a 1st year resident. I was able to hold my own. I completed a total of 12 months of medicine and medicine sub-specialties. I am happy its over. But I am also happy I did it. I am much more rounded now. With the exception of ER docs being a podiatrist is way more fun (I loved the ER).

 

[burritodoc]

Regarding irrelevance to current podiatry students taking the USMLE, I think that the exam actually does pertain to their future career. If podiatric medical students do just as well as MD/DO students on the USMLE, it would be undeniable proof of current educational parity. I don't think you could overestimate the value to our profession that would be - success would be truly historic and a lot of barriers and headaches faced by podiatrists would, in time, be eliminated.

Sorry if I wasn't clear, I completely agree with you - pod students performing well on this sort of exam would be fantastic for the podiatric academic field. Also would be useful for politics and fighting for parity. I'll be taking the exam for these reasons.

However, the amount of pressure that individual students will feel for this exam is absolutely not on par as MD/DO students because there is no consequence of scoring poorly on the USMLE for podiatry students. We are taking the USMLE to test the waters, not to seal our fate in a competitive residency slot. (Though, maybe it would make those pod students who passed the USMLE stand out when applying for pod residencies?)

My main point was that if schools don't make proper adjustments in schedules to allow for adequate study time, that worsens the outcome as well.

 

[dtrack22]

western is set up the best to do well on the exam, but even they are unlikely to do as well as their DO counterparts from their own school. CSPM will likely do worse. Look, from top to bottom our classes are not as strong (academically) as nearly every MD/DO program. Doesn't mean that the people who eventually graduate from residency are not as capable at treating patients within their scope as any other specialists, but we accept a lot of less than stellar students into podiatry school across the board. The schools have to in order to fill seats and pay the bills.

I probably tend to agree more with dyk regarding our education, it accomplishes its goal regarding training podiatry students to become podiatrists. You get enough medicine in school to function as a resident and in residency you (more often than not) get more medicine than you need. Like programs who do a whole year off service, that's 6-8 months worth of off service rotations more than what nearly every Ortho resident does. Residents can justify it however they want but it's totally unnecessary.

Back to the exam. Personally I'm glad the APMA or the schools or whoever owns the results. 15-20% of podiatry students don't pass our boards...the CBSE or USMLE wouldn't be pretty.

 

[Masttt91]

Back to the exam. Personally I'm glad the APMA or the schools or whoever owns the results. 15-20% of podiatry students don't pass our boards...the CBSE or USMLE wouldn't be pretty.

I do think that our lower boards pass rates at least in some small part might be due to how poorly written they are. Also, the fact the schools give no time off to study for boards, where as MDs/DOs get several weeks to months off and prep courses to boot. By the time we take boards part 1, many of the under-performers have failed out already. If we were to take a better written exam like the USMLE instead of APMLE and the schools gave allotted prep time/prep course/etc. I don't see why most students couldn't score within the bounds of MD/DO student ranges.

 

[JCJS]

I do think that our lower boards pass rates at least in some small part might be due to how poorly written they are. Also, the fact the schools give no time off to study for boards, where as MDs/DOs get several weeks to months off and prep courses to boot. By the time we take boards part 1, many of the under-performers have failed out already. If we were to take a better written exam like the USMLE instead of APMLE and the schools gave allotted prep time/prep course/etc. I don't see why most students couldn't score within the bounds of MD/DO student ranges.

So after taking boards I don't know if I agree with everyone who says our boards are written poorly. Maybe that was the case years ago, but I honestly felt it was quite fair. I felt First Aid was very very helpful as well although some people disagree. It's definitely a difficult exam though and considering podiatry programs let people in with subpar MCAT scores I can see why we have a 15% fail rate nationwide.

 

[yehrightdoc]

Hey colleagues! I'm a Norwegian medical student currently in 4th year of med school (med school is 6 years here). So I was wondering, can I take the USMLE exams during med school or do I have to graduate first, and then be able to sit the USMLEs?

 

[SLCpod]

You will probably get a better answer in the MD or DO forums.

I would talk the Dean of your school. I am sure they would know the answer.

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[PodiatryStudent2]

Taking the USMLE as our boards would be the best thing for the profession. I hope it eventually happens.

 

[Weirdy]

Taking the USMLE as our boards would be the best thing for the profession. I hope it eventually happens.

Genuinely curious why you think this is so.

 

[PodiatryStudent2]

Genuinely curious why you think this is so.

Because it’s a standard of training recognized by the entire medical community and would also give Podiatrists an unlimited scope of practice like MDs/DOs.

 

[bobtheweazel]

Because it’s a standard of training recognized by the entire medical community and would also give Podiatrists an unlimited scope of practice like MDs/DOs.

It wouldn't give pods an unlimited scope. That would be up to state legislation. Plenty of health professions expand their scope all the time, including podiatry, without requiring the USMLE to do it. Many DOs still don't take the USMLE and yet still have an unlimited scope.

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[PodiatryStudent2]

It wouldn't give pods an unlimited scope. That would be up to state legislation. Plenty of health professions expand their scope all the time, including podiatry, without requiring the USMLE to do it. Many DOs still don't take the USMLE and yet still have an unlimited scope.

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To me it just seems like taking the USMLE and having pod students pass would be the quickest way to prove “parity” and would make scope of practice battles a lot easier to win.

 

[DexterMorganSK]

To me it just seems like taking the USMLE and having pod students pass would be the quickest way to prove “parity” and would make scope of practice battles a lot easier to win.

That might be true but in order for us to prepare for the Step 1, our curriculum would need to be changed because there are few areas which we as a Pod are not taught in.

I wonder how the kids in Cali do on their "sample" like Step.

 

[de Ribas]

That might be true but in order for us to prepare for the Step 1, our curriculum would need to be changed because there are few areas which we as a Pod are not taught in.

I wonder how the kids in Cali do on their "sample" like Step.

I agree as well that the limiting factor is curriculum, then pods could take Steps and be recognized better by MD world. But curriculum is at the top.

 

[W19]

I dont understand what going on in the pod community... It seems like there some kind of inferiority complex. When I was a nurse, I considered pod just like physicians (MD/DO) in the OR and around the hospital. In the hospital I worked at, you guys had the same privilege (e.g., parking, physicians' lounge etc..) with MD/DO so I am not sure what is the quest for getting broad score of practice. Pod is like dentistry as far as you guys/gals knew beforehand that you will have somewhat limited scope of practice, which is not necessarily a bad thing. Physicians have broad scope of practice but you won't find an ophthalmologist trying to fix a broken ankle. I really don't see that same attitude in the dental forum.

As far as I am concerned, you guys are on par with MD/DO/DDS. You do damn well what you are trained for.

 

[de Ribas]

I dont understand what going on in the pod community... It seems like there some kind of inferiority complex. When I was a nurse, I considered pod just like physicians (MD/DO) in the OR and around the hospital. In the hospital I worked at, you guys had the same privilege (e.g., parking, physicians' lounge etc..) with MD/DO so I am not sure what is the quest for getting broad score of practice. Pod is like dentistry as far as you guys/gals knew beforehand that you will have somewhat limited scope of practice, which is not necessarily a bad thing. Physicians have broad scope of practice but you won't find an ophthalmologist trying to fix a broken ankle. I really don't see that same attitude in the dental forum.

As far as I am concerned, you guys are on par with MD/DO/DDS. You do damn well what you are trained for.

+

 

[GypsyHummus]

Most of the head butting in the physician realm comes from Ortho, particularly F&A Ortho. They are actively trying to make a distinction between Pods and MD/DO, and are insistant that Pods not be called "Physician". We are seeing this actively play out in congress with the VA equity bill.

I think the biggest problem is nobody knows what podiatry is, and for a long time Podiatrists didnt even know what podiatry was, both in education and legality. Podiatry in its history is a recent field. There were 0-3 year residences, you had people who were non surgical to just surgery of the foot, to surgery of the foot and ankle, etc. There are still people that think all pods do is clip nails and do corns. Hospital's still arnt sure the full scope of the profession, mainly because the full scope was just recently clearly defined (within the last 5 years). Now every residency is 3 year required and standardized, which is a big step in the right direction.

The Horizon looks nice for DPMs. There is a limit on schools (Only 9 with no plans for further expansion), so oversaturation isn't a huge issue. Most NPs/PAs generally dont want anything to do with the feet, so there is less competition there, and they wont be able to do surgery. Most states allow for Foot and Ankle surgical privliges now (the big one being New York finally allows it), and I see full physician privileges and responsibilities (Admitting your own patients, ability to take on general call, ability to bill for full physicals, etc.) in the next 10-20 years.

I think the biggest downside to podiatry is the limited scope. As an FM, you can basically do everything under the sun that isnt surgical. Want to pursue sleep medicine? How about Urgent care? PCP can offer you that. Want to make more money on the side? Moonlight at the local hospital is totally possible. The demand for Primary Care docs is astronomical, even more so than Surgeons. What if I wanted to open up a nutrition supplement store? PCPs can do that. The sky is the limit for MD/DO, for pods, the Tibial Tuberosity is the limit lol.

I dont understand what going on in the pod community... It seems like there some kind of inferiority complex. When I was a nurse, I considered pod just like physicians (MD/DO) in the OR and around the hospital. In the hospital I worked at, you guys had the same privilege (e.g., parking, physicians' lounge etc..) with MD/DO so I am not sure what is the quest for getting broad score of practice. Pod is like dentistry as far as you guys/gals knew beforehand that you will have somewhat limited scope of practice, which is not necessarily a bad thing. Physicians have broad scope of practice but you won't find an ophthalmologist trying to fix a broken ankle. I really don't see that same attitude in the dental forum.

As far as I am concerned, you guys are on par with MD/DO/DDS. You do damn well what you are trained for.

 

[W19]

Most of the head butting in the physician realm comes from Ortho, particularly F&A Ortho. They are actively trying to make a distinction between Pods and MD/DO, and are insistant that Pods not be called "Physician". We are seeing this actively play out in congress with the VA equity bill.

I think the biggest problem is nobody knows what podiatry is, and for a long time Podiatrists didnt even know what podiatry was, both in education and legality. Podiatry in its history is a recent field. There were 0-3 year residences, you had people who were non surgical to just surgery of the foot, to surgery of the foot and ankle, etc. There are still people that think all pods do is clip nails and do corns. Hospital's still arnt sure the full scope of the profession, mainly because the full scope was just recently clearly defined (within the last 5 years). Now every residency is 3 year required and standardized, which is a big step in the right direction.

The Horizon looks nice for DPMs. There is a limit on schools (Only 9 with no plans for further expansion), so oversaturation isn't a huge issue. Most NPs/PAs generally dont want anything to do with the feet, so there is less competition there, and they wont be able to do surgery. Most states allow for Foot and Ankle surgical privliges now (the big one being New York finally allows it), and I see full physician privileges and responsibilities (Admitting your own patients, ability to take on general call, ability to bill for full physicals, etc.) in the next 10-20 years.

I think the biggest downside to podiatry is the limited scope. As an FM, you can basically do everything under the sun that isnt surgical. Want to pursue sleep medicine? How about Urgent care? PCP can offer you that. Want to make more money on the side? Moonlight at the local hospital is totally possible. The demand for Primary Care docs is astronomical, even more so than Surgeons. What if I wanted to open up a nutrition supplement store? PCPs can do that. The sky is the limit for MD/DO, for pods, the Tibial Tuberosity is the limit lol.

I did not know if there was some kind of turf war b/t DPM and ortho docs because where I worked as a nurse the two podiatrists who operated in the OR were part of two different ortho groups. They did all foot and ankle surgeries and these guys were pretty good. Based on my experience, I would not hesitate to consult pod physicians for anything related to foot/ankle.

 

[GypsyHummus]

Yeah, Most docs dont have a problem with Pods and would happily refer out. And to be fair, there are a lot of Ortho Docs that like DPMs because they cost less than a F&A MD to hire. But there are a lot of MD F&A who have a problem with Pods.

I did not know if there was some kind of turf war b/t DPM and ortho docs because where I worked as a nurse the two podiatrists who operated in the OR were part of two different ortho groups. They did all foot and ankle surgeries and these guys were pretty good. Based on my experience, I would not hesitate to consult pod physicians for anything related to foot/ankle.

 

[DexterMorganSK]

Yeah, Most docs dont have a problem with Pods and would happily refer out. And to be fair, there are a lot of Ortho Docs that like DPMs because they cost less than a F&A MD to hire. But there are a lot of MD F&A who have a problem with Pods.

Same goes for some MDs hating on the DOs, but this would be less and less as the merger takes over.

Podiatry will get the name and recognition it deserves in the future, might start with the VA though.

But, even if Pod students take the USMLEs and complete every other requirement that the MD/DO students go through, there will always be a group hating Pods for whatever reason!!

 

[med2345]

I did not know if there was some kind of turf war b/t DPM and ortho docs because where I worked as a nurse the two podiatrists who operated in the OR were part of two different ortho groups. They did all foot and ankle surgeries and these guys were pretty good. Based on my experience, I would not hesitate to consult pod physicians for anything related to foot/ankle.

Most places when I shadowed the pods were took all the FA cases and everyone sat together chatted and had a good time between patients (with the orthos). If it was serious turf war I don’t think I’d be doing pod.

 

[PodiatryStudent2]

I dont understand what going on in the pod community... It seems like there some kind of inferiority complex. When I was a nurse, I considered pod just like physicians (MD/DO) in the OR and around the hospital. In the hospital I worked at, you guys had the same privilege (e.g., parking, physicians' lounge etc..) with MD/DO so I am not sure what is the quest for getting broad score of practice. Pod is like dentistry as far as you guys/gals knew beforehand that you will have somewhat limited scope of practice, which is not necessarily a bad thing. Physicians have broad scope of practice but you won't find an ophthalmologist trying to fix a broken ankle. I really don't see that same attitude in the dental forum.

As far as I am concerned, you guys are on par with MD/DO/DDS. You do damn well what you are trained for.

It’s not so much an inferiority complex. I’m at peace with being a foot dentist. It’s just a way to standardize curriculum and gain a little more recognition in the overall medical community.

 

[TimmyTurner]

The CBSE pilot is continuing for at least two more years, I believe.
There are measures to more formally prepare students being taken this year.
Honestly, I'd say this is all pretty moot, for a couple of reasons.
1) Set all details and context aside, and consider this alone: You're asked to study for and take a comprehensive exam that has literally zero impact on your GPA, class rank, residency placement, etc. How hard would you study for this exam? I know my answer.
2) Pod curriculum overlaps significantly with CBSE/USMLE topics, but not entirely. Pod curriculums are designed for our board exams, not someone else's. Already at a disadvantage.
3) The MCAT is supposed to be a predictor of USMLE performance. That is its' primary function as a predictor of future performance. If Pod students on average occupy the lower percentile range of MCAT performances, why do we expect performance on CBSE/USMLE to be any different?
4) The exam does not assess the greatest strength of a Pod student- Lower extremity anatomy. Without a chance to play to our strengths, I don't see how we'll be able to dedicate as much time as we do to LEA in our curriculums and still perform well on the exam.

I'm fine with moving towards using the USMLE as our board examination. We just have to supplement a measurement of LEA knowledge, and tailor our curriculum to include topics not currently covered in Pod school, particuarly- obgyn & psych.

 

[msion]

I am happy with the USMLE movement, at least if this will get our APMLE board to write better exam questions.
I can see our profession being very similar to the DOs in a few years if they are really pushing for the USMLE examination. You can take the APMLE board exams, graduate and match into a residency. Or, you can also take the USMLE as an option. Residency programs (prestigious ones) may start to prefer candidates who also take USMLE, and soon enough people will be taking both exams. That's what is going on in DO schools. You can either take COMLEX and be done with it. Or take USMLE to match into a better program/speciality.
And remember you likely won't need to take the entire USMLE (Step 1-3), as this is still a licensing exam. The DO students only take USMLE 1 and 2 for match purposes, and finish their own COMLEX series to get licensed.

 

[GypsyHummus]

What would happen to students who have already taken the APMLE for licensing purposes? Would they be grandfathered in like DOs who took the COMLEX are?

 

[msion]

What would happen to students who have already taken the APMLE for licensing purposes? Would they be grandfathered in like DOs who took the COMLEX are?

Probably won't matter as this still takes couple of years to become reality. And you likely just need USMLE for match purposes, and/or proving a point to the MD world. California is pushing for a plenary license for DPMs, and yes this may require graduating residents to take the USMLE again.

 

[med2345]

Probably won't matter as this still takes couple of years to become reality. And you likely just need USMLE for match purposes, and/or proving a point to the MD world. California is pushing for a plenary license for DPMs, and yes this may require graduating residents to take the USMLE again.

Would we have a different passing number or what exactly? Because of curriculum differences

 

[DexterMorganSK]

What would happen to students who have already taken the APMLE for licensing purposes? Would they be grandfathered in like DOs who took the COMLEX are?

Would we have a different passing number or what exactly? Because of curriculum differences

There is no way to know about the grandfather clause until this change actually takes place, whenever that is.

But, if this actually happens, and if the DPM students are required to sit the USMLE, then I'm sure the curriculum would be changed accordingly.

 

[med2345]

There is no way to know about the grandfather clause until this change actually takes place, whenever that is.

But, if this actually happens, and if the DPM students are required to sit the USMLE, then I'm sure the curriculum would be changed accordingly.

But lower extremity is 25 percent of APMLE. How could that be changed? We’d essentially lose one of our main purposes and identity. That’s why I’m mixed about it

 

[DexterMorganSK]

But lower extremity is 25 percent of APMLE. How could that be changed? We’d essentially lose one of our main purposes and identity. That’s why I’m mixed about it

I am not sure but probably make the boards into two exams similar to the DO COMLEX having their OMM part and the rest of the basic sciences.
We can have the APMLE that has basic sciences and the LEAN materials and then do the USMLE...but I can only speculate.

 

[de Ribas]

There is no way to know about the grandfather clause until this change actually takes place, whenever that is.

But, if this actually happens, and if the DPM students are required to sit the USMLE, then I'm sure the curriculum would be changed accordingly.

That's exactly what I am thinking. It's not so much about USMLE but about the curriculum.

 

[de Ribas]

I read the whole thread but still do not understand why would pods need to take USMLE? What's the purpose? To get a residency in other MD/DO specialties?

But pod curriculum is different than MD/DO curicculum. I think, to even try to get equal with MD/DO, pod curriculum has to include all courses that they take. Pod schools can keep the courses that are related to pod education like DO have OMM.

But then after some years people will start applying for old schools just to get into other specialties besides DPM. Pod schools will become as competitive as DO schools.

I don't really understand why would people push for it if that's the only way how they could get into med school anyways. Podiatry would lose its identity.

If one wants to be MD/DO then become a competitive applicant and go to MD/DO school.

I don't understand why some people go into DPT, nursing and other healthcare fields and then they try to shift their fields to be similar to physician. If you want to be a physician become one in the first place. And if you are DPT, be proud of yourself and know that you are needed where you are. There is a need in every healthcare field.

I am not against podiatry earning respect and recognition, but is having MD letters the only way?

I think that podiatry could benefit from having a closer education to MD/DO and having similar admission and graduating requirements and training. I think DPM degree can be fine by staying DPM.

 

[Weirdy]

-Insert relevant coursework so we can sit for USMLE (OB/GYN and Psych)
-Have DPM students take USMLE
-Have DPM students take our regular boards


Now what?
Did we really earn the respect of MD/DO residency directors/attendings?
Do you think they see us as equals now?
Did we change the perspective of older attendings and those in places of high power who are hiring us?

I am trained to work with the foot and ankle.
What benefit besides parity- has sitting for the USMLE done for me?
Will my paycheck be bigger?
Will the hospital give me more surgical privileges?
Will ortho kindly hand over their case load and the types of cases I am trained to do?

It is a great step for parity and shock value to have DPM students take the USMLE and do somewhat decent.

But I still have my doubts. I do not think it will completely solve the parity issue or power struggle.

 

[GypsyHummus]

Maybe, thats what DO school is doing right now, though it sounds like it isnt working out too well, they lost a lot of specialty spots. In return, they get to keep matching into MD residencies. Pod currently doesnt have a problem now with placing student in residencies like DO would have had if MD residencies had shut out DO grads.

It would certainly enforce the idea of parity. Weather or not other physicians would actually see us as equals would take generations, as it has and still continues for the DOs.

Same as last point. I think the best way to show other docs pods know their stuff through educational integration.

USMLE would enforce the notion that Pods are physicians first, pods second.

In some states, pods get paid less for the same procedure than an MD/DO would do.

Possibly. It would send a note to insurance companies that pods are physicians though and reimbursement should reflect as such.

They might, I know of many instances where DOs work in ortho groups and they are treated as partners. If pods were allowed to take general call, that would be a great boost to not only autonomy, but money.

It will be interesting to see if the strategy that DOs did (were strong armed by the accrediting body of MD residencies) works for them.

Did we really earn the respect of MD/DO residency directors/attendings?
Do you think they see us as equals now?
Did we change the perspective of older attendings and those in places of high power who are hiring us?

What benefit besides parity- has sitting for the USMLE done for me?
Will my paycheck be bigger?
Will the hospital give me more surgical privileges?
Will ortho kindly hand over their case load and the types of cases I am trained to do?

But I still have my doubts. I do not think it will completely solve the parity issue or power struggle.

 

[septoplasty]

I am unsure how I pondered upon this thread, but quite a unique views on this.

I do want to add, DPM's would be poorly trained for the USMLEs (I mean, depending on which one you guys take/or if all, as its everything basic sciences, states, pharm (heart failure, diabetes, etc.), to managing pre-eclampsia). This is not something you can just "study" and pass. Part 3 is geared to be taken after Year 1 of residency, (aka intern year, as all MD's/DO's go through varying degrees of training of this stuff).

Therefore, this is a poor way for DPM's to say they are "equivalent" because you guys don't go through such training. A famous analogy of "If You Judge a fish by Its Ability to Climb a Tree, It Will Live Its Whole Life Believing that It is Stupid."

Also there is a notion that USMLEs = unlimited practice power or opens the gateway to medicine, well, I think everyone forgets each specialist/sub specialist undergoes further board exams to be certified to do something. For the example that was given above. Without the actual board exam where day to day knowledge is tested, the USMLE is useless. Find a MD/DO who has never taken a specialty/subspecialty exam but only taken the USMLEs.. you won't find any.

" I think the biggest downside to podiatry is the limited scope. As an FM, you can basically do everything under the sun that isnt surgical. Want to pursue sleep medicine? How about Urgent care? PCP can offer you that. Want to make more money on the side? Moonlight at the local hospital is totally possible. The demand for Primary Care docs is astronomical, even more so than Surgeons. What if I wanted to open up a nutrition supplement store? PCPs can do that. The sky is the limit for MD/DO, for pods, the Tibial Tuberosity is the limit lol."

1. Sleep Medicine: Requires fellowship training
2. Expanded scope/training of FM. Let me give you a personal example, primary care goes through approximately 12 months of inpatient medicine (meaning hospital, subspecialities, running codes, intubating adults, kids and babies), 4 months is pediatrics (icu/amb), 3 months of ED, 2 months of Gyn, 2 months of Obstetrics, 4 months of ICU/CCU, and than electives geared towards: practice setting, or fellowship setting. Would you believe that they are not practicing within their scope? This isn't out of scope, or cowboy medicine.

As for the nutrition supplement store, heck, I'm sure my DPM colleagues could open one and it would do well, its more of a marketing ploy as there isn't really an oversight in this, unless of course you did a fellowship in nutrition/weight management, than yes, those credentials/knowledge is far greater than the competition. But you ask yourself, if you were an average person, would you go buy nutritional supplements from your DPM, or an FM who manages diseases as a result of malnutrition?

 

[de Ribas]

I am unsure how I pondered upon this thread, but quite a unique views on this.

I do want to add, DPM's would be poorly trained for the USMLEs (I mean, depending on which one you guys take/or if all, as its everything basic sciences, states, pharm (heart failure, diabetes, etc.), to managing pre-eclampsia). This is not something you can just "study" and pass. Part 3 is geared to be taken after Year 1 of residency, (aka intern year, as all MD's/DO's go through varying degrees of training of this stuff).

Therefore, this is a poor way for DPM's to say they are "equivalent" because you guys don't go through such training. A famous analogy of "If You Judge a fish by Its Ability to Climb a Tree, It Will Live Its Whole Life Believing that It is Stupid."

Also there is a notion that USMLEs = unlimited practice power or opens the gateway to medicine, well, I think everyone forgets each specialist/sub specialist undergoes further board exams to be certified to do something. For the example that was given above. Without the actual board exam where day to day knowledge is tested, the USMLE is useless. Find a MD/DO who has never taken a specialty/subspecialty exam but only taken the USMLEs.. you won't find any.

" I think the biggest downside to podiatry is the limited scope. As an FM, you can basically do everything under the sun that isnt surgical. Want to pursue sleep medicine? How about Urgent care? PCP can offer you that. Want to make more money on the side? Moonlight at the local hospital is totally possible. The demand for Primary Care docs is astronomical, even more so than Surgeons. What if I wanted to open up a nutrition supplement store? PCPs can do that. The sky is the limit for MD/DO, for pods, the Tibial Tuberosity is the limit lol."

1. Sleep Medicine: Requires fellowship training
2. Expanded scope/training of FM. Let me give you a personal example, primary care goes through approximately 12 months of inpatient medicine (meaning hospital, subspecialities, running codes, intubating adults, kids and babies), 4 months is pediatrics (icu/amb), 3 months of ED, 2 months of Gyn, 2 months of Obstetrics, 4 months of ICU/CCU, and than electives geared towards: practice setting, or fellowship setting. Would you believe that they are not practicing within their scope? This isn't out of scope, or cowboy medicine.

As for the nutrition supplement store, heck, I'm sure my DPM colleagues could open one and it would do well, its more of a marketing ploy as there isn't really an oversight in this, unless of course you did a fellowship in nutrition/weight management, than yes, those credentials/knowledge is far greater than the competition. But you ask yourself, if you were an average person, would you go buy nutritional supplements from your DPM, or an FM who manages diseases as a result of malnutrition?

Long post and little valuable info.

You touched on sleep medicine and nutrition supplement stores. Who cares about supplement stores. All you need to open any store is money. Then you can hire right people to do the rest. What DO degree or DPM has to do with being able to open or run a store?

 

[de Ribas]

As an FM, you can basically do everything under the sun that isnt surgical.

Why do you compare podiatry to FM?
Would Foot and Ankle orthopedist deliver a baby or work in cardiology or neurology without going back to residence? Of course not.

All specialties are limited. Even FM is limited. It's just that all specialties have their own types and sizes of limitations. Who cares...
Other healthacre degrees also have limitations: PAs, NPs, CRNAs, PTs, ODs, Pharmacists, nurses, even CNAs and MAs.

I have worked alongside pretty cool CNAs who have been working for 20+ years and they are happy.

Despite all of this, people choose what they like or prefer based on their life situations, family status, financial situations, personal characteristics and more.

I don't see that limitations of a specialty or a degree is necessarily a disadvantage.

There is no MD/DO specialty that can do everything under the sun anyways. And FM is NOT the most exciting specialty there is.

 

[bobtheweazel]

I do want to add, DPM's would be poorly trained for the USMLEs (I mean, depending on which one you guys take/or if all, as its everything basic sciences, states, pharm (heart failure, diabetes, etc.), to managing pre-eclampsia). This is not something you can just "study" and pass. Part 3 is geared to be taken after Year 1 of residency, (aka intern year, as all MD's/DO's go through varying degrees of training of this stuff).

Therefore, this is a poor way for DPM's to say they are "equivalent" because you guys don't go through such training. A famous analogy of "If You Judge a fish by Its Ability to Climb a Tree, It Will Live Its Whole Life Believing that It is Stupid."

The only things we don't cover heavily are OB/GYN and psychiatry, otherwise we learn the exact same pharm, path, anatomy, etc as our MD/DO colleagues.

Also every podiatry residency has about a year's worth of off service rotations, the same as MDs/DOs. Some have it all frontloaded as an intern year, some spread it out throughout the residency, but all current podiatrists do rotate through internal medicine, emergency department, general surgery, infectious disease, etc. But these are side by side with the MD/DO residents in those hospitals. Same patient load, same taking call, etc.

Not to say that pods wouldn't still be at a disadvantage taking the USMLE. Like I said most of the pod schools go light on the OB/GYN and psychiatry to make room for lower extremity and surgical courses. Also our 1st board exam is 25% lower extremity anatomy, so obviously taking both would require two very different study approaches and is probably not actually worth the trouble in my opinion, since scope of practice and "parity" is largely based on state law anyway and not the letters behind your name.


Enviado desde mi Pixel mediante Tapatalk

 

[de Ribas]

This is not something you can just "study" and pass.

Wrong.

There are hundreds of people (who got a medical degree) from foreign countries (often poor) that come here and after years or even a decade study for USMLE and get very competitive scores. Some even get into Cardiology. Of course they had medical degrees from their country. But their degree curriculum is much different than US one. I am sure it is easier for US podiatrist to study for USMLE than for any foreigner who got their degree years ago.

 

[Weirdy]

No one in this thread is saying DPM students being able to sit for the USMLE = unrestricted practicing power with no oversight.

We are also not trying to get into a trophy contest regarding exposure/level of training.

Being able to sit and do decently well on the USMLE would at least enable us to bargain for surgical privileges and case loads against hospitals who have a heavy ortho presence, insurance reimbursements, licensing so on so forth.

Even then-- the test being given is produced directly by NBME and is a modified version of the USMLE, not the full version. We know we did poorly on topics we were not taught. Other topics such as anatomy, physiology, pharmacology etc I would imagine the DPM students did fairly well. It is still professional medical education taught at a professional level and depth.

 

[med2345]

I am unsure how I pondered upon this thread, but quite a unique views on this.

I do want to add, DPM's would be poorly trained for the USMLEs (I mean, depending on which one you guys take/or if all, as its everything basic sciences, states, pharm (heart failure, diabetes, etc.), to managing pre-eclampsia). This is not something you can just "study" and pass. Part 3 is geared to be taken after Year 1 of residency, (aka intern year, as all MD's/DO's go through varying degrees of training of this stuff).

Therefore, this is a poor way for DPM's to say they are "equivalent" because you guys don't go through such training. A famous analogy of "If You Judge a fish by Its Ability to Climb a Tree, It Will Live Its Whole Life Believing that It is Stupid."

Also there is a notion that USMLEs = unlimited practice power or opens the gateway to medicine, well, I think everyone forgets each specialist/sub specialist undergoes further board exams to be certified to do something. For the example that was given above. Without the actual board exam where day to day knowledge is tested, the USMLE is useless. Find a MD/DO who has never taken a specialty/subspecialty exam but only taken the USMLEs.. you won't find any.

" I think the biggest downside to podiatry is the limited scope. As an FM, you can basically do everything under the sun that isnt surgical. Want to pursue sleep medicine? How about Urgent care? PCP can offer you that. Want to make more money on the side? Moonlight at the local hospital is totally possible. The demand for Primary Care docs is astronomical, even more so than Surgeons. What if I wanted to open up a nutrition supplement store? PCPs can do that. The sky is the limit for MD/DO, for pods, the Tibial Tuberosity is the limit lol."

1. Sleep Medicine: Requires fellowship training
2. Expanded scope/training of FM. Let me give you a personal example, primary care goes through approximately 12 months of inpatient medicine (meaning hospital, subspecialities, running codes, intubating adults, kids and babies), 4 months is pediatrics (icu/amb), 3 months of ED, 2 months of Gyn, 2 months of Obstetrics, 4 months of ICU/CCU, and than electives geared towards: practice setting, or fellowship setting. Would you believe that they are not practicing within their scope? This isn't out of scope, or cowboy medicine.

As for the nutrition supplement store, heck, I'm sure my DPM colleagues could open one and it would do well, its more of a marketing ploy as there isn't really an oversight in this, unless of course you did a fellowship in nutrition/weight management, than yes, those credentials/knowledge is far greater than the competition. But you ask yourself, if you were an average person, would you go buy nutritional supplements from your DPM, or an FM who manages diseases as a result of malnutrition?

This whole post was a contradiction. Sky is the limit for an MD/DO hmm what happens when you do your residency restricted by your USMLE step 1 and, complete your specialty, and pass your specialty specific boards? You’re limited to that scope (what you’re trained in). If you think you still have unlimited scope, welcome to the world of lawsuits.

 

[de Ribas]

No one in this thread is saying DPM students being able to sit for the USMLE = unrestricted practicing power with no oversight.

We are also not trying to get into a trophy contest regarding exposure/level of training.

Being able to sit and do decently well on the USMLE would at least enable us to bargain for surgical privileges and case loads against hospitals who have a heavy ortho presence, insurance reimbursements, licensing so on so forth.

Even then-- the test being given is produced directly by NBME and is a modified version of the USMLE, not the full version. We know we did poorly on topics we were not taught. Other topics such as anatomy, physiology, pharmacology etc I would imagine the DPM students did fairly well. It is still professional medical level content taught at a professional level and depth.

Let's say if there would be more incentives for pods for taking USMLE, I am sure pods could do even better.

It is much about motivation. FMGs have quite different curriculum and they still can take USMLE and get competitive scores.

One of my friends graduated from medical school in 1994 in a foreign country. Just 5 years ago he decided to buy books and study. He studied for a little over half a year and he got competitive scores and matched into neurology in his local city. He didn't even have to move anywhere. He matched his 1st choice.

He was out of med school for 20 years and he still did it.

 

[DexterMorganSK]

Anyone that takes the USMLE Step 1 exam prepares for it by using First Aid for Step 1.
The authors of that book acknowledge the similarities between the basic sciences of a Podiatry curriculum and that of an MD/DO. Which is why they include DPM students to use that same book to prepare for the APMLE Part 1. With the extra classes and review sessions, podiatry students will the best in line to tackle this exam due to these educational similarities.

 

[Weirdy]

The goal is to practice within our scope of practice and use our full skill set-- without being discriminated against by insurance companies and hospitals.

We do not want to use the USMLE to deliver babies or practice FM.