My post will have some parallels to podfather. I also graduated around the same time as podfather, and was fortunate enough to obtain a residency program that also included a second year that was not offered to all the first year residents. There were more first year positions than second year positions, and that alone created significant tension among some of the residents. It didn't always create a very cohesive group and unfortunatley brought out the "worst" in a few of the residents.
Fortunately, it was a very podiatry friendly hospital, and as a result we had the ability to basically train with general surgeons, vascular surgeons, plastic surgeons, rotate through the ER, etc. Since it was in a major city, we were exposed to significant trauma and basically you were able to learn as much or little as you wanted. Unfortunately, learning was really "on your own" because I don't feel that there were many strong surgeons on staff to teach. I believe that most of what I learned and my colleagues learned was from trial and error and volume, as unfortunate as that sounds.
My training is no where near the quality that is available today. I was put in a lot of situations where I basically had to figure out what to do, so I simply did it with the help of my fellow residents. And quite a few of us turned out to be pretty decent surgeons.
I often get upset with some of the cockiness I encounter when interviewing or speaking with some of today's graduates, when they refer to some of the "older" docs with "inferior" training. Similar to podfather, approximately 47% of my class were fortunate enough to obtain residencies. The rest did "preceptorships", joined the service (which counted as a residency) or went into private practice. I can tell you that some of my classmates that were brilliant, did NOT obtain a residency. Some of those people today would probably be competing for top residency positions.
So naturally it upsets me when the younger generation finds fault with the older generation's "inferior training", when in fact many brilliant docs simply were shut out of the opportunity to obtain a residency. Some were simply unlucky.
Additionally, some docs that may not have performed the most prestigious programs are also the same docs that may have opened up privileges in hospitals that now have 3 year residency programs!!!
After my residency, I was offered an excellent position as an associate with a lot of promises for partnership, etc.,etc. After 3 years, I got royally screwed and went out on my own. I practice honestly and ethically and as corny as it sounds, to this day I have never taken an x-ray, made an orthoses or performed a surgery on a patient that I wouldn't have performed on a family member.
When I first obtained privileges at most hospitals, DPM's were treated decent, but not as equals. After performing a lot of surgery at a particular hospital and admitting a decent amount of patients, I finally also requested ER privileges/rotation for foot/ankle trauma. Naturally, they thought I was crazy and the orthopods went nuts. So I politely did what every hospital understands most......I hit them in their pocketbook. I told them if I did not get the privileges, I would bring ALL my surgeries, admissions, MRI referrals, lab referrals, etc., to a competing hospital.
Needless to say, I obtained ER privileges.
I then obtained surgical privileges at another local hospital, and as I've told before on this site, my privilege sheet stated; nail care, warts, skin lesions, hammertoe repair and "simple" bunion repair. I then typed up a three page list of "additional" procedures including a lot of rearfoot procedures, the use of internal fixation, ORIF, etc.
The chief of podiatry called me in a panic asking me "not to make waves" and the chief of orthopedics told me "no way". I ignored the podiatrist but asked to meet with the chief of orthopedics. I asked him why "no way" and he said DPM's don't do that stuff. I asked if HE had privileges to perform the procedures I requested and he said "of course". I handed him my surgical log and showed him proof that I was able to perform everything I requested. I then asked him the last time he performed ANY of the foot/ankle cases he had privileges for at that hospital.
I went to administration at that hospital with the same info, and threatened a lawsuit. I was granted ALL privileges, as long as I was observed by the chief of orthopedics or podiatry first for each case. Ironically, when I was being observed by the chief of podiatry, he didn't even know what he was watching!!!
Since that time, a lot of young studs have joined the staff and now their privileges are endless and the orthopods leave them alone.
I believe more young guys/gals need to get involved. I was very active with the APMA on a local level and I was involved with various ACFAS committees and I was involved with the ABPS as an examiner and beyond.
In the "older" days, I'm sure podfather will remember, there was a select group of about 10-12 doctors that "owned" the lecture circuit. They lectured at Hershey (which used to be the prestigious seminar) and across the country. It was always the same 10-12 guys. Many of them are still around and many of them still lecture. They are/were good doctors, but now the profession has moved on and it's great to see the younger doctors moving forward, performing research and gaining parity with "mainstream" medicine. Doctors like David Armstrong, John Steinberg, etc., have been great for our profession because they have aligned with major institutions have spread the name of podiatry throughout the world.
The older generation like Lowell Scott Weil Sr. also spread our profession internationally, and we need the younger docs to not only move forward but to remember their roots. Our profession is different than orthopedics, and I hope that the new well trained surgeons keep in mind that despite their excellent training, not all patients require surgical intervention. And sometimes you are a better doctor if you can keep your patient OUT of the O.R.
