Desperation for enrollment at NYCPM

[bloxxeeey]

I think we'll see fellowships become the default in a decade or so which is unfortunate. I'd say a ton of residents are looking towards it for better job opportunities but they'll face the same market we all face.

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[air bud]

You got my vote on that. I 100% agree and am glad that ABPM is open to working with AFBAS to be a unified board.

If it walks like a duck... We use the term "podiatric physician" and are performing surgery, prescribing meds, doing H&Ps, rounding on patients etc which by any other name is what a medical doctor does. Our problems (discrepancies in admissions, residency, boards in-fighting) and limitations (legislative scope of practice issues, pods sniping others in their own healthcare system, etc) seem to stem from the fact that we've legally emancipated ourselves from medical doctors. Prior to 1973 being an osteopathic physician was a legally distinct profession until they decided to play by MD rules to function in the same manner. I'm sure they sat down and said something along the lines of "our training isnt consistent, our jobs prospects aren't that great, and most people don't know what we're medically capable of." Then decided to change it while keeping the essence of what makes DOs different by integrating OMM into the 4 year curriculum. Our 'path to parity" and "podiatry 2020" puts us in that same footing (pun intended). Why would we want parity with a set of professionals from which we "legally differ"? I suspect we all know the reason. Let me be clear though, podiatry is a distinct enough set of skills and medical knowledge that it can, in my opinion, be its own specialty of medicine that exists alongside EM, FM, GI, Cards, etc. We should just (maybe need to) get all of the stakeholders (students, residents, physicians, boards, CPME, APMA, state components, etc) in a room and decide what the future of our practice should be because Podiatry 2020 and declaring "We have parity" doesn't really seem to have put us where we wanted.


One that is attainable. It'll be painful and people will complain but a comprehensive exam is necessary. Yeah, scores will be crappy at first but I don't see how this would be a net negative for our field. If it came to fruition and I'm 10 years into practice, I'd still take it and hope theres no grandfather clause. Like I do to maintain my EMT license (i know its not the same in terms of content both depths and breadth)

Oh I have been and its an awesome resource for finding out what programs in which areas I'd want to visit/clerk at. If the differences are that profound then we (read all of us as students, residents, and practicing podiatric physicians) should be getting on the CPME and asking them to review training outcomes and residency programs. Yeah, it'll suck to be a crappy program PD since they'll be on the hot seat to adapt or get shut down. But that's kind of the point of becoming better at self-assessment, right?

This is something thats become crystal clear to me from my own (admittedly limited) observations. We can't just wake up tomorrow and make the admissions reqs 3.8 GPA and 515+ MCAT. There'd be no one in any school. Ditto for the subpar residency programs.

The f*** I am....you know what my physical exam is on a 20 year old healthy ingrown - on exam there is erythema edema purulence on the medial border of the right hallux nail not extending proximal to the IPJ. Palpaple do/PT pulse.

The end. Obviously easier with new coding rules. I haven't touched a stethoscope in 5 years and probably never will again.

You want to know where my most complete exam is....diabetic nail care.


Remember kids, it all comes back to 💅

 

[air bud]

I'm opposed to limiting people's options as well, but we should all acknowledge that if it becomes de rigeuer to do a fellowship year in order to be taken seriously in this profession, this reduces the ROI on the DPM degree and will only deter qualified pre-health students from pursuing a career in podiatry. So, Dr Rogers, by all means continue.

Also I find it hilarious that most of our fellowships aren't accredited (ACFAS is not an accrediting body) therefore just about anything can be a fellowship. Work a year for healthdrive, then say you're a fellowship trained foot and ankle surgeon specializing in foot and ankle mycology (FTFAS FAM)

So that means @Pronation would be a fellowship trained mycological total nail reconstructive surgeon?

 

[MicroPod]

Can second the notion that fellowships take away from the training for residents. At my program, there is an attending who has a limb salvage fellowship that started just two years ago. We still get to work with them, but definitely get less hands on experience now that the focus is on the fellow. Additionally, this is the rotation we get the most experience with Charcot recon and frames, so it was a decently big hit for the residents here.

 

[Adam Smasher]

Can second the notion that fellowships take away from the training for residents. At my program, there is an attending who has a limb salvage fellowship that started just two years ago. We still get to work with them, but definitely get less hands on experience now that the focus is on the fellow. Additionally, this is the rotation we get the most experience with Charcot recon and frames, so it was a decently big hit for the residents here.

The dirty secret is that external fixators are impractical outside of a teaching hospital where you have residents/fellows to manage the numerous complications you'll get. Don't feel like you're missing out.

 

[Adam Smasher]

Decreased enrollment and more schools is a recipe for disaster. Now there is more competition for schools to maintain their financial upkeeps.

I disagree about disaster. If we have 11 schools but pressure from the market for prehealth students forces them to limit their class size to 30 each, the only thing the colleges can do is innovate and make their programs better. It forces accountability.

I wouldn't worry about finance either, since most/all the schools are affiliated with some MD/DO school. The DPM students would just tag along and utilize resources the university already has in place for the other health professions classes

 

[air bud]

Can second the notion that fellowships take away from the training for residents. At my program, there is an attending who has a limb salvage fellowship that started just two years ago. We still get to work with them, but definitely get less hands on experience now that the focus is on the fellow. Additionally, this is the rotation we get the most experience with Charcot recon and frames, so it was a decently big hit for the residents here.

Fellowships with a residency are a huge growing problem. Only detracts from residents growth....thus fueling the desire for more fellowships....the chicken or the egg?

 

[diabeticfootdr]

Fellowships with a residency are a huge growing problem. Only detracts from residents growth....thus fueling the desire for more fellowships....the chicken or the egg?

They don’t have to be and our fellowship isn’t.

Our fellows’ primary duty is teaching and they are learning how to refine their skills and be an effective leader. They never take first assist or any numbers from the residents.

Many students get their first skin to skin experience being taught by one of our fellows. Just last week a Scholl student did a Chopart’s skin to skin.

But to the fellow’s own detriment, none of the cases count toward boards, even though I may not scrub and they’re teaching the resident.

Of course, that’s modified on complex recons, we do a lot of pre-planning and there are many people scrubbed. But our goal is to be able to have faculty scrub out for the tibial block application at least and the residents and fellows independently able to do that without direct supervision.

 

[heybrother]

They don’t have to be and our fellowship isn’t.

Our fellows’ primary duty is teaching and they are learning how to refine their skills and be an effective leader. They never take first assist or any numbers from the residents.

Many students get their first skin to skin experience being taught by one of our fellows. Just last week a Scholl student did a Chopart’s skin to skin.

But to the fellow’s own detriment, none of the cases count toward boards, even though I may not scrub and they’re teaching the resident.

Of course, that’s modified on complex recons, we do a lot of pre-planning and there are many people scrubbed. But our goal is to be able to have faculty scrub out for the tibial block application at least and the residents and fellows independently able to do that without direct supervision.

You are as usual being given a front row seat to a concern you won't hear elsewhere. Younger podiatrists are concerned that fellows are potentially detrimental to the quality of their education by poaching cases/opportunities. I don't think the prior comments are meant to be directed at your program. You've already acknowledge that there has been a fellowship explosion and that there's minimal oversight/accreditation. A lot of programs have that "famous person" that everyone is looking for the opportunity to be taught by. When it takes being the fellow to access that person the opportunities for the residents and therefore the program itself are diminished. Meanwhile, its entirely possible the residents have been taking that person's call and handling their clinic/problems waiting for their moment.

The heart of all of these problems - is scarcity.

 

[diabeticfootdr]

You are as usual being given a front row seat to a concern you won't hear elsewhere. Younger podiatrists are concerned that fellows are potentially detrimental to the quality of their education by poaching cases/opportunities. I don't think the prior comments are meant to be directed at your program. You've already acknowledge that there has been a fellowship explosion and that there's minimal oversight/accreditation. A lot of programs have that "famous person" that everyone is looking for the opportunity to be taught by. When it takes being the fellow to access that person the opportunities for the residents and therefore the program itself are diminished. Meanwhile, its entirely possible the residents have been taking that person's call and handling their clinic/problems waiting for their moment.

The heart of all of these problems - is scarcity.

Thank you for helping reset my perspective. I do see where the concern is.

One of the ways to have a little more control over this is to require CPME approval for the fellowship if in an institution with a CPME-approved residency. Then there is some oversight on the interaction between the residents and fellows.

But fellowships are not currently standardized by CPME. Most are a glorified apprenticeship.

There is no standard application or interview process. There is no oversight over their agreements. For example some could have non-competes, no PTO, no process to redress academic concerns, etc. That wouldn’t be allowed by CPME.

Many don’t even have a curriculum or objectives, even if they’re CPME-approved they just have you submit your own objectives.

So yes, I pointed out the explosion of fellowships. Getting oversight is the first step in correcting this problem.

 

[diabeticfootdr]

View attachment ABPM Comments on DRAFT 820-830- Lee.pdf

Here is the letter we wrote CPME re: fellowships and the Document 820 revisions currently in process.

And this discussion gave me an idea. I think both 320 (residency standards) and 820 (fellowship standards) should have mutual requirements that if a fellowship is in an institution with a CPME-approved residency, it should be a requirement to be approved. I'll suggest this in a letter to CPME and APMA.

 

[AttackNME]

Thank you for helping reset my perspective. I do see where the concern is.

One of the ways to have a little more control over this is to require CPME approval for the fellowship if in an institution with a CPME-approved residency. Then there is some oversight on the interaction between the residents and fellows.

But fellowships are not currently standardized by CPME. Most are a glorified apprenticeship.

There is no standard application or interview process. There is no oversight over their agreements. For example some could have non-competes, no PTO, no process to redress academic concerns, etc. That wouldn’t be allowed by CPME.

Many don’t even have a curriculum or objectives, even if they’re CPME-approved they just have you submit your own objectives.

So yes, I pointed out the explosion of fellowships. Getting oversight is the first step in correcting this problem.

Who is the responsible party for the fellow’s salary once CPME approves the fellowship? Like for podiatry groups in private practice, are they still paying the fellow’s salary?

 

[diabeticfootdr]

Who is the responsible party for the fellow’s salary once CPME approves the fellowship? Like for podiatry groups in private practice, are they still paying the fellow’s salary?

That wouldn't change unless the fellowship is part of an institution with a GME program.

If so, the institution would be reimbursed by GME for 50% of direct GME, 100% of indirect GME, and 100% of DSH funds, which equals about 85% of a resident reimbursement. Plenty to fund a fellow at the PGY4 rate.

I'm not sure if fellowships have the same rules as new residencies for GME, that the first year of the fellowship the institution is on the hook for the full cost and reimbursement starts year 2.

 

[AttackNME]

That wouldn't change unless the fellowship is part of an institution with a GME program.

If so, the institution would be reimbursed by GME for 50% of direct GME, 100% of indirect GME, and 100% of DSH funds, which equals about 85% of a resident reimbursement. Plenty to fund a fellow at the PGY4 rate.

I'm not sure if fellowships have the same rules as new residencies for GME, that the first year of the fellowship the institution is on the hook for the full cost and reimbursement starts year 2.

So for folks in private practice with no affiliations they’re going to be paying the fellow’s salary. Then what’s the point of applying for CPME approval? As an associate/fellow, they can be primary on cases and log them for boards. Will that change once the fellowship becomes CPME approved?

 

[icebreaker32]

So for folks in private practice with no affiliations they’re going to be paying the fellow’s salary. Then what’s the point of applying for CPME approval? As an associate/fellow, they can be primary on cases and log them for boards. Will that change once the fellowship becomes CPME approved?

So are the fellows at non CPME fellowships counting their cases for boards? I would still assume the attending would be the surgeon of record on the OR paperwork ABFAS would look at.

I agree if they are getting to count their numbers for boards this seems like a huge advantage. Most are doing this to make their CV competitive for one of the few good jobs anyways. To have their cases already knocked out for RRA seems like an advantage.

If there comes a point where employers only want a CPME approved fellow then maybe the private practice fellowships would dwindle.

 

[Pronation]

So are the fellows at non CPME fellowships counting their cases for boards? I would still assume the attending would be the surgeon of record on the OR paperwork ABFAS would look at.

I agree if they are getting to count their numbers for boards this seems like a huge advantage. Most are doing this to make their CV competitive for one of the few good jobs anyways. To have their cases already knocked out for RRA seems like an advantage.

If there comes a point where employers only want a CPME approved fellow then maybe the private practice fellowships would dwindle.

I was under the impression that cases done during cheaper than associate labor (aka fellowship) do not count towards ABFAS numbers because fellows are not the sturgeon of record.

 

[heybrother]

I was under the impression that cases done during cheaper than associate labor (aka fellowship) do not count towards ABFAS numbers because fellows are not the sturgeon of record.

On one hand - there's answer on ABFAS website - on the other hand, I'm not sure that's really an answer.

 

[PatchAdamsFan]

I was under the impression that cases done during cheaper than associate labor (aka fellowship) do not count towards ABFAS numbers because fellows are not the sturgeon of record.

The majority of non-CPME accredited fellowships (aka ACFAS) are essentially private practice preceptorships - as you mentioned very cheap labor. The term "fellow" doesn't really mean anything official in these settings, as it does in the MD/DO world (let alone remaining the same profession = still podiatrist), and in some programs you are just a cheap associate who can in fact do their own cases and log for ABFAS. It is not common, IMO because it cuts into the program directors bottom line of not billing for the cases themselves, even when they may not be in the room. Fantastic hack for some 'fellowships' that have managed to outdo the podiatry associate model by lowering their overhead even further.

 

[Pronation]

View attachment 368891
On one hand - there's answer on ABFAS website - on the other hand, I'm not sure that's really an answer.

I’ve not heard of a cheaper than an associate laborer being allowed to list themselves as the sturgeon of record, so it sounds like their cases during this period of indentured servitude will not count towards ABFAS cases.

Perhaps the ABPM president can weigh in on whether fellowship cases could count towards a CAQ in total toenail replacement.

 

[diabeticfootdr]

So are the fellows at non CPME fellowships counting their cases for boards? I would still assume the attending would be the surgeon of record on the OR paperwork ABFAS would look at.

They can be. And often our fellow is the surgeon if record when they’re operating independently with the residents. But I don’t think that’s common in podiatry.

What else is not common (probably nonexistent) is MD fellowships in private practice. Just sayin’.

*** Yes there are non-ACGME MD fellowships, they’re in institutions ***

 

[bloxxeeey]

The majority of non-CPME accredited fellowships (aka ACFAS) are essentially private practice preceptorships - as you mentioned very cheap labor. The term "fellow" doesn't really mean anything official in these settings, as it does in the MD/DO world (let alone remaining the same profession = still podiatrist), and in some programs you are just a cheap associate who can in fact do their own cases and log for ABFAS. It is not common, IMO because it cuts into the program directors bottom line of not billing for the cases themselves, even when they may not be in the room. Fantastic hack for some 'fellowships' that have managed to outdo the podiatry associate model by lowering their overhead even further.

TBH fellowships look extremely attractive sometime. Job with 100k vs 50k job (with benefits, and fellowship title). The gap isn't that big. Hell I've seen some fellowships in the bay area pay 90k when an associate job will probably still only pay 100k.

 

[icebreaker32]

They can be. And often our fellow is the surgeon if record when they’re operating independently with the residents. But I don’t think that’s common in podiatry.

What else is not common (probably nonexistent) is MD fellowships in private practice. Just sayin’.

*** Yes there are non-ACGME MD fellowships, they’re in institutions ***

Preceptorships were replaced by residencies and now they have returned and are called fellowships.

 

[diabeticfootdr]

TBH fellowships look extremely attractive sometime. Job with 100k vs 50k job (with benefits, and fellowship title). The gap isn't that big. Hell I've seen some fellowships in the bay area pay 90k when an associate job will probably still only pay 100k.

You can also get deferred repayment of loans during that time … but, yes, interest still accrues. Banks will always find a way to get theirs! On a side note, it’s why airlines have all primarily become credit card companies that also fly airplanes.

 

[619]

Do y'all notice that most fellowships at big podiatry groups end up hiring their fellow at the end of the year. Year after year they hire their fellow and then grow the group. The one year fellowship year is more like a one year long interview to get the job at the group.

 

[Feli]

Do y'all notice that most fellowships at big podiatry groups end up hiring their fellow at the end of the year. Year after year they hire their fellow and then grow the group. The one year fellowship year is more like a one year long interview to get the job at the group.

Yes, this is pathetic... utter trash. ^^

It was embarrassing to me that one of the training programs that scrubbed with me in Mich - solid residency program - tended to do this: good 3yr training, ready to practice in basically any way, shape or form upon graduation (pod PP, hospital, ortho, etc)... yet many went to various fellowships... and most ended up signing on with that group they did fellowship at. It was clearly the plan for some of them from the start: to get the "inside track" on the job. Ridiculous. I would be supportive, offer them LOR, etc... but what a pile of junk "career plan."

I have seen it from grads of other top residencies also... West Penn resident to Weil group "fellowship" ... DMC resident to NMex PP "fellowship" ... Inova to Ohio PP fellowship. Huh? Why? The funny thing is that all of those residents who did the "fellowship" to get the job didn't even last long after fellowship. Insanity.

As it stands: there are basically a few types of DPM fellowships:
1) Actual good RRA attending(s) that do tough and rare procedures, so this is a good 1yr for someone who didn't do those in residency (yet they tend to only take from good residencies where they already learned the compex RRA...go figure). There are maybe a dozen such fellowship, and they take people who don't really need to do them.
2) Mediocre PP fellowships or hospital-based fellowship with very mediocre attendings... basically only undertaken to say "I did a fellowship" or to "network" or try to get a job there or because residents couldn't find a good job. This shows anyone how sad our job market is that we need to donate our time for a year to maaaybe get a chance to line the pockets of another doc at that place. Hmm, let's do a fellowship with "teachers" who you'd already have more skills than if you'd done a good residency? Yikes.
3) Trash fellowships and "mini-fellowships" for 'niche' skills (derm, wound, research, prac mgmt, etc) that should have been learned in any decent residency.
4) Fellowship that leads to DPM having additional cert, skill.... wait, that doesn't exist. They are simply an additional year of residency in an already narrow speciality.

The bottom line is do a good residency and read; pick good mentors and prep for cases...
You will miraculously do fine without having to risk another 65k salary slave year to maybe get the chance to make money for a boss/owner. You can have that chance without fellowship. The training wheels have to come off someday.

 

[JustAPedicurist]

So as we are getting close to a new batch of podiatry students starting… do we have any data on class sizes? Any inside info? Is it close to the rumored 50% of total spots available?

 

[diabeticfootdr]

Yes, this is pathetic... utter trash. ^^

It was embarrassing to me that one of the training programs that scrubbed with me in Mich - solid residency program - tended to do this: good 3yr training, ready to practice in basically any way, shape or form upon graduation (pod PP, hospital, ortho, etc)... yet many went to various fellowships... and most ended up signing on with that group they did fellowship at. It was clearly the plan for some of them from the start: to get the "inside track" on the job. Ridiculous. I would be supportive, offer them LOR, etc... but what a pile of junk "career plan."

I have seen it from grads of other top residencies also... West Penn resident to Weil group "fellowship" ... DMC resident to NMex PP "fellowship" ... Inova to Ohio PP fellowship. Huh? Why? The funny thing is that all of those residents who did the "fellowship" to get the job didn't even last long after fellowship. Insanity.

As it stands: there are basically a few types of DPM fellowships:
1) Actual good RRA attending(s) that do tough and rare procedures, so this is a good 1yr for someone who didn't do those in residency (yet they tend to only take from good residencies where they already learned the compex RRA...go figure). There are maybe a dozen such fellowship, and they take people who don't really need to do them.
2) Mediocre PP fellowships or hospital-based fellowship with very mediocre attendings... basically only undertaken to say "I did a fellowship" or to "network" or try to get a job there or because residents couldn't find a good job. This shows anyone how sad our job market is that we need to donate our time for a year to maaaybe get a chance to line the pockets of another doc at that place. Hmm, let's do a fellowship with "teachers" who you'd already have more skills than if you'd done a good residency? Yikes.
3) Trash fellowships and "mini-fellowships" for 'niche' skills (derm, wound, research, prac mgmt, etc) that should have been learned in any decent residency.
4) Fellowship that leads to DPM having additional cert, skill.... wait, that doesn't exist. They are simply an additional year of residency in an already narrow speciality.

The bottom line is do a good residency and read; pick good mentors and prep for cases...
You will miraculously do fine without having to risk another 65k salary slave year to maybe get the chance to make money for a boss/owner. You can have that chance without fellowship. The training wheels have to come off someday.

There are useful fellowships and sometimes programs don’t have enough funding/positions to hire someone good directly out of residency. Happens to me all the time with the University budget, which needs to be done almost a year in advance. So I give someone the opportunity to come on as a fellow and save (or create) a spot for them for next year.

 

[Pronation]

There are useful fellowships and sometimes programs don’t have enough funding/positions to hire someone good directly out of residency. Happens to me all the time with the University budget, which needs to be done almost a year in advance. So I give someone the opportunity to come on as a fellow and save (or create) a spot for them for next year.

Soooo basically the job market is so awful that someone has to do a fellowship unnecessarily just to lock in a spot for them next year?

 

[diabeticfootdr]

Soooo basically the job market is so awful that someone has to do a fellowship unnecessarily just to lock in a spot for them next year?

Maybe they want to be here and make a difference in the world?

Nothing will convince some of SDN posters that podiatry is a good career. Yes, it has its problems. So does every profession.

Either one can choose to be miserable (which loves company on SDN) or you can be part of the solution.

I don’t think the solution is tearing down the profession on blog by anonymous posters, who may or may not even be podiatrists, or may be doing it for anticompetitive reasons. I’ve read the posts here. They’re not altruistic for the benefit of the profession and patients. A majority of the posts focus on personal financial considerations, not how to provide good foot and ankle care to the country by competent professionals.

If you want to be rich, you have to be an entrepreneur and have the drive to start something. You can be rich as a podiatrist, but you probably should do something else.

Instead, you can make a good living in podiatry. In fact, all the SDN posters claim they are … they just don’t want competition in the profession (by claiming over-saturation of the market).

But really importantly, you can do something no one else is willing or capable of doing and help many patients remain active, pain-free, and avoid amputation.

 

[icebreaker32]

The problem with podiatry as a profession is not what it can be for some. There are some excellent surgeons using their full scope of training as well as entrepreneurs doing very, very well.

The problem is what this profession is for those doing average or below average.

If you go into this profession compared to many other healthcare professions nothing will be handed to you. Supply and demand will not be your savior. You will be self made.

Roll the dice if you want....it might work out well or chose a profession with a much better job market and ROI.

 

[Adam Smasher]

you can do something no one else is willing

Bottom feeders unite!

 

[diabeticfootdr]

Bottom feeders unite!

“feeters”

 

[newfeet]

Soooo basically the job market is so awful that someone has to do a fellowship unnecessarily just to lock in a spot for them next year?

Interesting that’s what I did when I stayed for the PMSR instead of leaving with a PMS-24. Best decision because I was able to get ABPM without cases.

 

[Shiyuan]

But really importantly, you can do something no one else is willing or capable of doing and help many patients remain active, pain-free, and avoid amputation.

Agreed.

BTW good new icon 😎

 

[HardRoadPaved]

or may be doing it for anticompetitive reasons. I’ve read the posts here. They’re not altruistic for the benefit of the profession and patients. A majority of the posts focus on personal financial considerations, not how to provide good foot and ankle care to the country by competent professionals.

Instead, you can make a good living in podiatry. In fact, all the SDN posters claim they are … they just don’t want competition in the profession (by claiming over-saturation of the market).

But really importantly, you can do something no one else is willing or capable of doing and help many patients remain active, pain-free, and avoid amputation.

Or maybe we are tired of 100k jobs upon graduation with a predatory situations when we are looking to pay back 300-400k in undergrad + dpm debt. The overwhelming MAJORITY of graduates face this reality. Of course there will always be that gem who gets the dream hospital job just like there will always be a crook that gets busted billing medicare improperly.

Or maybe the fact that 3 years of surgical training is necessary to practice and then must obtain board certification though a convoluted system.

Or maybe to all the female podiatrists who are tired of coming out only to find out that because they are of "child-bearing age" they should be given a salary SIGNIFICANTLY less than their male counterparts because they might take a leave of absence and become mothers.

There are just easier ways to go in medicine so anyone looking to be called 'doctor' needs to think about their choices.

 

[HardRoadPaved]

The problem is what this profession is for those doing average or below average.

Yep the profession allowing the average to below average to enter is the issue. After you are given a letter to hop into school because of "easy admissions" or a "generous scholarship" you then face poor attrition rates, abysmal part 1 test rates, unequal residency training to become a "surgeon" only then to find out that you need to pass a surgical board to get the privileges to do that work.

If your drive is low, GPA/MCAT is meh, then it should be a warning to those looking to add Dr. to their name. It comes at a high cost of time and expense because you will be in for a real ride that lasts a lifetime since you cant just get a different job with your degree (or limited license).

 

[Adam Smasher]

I wrote a post a few months back where I boiled the problem down to three bullet points.

• 7 years
• 250k debt (or is it 300 now?)
• 140k mean salary (according to the most recent PM news survey)

If you can't change 2 of those three, this is a done deal. Everything on SDN is just sound and fury, signifying nothing. (Especially the memes.) I can't discourage anyone anymore than Dr Rogers can encourage anyone. Sure there are people out there who are looking for something else and aren't about the money, they just want to help people. Well, for a pre-health student there are paths you can take where you get to help people without worrying about a high salary (PT, athletic trainer, nurse educator, respiratory thearpist, audiologist, speech therapist).

Ultimately though, pre-health students aren't stupid, they understand the numbers.

 

[deleted1093615]

250k debt (or is it 300 now?)

250k? 300k? Try 400K.

Podiatric Medicine - Glendale

Podiatric Medicine

www.midwestern.edu

tuition = >200k
living = 200k

 

[DMEpod]

I went to MWU where tuition increased ~2k a yr every year. Interestingly my undergrad locked in your rate from freshman yr so no increases the whole time I was enrolled. With the example above that would be 52, 54, 56, and 58k from 1st-4th yr. That alone is 220k... ouch

 

[Poddy2Hotty]

250k? 300k? Try 400K.

Memes of Podiatry

Current state

forums.studentdoctor.net

 

[JustAPedicurist]

I wrote a post a few months back where I boiled the problem down to three bullet points.

• 7 years
• 250k debt (or is it 300 now?)
• 140k mean salary (according to the most recent PM news survey)

If you can't change 2 of those three, this is a done deal. Everything on SDN is just sound and fury, signifying nothing. (Especially the memes.) I can't discourage anyone anymore than Dr Rogers can encourage anyone. Sure there are people out there who are looking for something else and aren't about the money, they just want to help people. Well, for a pre-health student there are paths you can take where you get to help people without worrying about a high salary (PT, athletic trainer, nurse educator, respiratory thearpist, audiologist, speech therapist).

Ultimately though, pre-health students aren't stupid, they understand the numbers.

Yeah it’s mainly $300k+ more than likely. Especially if you don’t consider low cost of living areas like DMU, texas, and Kent.

Bay Area, NYC, Miami aren’t exactly cheap places to live…

Podiatry is a scam

 

[air bud]

Or maybe we are tired of 100k jobs upon graduation with a predatory situations when we are looking to pay back 300-400k in undergrad + dpm debt. The overwhelming MAJORITY of graduates face this reality. Of course there will always be that gem who gets the dream hospital job just like there will always be a crook that gets busted billing medicare improperly.

Or maybe the fact that 3 years of surgical training is necessary to practice and then must obtain board certification though a convoluted system.

Or maybe to all the female podiatrists who are tired of coming out only to find out that because they are of "child-bearing age" they should be given a salary SIGNIFICANTLY less than their male counterparts because they might take a leave of absence and become mothers.

There are just easier ways to go in medicine so anyone looking to be called 'doctor' needs to think about their choices.

oh man this cannot be understated...podiatrists who are able to birth a child (lol) are in for a hard reality. MD/DO who gets a hospital employed job (default) will often be easily able to take full 3 months plus (more if university)....good luck in PP with that.

 

[air bud]

I went to MWU where tuition increased ~2k a yr every year. Interestingly my undergrad locked in your rate from freshman yr so no increases the whole time I was enrolled. With the example above that would be 52, 54, 56, and 58k from 1st-4th yr. That alone is 220k... ouch

thats crazy. DMU 2009-2013 was like 26-29...

 

[JustAPedicurist]

thats crazy. DMU 2009-2013 was like 26-29...

you're officially an old.

 

[Adam Smasher]

oh man this cannot be understated...podiatrists who are able to birth a child (lol) are in for a hard reality. MD/DO who gets a hospital employed job (default) will often be easily able to take full 3 months plus (more if university)....good luck in PP with that.

I'm sympathetic to birthing persons on this issue, in theory this person is generating 300k their first year even if they're only mildly busy. 8 weeks parental leave is going to set you back what 12k if they're paid a typical associate salary? And this person is probably using this benefit twice their entire career? If they're good enough to hire, they're good enough to support through a major life event.

On the other hand if you're a solo owner looking to expand, I can understand not wanting to support another person's pregnancy...

 

[air bud]

I'm sympathetic to birthing persons on this issue, in theory this person is generating 300k their first year even if they're only mildly busy. 8 weeks parental leave is going to set you back what 12k if they're paid a typical associate salary? And this person is probably using this benefit twice their entire career? If they're good enough to hire, they're good enough to support through a major life event.

On the other hand if you're a solo owner looking to expand, I can understand not wanting to support another person's pregnancy...

What makes you think the PP owner is reasonable?

 

[HardRoadPaved]

What makes you think the PP owner is reasonable?

Run if you see a hint of mustache shadow (regardless of gender)

 

[Adam Smasher]

What makes you think the PP owner is reasonable?

I know we hate on owners all the time here but I've had MAs get pregnant. We liked them, thought they were valuable to the organization, wanted to keep them, so we worked something out. A different type of doctor would just throw them to the wolves but, in the long run, you never get more than entry level talent that way. There's a selfish rationale for offering parental leave.

 

[air bud]

I know we hate on owners all the time here but I've had MAs get pregnant. We liked them, thought they were valuable to the organization, wanted to keep them, so we worked something out. A different type of doctor would just throw them to the wolves but, in the long run, you never get more than entry level talent that way. There's a selfish rationale for offering parental leave.

Yeah I forget you are a member of the bourgeoisie sometimes.

 

[DogSnoot]

Or maybe to all the female podiatrists who are tired of coming out only to find out that because they are of "child-bearing age" they should be given a salary SIGNIFICANTLY less than their male counterparts because they might take a leave of absence and become mothers.

There are just easier ways to go in medicine so anyone looking to be called 'doctor' needs to think about their choices.

As a female during externships I’ve been asked by a director of a residency if “I plan to have a child soon”.

Edit: this question was approached in a hallway tactlessly and out of the blue. I remember that incident clear as daylight because I was taken back by the direct questioning style.