Don’t do podiatry

[JustAPedicurist]

All the jobs out there for new grads start at about $100,000 or less for slave hours. It’s nearly impossible to get hospital employed as a new grad, VA’s are impossible as well. More and more places only want people abfas certified/years of experience/fellowship trained.

It’s hopeless. I’m starting to look at new career options

Students are now getting accepted with less than 490 MCAT scores. Pretty sure you get that just by choosing the letter C on every question. This profession is close to finished

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Members don't see this ad.

 

[Hybrocure]

Buccees. 225k a year no call, non op. Full benefits including 401k and medical.

 

[JustAPedicurist]

Buccees. 225k a year no call, non op. Full benefits including 401k and medical.

In all honesty is there a worse return on investment in the world than podiatry?

11 years of your life working like a dog
300k in debt
To make $100k and continue to work like a dog

 

[Hybrocure]

In all honesty is there a worse return on investment in the world than podiatry?

11 years of your life working like a dog
300k in debt
To make $100k and continue to work like a dog

Some people just really like feet.

 

[Adam Smasher]

Guys, guys...all you need to do is wait for the onrush of elderly diabetics. Time is on your side

 

[Hybrocure]

Guys, guys...all you need to do is wait for the onrush of elderly diabetics. Time is on your side

Lol as insurances continue to make it harder and harder to cover diabetic visits

 

[halluxander.the.great]

All the jobs out there for new grads start at about $100,000 or less for slave hours. It’s nearly impossible to get hospital employed as a new grad, VA’s are impossible as well. More and more places only want people abfas certified/years of experience/fellowship trained.

It’s hopeless. I’m starting to look at new career options

Students are now getting accepted with less than 490 MCAT scores. Pretty sure you get that just by choosing the letter C on every question. This profession is close to finished

See though....this is kind of where I see ABPM coming in. If ABPM becomes acceptable, I think it would open a lot of doors for new grads. Obvi, there are still issues within our field (i.e. oversaturation mainly), but I think that we have this rigid idea of what is possible simply bc of the way things have been for many years... it's not totally out of the question to have broad acceptance of ABPM cert--this has happened in other fields as well (internal med has had similar controversy over their boards and a new board was created, which is pretty widely accepted).

I know many of you believe that the differences in residency quality is a huge deal. Honestly, I disagree. Podiatry isn't brain surgery and we can all do HTs, bunions, limb salvage. Sure we don't all do RF/trauma stuff, but most orthos don't do rotationplasties and many don't even do like, knee replacements. Some plastic surgeons only do breast augs. And there are bad docs everywhere. I know of a Harvard fellowship-trained interventional cardiologist at a prestigious institution that has a horrible reputation.....

 

[icebreaker32]

Some will not get into medical school. So many DO schools are opening that offshore medical school is getting very hard to match for anything other than family practice/peds/psych and mainly even that just for US citizens now.

Add to that mid-levels…….PA, NP, CRNA

Add to that one can start as a BSN and work their way up to a midlevel or a high paid management job with experience and a MHA or MBA.

Many of the above professions have jobs everywhere, with good benefits. Many have loan repayments option.

Where does that leave podiatry? Where it has always been really mainly private practice.

Podiatry is not really less desirable because it has changed. It is less desirable because it has not changed enough compared to other professions. Yes it slowly moves forward, but not as fast as others professions and with saturation and slow job growth, with limited organizational jobs.

Some will not get into medical school or many other careers…..podiatry school will still take them. Some are just so set on being a doctor/surgeon also.

It is nice there are some doing really well with great jobs in great hospital systems and owners of really nice offices in upscale suburbs. The problem with these highly visible situations is it sort of fools many pre pods into thinking what is possible is the norm.

If one goes into podiatry they can either try to compete for those few great jobs. Elite residencies, fellowships, ABFAS RRA , geographically open, connections bordering on nepotism etc usually required. Some will get those jobs obviously and good for them.

Where does that leave most? As an associate with a poor ROI. For a few they will eventually get a great job. Many will eventually open their own office. The reality is savings if you are fortunate enough to have a lot, family money or a high earning spouse is huge advantage here. For some it will be to forever be an associate or mobile podiatry.

The most common path for most to be successful in this profession is definitely still opening an office. This is a trend opposite to most of healthcare. If this becomes much harder I really do not know what will happen with this profession. I personally do not think this is for everyone, but once you are an associate it is often the only way to ever improve one’s situation.

 

[Sweatshirt]

I don't want to beat a dead horse here but if you haven't already, look at rural hospitals. They don't care about years of practice or ABFAS status. You will likely need to cold call/cold email. Not everyone is able to go rural due to spouse/family/other issues but if you are then it's the best option for new grads. Myself as well as at least 5 other friends got great rural gigs

 

[Hybrocure]

I don't want to beat a dead horse here but if you haven't already, look at rural hospitals. They don't care about years of practice or ABFAS status. You will likely need to cold call/cold email. Not everyone is able to go rural due to spouse/family/other issues but if you are then it's the best option for new grads. Myself as well as at least 5 other friends got great rural gigs

MONTANA?!

 

[Sweatshirt]

MONTANA?!

More like West Virginia. Loads of diabetics to treat

 

[icebreaker32]

I don't want to beat a dead horse here but if you haven't already, look at rural hospitals. They don't care about years of practice or ABFAS status. You will likely need to cold call/cold email. Not everyone is able to go rural due to spouse/family/other issues but if you are then it's the best option for new grads. Myself as well as at least 5 other friends got great rural gigs

A known method that can still work. It is not like everyone can find jobs this way, but obviously many are not willing to go extremely rural.

 

[halluxander.the.great]

Some will not get into medical school. So many DO schools are opening that offshore medical school is getting very hard to match for anything other than family practice/peds/psych and mainly even that just for US citizens now.

Add to that mid-levels…….PA, NP, CRNA

Add to that one can start as a BSN and work their way up to a midlevel or a high paid management job with experience and a MHA or MBA.

Many of the above professions have jobs everywhere, with good benefits. Many have loan repayments option.

Where does that leave podiatry? Where it has always been really mainly private practice.

Podiatry is not really less desirable because it has changed. It is less desirable because it has not changed enough compared to other professions. Yes it slowly moves forward, but not as fast as others professions and with saturation and slow job growth, with limited organizational jobs.

Some will not get into medical school or many other careers…..podiatry school will still take them. Some are just so set on being a doctor/surgeon also.

It is nice there are some doing really well with great jobs in great hospital systems and owners of really nice offices in upscale suburbs. The problem with these highly visible situations is it sort of fools many pre pods into thinking what is possible is the norm.

If one goes into podiatry they can either try to compete for those few great jobs. Elite residencies, fellowships, ABFAS RRA , geographically open, connections bordering on nepotism etc usually required. Some will get those jobs obviously and good for them.

Where does that leave most? As an associate with a poor ROI. For a few they will eventually get a great job. Many will eventually open their own office. The reality is savings if you are fortunate enough to have a lot, family money or a high earning spouse is huge advantage here. For some it will be to forever be an associate or mobile podiatry.

The most common path for most to be successful in this profession is definitely still opening an office. This is a trend opposite to most of healthcare. If this becomes much harder I really do not know what will happen with this profession. I personally do not think this is for everyone, but once you are an associate it is often the only way to ever improve one’s situation.

I agree and I think most of the issues you discuss are due to oversaturation--even all the stuff you discuss about other professions (i.e. Caribbean MD). And I think, tbh, the oversaturation within the NP for sure (mark my words--with all the NPs killing young, healthy ppl out there, a study will eventually come out comparing NP vs. DO/MD outcomes), and also perhaps PA, will come along down the road.

Many will prob disagree with me but I think the place where we have the biggest shot is limb salvage. At many hospitals, vasc or gen sx do those cases but they don't want to be doing them at all. They'd rather be doing bypasses/choles (respectively), etc etc. I'm not sure why we haven't been more welcomed in this area--like I never see any pods working for vasc/gen sx even tho there are a (very) few that work for ortho groups. Maybe it's our reputation, maybe at certain places they actually want those cases, I don't know. But I wish that more advocacy would go into that area for us. Would it solve the oversaturation problem? No. Close the ****ing schools.

I also disagree with you about the private practice thing. Most groups in various fields want to stay in private practice. Retiring owners are selling out for the big payout, but no one in any field ACTIVELY WANTS to work for corporate medicine. They're paid less, have less power, less flexibility, etc. It may be going that way simply bc Corporate America runs America and wants to make money in every realm possible, but no one working in medicine today WANTS to work for these companies.

 

[halluxander.the.great]

MONTANA?!

I think Montana is more discovered than you think lol. Bozeman/Big Sky are the new Jackson Hole

 

[halluxander.the.great]

I think Montana is more discovered than you think lol. Bozeman/Big Sky are the new Jackson Hole

 

[halluxander.the.great]

Unfortunately the pandemic did ruin a lot of the cool, "rural" ("" bc many aren't so rural anymore) spots what with people moving or buying second homes in "the country." Like I had always had a little bit of a dream to live near Boise, Idaho. Cool, liberal oasis (unfortunately amongst all the white supremacist hill communes...), but that area has blown up and is extremely expensive. Cool, rural places still exist tho. You just gotta do a lil research.

 

[halluxander.the.great]

Some people just really like feet.

🤣🤣🤣 is my response when people say that or anything "do-what-you-love!!!!!!!"-related.....like give me a break. Like a job is still a job. Even if my job was catching butterflies in a field full of wildflowers I'd still hate it bc it's my job... but people in this field really love their Kool Aid.....

 

[Shiyuan]

I don't want to beat a dead horse here but if you haven't already, look at rural hospitals. They don't care about years of practice or ABFAS status. You will likely need to cold call/cold email. Not everyone is able to go rural due to spouse/family/other issues but if you are then it's the best option for new grads. Myself as well as at least 5 other friends got great rural gigs

10000%.

But yes, ROI is pretty bad. Job search daunting and depressing.

 

[Adam Smasher]

Many will prob disagree with me but I think the place where we have the biggest shot is limb salvage.

Good comments. I happen to find wounds and infection cases interesting, plus they tend to be higher complexity. If you're not shy about putting in the work, it can be a good cash flow for you.

At many hospitals, vasc or gen sx do those cases but they don't want to be doing them at all.

The lobster podiatrist scours the floor for what the big fish leave us

Most groups in various fields want to stay in private practice.

Another good comment. I saw a Medicare article about how PP was making a comeback. The challenge is running into questions of scale. Docs want control over their business, but 6+ equal co-owners doesn't lend itself to efficient decision making either. If you can get through the turd feast of being an associate, being a practice owner gives you a lot of liberties for shaping your work environment (along with a ton of obligations)

 

[air bud]

IHS. Learn to treat really sick people. Good pay and Benny's to start. Loan repayment. Get board certified fast.

 

[Hybrocure]

IHS. Learn to treat really sick people. Good pay and Benny's to start. Loan repayment. Get board certified fast.

Just as competitive as VA and hospital jobs

 

[halluxander.the.great]

Good comments. I happen to find wounds and infection cases interesting, plus they tend to be higher complexity. If you're not shy about putting in the work, it can be a good cash flow for you.



The lobster podiatrist scours the floor for what the big fish leave us



Another good comment. I saw a Medicare article about how PP was making a comeback. The challenge is running into questions of scale. Docs want control over their business, but 6+ equal co-owners doesn't lend itself to efficient decision making either. If you can get through the turd feast of being an associate, being a practice owner gives you a lot of liberties for shaping your work environment (along with a ton of obligations)

"The lobster podiatrist"--I mean a lot of other fields serve this purpose in some/similar ways. Urology fixes when OBGYN cuts the ureter instead of the artery during a hysterectomy. Vascular fixes when ortho nicks whatever artery. And those examples are actually SHAMEFUL. Helping where help is needed isn't shameful. All of medicine works as a team.

Good comments. I happen to find wounds and infection cases interesting, plus they tend to be higher complexity. If you're not shy about putting in the work, it can be a good cash flow for you.



The lobster podiatrist scours the floor for what the big fish leave us



Another good comment. I saw a Medicare article about how PP was making a comeback. The challenge is running into questions of scale. Docs want control over their business, but 6+ equal co-owners doesn't lend itself to efficient decision making either. If you can get through the turd feast of being an associate, being a practice owner gives you a lot of liberties for shaping your work environment (along with a ton of obligations)

I also don't necessarily think that PP is "making a comeback," more like PP is clinging to their autonomy.

 

[halluxander.the.great]

Good comments. I happen to find wounds and infection cases interesting, plus they tend to be higher complexity. If you're not shy about putting in the work, it can be a good cash flow for you.



The lobster podiatrist scours the floor for what the big fish leave us



Another good comment. I saw a Medicare article about how PP was making a comeback. The challenge is running into questions of scale. Docs want control over their business, but 6+ equal co-owners doesn't lend itself to efficient decision making either. If you can get through the turd feast of being an associate, being a practice owner gives you a lot of liberties for shaping your work environment (along with a ton of obligations)

"The lobster podiatrist"--I mean a lot of other fields serve this purpose in some/similar ways. Urology fixes when OBGYN cuts the ureter instead of the artery during a hysterectomy. Vascular fixes when ortho nicks whatever artery. And those examples are actually SHAMEFUL. Helping where help is needed isn't shameful. All of medicine works as a team. I mean

Good comments. I happen to find wounds and infection cases interesting, plus they tend to be higher complexity. If you're not shy about putting in the work, it can be a good cash flow for you.



The lobster podiatrist scours the floor for what the big fish leave us



Another good comment. I saw a Medicare article about how PP was making a comeback. The challenge is running into questions of scale. Docs want control over their business, but 6+ equal co-owners doesn't lend itself to efficient decision making either. If you can get through the turd feast of being an associate, being a practice owner gives you a lot of liberties for shaping your work environment (along with a ton of obligations)

I also don't necessarily think that PP is "making a comeback," more like PP is clinging to their autonomy. Bc America continues to be steadfast in its capitalism, medicine continues to be lucrative. There is no reason that individuals should not profit from this vs corporations. And I hope PP never dies, unless I suppose some form of universal healthcare is adopted, but imo that will never happen and that's an entirely different conversation

 

[halluxander.the.great]

IHS. Learn to treat really sick people. Good pay and Benny's to start. Loan repayment. Get board certified fast.

Yes I did actually apply to a job in New Mexico at the res for IHS. Unfortunately the doctor spouse's position will always be much more lucrative than my own so we must go where they find the best position

 

[icebreaker32]

I agree and I think most of the issues you discuss are due to oversaturation--even all the stuff you discuss about other professions (i.e. Caribbean MD). And I think, tbh, the oversaturation within the NP for sure (mark my words--with all the NPs killing young, healthy ppl out there, a study will eventually come out comparing NP vs. DO/MD outcomes), and also perhaps PA, will come along down the road.

Many will prob disagree with me but I think the place where we have the biggest shot is limb salvage. At many hospitals, vasc or gen sx do those cases but they don't want to be doing them at all. They'd rather be doing bypasses/choles (respectively), etc etc. I'm not sure why we haven't been more welcomed in this area--like I never see any pods working for vasc/gen sx even tho there are a (very) few that work for ortho groups. Maybe it's our reputation, maybe at certain places they actually want those cases, I don't know. But I wish that more advocacy would go into that area for us. Would it solve the oversaturation problem? No. Close the ****ing schools.

I also disagree with you about the private practice thing. Most groups in various fields want to stay in private practice. Retiring owners are selling out for the big payout, but no one in any field ACTIVELY WANTS to work for corporate medicine. They're paid less, have less power, less flexibility, etc. It may be going that way simply bc Corporate America runs America and wants to make money in every realm possible, but no one working in medicine today WANTS to work for these companies.

Of course many MDs in many specialties want to be a partner in a group in the right area with the right insurance mix, good referrals, lots of ancillary revenue sources. It is much easier to make a million dollars that way although some specialties can still make that much working for a hospital. Realistically most of medicine is not in these areas. Most specialties expect to make close to MGMA no matter what setting. Maybe a doctor that really wants to give back or that has poor credentials will take 25 percent less than MGMA with loan repayment options but that is the basement.

Is 25 percent less than MGMA the basement for podiatry with loan repayment and good benefits?.....no our basement is much lower.

MDs don't generally risk opening a solo office anymore these days (without a salary guarantee) unless they are already established or want to live in a dream location practicing concierge medicine and give it a try to see what happens knowing they can always go back to an organizational job.

What doctors don't want is to feel they have to go private practice in an area with less than an ideal insurance mix or referral patterns and practice lobster medicine knowing if it fails they are now more in debt with a job way below MGMA dollars.

Is private practice in podiatry a way to keep more dollars and have more control? Yes

Is private practice podiatry(as an owner) an escape from being an underpaid associate due to a lack of organizational jobs even if it means practicing lobster medicine or making treatment protocols based completely on $ to survive also when one does not even want to be a small business owner also?....yes.

Is being in private practice as an associate in podiatry common because one has no other options making way below MGMA and following protocols? Definitely yes.

 

[halluxander.the.great]

Of course many MDs in many specialties want to be a partner in a group in the right area with the right insurance mix, good referrals, lots of ancillary revenue sources. It is much easier to make a million dollars that way although some specialties can still make that much working for a hospital. Realistically most of medicine is not in these areas. Most specialties expect to make close to MGMA no matter what setting. Maybe a doctor that really wants to give back or that has poor credentials will take 25 percent less than MGMA with loan repayment options but that is the basement.

Is 25 percent less than MGMA the basement for podiatry with loan repayment and good benefits?.....no our basement is much lower.

MDs don't generally risk opening a solo office anymore these days (without a salary guarantee) unless they are already established or want to live in a dream location practicing concierge medicine and give it a try to see what happens knowing they can always go back to an organizational job.

What doctors don't want is to feel they have to go private practice in an area with less than an ideal insurance mix or referral patterns and practice lobster medicine knowing if it fails they are now more in debt with a job way below MGMA dollars.

Is private practice in podiatry a way to keep more dollars and have more control? Yes

Is private practice podiatry(as an owner) an escape from being an underpaid associate due to a lack of organizational jobs even if it means practicing lobster medicine or making treatment protocols based completely on $ to survive also when one does not even want to be a small business owner also?....yes.

Is being in private practice as an associate in podiatry common because one has no other options making way below MGMA and following protocols? Definitely yes.

I agree thats the way it is now. I disagree with calling what we do "lobster" medicine though. Do I believe that largely a lot of what we do in this profession is useless bc of significant overlap bc of other specialties (i.e. ortho)? YES. But just bc a giant portion of what we do is also something other specialties can do doesn't make us useless in and of itself. Vascular surgery would rather do 4-6 hr (imo, useless) fem-pop bypasses for smokers refusing to quit than doing a stupid toe amp on a diabetic with a Dr pepper addiction. Like, in that regard, ALL (ok fine, a large %, obvi some ppl have genetic/hereditary issues beyond their control) OF MEDICINE IS USELESS.

 

[Feli]

...Podiatry is not really less desirable because it has changed. It is less desirable because it has not changed enough compared to other professions. Yes it slowly moves forward, but not as fast as others professions and with saturation and slow job growth, with limited organizational jobs. ...

Podiatry has changed a bit with more surgery training, more med/surg rotations in residency, and more hospital and MSG jobs.

The problem is that change has only affected about 20% of DPMs. There are not enough of those jobs to support the training. Expectations and cost of education have grown greatly, and expectations now are not met for the majority of DPMs.

The fact that tuition and debt has more than doubled and the training is longer effects everyone. 25 years ago, it was not a big deal to be getting $75k associate gigs out of training when loan burden was around 100k (1.3:1 debt:income ratio, reasonable enough), but it's a huuuuge problem getting $125k offers with 400k debt (3:1 ratio... insanity).

So, things change for 100% of DPMs (cost of training and ROI, harder to get loan to start/buy office), yet things mostly stay the same (still a largely PP profession with low associate pay and few hospital jobs). It'd be the same if pay for any profession (relative to edu cost) was halved... and expectations were set higher than ever by the schools/org.

 

[halluxander.the.great]

Of course many MDs in many specialties want to be a partner in a group in the right area with the right insurance mix, good referrals, lots of ancillary revenue sources. It is much easier to make a million dollars that way although some specialties can still make that much working for a hospital. Realistically most of medicine is not in these areas. Most specialties expect to make close to MGMA no matter what setting. Maybe a doctor that really wants to give back or that has poor credentials will take 25 percent less than MGMA with loan repayment options but that is the basement.

Is 25 percent less than MGMA the basement for podiatry with loan repayment and good benefits?.....no our basement is much lower.

MDs don't generally risk opening a solo office anymore these days (without a salary guarantee) unless they are already established or want to live in a dream location practicing concierge medicine and give it a try to see what happens knowing they can always go back to an organizational job.

What doctors don't want is to feel they have to go private practice in an area with less than an ideal insurance mix or referral patterns and practice lobster medicine knowing if it fails they are now more in debt with a job way below MGMA dollars.

Is private practice in podiatry a way to keep more dollars and have more control? Yes

Is private practice podiatry(as an owner) an escape from being an underpaid associate due to a lack of organizational jobs even if it means practicing lobster medicine or making treatment protocols based completely on $ to survive also when one does not even want to be a small business owner also?....yes.

Is being in private practice as an associate in podiatry common because one has no other options making way below MGMA and following protocols? Definitely yes.

Ok but so like once again, why can't we work for vasc/gen surg private practices? In that scenario, you may get a reasonable contract without with poss partnership (or not, but might not necessarily matter) and a reasonable salary. Like I guess that's my point. I don't want to own my own practice--I never have. And I'd take a small pay-cut to not own my own practice, but not like... a 2/3 pay cut....

Edited to add: I am also speaking towards a rural hospital situation. I think in saturated areas, this scenario prob isn't possible.

 

[halluxander.the.great]

Podiatry has changed a bit with more surgery training, more med/surg rotations in residency, and more hospital and MSG jobs.

The problem is that change has only affected about 20% of DPMs. There are not enough of those jobs to support the training. Expectations and cost of education have grown greatly, and expectations now are not met for the majority of DPMs.

The fact that tuition and debt has more than doubled and the training is longer effects everyone. 25 years ago, it was not a big deal to be getting $75k associate gigs out of training when loan burden was around 100k (1.3:1 debt:income ratio, reasonable enough), but it's a huuuuge problem getting $125k offers with 400k debt (3:1 ratio... insanity).

So, things change for 100% of DPMs (cost of training and ROI, harder to get loan to start/buy office), yet things mostly stay the same (still a largely PP profession with low associate pay and few hospital jobs). It'd be the same if pay for any profession (relative to edu cost) was halved... and expectations were set higher than ever by the schools/org.

Yes, agree.

 

[Retrograde_Nail]

See though....this is kind of where I see ABPM coming in. If ABPM becomes acceptable, I think it would open a lot of doors for new grads. Obvi, there are still issues within our field (i.e. oversaturation mainly), but I think that we have this rigid idea of what is possible simply bc of the way things have been for many years... it's not totally out of the question to have broad acceptance of ABPM cert--this has happened in other fields as well (internal med has had similar controversy over their boards and a new board was created, which is pretty widely accepted).

I know many of you believe that the differences in residency quality is a huge deal. Honestly, I disagree. Podiatry isn't brain surgery and we can all do HTs, bunions, limb salvage. Sure we don't all do RF/trauma stuff, but most orthos don't do rotationplasties and many don't even do like, knee replacements. Some plastic surgeons only do breast augs. And there are bad docs everywhere. I know of a Harvard fellowship-trained interventional cardiologist at a prestigious institution that has a horrible reputation.....

What are you talking about? ABPM is a medicine board. Not surgery. It’s not going to change your prospects of getting a hospital job.

Podiatry training is not different from one program to the next? What???

There is a gross discrepancy in training in podiatry. This is widely accepted by everyone.

 

[icebreaker32]

Ok but so like once again, why can't we work for vasc/gen surg private practices? In that scenario, you may get a reasonable contract without with poss partnership (or not, but might not necessarily matter) and a reasonable salary. Like I guess that's my point. I don't want to own my own practice--I never have. And I'd take a small pay-cut to not own my own practice, but not like... a 2/3 pay cut....

Edited to add: I am also speaking towards a rural hospital situation. I think in saturated areas, this scenario prob isn't possible.

Opportunities such as working for a vascular group are often easier when you are already established in an area. Some vascular groups also know how cheap they can get a podiatrist for.

Rural hospital jobs can sometimes work out. As you should know by now some rural areas are pretty remote. Many people can do a lot of things for a couple years, but very few can live in the middle of nowhere longterm.

The myth you are guaranteed to make a good salary by opening your office is false also. It involves a lot of work and risk even though it works out for many.

 

[Pronation]

See though....this is kind of where I see ABPM coming in. If ABPM becomes acceptable, I think it would open a lot of doors for new grads. Obvi, there are still issues within our field (i.e. oversaturation mainly), but I think that we have this rigid idea of what is possible simply bc of the way things have been for many years... it's not totally out of the question to have broad acceptance of ABPM cert--this has happened in other fields as well (internal med has had similar controversy over their boards and a new board was created, which is pretty widely accepted).

I know many of you believe that the differences in residency quality is a huge deal. Honestly, I disagree. Podiatry isn't brain surgery and we can all do HTs, bunions, limb salvage. Sure we don't all do RF/trauma stuff, but most orthos don't do rotationplasties and many don't even do like, knee replacements. Some plastic surgeons only do breast augs. And there are bad docs everywhere. I know of a Harvard fellowship-trained interventional cardiologist at a prestigious institution that has a horrible reputation.....

I’m just going to touch on the ABPM aspect, I don’t feel like picking apart the rest of your post.

This isn’t going to help new grads worth a damn. You’re in the right ball field when you mention our gross over saturation. Even if a certain podiometric politician is able to whine enough to make a back door non surgical board signed into law that it must be accepted or be considered discriminatory if excluded, then hospitals will STILL find a way to exclude applicants. Why? Because every single organizational job gets literally hundreds of applications within just the first few days of being advertised. They need a way to chop off at least half of the applicants. So instead they will ask for something else such as hard requirement for minimum 5 years exp, etc.

Welcome to the life of the podiometric technician.

 

[halluxander.the.great]

I’m just going to touch on the ABPM aspect, I don’t feel like picking apart the rest of your post.

This isn’t going to help new grads worth a damn. You’re in the right ball field when you mention our gross over saturation. Even if a certain podiometric politician is able to whine enough to make a back door non surgical board signed into law that it must be accepted or be considered discriminatory if excluded, then hospitals will STILL find a way to exclude applicants. Why? Because every single organizational job gets literally hundreds of applications within just the first few days of being advertised. They need a way to chop off at least half of the applicants. So instead they will ask for something else such as hard requirement for minimum 5 years exp, etc.

Welcome to the life of the podiometric technician.

"Back door surgical board" hmm...
Like I said, this issue with boards is happening in other fields: IM and I've heard EM as well. Becoming abfas cert does not necessarily mean anyone is qualified just as getting a Harvard interv cardiology fellowship doesn't necessarily mean one is qualified either (see earlier comment with regards to other specialties). There's a whole podcast called Dr death about a fellowship trained spinal surgeon who was not qualified to practice yet did (I understand this is on the far end of the spectrum but then there must be many many more OK-to-not-so-great physicians that fall in the middle somewhere with regards to skill level). I agree there's oversaturation within our field like prob no other medical field, but the fact of the matter is that board exams are supposed to be minimal competency exams, and as I've said before, I don't personally think the general pod surgeries we do are very complicated--most of us should therefore be able to pass them.

I agree these ideas won't necessarily help new grads. However I think if we continue to advocate for greater presence doing limb salvage alongside vasc/gen surg we might actually create new positions for us in the inpatient setting. Once again, we are discussing something that has been the way it has been (i.e. very few hospital positions) for many years so sometimes it's hard to think of other possibilities....

I am currently on the job hunt in a specific rural area and what I have been doing is reaching out to vasc/gen sx groups (which in this area are private groups), as they do most of the limb salvage, and seeing if there's enough volume to want to take on a pod to cover some of it. I could be totally wrong about this being a viable route for me or anyone else but like, I've gotta figure out how to make this profession work for me so it's worth a shot.

 

[Feli]

"Back door surgical board" hmm...
Like I said, this issue with boards is happening in other fields: IM and I've heard EM as well....

They are not HIGHLY saturated fields. The comparison doesn't apply. They will have jobs regardless due to demand >> supply.

Look at RN... you could have RN from the dinkiest online program in the USA and still have tons of good-paying job options.
If RN became saturated, suddenly they'd filter apps from the better colleges, more exp, etc... and they'd offer lower pay.
As it stands, they have many job offers, location choices, good pay, sign bonuses (just like MDs do) because they are not saturated.

...Supply/demand logic of high demand and balanced health professions doesn't apply to podiatry.
As said, having ABPM is like having a car to get to work or having scrubs to wear... ok, everyone else has the same, or better.

 

[halluxander.the.great]

What are you talking about? ABPM is a medicine board. Not surgery. It’s not going to change your prospects of getting a hospital job.

Podiatry training is not different from one program to the next? What???

There is a gross discrepancy in training in podiatry. This is widely accepted by everyone.

Some hospitals only require you hold some board cert--so in our little pod world we care more about abfas vs abpm than most hospitals do (unless your in a metro/overly saturated area). There are plenty of pods across the country doing surgery with ABPM alone RIGHT NOW so that's all I'll say about that.

Also I'll disagree that it's "widely accepted" that our training varies widely. As I said above, I believe we're all capable of doing the basic pod surgeries: bunions, HTs, limb salvage. They are not hard surgeries. Sure, RF varies but again, some ortho don't do knee replacements even tho technically that's covered under their boards, some anesthesiologists suck at blocks even tho that's covered under their boards, etc etc

 

[halluxander.the.great]

They are not HIGHLY saturated fields. The comparison doesn't apply. They will have jobs regardless due to demand >> supply.

Look at RN... you could have RN from the dinkiest online program in the USA and still have tons of good-paying job options.
If RN became saturated, suddenly they'd filter apps from the better colleges, more exp, etc... and they'd offer lower pay.
As it stands, they have many job offers, location choices, good pay, sign bonuses (just like MDs do) because they are not saturated.

...Supply/demand logic of high demand and balanced health professions doesn't apply to podiatry.
As said, having ABPM is like having a car to get to work or having scrubs to wear... ok, everyone else has the same, or better.

IM is not but ER is.

I dont disagree that we have an oversaturation problem. I'm simply saying there are solutions to improve it (not resolve it unless they close some schools)

 

[halluxander.the.great]

They are not HIGHLY saturated fields. The comparison doesn't apply. They will have jobs regardless due to demand >> supply.

Look at RN... you could have RN from the dinkiest online program in the USA and still have tons of good-paying job options.
If RN became saturated, suddenly they'd filter apps from the better colleges, more exp, etc... and they'd offer lower pay.
As it stands, they have many job offers, location choices, good pay, sign bonuses (just like MDs do) because they are not saturated.

...Supply/demand logic of high demand and balanced health professions doesn't apply to podiatry.
As said, having ABPM is like having a car to get to work or having scrubs to wear... ok, everyone else has the same, or better.

I also don't think comparing RN is a great comparison--nursing has a LOT of administrative advocacy, as well as unions and there are simply many more nurses needed than docs to run a hospital to support a community, even a small one. But there's still wide pay gaps in nursing.

 

[halluxander.the.great]

They are not HIGHLY saturated fields. The comparison doesn't apply. They will have jobs regardless due to demand >> supply.

Look at RN... you could have RN from the dinkiest online program in the USA and still have tons of good-paying job options.
If RN became saturated, suddenly they'd filter apps from the better colleges, more exp, etc... and they'd offer lower pay.
As it stands, they have many job offers, location choices, good pay, sign bonuses (just like MDs do) because they are not saturated.

...Supply/demand logic of high demand and balanced health professions doesn't apply to podiatry.
As said, having ABPM is like having a car to get to work or having scrubs to wear... ok, everyone else has the same, or better.

I also don't think comparing RN is a great comparison--nursing has a LOT of administrative advocacy, as well as unions and there are simply many more nurses needed than docs to run a hospital to support a community, even a small one. But there's still wide pay gaps in nursing.

 

[halluxander.the.great]

Feli, I am basically entirely agreeing with you. And I would never ever EVER recommend students go into podiatry right now or ever. Why? When you could make as much as a nurse! I'm simply saying I think there are ways to improve the field for those of us in the mud right now.

 

[icebreaker32]

IM is not but ER is.

I dont disagree that we have an oversaturation problem. I'm simply saying there are solutions to improve it (not resolve it unless they close some schools)

Know plenty of ER docs that work locums (one was living in NYC, the other a large city in FL that come to mind)) and they work as much or as little as they want but do often work far from home. Perhaps in some parts the country it is somewhat saturated.

I also know an ER doc working in one of the most desirable suburbs outside a major city. He had such a long list of job offers he had to make a long list of pros and cons to try and decide. He ended up taking a job working 30 hours with full time benefits. So I find it hard to believe ER is saturated most places.

Yah pharmacy is pretty saturated, and PT maybe in the most desirable locations, but not many other healthcare professions.

 

[halluxander.the.great]

Know plenty of ER docs that work locums (one was living in NYC, the other a large city in FL that come to mind)) and they work as much or as little as they want but do often work far from home. Perhaps in some parts the country it is somewhat saturated.

I also know an ER doc working in one of the most desirable suburbs outside a major city. He had such a long list of job offers he had to make a long list of pros and cons to try and decide. He ended up taking a job working 30 hours with full time benefits. So I find it hard to believe ER is saturated most places.

Yah pharmacy is pretty saturated, and PT maybe in the most desirable locations, but not many other healthcare professions.

Interesting. In residency when I was doing my ER rotation, I used to work with a female ER doc whose spouse was also an ER doc. They were from CA and had moved to the east coast. She said the job prospects in Cali were terrible. Not a ton of jobs and the pay was abysmal.

 

[halluxander.the.great]

Know plenty of ER docs that work locums (one was living in NYC, the other a large city in FL that come to mind)) and they work as much or as little as they want but do often work far from home. Perhaps in some parts the country it is somewhat saturated.

I also know an ER doc working in one of the most desirable suburbs outside a major city. He had such a long list of job offers he had to make a long list of pros and cons to try and decide. He ended up taking a job working 30 hours with full time benefits. So I find it hard to believe ER is saturated most places.

Yah pharmacy is pretty saturated, and PT maybe in the most desirable locations, but not many other healthcare professions.

I have also seen it mentioned elsewhere on reddit (r/medicine, r/residency) that ER is saturated but there's no data to really back up either claim

 

[Pronation]

I have also seen it mentioned elsewhere on reddit (r/medicine, r/residency) that ER is saturated but there's no data to really back up either claim

Could you please learn how to use the edit button and multi quote. You are bombarding everyone with post notifications…

 

[newfeet]

They are not HIGHLY saturated fields. The comparison doesn't apply. They will have jobs regardless due to demand >> supply.

Look at RN... you could have RN from the dinkiest online program in the USA and still have tons of good-paying job options.
If RN became saturated, suddenly they'd filter apps from the better colleges, more exp, etc... and they'd offer lower pay.
As it stands, they have many job offers, location choices, good pay, sign bonuses (just like MDs do) because they are not saturated.

...Supply/demand logic of high demand and balanced health professions doesn't apply to podiatry.
As said, having ABPM is like having a car to get to work or having scrubs to wear... ok, everyone else has the same, or better.

RN and MD hell even PAs will never get saturated. They are needed. I don't believe DPMs are needed. The world would be just fine if Thanos snapped us out of existence.

 

[halluxander.the.great]

RN and MD hell even PAs will never get saturated. They are needed. I don't believe DPMs are needed. The world would be just fine if Thanos snapped us out of existence.

Again, largely agree. I think some MD fields in desirable metro areas will have more competition thus lower salaries, but they'll never not have jobs like us. I also think we are useless as a field. There is nothing we do that other fields (docs and nurses) can't do. Wouldn't be so sure about NPs and PAs though. Online programs are quietly opening up in those areas. I just think my idea is a good idea on how to improve our current situation. No solution is perfect. I'm almost 40 so I'm not going back to nursing/PA school lol.

 

[Pronation]

I just think my idea is a good idea on how to improve our current situation.

I don’t. It’s just background noise. The underlying massive problem is the over saturation and job market. The hospital ads asking for ABFAS cert know what comes with it - experience. So if you try to back door your way in with an alternative board without experience then they will just flat out make several years of experience a requirement to chop off the hoards of applicants.

 

[Shiyuan]

RN and MD hell even PAs will never get saturated. They are needed. I don't believe DPMs are needed. The world would be just fine if Thanos snapped us out of existence.

Thanos would only get half of us though. May still cause lingering problems in metros 😅

 

[halluxander.the.great]

I don’t. It’s just background noise. The underlying massive problem is the over saturation and job market. The hospital ads asking for ABFAS cert know what comes with it - experience. So if you try to back door your way in with an alternative board without experience then they will just flat out make several years of experience a requirement to chop off the hoards of applicants.

 

[Winograd1717]

In all honesty is there a worse return on investment in the world than podiatry?

11 years of your life working like a dog
300k in debt
To make $100k and continue to work like a dog

Luckily this is not the case for everyone. But yes, if you go into this field without a clear and solid plan on what you'll do AFTER you're out, you should have probably looked into something else. Hopefully youre not too far into it to realize this now

 

[halluxander.the.great]

Well, as most on here have reiterated in other threads--many (if not most) good positions aren't even advertised, or even EXIST (i.e. you need to create them yourselves). I've never even SEEN a hospital job advertised lol. Most small rural hospitals/docs have no clue--nor do they care--about all our board drama. I know someone who does all types of surgery (FF, RF, trauma, elective, wound care, limb salvage) in a rural hospital position with only ABPM. But that person created the position for themselves. Once again, this issue has come up in IM which is why there's another widely-accepted board. And regardless of saturation or not in IM, that field has largely determined that specific board cert does not = competency. My point is we all know how to do limb salvage and basic podiatric surgeries. Why not use that to our advantage. I don't think you understand that I'm like 95% agreeing with you and if I could go back and do it over again I'd never do this. But my goal is to only make as much as the lowest paid MD/DO physician at this point, which in my current position I am making (along with decent benefits, PTO, paid sick time). But unfortunately we'll be moving so that's the way it is.

We're all here so we might as well make the best of the situation.