What do the podiatry schools think of premed applicants?

[densmore22]

Does this mean I can't argue with Dr_Feelgood anymore? I like his cowbell avatar.

That's what makes this forum and Country great is that you can argue with whomever you want.

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[Envision]

You know where I stand on this one. Any doctor that:

1) Is a member of medical staff at a hospital
2) Has full hospital privileges
3) Can write prescriptions

is a physician but that's just my humble opinion. I just took out a home loan from "Physician Loans" so I guess that settles it!

Search the archives. This argument is well documented!!!

Sorry to feed the flames on this one, but according to this list of prerequisites, do dentists and optometrist refer to themselves as dental physicians or optometric physicians as well? traditionally, physician refers to MDs/DOs only. At some schools (Columbia dental is an example) takes all their basic sciences with MDs. However, as far i know, it is uncommon to call a dentist a dental physician. There was a huge argument over the term optometric physician as well. This is because, although the title doesn't really matter to much, the term "doctor" is being used by many different healthcare professions and can come off as confusing to the public who their medical providers actually are. However, the word physician, has traditionally been exclusive to MDs/DOs. One of my closest friends in applying to pod school and i suggested this career to my brother as well. So needless to say, i have a lot of respect for podiatrist. However, i think podiatric physician does come off as slightly misleading. Also, the argument that podiatry is a medical profession still doesn't justify it. Dentistry and optometry are medical professions, it is still not medical school. Just my 2cent.

PS: Dear Dr Feelgood, thank you for your advice on the marathon. My feet are feeling great.

 

[Podman]

Sorry to feed the flames on this one, but according to this list of prerequisites, do dentists and optometrist refer to themselves as dental physicians or optometric physicians as well? traditionally, physician refers to MDs/DOs only. At some schools (Columbia dental is an example) takes all their basic sciences with MDs. However, as far i know, it is uncommon to call a dentist a dental physician. There was a huge argument over the term optometric physician as well. This is because, although the title doesn't really matter to much, the term "doctor" is being used by many different healthcare professions and can come off as confusing to the public who their medical providers actually are. However, the word physician, has traditionally been exclusive to MDs/DOs. One of my closest friends in applying to pod school and i suggested this career to my brother as well. So needless to say, i have a lot of respect for podiatrist. However, i think podiatric physician does come off as slightly misleading. Also, the argument that podiatry is a medical profession still doesn't justify it. Dentistry and optometry are medical professions, it is still not medical school. Just my 2cent.

PS: Dear Dr Feelgood, thank you for your advice on the marathon. My feet are feeling great.

podiatrists go through 4 years of schooling - including rotations in podiatric and general medicine and then are obliged to complete a minimum of 2-3 years of residency training. During our residency training, our PGY-1 year is comprised of rotations in medical specialties like internal medicine, neurology, etc. We are expected to work up these patients, and present to attendings just like any other medical residents - these attributes are not available to dental or optometry professionals with all due respect of course.

I personally dont have a problem with being referred to as a "podiatrist" as opposed to podiatric physician - Though, I'd rather see "Dr. John Doe, podiatrist" or "Dr. Jane Smith, internist" on white coats to tell u the truth. From my short experience in externships so far, I've seen "podiatric surgeon" as the popular and common ground - its not misleading and its not confusing. The reason there is a push for "podiatric surgeon" or "podiatric physician" is to emphasize a higher level of advanced training. >30 years ago DPMs were able to graduate with virtually no surgical training and were essentially practicing chiropody. However, today we are in an era where the profession has moved to become a recognizable medical surgical specialty and that is why you'll see the push for those titles.


FYI - Case western reserve university refers to its dental school as "school of dental medicine". And it is a very respectable school without a doubt.

 

[Envision]

podiatrists go through 4 years of schooling - including rotations in podiatric and general medicine and then are obliged to complete a minimum of 2-3 years of residency training. During our residency training, our PGY-1 year is comprised of rotations in medical specialties like internal medicine, neurology, etc. We are expected to work up these patients, and present to attendings just like any other medical residents - these attributes are not available to dental or optometry professionals with all due respect of course.

I personally dont have a problem with being referred to as a "podiatrist" as opposed to podiatric physician - Though, I'd rather see "Dr. John Doe, podiatrist" or "Dr. Jane Smith, internist" on white coats to tell u the truth. From my short experience in externships so far, I've seen "podiatric surgeon" as the popular and common ground - its not misleading and its not confusing. The reason there is a push for "podiatric surgeon" or "podiatric physician" is to emphasize a higher level of advanced training. >30 years ago DPMs were able to graduate with virtually no surgical training and were essentially practicing chiropody. However, today we are in an era where the profession has moved to become a recognizable medical surgical specialty and that is why you'll see the push for those titles.


FYI - Case western reserve university refers to its dental school as "school of dental medicine". And it is a very respectable school without a doubt.

Thank you for your thorough reply. I agree, podiatric surgeon is not misleading but i keep my views on the physician title. Actually, the term dental medicine is not exclusive to Case Western, but many other dental schools. However, my point was that despite the fact the dentistry is a branch of medicine, we do not refer ourselves as dental physicians. Again, this is just my humble opinion.

 

[corpsmanUP]

It's misleading to say that orthopods are not foot experts if they do not complete a foot and ankle fellowship. The vast majority of foot and ankle problems are handled by primary care docs who refer out to general orthopods PRN. Where I am doing my residency, for whatever reason, we have no Pods in the hospital. I am at a tertiary medical facility with 800 beds and over a thousand physicians. But no Pods. And this is in a state where there is a Pod school. Ortho handles all the foot stuff here, all through their residency. I would venture to say that in the 80+ hours a week they work x 5 years, that they get as much foot and ankle exposure as the average 2-3 year Pod residency. I've seen the Pod residents, and some don't work that hard. There is a program in Harris County (Houston, Texas), and their residents used to work with my partner who was a Pod in our family practice. The requirements for these residents were minimal because they were essentially performing a 1 on 1 preceptorship with each surgeon they worked with. It was nowhere near as rigorous as ortho. I would argue that a general trained ortho is equally qualified to treat feet as a Podiatrist. It's not like Ortho guys get to skip the lower extremity on their boards. I've been well educated by my ortho colleagues on foot issues.

The beef people have with Pods calling themselves physicians is that the term physician is a well established societal norm that most laypersons associate with meaning a doctor who has training in all aspects of the body first and foremost. Podiatry eventually needs to become a residency in the MD/DO world and this will be null and void. I honestly don't even mind them calling themselves surgeons, but physician is a misleading term.

 

[calcaneus]

The beef people have with Pods calling themselves physicians is that the term physician is a well established societal norm that most laypersons associate with meaning a doctor who has training in all aspects of the body first and foremost. Podiatry eventually needs to become a residency in the MD/DO world and this will be null and void. I honestly don't even mind them calling themselves surgeons, but physician is a misleading term.[/quote]

I can't speak for all schools, but at Temple podiatry students take the basic science classes taught by the same MD professors and take the same tests. They do clinical rotations with the MD students in the other parts of the body in 3rd and 4th year. I am not sure, but I think all the 3 year residencies include a year of interning in various departments-vascular, derm, ortho, general surgery, etc. So they do get training in all aspects of the body.

With that said, of all the pods I've had contact with, I've only ever heard them refer to themselves as podiatric physicians, podiatric surgeon, or podiatrist. All the podiatrists I've known have no desire to mislead anyone that they are an MD and will correct anyone that appears confused about it.

I would like to say that I am glad to hear corpsmanUP and Northerners comments though.

 

[Podman]

It's misleading to say that orthopods are not foot experts if they do not complete a foot and ankle fellowship. The vast majority of foot and ankle problems are handled by primary care docs who refer out to general orthopods PRN. Where I am doing my residency, for whatever reason, we have no Pods in the hospital. I am at a tertiary medical facility with 800 beds and over a thousand physicians. But no Pods. And this is in a state where there is a Pod school. Ortho handles all the foot stuff here, all through their residency. I would venture to say that in the 80+ hours a week they work x 5 years, that they get as much foot and ankle exposure as the average 2-3 year Pod residency. I've seen the Pod residents, and some don't work that hard. There is a program in Harris County (Houston, Texas), and their residents used to work with my partner who was a Pod in our family practice. The requirements for these residents were minimal because they were essentially performing a 1 on 1 preceptorship with each surgeon they worked with. It was nowhere near as rigorous as ortho. I would argue that a general trained ortho is equally qualified to treat feet as a Podiatrist. It's not like Ortho guys get to skip the lower extremity on their boards. I've been well educated by my ortho colleagues on foot issues.

The beef people have with Pods calling themselves physicians is that the term physician is a well established societal norm that most laypersons associate with meaning a doctor who has training in all aspects of the body first and foremost. Podiatry eventually needs to become a residency in the MD/DO world and this will be null and void. I honestly don't even mind them calling themselves surgeons, but physician is a misleading term.

tooooooo many assumptions you're making over there my friend. I liked your previous posts but this one is off the mark. Lets look at the issues you're raising here. A general trained ortho does not cover the same amount of cases as the 3-year trained DPM. This isn't something I'm claiming, but rather reported for the purpose of our board certification. I'm not saying that general orthos don't do alot of foot and ankle - I'm sure that they do, because they get a ton of exposure in peds, trauma, etc. In terms of the attitudes of the DPM residents, the one hospital that you work at does not make it the general rule - I'm externing at a program right now where podiatrists split calls with ortho. The "preceptor" programs are not the norm - we have alot - and I mean alot of high powered surgical programs. If you're not convinced, look up the residencies mentioned in the podiatric residency forum.

As for the definition of physician - you just answered your own question/assumption. You said, that physicians are trained in the body first and foremost - well, this is probably the biggest assumption tagged to our profession - many people assume that DPM's spend 4 years to learn feet and 3 years to work on them in residency. We study and learn the WHOLE body as well - believe it or not. Our rotations in 3rd and 4th years are not identical but we do cover many of the rotations in our PGY-1 (for 3 year programs) with Neuro, Internal, Derm, etc. Our training is founded on the principle that the foot is attached to the body - I don't need to tell you the necessity of understanding this principle especially when it comes to dealing with diabetic, and immunocompromised patients. Yes in practical terms, we do specialize early with lower extremity - but the principle is always treat the patient as a whole.

I also wanted to say that the term "physician" without the word "podiatric" is never voluntarily employed by the DPM. No one wants to mislead patients. The only time you'd see a situation where there is a listing looking as such:
physician - podiatric surgery/podiatry
is probably at a hospital listing and this isn't something the DPM would voluntarily emphasize or enter into the database. But we're splitting hairs over something very irrelevant because at the end of the day, each specialist will work within his domain or realm - a cardiologist is not going to perform a biomechanical exam on a patient with Hallux limitus, and a DPM is not going to surgically treat a brain tumor. A psychiatrist will not surgically remove plantar warts. So, Each specialist will typically stick to their domain and training - and this is why the medical community as a whole needs to focus their "energy" and worry about the bigger problems in our healthcare.

I will agree though with your proposed model in podiatric residency as I would love to see podiatry becoming a residency available to MD/DO. This will happen when the students take same statandardized board exams - and this will definitely nullify any obscurity about our education and training. This is a step for the future though - not going to happen in the near future.

 

[dpmrunner]

Posing a thought for those that think Pods could/should/might get dissolved into MD/DO programs.....how long do you really think this will take?

I think the MD and DO programs would have to fight to take it moreso, which, why would they want to? The Pod schools have money and want to make money(it is a type of business in the end), the governing boards have money and power. Who will give up their positions for the betterment of the profession, some but not all.

Any way that it might happen, although in the end it would produce equality I think it is more the past of podiatry and starting out as a freestanding institution that it will remain so.

any other thoughts on this for the people posting on the topic? I think it would be quite a few years before we would see any actual absorption, then again, the alignment with MD/DO schools is a step in the right direction...

 

[Dr_Feelgood]

Sorry to feed the flames on this one, but according to this list of prerequisites, do dentists and optometrist refer to themselves as dental physicians or optometric physicians as well? traditionally, physician refers to MDs/DOs only. At some schools (Columbia dental is an example) takes all their basic sciences with MDs. However, as far i know, it is uncommon to call a dentist a dental physician. There was a huge argument over the term optometric physician as well. This is because, although the title doesn't really matter to much, the term "doctor" is being used by many different healthcare professions and can come off as confusing to the public who their medical providers actually are. However, the word physician, has traditionally been exclusive to MDs/DOs. One of my closest friends in applying to pod school and i suggested this career to my brother as well. So needless to say, i have a lot of respect for podiatrist. However, i think podiatric physician does come off as slightly misleading. Also, the argument that podiatry is a medical profession still doesn't justify it. Dentistry and optometry are medical professions, it is still not medical school. Just my 2cent.

PS: Dear Dr Feelgood, thank you for your advice on the marathon. My feet are feeling great.

I think that you must include the enviroment in the equation. While there are a few dental programs that are integrated. The vast majority of dental visits/cases are seen in a private practice. Heck dental care is not even covered under medical insurance (which I think is crap.) Pods on the other hand are moving more towards a hospital setting, orthopedic setting, or large multispecialty clinics.

I, again, don't care what you call me, but I do care that about being call a podiatric medical school. I feel this is again due to the environment. While there maybe 1 or 2 dental schools that are integrated. Dental and optometric students are not required to do post-graduation training. They do not do rotations in internal medicine, family medicine, general surgery, anesthesia, pediatrics, vascular, cardiology, ect. Pod students do all of these things during their clinical training and residency.

Also, for historic purposes a physician is an internist. It was used to describe a doctor that only treats pathology with medical treatment and not surgical treatment (i.e. a surgeon). Using this definition, there are pods out there that do not do surgery. So they would be a podiatric physician.

P.S. No problem. I hope you ran a good time.

 

[Dr_Feelgood]

It's misleading to say that orthopods are not foot experts if they do not complete a foot and ankle fellowship. The vast majority of foot and ankle problems are handled by primary care docs who refer out to general orthopods PRN. Where I am doing my residency, for whatever reason, we have no Pods in the hospital. I am at a tertiary medical facility with 800 beds and over a thousand physicians. But no Pods. And this is in a state where there is a Pod school. Ortho handles all the foot stuff here, all through their residency. I would venture to say that in the 80+ hours a week they work x 5 years, that they get as much foot and ankle exposure as the average 2-3 year Pod residency. I've seen the Pod residents, and some don't work that hard. There is a program in Harris County (Houston, Texas), and their residents used to work with my partner who was a Pod in our family practice. The requirements for these residents were minimal because they were essentially performing a 1 on 1 preceptorship with each surgeon they worked with. It was nowhere near as rigorous as ortho. I would argue that a general trained ortho is equally qualified to treat feet as a Podiatrist. It's not like Ortho guys get to skip the lower extremity on their boards. I've been well educated by my ortho colleagues on foot issues.

The beef people have with Pods calling themselves physicians is that the term physician is a well established societal norm that most laypersons associate with meaning a doctor who has training in all aspects of the body first and foremost. Podiatry eventually needs to become a residency in the MD/DO world and this will be null and void. I honestly don't even mind them calling themselves surgeons, but physician is a misleading term.

I posted a few articles under the podiatric student section that were published by orthopedic surgeons saying the exact opposite. Similar to many other physicians and surgeons, they ignore the feet. There are many other examples in Foot and Ankle International and the Foot and Ankle clinics, where the higher ups in the College of Foot and Ankle Orthopods call of a reclaiming of the foot b/c they have lost control of the area and pods are starting gain an upper hand. Most general orthopods don't want it b/c 1) the joints are small; 2) the pay is small; 3) high levels of complications and co-morbidities (i.e. PAD, DM); 4) they just don't like the feet; 5) they don't care.

I just had a case today that an orthopod only treated a patients tibial fracture and ignored his ankle pain b/c "he said he doesn't wok on feet." The guys got a dead talus and some serious sequela.

P.S. I always love this debate b/c if nothing else we educate a few other people about podiatry. Some people still think that we are foot fetish people that were too dumb to get into a DO program (this maybe true for some). Many people are surprised that we have a residency that is as long as a family practice physician.

 

[Dr_Feelgood]

Just to help here is the link to the artilces.

http://forums.studentdoctor.net/showthread.php?t=362432

 

[jonwill]

I would venture to say that in the 80+ hours a week they work x 5 years, that they get as much foot and ankle exposure as the average 2-3 year Pod residency.

Actually this is no where near true. Their exposure to foot and ankle is EXTREMELY limited. In order to be certified in general orthopaedics, orthopods are required to do 10 foot/ankle cases during residency. I've seen ortho do a lot of ankles but I have never seen a general ortho touch the foot. It sounds that you may be a residency program that has a foot & ankle fellow. This is an exception, not a rule.

At the end of my 3 year residency, I'll have 2500+ foot and ankle procedures. I promise you that no general ortho resident will even remotely come close to that. You mentioned Harris County which is a descent general program. I have a buddy starting there in July. However, I don't think it is a good example of many of our residency programs. John Peter Smith in Dallas/Ft. Worth and UT-San Antonio HCS are a few good examples of how podiatrists are now utilized.

If general ortho won't touch hands, why would they touch the feet???

 

[jonwill]

It's misleading to say that orthopods are not foot experts if they do not complete a foot and ankle fellowship. The vast majority of foot and ankle problems are handled by primary care docs who refer out to general orthopods PRN.

This is an untrue statement as well. The vast majority of foot and ankle problems are handled by primary care docs who refer out to podiatrists. There are 15,000 podiatrists in the nation. Compare that to F&A ortho. Nearly all of our business (with the exception of ER stuff) comes from refering MD's. This does not appear to be the case at your hospital but realize that at many hospitals throughout the nation, it is.

 

[jonwill]

Sorry to feed the flames on this one, but according to this list of prerequisites, do dentists and optometrist refer to themselves as dental physicians or optometric physicians as well? traditionally, physician refers to MDs/DOs only. At some schools (Columbia dental is an example) takes all their basic sciences with MDs. However, as far i know, it is uncommon to call a dentist a dental physician. There was a huge argument over the term optometric physician as well. This is because, although the title doesn't really matter to much, the term "doctor" is being used by many different healthcare professions and can come off as confusing to the public who their medical providers actually are. However, the word physician, has traditionally been exclusive to MDs/DOs. One of my closest friends in applying to pod school and i suggested this career to my brother as well. So needless to say, i have a lot of respect for podiatrist. However, i think podiatric physician does come off as slightly misleading. Also, the argument that podiatry is a medical profession still doesn't justify it. Dentistry and optometry are medical professions, it is still not medical school. Just my 2cent.

PS: Dear Dr Feelgood, thank you for your advice on the marathon. My feet are feeling great.

But you see my point. MD's, DO's, and DPM's can claim those things that I listed (rx, medical staff, hospital privileges). Dentists and Optometrists cannot.

 

[jonwill]

Podiatry eventually needs to become a residency in the MD/DO world and this will be null and void.

This is an interesting debate. In your opinion, is this an eventual possibility? Podiatric medicine has evolved into a surgical sub-specialty. So much so that I could easily see MD/DO's wanting to specialize in podiatry or podiatric surgery.

 

[Dr_Feelgood]

I posted a few more articles from orthopaedic journals and that it would be interesting to see what orthopaedic leadership had on their website. There were many interesting posts most about how they are trying to block any expansion of podiatric scope. One of my favorite claims was:

http://www2.aaos.org/aaos/archives/bulletin/jun99/scope.htm

In South Carolina, for example, House Bill 3240 sought to give podiatrists the right to amputate toes.

Jan Kellar, director of health policy and affairs for the South Carolina Medical Association, says "We had two orthopaedic surgeons testify at three different times against the bill. They testified, in essence, that you can teach anybody to cut off the toes, but podiatrists are not trained to treat the disease itself-diabetes. A lot of diabetics eventually have to have their toes amputated, but cutting off a limb should always be a last resort. If podiatrists were allowed to do it, the surgeons argued, it would happen more often. And where does it stop, will they want to remove the foot next? Fortunately, we were able to defeat the bill, but we know they'll be back next year."​

So I just wanted to see how much exposure orthopods had in their residency to other medical specialties. Here are a few examples:

http://www.bumc.bu.edu/Dept/Content.aspx?DepartmentID=62&PageID=6784

http://www.mcg.edu/resident/ortho/rotations.html

So the only exposure that they have to endocrinology or internal medicine come in their 3rd and 4th year internships. So lets compare that to podiatric residencies (just to make it fair, I tried to pick programs in the same states).

http://www.casprcrip.org/html/casprcrip/pdf/Dir_Pgs/Massachusetts.pdf

http://www.casprcrip.org/html/casprcrip/pdf/Dir_Pgs/Northlake.pdf

Rotations in internal medicine, family medicine, endocrinology/diabetes, and ER. Who is exposed to the treatment of diabetes and who is not??? It would be nice to hear from outside of the pod world on this subject. Maybe it is just me but as we discuss the title of physician and scope. How can things like this be ignored? I just think that comments like the one above are based on ignorance not fact.

 

[jonwill]

I posted a few more articles from orthopaedic journals and that it would be interesting to see what orthopaedic leadership had on their website. There were many interesting posts most about how they are trying to block any expansion of podiatric scope. One of my favorite claims was:

http://www2.aaos.org/aaos/archives/bulletin/jun99/scope.htm

In South Carolina, for example, House Bill 3240 sought to give podiatrists the right to amputate toes.

Jan Kellar, director of health policy and affairs for the South Carolina Medical Association, says "We had two orthopaedic surgeons testify at three different times against the bill. They testified, in essence, that you can teach anybody to cut off the toes, but podiatrists are not trained to treat the disease itself-diabetes. A lot of diabetics eventually have to have their toes amputated, but cutting off a limb should always be a last resort. If podiatrists were allowed to do it, the surgeons argued, it would happen more often. And where does it stop, will they want to remove the foot next? Fortunately, we were able to defeat the bill, but we know they'll be back next year."​

So I just wanted to see how much exposure orthopods had in their residency to other medical specialties. Here are a few examples:

http://www.bumc.bu.edu/Dept/Content.aspx?DepartmentID=62&PageID=6784

http://www.mcg.edu/resident/ortho/rotations.html

So the only exposure that they have to endocrinology or internal medicine come in their 3rd and 4th year internships. So lets compare that to podiatric residencies (just to make it fair, I tried to pick programs in the same states).

http://www.casprcrip.org/html/casprcrip/pdf/Dir_Pgs/Massachusetts.pdf

http://www.casprcrip.org/html/casprcrip/pdf/Dir_Pgs/Northlake.pdf

Rotations in internal medicine, family medicine, endocrinology/diabetes, and ER. Who is exposed to the treatment of diabetes and who is not??? It would be nice to hear from outside of the pod world on this subject. Maybe it is just me but as we discuss the title of physician and scope. How can things like this be ignored? I just think that comments like the one above are based on ignorance not fact.

I think you are right. A lot of these arguments stem from the fact that most people are unaware of a DPM's education and training. That is why I put the "What Is Podiatric Medicine" thread at the top of the podiatry forum. I'm glad to see so many people reading it!

People are always quick to compare pods to optometrists, dentists, chiro, etc. I think that these are very poor comparisons. While these are all challenging and respectable professions, unlike all others with the exception of MD and DO, we receive extensive hospital based training. Both during school and residency, we do multiple rotations in IM, Anes, Vasc, Gen Surg, Plastics, Infectious Disease, Rad, etc. I think that many believe that we simply learn about these subjects in the classroom similar to some of the previous listed professions.

Needless to say, if anyone followed one of us around for a day or two, there wouldn't be much of a debate. Yesterday alone, we had two ankle fracture orif's, two amputations, a plantar fasciotomy, a full afternoon of clinic, and a trip to the ER to admit an abcess/diabetic foot infection. Not to mention rounding on, and dare I say, medically managing our inpatients!

 

[Northerner]

I posted a few more articles from orthopaedic journals and that it would be interesting to see what orthopaedic leadership had on their website. There were many interesting posts most about how they are trying to block any expansion of podiatric scope. One of my favorite claims was:

http://www2.aaos.org/aaos/archives/bulletin/jun99/scope.htm

In South Carolina, for example, House Bill 3240 sought to give podiatrists the right to amputate toes.

Jan Kellar, director of health policy and affairs for the South Carolina Medical Association, says "We had two orthopaedic surgeons testify at three different times against the bill. They testified, in essence, that you can teach anybody to cut off the toes, but podiatrists are not trained to treat the disease itself-diabetes. A lot of diabetics eventually have to have their toes amputated, but cutting off a limb should always be a last resort. If podiatrists were allowed to do it, the surgeons argued, it would happen more often. And where does it stop, will they want to remove the foot next? Fortunately, we were able to defeat the bill, but we know they'll be back next year."​

So I just wanted to see how much exposure orthopods had in their residency to other medical specialties. Here are a few examples:

http://www.bumc.bu.edu/Dept/Content.aspx?DepartmentID=62&PageID=6784

http://www.mcg.edu/resident/ortho/rotations.html

So the only exposure that they have to endocrinology or internal medicine come in their 3rd and 4th year internships. So lets compare that to podiatric residencies (just to make it fair, I tried to pick programs in the same states).

http://www.casprcrip.org/html/casprcrip/pdf/Dir_Pgs/Massachusetts.pdf

http://www.casprcrip.org/html/casprcrip/pdf/Dir_Pgs/Northlake.pdf

Rotations in internal medicine, family medicine, endocrinology/diabetes, and ER. Who is exposed to the treatment of diabetes and who is not??? It would be nice to hear from outside of the pod world on this subject. Maybe it is just me but as we discuss the title of physician and scope. How can things like this be ignored? I just think that comments like the one above are based on ignorance not fact.

Personally, I think toe amputations are probably fine. I think it's fine as long as you stick to the foot. But I also think they have a good argument that an MD/DO provides a better background in systemic diseaes (such as diabetes) - that's what you went to podiatry school for, to keep the scope narrow early at the expense of a more general medical education. You can't claim that your focused curriculum and training make you the preeminent experts in the foot, and then turn around and say, "yeah, but we're just as good as you at the other stuff too". But really what everyone's worried about is the slippery slope. Orthopedists don't want pods creeping their way up the leg bit by bit under the rehashed argument, "well, we're operating right next to it anyway, what's the difference, why not just include this little bit more...." and they don't want this coming back to bite them in the ass and set some sort of precedent that would include a broader scope.

 

[calcaneus]

I think this is strong argument for both DPM's and MD/DO's to get behind a national scope of practice for podiatrists.

It could help out DPM's, especially in states like NY, to get everyone on the same playing field. And it could help MD/DO orthos in that the scope of practice could put alot of the slippery slope fears to rest by having a national standard.

So, Northerner, get your MD/DO friends to help us push for a national scope of practice instead of the state-to-state regulation the way it is now!

 

[Dr_Feelgood]

Personally, I think toe amputations are probably fine. I think it's fine as long as you stick to the foot. But I also think they have a good argument that an MD/DO provides a better background in systemic diseaes (such as diabetes) - that's what you went to podiatry school for, to keep the scope narrow early at the expense of a more general medical education. You can't claim that your focused curriculum and training make you the preeminent experts in the foot, and then turn around and say, "yeah, but we're just as good as you at the other stuff too". But really what everyone's worried about is the slippery slope. Orthopedists don't want pods creeping their way up the leg bit by bit under the rehashed argument, "well, we're operating right next to it anyway, what's the difference, why not just include this little bit more...." and they don't want this coming back to bite them in the ass and set some sort of precedent that would include a broader scope.

I do agree that we choose a specific scope early, but I cannot say that we sacrifice an education in general medicine. No one, NO ONE is an expert at everything. That is why we have specialty physicians. You do not see OB-GYNs don't work on vascular issues and a cardiologist doesn't take out an appendix. But they have unlimited scope, why don't they do everything; because training determines scope. If a cardiologist removed an inflammed appendix, they are wide open for a malpractice lawsuit.

Since you bring up scope, what would is your ideal the podiatric scope? My opinion is Georgia's scope. Nothing osseous above the tibial tuberosity (i.e. no knee) and soft tissue to the iliac crest. I will explain my opinion:

1) We must bring in another surgeon to take skin grafts from the hip or buttocks. We are trying to find a way to save money in health care, well how about having to surgeons in the OR??? So pods have to harvest from the calf which is no where near as good as the hip.

2) Pods should be able to perform a BKA. If we are going to see the diabetic population, we should see it through to the end. Heck think about it, must pods will fight harder to keep the leg than any other specialty. When it is gone we lose the patient.

3) Pilion fractures and ankle fractures can be higher in the leg than most states allow. If you are going to have the ankle than you should be able to treat all ankle trauma.​

 

[krabmas]

I do agree that we choose a specific scope early, but I cannot say that we sacrifice an education in general medicine. How much did you really learn in your 3rd and 4th year compared to residency? Residency is where you learn how to practice medicine. So for any orthopod to claim that they know more about diabetes than a pod is ridiculous; they don't even rotate in any area of medicine, only surgery. It would be like an endocrinologist saying they know more about foot orthopedics than a podiatrist. No one, NO ONE is an expert at everything. That is why we have specialty physicians. You do not see OB-GYNs don't work on vascular issues and a cardiologist doesn't take out an appendix. But they have unlimited scope, why don't they do everything; because training determines scope. If a cardiologist removed an inflammed appendix, they are wide open for a malpractice lawsuit.

Since you bring up scope, what would is your ideal the podiatric scope? My opinion is Georgia's scope. Nothing osseous above the tibial tuberosity (i.e. no knee) and soft tissue to the iliac crest. I will explain my opinion:

1) We must bring in another surgeon to take skin grafts from the hip or buttocks. We are trying to find a way to save money in health care, well how about having to surgeons in the OR??? So pods have to harvest from the calf which is no where near as good as the hip.

2) Pods should be able to perform a BKA. If we are going to see the diabetic population, we should see it through to the end. Heck think about it, must pods will fight harder to keep the leg than any other specialty. When it is gone we lose the patient.

3) Pilion fractures and ankle fractures can be higher in the leg than most states allow. If you are going to have the ankle than you should be able to treat all ankle trauma.​

Be very careful how you word things.

You get mad when others are ignorant of our profession so don't make ignorant comments about their's.

All MDs do an intern year. Even orthos - the first year is still considered an intern year, gen surgery's 1st year is an intern year...

they do Imed rotations and all just like we do.

 

[Dr_Feelgood]

Be very careful how you word things.

You get mad when others are ignorant of our profession so don't make ignorant comments about their's.

All MDs do an intern year. Even orthos - the first year is still considered an intern year, gen surgery's 1st year is an intern year...

they do Imed rotations and all just like we do.

Sam I maybe wrong but everything that I look at for orthopaedic residencies say that the PGY-1 (i.e. the intern year) is done in general surgery. The only medical rotation I can find is in the ER. I maybe wrong (so I edited my statement above) but I cannot find anything saying that they do any work in an Imed rotation.

 

[Northerner]

Sam I maybe wrong but everything that I look at for orthopaedic residencies say that the PGY-1 (i.e. the intern year) is done in general surgery. The only medical rotation I can find is in the ER. I maybe wrong (so I edited my statement above) but I cannot find anything saying that they do any work in an Imed rotation.

Listen, this is getting ridiculous. If you're now to the point where you can't even acknowledge that an MD/DO degree gets a better general medical education, then I'm talking to a delusional person. Half the time you're trying to convince me your education is the exact same as an MD/DO, and half the time you're trying to tell me you're the foot & ankle experts because of how much time you spend on it. There are only so many hours in a day.

 

[Dr_Feelgood]

Listen, this is getting ridiculous. If you're now to the point where you can't even acknowledge that an MD/DO degree gets a better general medical education, then I'm talking to a delusional person. Half the time you're trying to convince me your education is the exact same as an MD/DO, and half the time you're trying to tell me you're the foot & ankle experts because of how much time you spend on it. There are only so many hours in a day.

See we went from having a good debate on the issue to you personally insulting me again. Are you that insecure? I'm just surprised your name is Sam.

So you are telling me that a cardiologist is not an expert of the cardiovascular system? And a urologist is not an expert of the urinary system? But the are MD/DO specialties. How can they do this? It is impossible, their is not enough hours in the day for them to know general medicine and then specialize. I am telling you that as I have posted above PGY-1, pod residents see more specialties than those two residency programs. Orthopaedic interns are surgical interns; they do not see much in general medicine (every program I've found only has an ER rotation as a medicine rotation). My point being, they have an unlimited scope, but have some areas where they aren't experts. Why b/c there are only 24hrs in the day, and no one can be an expert of everything (as I posted above).

So, I ask for you opinion on 1 thing and you just choose to insult me. Are you here to debate or to be a jerk?

 

[jonwill]

This is actually a good debate. Let's keep it professional.

 

[Dr_Feelgood]

This is actually a good debate. Let's keep it professional.

Agreed, I really like this debate. Why not post facts and links, not insults and BS.

 

[Northerner]

See we went from having a good debate on the issue to you personally insulting me again. Are you that insecure? I'm just surprised your name is Sam.

So you are telling me that a cardiologist is not an expert of the cardiovascular system? And a urologist is not an expert of the urinary system? But the are MD/DO specialties. How can they do this? It is impossible, their is not enough hours in the day for them to know general medicine and then specialize. I am telling you that as I have posted above PGY-1, pod residents see more specialties than those two residency programs. Orthopaedic interns are surgical interns; they do not see much in general medicine (every program I've found only has an ER rotation as a medicine rotation). My point being, they have an unlimited scope, but have some areas where they aren't experts. Why b/c there are only 24hrs in the day, and no one can be an expert of everything (as I posted above).

So, I ask for you opinion on 1 thing and you just choose to insult me. Are you here to debate or to be a jerk?

"Delusional" is not name-calling. "Jerk" is. I'll ignore it though, because I'm not oversensitive (note: "oversensitive" is not name-calling either).

Maybe let's start from the beginning.
1) Does your pre-clinical podiatry school education better prepare you to be a foot expert than an MD/DO? If so, explain.
(I think it does)

2) Do your clinical rotations better prepare you to be a foot expert than an MD/DO? If so, explain.
(I think it does)

3) Does your (shorter and more focused) residency better prepare you to be a foot expert than (let's exclude F&A ortho) in an MD/DO path?
(I think it does)

4) Explain to me how you can have 1-3 without sacrificing a more general medicine (systemic disease management, etc.) training.

I agree with you that each specialist is an expert within their own scope of practice, mostly to the exclusion of other areas of medicine. I also argue, however, that the generalization can easily be made that podiatry school and podiatry residency prepare a person to have been trained with a more narrow scope of medicine practice than an MD/DO. Why are you fighting this one?

 

[densmore22]

I agree w/ the 3 qualifiers you listed. I don't think he's fighting you on the narrowed scope of practice per se, he is and he isn't. I think his point is that during Pod residency, our PGY1 is an intern year (just like every residency out there) and during that PGY1, a pod resident will go on more medicine rotations than an ortho PGY1, according to the sites listed above, it seems that ortho residents focus mainly on surgery during PGY1 and less on medicine (read IM and FP) than pod residencies where we do IM and FP rotations along with surgical rotations.

I personally think that pod school prepares you to be the preeminent F/A specialists from the get go. DMU doesn't really expose it's first years to much if any real foot and ankle stuff other than our intro to pod med course which is really just sort of showing us pictures of foot and ankle procedures as well as in anatomy when we get to the lower limb. Other schools start from day 1 with podiatry related curriculum, that being said, yeah we are highly focused on the foot and ankle in the preclinical years, but we are also highly focused on general medicine too.

 

[Feli]

...Orthopedists don't want pods creeping their way up the leg bit by bit under the rehashed argument, "well, we're operating right next to it anyway, what's the difference, why not just include this little bit more...." and they don't want this coming back to bite them in the ass and set some sort of precedent that would include a broader scope.

I that you have noted exactly where the heart of the anti-pod mentality arises from.

I, like many DPM students and graduates, would like to see the national DPM scope which Dr_Feelgood mentions, Georgia's. Podiatry will never attempt to move above the tibial tuberosity (surgically). The knee is the largest joint in the human body, it is a surgical gold mine, and orthopaedic surgeons do a fantastic job treating it. Podiatrists are foot and ankle experts, not "lower leg-ologists," and I don't think any DPM should or will ever lobby for surgeries on the knee joint. I would vote against any such motion. As soon as a podiatrist infected a knee joint or had a less than stellar surgical success rate, there would be all kinds of hell to pay. It is important that all DPMs understand the anatomy of the knee (and the entire body) for biomechanical purposes, physiological, and pathological purposes, but knee problems/surgeries are always referred out and will always continue to be. (I will note that my opinions on DPMs and the knee are largely derived from my lower extremity anatomy prof, a DPM, who advised us to (paraphrased), "know it well, but you are a guest. Your real estate lies to the south. Treat the knee as a respected friend's property which you occasionally visit"... I wholeheartedly agree)

I think the far more slippery slope is hand and fingernail care by DPMs. The surgical procedures are not an issue; ortho, plastic, general, trauma and vascular MD/DO surgeons do a fine job on hand procedures, so podiatry has no business in that arena - no matter how similar the anatomy may be. However, many skin and nail pathologies present very similarly in hands. Should podiatrists be allowed to biopsy a suspicious brownish blue plaque on the hand of a beach bum or a pigmented streak in a caucasian's nail? Should DPM scope include treatment of an ingrown finger nail or a yeast-infected webspace on the hand? There is a lot of risk in referring these patients off for follow-up with derm, especially if they do not have insurance or the pathology is agressive and has poential to get very bad very fast. Yes, any smart DPM would document well when he sends away a suspected hand melanoma to follow up with derm, but what is really best for the patient? States differ on these issues, but a uniform national DPM scope would fix that also.

 

[Northerner]

I agree w/ the 3 qualifiers you listed. I don't think he's fighting you on the narrowed scope of practice per se, he is and he isn't. I think his point is that during Pod residency, our PGY1 is an intern year (just like every residency out there) and during that PGY1, a pod resident will go on more medicine rotations than an ortho PGY1, according to the sites listed above, it seems that ortho residents focus mainly on surgery during PGY1 and less on medicine (read IM and FP) than pod residencies where we do IM and FP rotations along with surgical rotations.

I personally think that pod school prepares you to be the preeminent F/A specialists from the get go. DMU doesn't really expose it's first years to much if any real foot and ankle stuff other than our intro to pod med course which is really just sort of showing us pictures of foot and ankle procedures as well as in anatomy when we get to the lower limb. Other schools start from day 1 with podiatry related curriculum, that being said, yeah we are highly focused on the foot and ankle in the preclinical years, but we are also highly focused on general medicine too.

Well, my point is that you can't have a classroom education MORE focused on F&A, clinical rotations MORE focused on F&A, residency MORE focused on F&A without sacrificing a more general swath of medicine. The only way to get 100% of the general medical education + a focus on F&A would be if you're claiming podiatry school is more rigorous than medical school, and that your rotations are more expansive than MD/DO rotations. I don't think that this is the claim you're trying to make....

I that you have noted exactly where the heart of the anti-pod mentality arises from.

I, like many DPM students and graduates, would like to see the national DPM scope which Dr_Feelgood mentions, Georgia's. Podiatry will never attempt to move above the tibial tuberosity (surgically). The knee is the largest joint in the human body, it is a surgical gold mine, and orthopaedic surgeons do a fantastic job treating it. Podiatrists are foot and ankle experts, not "lower leg-ologists," and I don't think any DPM should or will ever lobby for surgeries on the knee joint. I would vote against any such motion. As soon as a podiatrist infected a knee joint or had a less than stellar surgical success rate, there would be all kinds of hell to pay. It is important that all DPMs understand the anatomy of the knee (and the entire body) for biomechanical purposes, physiological, and pathological purposes, but knee problems/surgeries are always referred out and will always continue to be. (I will note that my opinions on DPMs and the knee are largely derived from my lower extremity anatomy prof, a DPM, who advised us to (paraphrased), "know it well, but you are a guest. Your real estate lies to the south. Treat the knee as a respected friend's property which you occasionally visit"... I wholeheartedly agree)

I think the far more slippery slope is hand and fingernail care by DPMs. The surgical procedures are not an issue; ortho, plastic, general, trauma and vascular MD/DO surgeons do a fine job on hand procedures, so podiatry has no business in that arena - no matter how similar the anatomy may be. However, many skin and nail pathologies present very similarly in hands. Should podiatrists be allowed to biopsy a suspicious brownish blue plaque on the hand of a beach bum or a pigmented streak in a caucasian's nail? Should DPM scope include treatment of an ingrown finger nail or a yeast-infected webspace on the hand? There is a lot of risk in referring these patients off for follow-up with derm, especially if they do not have insurance or the pathology is agressive and has poential to get very bad very fast. Yes, any smart DPM would document well when he sends away a suspected hand melanoma to follow up with derm, but what is really best for the patient? States differ on these issues, but a uniform national DPM scope would fix that also.

I think I agree with you. The problem is, it seems like no one's making promises like that ("we'll just do this much and won't push for more"). Obviously, with dynamic practice techniques (e.g. hip skin grafting) it's hard to lock yourself in to limitations when you don't know how those limitations will impact the future of podiatry. I understand the general perspective, I do. I'm hoping people can also understand the ortho or MD perspective.

 

[Dr_Feelgood]

I that you have noted exactly where the heart of the anti-pod mentality arises from.

I, like many DPM students and graduates, would like to see the national DPM scope which Dr_Feelgood mentions, Georgia's. Podiatry will never attempt to move above the tibial tuberosity (surgically). The knee is the largest joint in the human body, it is a surgical gold mine, and orthopaedic surgeons do a fantastic job treating it. Podiatrists are foot and ankle experts, not "lower leg-ologists," and I don't think any DPM should or will ever lobby for surgeries on the knee joint. I would vote against any such motion. As soon as a podiatrist infected a knee joint or had a less than stellar surgical success rate, there would be all kinds of hell to pay. It is important that all DPMs understand the anatomy of the knee (and the entire body) for biomechanical purposes, physiological, and pathological purposes, but knee problems/surgeries are always referred out and will always continue to be. (I will note that my opinions on DPMs and the knee are largely derived from my lower extremity anatomy prof, a DPM, who advised us to (paraphrased), "know it well, but you are a guest. Your real estate lies to the south. Treat the knee as a respected friend's property which you occasionally visit"... I wholeheartedly agree)

I think the far more slippery slope is hand and fingernail care by DPMs. The surgical procedures are not an issue; ortho, plastic, general, trauma and vascular MD/DO surgeons do a fine job on hand procedures, so podiatry has no business in that arena - no matter how similar the anatomy may be. However, many skin and nail pathologies present very similarly in hands. Should podiatrists be allowed to biopsy a suspicious brownish blue plaque on the hand of a beach bum or a pigmented streak in a caucasian's nail? Should DPM scope include treatment of an ingrown finger nail or a yeast-infected webspace on the hand? There is a lot of risk in referring these patients off for follow-up with derm, especially if they do not have insurance or the pathology is agressive and has poential to get very bad very fast. Yes, any smart DPM would document well when he sends away a suspected hand melanoma to follow up with derm, but what is really best for the patient? States differ on these issues, but a uniform national DPM scope would fix that also.

Very well thought out comments, and I agree that while orthopaedics worries about the knee, pods aren't going to go there. But I have never thought about dermatology of the hand. That is an area I can see pods trying to backdoor if they got an unlimited scope. I don't know how I feel about it. Fungus is fungus, and psoriasis is psoriasis. I would probably stick the the feet, but I can't say that for everyone.

Great comments.

 

[Feli]

Well, my point is that you can't have a classroom education MORE focused on F&A, clinical rotations MORE focused on F&A, residency MORE focused on F&A without sacrificing a more general swath of medicine. The only way to get 100% of the general medical education + a focus on F&A would be if you're claiming podiatry school is more rigorous than medical school, and that your rotations are more expansive than MD/DO rotations. I don't think that this is the claim you're trying to make....

I hate to say it lol... but this is correct and his logic is sound. We can't have our cake and eat it too.

As a DPM student about to begin 3rd year and clinics, I feel that I will be significantly weaker than MD/DO counterparts in neuro, internal med, and anat/phys of the special senses. I will probably be slightly weaker in general path, pharm, and micro yet better in those subjects as they relate to podiatry. I think pod students are better in general radiology and far better in lower extremity radiology than their MD/DO counterparts.

Yes, there are differences. Those will always vary between schools and between degrees. There is no getting around it. I think DPM programs generally put in extra lower extremity anat, pod med, and radiology at the main expenses of neuro and internal med. While graduating DPMs are generally adequate in internal med and have experience in general physical diagnosis, the systemic training volume (classroom and clinical) is not always on par with MD/DO because we specialize earlier. Some exceptional DPM students may have IM/neuro/etc knowledge that is on par or above MD students, but I think those are rare cases and not your "average."

 

[Dr_Feelgood]

"Delusional" is not name-calling. "Jerk" is. I'll ignore it though, because I'm not oversensitive (note: "oversensitive" is not name-calling either).

Maybe let's start from the beginning.
1) Does your pre-clinical podiatry school education better prepare you to be a foot expert than an MD/DO? If so, explain.
(I think it does)

2) Do your clinical rotations better prepare you to be a foot expert than an MD/DO? If so, explain.
(I think it does)

3) Does your (shorter and more focused) residency better prepare you to be a foot expert than (let's exclude F&A ortho) in an MD/DO path?
(I think it does)

4) Explain to me how you can have 1-3 without sacrificing a more general medicine (systemic disease management, etc.) training.

I agree with you that each specialist is an expert within their own scope of practice, mostly to the exclusion of other areas of medicine. I also argue, however, that the generalization can easily be made that podiatry school and podiatry residency prepare a person to have been trained with a more narrow scope of medicine practice than an MD/DO. Why are you fighting this one?

If you look back, I asked what legal scope you would like to see and why. I gave my opinion on the subject. It has nothing to do with the level of expertise that pods have in general meds.

Going back to previous posts, I was addressing Sam not you. On my comments about PGY-1 of orthopaedics, which I still cannot find any internal med rotation. Which makes me wonder why orthopods testified that podiatrist don't know anything about treating DM, and eluding to the fact that they did. They have no formal training outside of medical school. Most clinicians would agree that you don't learn how to practice in medical school.

Now onto your three points, I disagree with point 1. The pre-clinical training for in podiatric medical school is general medicine. The only basic science class that is added is lower limb anatomy, that is it. Podiatrist are trained in general medicine.

Even in clinical exposure (point 2), we rotate with vascular surgeons, internal medicine, cardiologist (possibly next year at DMU), and orthopaedic surgeons. While, yes, we discuss the foot and ankle, a patient with carotid stenosis (I've seen a ton of these) does not really apply to the LE. Neither does the total knee replacement or shoulder scope I scrubbed in on with the orthopaedic surgeon.

I do think that we get less exposure to general medicine than MD/DO students. But to paint the picture as a gross difficency is inaccurate. We also have more medical rotations PGY-1 than some other surgeon interns. I understand why. I have never and will never make the claim that we are better trained than any MD/DO, but I think that it is unfair and unfounded for people to act as if we are not well trained in general medicine. I bet some DPMs know more about treating DM than many MDs/DOs. They see it every single day.

 

[Dr_Feelgood]

I hate to say it lol... but this is correct and his logic is sound. We can't have our cake and eat it too.

As a DPM student about to begin 3rd year and clinics, I feel that I will be significantly weaker than MD/DO counterparts in neuro, internal med, and anat/phys of the special senses. I will probably be slightly weaker in general path, pharm, and micro yet better in those subjects as they relate to podiatry. I think pod students are better in general radiology and far better in lower extremity radiology than their MD/DO counterparts.

Yes, there are differences. Those will always vary between schools and between degrees. There is no getting around it. I think DPM programs generally put in extra lower extremity anat, pod med, and radiology at the main expenses of neuro and internal med. While graduating DPMs are generally adequate in internal med and have experience in general physical diagnosis, the systemic training volume (classroom and clinical) is not always on par with MD/DO because we specialize earlier. Some exceptional DPM students may have IM/neuro/etc knowledge that is on par or above MD students, but I think those are rare cases and not your "average."

See and I never felt this way. Probably b/c I saw some the level at which the DOs know medicine.

 

[densmore22]

But we do learn both, quite extensively. We don't want to be general practioners or IM or FP. We want to be Podiatrists. To be the best at what you do, yeah, you gotta know the area you work on and you have to know it well. But also knowing about the generalities of medicine and disease processes and how to treat them just makes us that much better at what we do. We can learn both the F/A AND general medicine, there's enough time to do it and we DO, do it.

 

[bdaddyjolley]

Being a jerk is a verb not an adjuctive.

.

Not to spit hairs but actually, jerk is a noun, a person place or thing. Verbs are actions. You don't say "he jerks it" or "he is jerking it" because that sounds really bad. The way you decribe though can make it like an adverb instead of a noun becuase it describes the verb, how he is acting or as you said "being". For the record my grammer sucks and I only know this correction from learning two different languages which taught me more about english grammer than elementary school did.

 

[Feli]

See and I never felt this way. Probably b/c I saw some the level at which the DOs know medicine.

That is a very good possibility.

I can only speak for my Barry program, but already in two years, I have had the following:
Intro to Podiatric Medicine (2cr)
Applied Lower Extremity Anat w/ Lab (4cr)
Conceptual Lower Extremity Anat (3cr)
General Radiology (3cr)
Podiatric Medicine I (2cr)
Podiatric Medicine II (2cr)
Podiatric Medicine Lab (1cr)
Radiology Lab (1cr)

With many more pod med, pod sx, podopeds, pod sports med, etc classes and labs as well as many pod med clinical rotations and pod clerkships upcoming during my two remaining years, I feel that, while we get plenty, it's hard or impossible for a DPM student to get the internal med and general physical diagnostic volume that a MD/DO does during school. However, nobody can question how much more education and experience we have with lower extremity anat, path, etc upon graduation when compared with MD/DO grads.

_________________

I definetly agree that this is an excellent thread. I am learning a lot, and I feel it is great to discuss education and training differences to further understanding and mutual respect. That said, my First Aid for USMLE isn't gonna read itself ... I'm out for now.

 

[Dr_Feelgood]

Not to spit hairs but actually, jerk is a noun, a person place or thing. Verbs are actions. You don't say "he jerks it" or "he is jerking it" because that sounds really bad. The way you decribe though can make it like an adverb instead of a noun becuase it describes the verb, how he is acting or as you said "being". For the record my grammer sucks and I only know this correction from learning two different languages which taught me more about english grammer than elementary school did.

Yeah after I posted that I knew it was crap but I was in a hurry. What I meant to say is I was describing his actions not himself.

 

[Dr_Feelgood]

That is a very good possibility.

I can only speak for my Barry program, but already in two years, I have had the following:
Intro to Podiatric Medicine (2cr)
Applied Lower Extremity Anat w/ Lab (4cr)
Conceptual Lower Extremity Anat (3cr)
General Radiology (3cr)
Podiatric Medicine I (2cr)
Podiatric Medicine II (2cr)
Podiatric Medicine Lab (1cr)
Radiology Lab (1cr)

With many more pod med, pod sx, podopeds, pod sports med, etc classes and labs as well as many pod med clinical rotations and pod clerkships upcoming during my two remaining years, I feel that, while we get plenty, it's hard or impossible for a DPM student to get the internal med and general physical diagnostic volume that a MD/DO does during school. However, nobody can question how much more education and experience we have with lower extremity anat, path, etc upon graduation when compared with MD/DO grads.

_________________

I definetly agree that this is an excellent thread. I am learning a lot, and I feel it is great to discuss education and training differences to further understanding and mutual respect. That said, my First Aid for USMLE isn't gonna read itself ... I'm out for now.

That is difference of programs. At DMU, you have 1 pod class your first year, Intro to Pod. Your second year you don't get any pod classes until the second semester. Your first 1 1/2 is sent on general medicine only (Basic science year 1 and systems the first half of year 2).

 

[krabmas]

Sam I maybe wrong but everything that I look at for orthopaedic residencies say that the PGY-1 (i.e. the intern year) is done in general surgery. The only medical rotation I can find is in the ER. I maybe wrong (so I edited my statement above) but I cannot find anything saying that they do any work in an Imed rotation.

This may be true. I only had experience with the orthos at Shands UF hospital in Jax. They have a great program there. Anyway, they did a medicine rotation as far as I could tell.

Even if it is on general surgery they are learning how to manage their in patients and take care of the surgical patient. Wait a minute.... that is what we learn to do as well.

And...

I am on my general surgery rotation now. A few days ago a patient was stroking. He did not code so there was no need to call the code team. (ACLS goals are to recognize the faltering patient before they code.) So they decided that since his BP was 196/85 that he needed nitrus pruside (sp?). The cheif told the intern that the intern could not just give the patient the drug. The intern should call cardiac for a consult to make sure that it was OK to give the drug. Cardiac wanted to give lopressor only. Surgery disagreed. The outcome is not important in this story so I will stop here.

The point of my story is that even though the surgeons have the big and mighty and all powerful MD degree they still are very restricted in practice. I'm not sure if all SICUs are like this but it seems that many probably are.

So even if podiatry was given an unrestricted scope of practice it would not be unrestricted. It would be esentially the same as it is now just less confusing to the patients. we would not be treating arm burns or head lacerations or common colds or brain tumors or HTN or even DM. I may know how to treat a diabetic wound and know that the BS has to be controlled for the wound to heal but I do not want to treat the DM. If I wanted to do that I would have gone to MD or DO or nutrition school.

 

[jonwill]

So even if podiatry was given an unrestricted scope of practice it would not be unrestricted. It would be esentially the same as it is now just less confusing to the patients. we would not be treating arm burns or head lacerations or common colds or brain tumors or HTN or even DM. I may know how to treat a diabetic wound and know that the BS has to be controlled for the wound to heal but I do not want to treat the DM. If I wanted to do that I would have gone to MD or DO or nutrition school.

Those ortho residents at Shands Jacksonville were truly impressive. And the funny thing is that they were some of the nicest people that I've ever met. It is nice to see there is still some humility left in medicine.

I totally agree with you. Theoretics are theoretics but when it comes down to it, every doc has a limited scope of practice.

 

[krabmas]

Those ortho residents at Shands Jacksonville were truly impressive. And the funny thing is that they were some of the nicest people that I've ever met. It is nice to see there is still some humility left in medicine.

I totally agree with you. Theoretics are theoretics but when it comes down to it, every doc has a limited scope of practice.

Yeah they were sooo nice. Even to their own prospective residents. They were hard on their residents though, which is why I think it is such a great program, they have high expectations and never let up.

 

[doclm]

That is difference of programs. At DMU, you have 1 pod class your first year, Intro to Pod. Your second year you don't get any pod classes until the second semester. Your first 1 1/2 is sent on general medicine only (Basic science year 1 and systems the first half of year 2).

At Scholl, we only have 1 pod class our first year, Intro to Pod. Also, the second year has its fair share of Basic science classes.

With in the first year we get nailed with special senses in our extensive Neuro with the PT, and PA students. Actually, a Scholl professor teaches a lot of the special senses for both MD and DPM neuro classes so we learn the same thing with the same standards of acheivement.

 

[Northerner]

At Scholl, we only have 1 pod class our first year, Intro to Pod. Also, the second year has its fair share of Basic science classes.

With in the first year we get nailed with special senses in our extensive Neuro with the PT, and PA students. Actually, a Scholl professor teaches a lot of the special senses for both MD and DPM neuro classes so we learn the same thing with the same standards of acheivement.

Not sure where you were going with this, but it doesn't really prove or disprove anything...

 

[Dr_Feelgood]

Not sure where you were going with this, but it doesn't really prove or disprove anything...

I'm still waiting to hear what you would like written into law as a pods scope. Do you think that they should be included with MD/DOs it that the law says that they practice what they are taught; no written restrictions. Or what limits would you like to see? Lets pretend you are being called to the state legislature to discuss a new law.

 

[krabmas]

I'm still waiting to hear what you would like written into law as a pods scope. Do you think that they should be included with MD/DOs it that the law says that they practice what they are taught; no written restrictions. Or what limits would you like to see? Lets pretend you are being called to the state legislature to discuss a new law.

can I play? can I play? I love playing make believe

 

[Dr_Feelgood]

can I play? can I play? I love playing make believe

Okay Sam. You are a NY metro woman. Lets here your testimony in front of the NY Congress in Albany. Mrs. Krabmas, what do you think the state of NY should have as the scope for podiatric medicine? Also, generally when people address the legislature they wear more than their bathrobes; are you looking for cheap votes? (You said you wanted make believe. )

 

[krabmas]

Okay Sam. You are a NY metro woman. Lets here your testimony in front of the NY Congress in Albany. Mrs. Krabmas, what do you think the state of NY should have as the scope for podiatric medicine? Also, generally when people address the legislature they wear more than their bathrobes; are you looking for cheap votes? (You said you wanted make believe. )

Unlimited scope for all podiatrist regrdless of residency training or when educated even the chiropodists should have unlimited scope. This way all the foot doctors can start controlling their patients' DM, PVD, HTN, and Cholesterol. We will put the internal medicine docs out of business and take over the world. (insert evil laugh here) ha ha ha ha ha.

 

[Northerner]

I'm still waiting to hear what you would like written into law as a pods scope. Do you think that they should be included with MD/DOs it that the law says that they practice what they are taught; no written restrictions. Or what limits would you like to see? Lets pretend you are being called to the state legislature to discuss a new law.

Well, I'm no expert on podiatry practice laws, but including treatment and most if not all operations restricted to the foot and ankle seems reasonable

 

[Dr_Feelgood]

Well, I'm no expert on podiatry practice laws, but including treatment and most if not all operations restricted to the foot and ankle seems reasonable

What do you think about harvesting skin grafts from the hip or below knee amputations?