Options after residency ?. I appreciate your advice!

[podiatryresident]

Hello Everyone. I hope everyone is doing well. I would like to hear your advice about my situation. I'm currently in residency, I have 2 more years but I just want to prepare myself because my PD has been asking me about my plan. I have few options potentially such as:
1. Stay with my PD after graduation, of course not earning good salary ( I haven't asked but everyone here can tell! ). This option looks safe, he will look after me and I may get certified sooner ( at least it is what I think ). My wife has a good job here. We have no family or friends in this area
2. Go solo myself and open private practice in different state ( I'm East Coast now, want to go back West where my family's there ). One of private podiatrist who's bringing cases to hospital is new start-up too, I'm keeping good connection with her
3. Buy a practice from another podiatrist in West Coast.
4. Work for another podiatrist in West Coast first. I don't like this option. I'd rather work for my PD than someone else
P.S : I'm in a average program, not doing crazy things. I know what I'm confident to do in the future are Forefoot surgeries, Haglund Speedbridge, ATFL repair, simple OCD and simple ankle scope, simple trauma injuries. I have saved some money before school, no student loans! I have active CCS,CDIP and RHIA because I was a consultant before.
And I'm a little bit older than average residents!
Once again, thanks everyone for reading. I wish I knew this forum earlier. I have gone too far now....

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[HardRoadPaved]

1. No. Find a good practice especially if you are doing scopes and simple trauma. Why work for a regular DPM practice and not shoot for MSG/Ortho
2. Are you prepared to run a business? How's your coding knowledge? Is the area open panel for insurance?
3. Very vague, will doc stay on for transition or just buy outright?
4. no different than #1 and will your wife downgrade her life to satisfy yours?

Good thing you're a PGY-1. So as for surgical confidence I hope you can do those cases but if not get your total toenail replacement skills up to snuff

 

[Poddy2Hotty]

West coast is expensive. I vote wRVU hospital gig if you can swing it. Will likely get you ABFAS within 2 years as long as not pus only. Not gonna happen in a bigger metro though. Start making connections now. Go to regional conferences and talk to docs in the area you want to practice.

 

[podiatryresident]

1. No. Find a good practice especially if you are doing scopes and simple trauma. Why work for a regular DPM practice and not shoot for MSG/Ortho
2. Are you prepared to run a business? How's your coding knowledge? Is the area open panel for insurance?
3. Very vague, will doc stay on for transition or just buy outright?
4. no different than #1 and will your wife downgrade her life to satisfy yours?

Good thing you're a PGY-1. So as for surgical confidence I hope you can do those cases but if not get your total toenail replacement skills up to snuff

Thank you, sir. I'm thinking about obvious/unlucky opportunities first. About coding : I'm certified professionally by AHIMA, of course I'm learning for private practice too but it should be quick.

 

[podiatryresident]

West coast is expensive. I vote wRVU hospital gig if you can swing it. Will likely get you ABFAS within 2 years as long as not pus only. Not gonna happen in a bigger metro though. Start making connections now. Go to regional conferences and talk to docs in the area you want to practice.

Thank you so much for your comment, sir. I'm looking for obvious jobs first. I want to move to states below that expensive states you mentioned!

 

[Hybrocure]

Important thing to keep in mind for west coast is it is fairly saturated unless you’re really rural. And even then there’s a lot of competition for the west coast rural/hospital jobs. Especially in Utah or Nevada.

 

[podiatryresident]

Important thing to keep in mind for west coast is it is fairly saturated unless you’re really rural. And even then there’s a lot of competition for the west coast rural/hospital jobs. Especially in Utah or Nevada.

Is Nevada saturated already ? so sad!

 

[Hybrocure]

Is Nevada saturated already ? so sad!

I feel that Nevada jobs are pretty competitive especially near Vegas. New Mexico is pretty much the only state out west that seems to have ok job postings now and again.

Good luck getting anything in Colorado/Utah/AZ/Nevada that isn’t a 100k/30% job

 

[podiatryresident]

I feel that Nevada jobs are pretty competitive especially near Vegas. New Mexico is pretty much the only state out west that seems to have ok job postings now and again.

Good luck getting anything in Colorado/Utah/AZ/Nevada that isn’t a 100k/30% job

Thanks again, do you think NY/CA are better than AZ/NV ?

 

[Feli]

Another year or two can change a lot.

Fyi, you can't say you're confident/proficient and "confident to do in the future" things you haven't even done as first assist yet.

 

[Hybrocure]

Thanks again, do you think NY/CA are better than AZ/NV ?

NY is trash for jobs. Avoid at all costs. CA tends to have a lot of good job offers though but keep in mind higher taxes than many states and factor in rent costs which will be high too then see if those 200k salaries end up being better than the middle of the road ones in other states.

The best jobs won’t be in PM News or Podiatry based job postings. The good jobs will be either through word of mouth or hospital/MSG postings on proper job websites.

 

[podiatryresident]

Another year or two can change a lot.

Fyi, you can't say you're confident/proficient and "confident to do in the future" things you haven't even done as first assist yet.

Yup, sorry for over saying that. I know being attending without help is totally different than now. I have no seniors, PD is only doing certain procedures I said above, and same way every time. I just want to draw a picture for what I potentially can do. Anyway, you're right, not skin to skin for me on those procedures yet. .
Thanks again

 

[Feli]

Yup, sorry for over saying that. I know being attending without help is totally different than now. I have no seniors, PD is only doing certain procedures I said above, and same way every time. I just want to draw a picture for what I potentially can do. Anyway, you're right, not skin to skin for me on those procedures yet. .
Thanks again

It's fine, you an say whatever you want. People don't actually know what they're comfortable with and like until after the training wheels come off (reason #451 why fellowships are dumb). Many grads from good programs end up not doing full scope, and some from low end programs try to do everything. You don't know until you know.

Either way, do what you want for now. See how you feel in a year.

I'd think working with your residency director is the worst option by a mile. You obviously view him as your leader and your everything (why wouldn't a pgy1?), but try a different take from someone more removed from the situ. The $ wouldn't be good, you will already know everything he can teach if you are at a brand new program with no seniors, you said the program's new and mediocre (hint: it will be BAD once it has full pgy1, pgy2, and pgy3 filled once new pod schools are graduating ppl!), and there's no major desire on your part to teach (I'd assume because all other options you mention are non-acad). There is no reason to be his worker bee for 3 years and then do more years voluntarily; learn what you can and move along.

Starting solo (from scratch or buyout) will make by far the most $, lets you control your time, and is likely your best option unless you don't think you're ready in terms of office/billing/savings exp (so work at a good PP to get some $ and some insight on how to run an office)... but again, you'll need to eval in a year or so. You'd probably be well suited to it if you've had real jobs before and have good sales/customer skill set.

...The best podiatry options - for any DPM - fresh out of residency are almost always going solo or working for busy hospital/MSG/group to get your ABFAS numbers... then staying there or going solo, depending on personal preference. Working for other pods (or doing a fellowship nowadays... and then working for other pods anyways) is almost always the less optimal but much more common route.

As in anything you ask about, people will tend to recommend for you what they happen to have... "solo lets you have the best income," "hospital jobs are the way to do real surgery," "academic is the highest calling," "VA jobs are great since that's what I do," "my place treats associates well and has good refers," "nursing homes let you have a lot of days off," etc. The real answer is that what's best for you is best for you.

 

[icebreaker32]

You are ahead of most right now....no debt and your wife has a good job. You are in a better situation than most to open an office now or later.

Honestly the thee most common ways I know where the majority ended up being successful are below.

1. Work as an associate for 2-3 years then open up you own office. Most took their first job close to their residency and also opened their office near their residency. If you really do not want to live in the area do not stay after residency.....you might end up there forever.

2. Chasing the organizational job. It helps to be geographically open. You need to "build" your CV. Get numbers for ABFAS, do a fellowship etc. I know many whom it took a few years of experience to get their first organizational job and then in some cases their second organizational job if they continued to search for another organizational job was to closer to their hometown or desired geographical area. Getting closer to where they wanted to live did not always happen and when it did it might have been 10 years after residency.

3. This only applies to some. Being from a non saturated state or area and wanting to return to that area. Most in this category still did a much better than average residency often in the same state or an adjacent one and networked. Maybe they did not end up in the exact city they wanted to, but it is surprising just how many ended up within two or three hours from their desired location at an organizational job or decent podiatry group with partnership potential immediately after residency.

The first thing you and your wife need to decide is if you are open to living where you are at now, if you want to live in one certain area or are very open geographically. You have an advantage with no debt and a spouse that can find a good job also to move to where you want to live and open an office either immediately or after a couple years of experience . I will always warn others that running a small business is not for everyone and not without risk. Many that did not really want to be a small business owner have done so anyways in this profession because the risk is greater to remain an associate. Not just the risk of lower income as an associate which is usually true, but also control over how you practice and longterm job stability.

Your PD probably wants an associate to help out with the residency and his office, but he will also have an endless supply of other residents to take an associate job so your longterm prospect to be a partner or negotiate a better deal are probably slim.

 

[Feeter]

Open up your own if you know where you want to be in long term and are not geographically open. Since you don't have loans and your wife also works you can take that risk. Learning all about private practice seems to be tough and never ending process. I am not in PP though. Hospital jobs are great but you may have to move if you don't fit in, don't like the town, don't like your management or your pay is reduced etc.

 

[newfeet]

Hello Everyone. I hope everyone is doing well. I would like to hear your advice about my situation. I'm currently in residency, I have 2 more years but I just want to prepare myself because my PD has been asking me about my plan. I have few options potentially such as:
1. Stay with my PD after graduation, of course not earning good salary ( I haven't asked but everyone here can tell! ). This option looks safe, he will look after me and I may get certified sooner ( at least it is what I think ). My wife has a good job here. We have no family or friends in this area
2. Go solo myself and open private practice in different state ( I'm East Coast now, want to go back West where my family's there ). One of private podiatrist who's bringing cases to hospital is new start-up too, I'm keeping good connection with her
3. Buy a practice from another podiatrist in West Coast.
4. Work for another podiatrist in West Coast first. I don't like this option. I'd rather work for my PD than someone else
P.S : I'm in a average program, not doing crazy things. I know what I'm confident to do in the future are Forefoot surgeries, Haglund Speedbridge, ATFL repair, simple OCD and simple ankle scope, simple trauma injuries. I have saved some money before school, no student loans! I have active CCS,CDIP and RHIA because I was a consultant before.
And I'm a little bit older than average residents!
Once again, thanks everyone for reading. I wish I knew this forum earlier. I have gone too far now....

It will depend on your wife. If she wants to stay take the job with the PD. If not go west. Living in place with no friends and family succcccccckkkkkkks. I wish my PD made an offer I would have taken it on the spot because I did residency in my home state. I left and it has been a struggle to adjust ever since. But for you I would say really consider what your life is like if you dont head to an area where you or your wife has family.

 

[Shiyuan]

It will depend on your wife. If she wants to stay take the job with the PD. If not go west. Living in place with no friends and family succcccccckkkkkkks. I wish my PD made an offer I would have taken in it on the spot because I did residency in my home state. I left and it has been a struggle to adjust ever since. But for you I would say real consider what your life is like if you dont head to an area where you or your wife has family.

100% this.

 

[FutureDPM323]

It will depend on your wife. If she wants to stay take the job with the PD. If not go west. Living in place with no friends and family succcccccckkkkkkks. I wish my PD made an offer I would have taken it on the spot because I did residency in my home state. I left and it has been a struggle to adjust ever since. But for you I would say really consider what your life is like if you dont head to an area where you or your wife has family.

This. Currently doing residency in a state away from family and friends and it sucks big time. Doing everything I can to try and go back home post residency.

 

[air bud]

This. Currently doing residency in a state away from family and friends and it sucks big time. Doing everything I can to try and go back home post residency.

Right. But also if that doesn't happen you go where the most money is, rent and write things out in pencil.

Also, tons of MDs/DOs go to locations away from friends and family. This is just the way medicine is. As a podiatrist with even more limited job opportunities, the likelihood of this is higher. I think a significant problem with oversaturation is due to the lack of employed opportunities. When they can't find an employed job someplace they just default to go home.

Obviously as someone who has chosen to take rural jobs I am biased, although I have certainly had challenges with not having family close by. But I have very little sympathy for a new grad who was born and raised in NYC went to NYCPM, did a NY residency then is taking a garbage offer there because of " family obligations" and then set their careers off on a terrible foot with limited income potential. Not everyone gets to write the perfect story. Hell there are entire cultures built on the premise of going someplace away from friends and family for years at a time to provide for a better life for themselves and family.

I know there is more to life than your job, but it's not always sunshine and roses. You are a podiatrist. You don't get to dictate your circumstances as an over arching theme here ...you signed away that right when you decided to go to podiatry school.

 

[Feli]

Right. But also if that doesn't happen you go where the most money is, rent and write things out in pencil.

Also, tons of MDs/DOs go to locations away from friends and family. This is just the way medicine is. As a podiatrist with even more limited job opportunities, the likelihood of this is higher. I think a significant problem with oversaturation is due to the lack of employed opportunities. When they can't find an employed job someplace they just default to go home.

Concur.... a lot depends how good you are at making new friends, social support, activities, meeting ppl, etc.

There are always people to lift weights with, hang out with, BS with, date, party with, go see a show with almost anywhere. Sure, there are fewer events and dining and entertainment options rural, but even in IHS isolation (and during COVID), I threw some parties and we had some fun times. It is definitely not impossible if you you're outgoing and have some imagination.

This is nothing unique to podiatry... computer science ppl, engineers, tradesmen, sales ppl, etc go around the country or the world to get good work.

lf you are in podiatry and married to a certain city/county, that can end up very rough (assuming your dad doesn't run a booming PP there). We don't have the job options MDs do... that's for sure.

 

[Boba Foot]

This. Currently doing residency in a state away from family and friends and it sucks big time. Doing everything I can to try and go back home post residency.

You don't have to live somewhere you don't want to live just to take a job. It might not be the absolute best job with the highest income, and there might be some things you have to settle on, but if you look hard enough you can probably find a decent job where you want to live. Except for maybe in NYC. To me, quality of life and location is just as important as income so I am OK with doing PP in an area I want to live in.

 

[FutureDPM323]

Right. But also if that doesn't happen you go where the most money is, rent and write things out in pencil.

Also, tons of MDs/DOs go to locations away from friends and family. This is just the way medicine is. As a podiatrist with even more limited job opportunities, the likelihood of this is higher. I think a significant problem with oversaturation is due to the lack of employed opportunities. When they can't find an employed job someplace they just default to go home.

Obviously as someone who has chosen to take rural jobs I am biased, although I have certainly had challenges with not having family close by. But I have very little sympathy for a new grad who was born and raised in NYC went to NYCPM, did a NY residency then is taking a garbage offer there because of " family obligations" and then set their careers off on a terrible foot with limited income potential. Not everyone gets to write the perfect story. Hell there are entire cultures built on the premise of going someplace away from friends and family for years at a time to provide for a better life for themselves and family.

I know there is more to life than your job, but it's not always sunshine and roses. You are a podiatrist. You don't get to dictate your circumstances as an over arching theme here ...you signed away that right when you decided to go to podiatry school.

Well I did move across the country for residency in order to get the best training possible at a program that I (and I think many on here would agree) felt would set me up for success afterwards

But what I’m slowly realizing is that none of that matters especially in this profession. You could have graduated a top residency yet your job prospects are just the same as the person who didn’t. Yes sure I’ll have better training but will I get to even use it? TBD.

Either way my goal is to move back home to my family and friends at the end of residency. I have no problems making friends out here but it’s not the same. Unfortunately podiatry will make that even more difficult given the job market especially in the area I want to move to.

Im happy you’re able to live rurally and it’s worked out for you but that’s not for everyone.

 

[FutureDPM323]

You don't have to live somewhere you don't want to live just to take a job. It might not be the absolute best job with the highest income, and there might be some things you have to settle on, but if you look hard enough you can probably find a decent job where you want to live. Except for maybe in NYC. To me, quality of life and location is just as important as income so I am OK with doing PP in an area I want to live in.

Luckily it’s NOT NYC and I’d honestly quit podiatry if that’s where I had to practice lol

But yes I agree with you 100%. For me quality of life and location is just as important if not more important than income.

And I tried to branch out and give it a go being away from home. I used residency as an opportunity to move away and see if I like it but it’s not for me 😅

 

[p100]

Well I did move across the country for residency in order to get the best training possible at a program that I (and I think many on here would agree) felt would set me up for success afterwards

But what I’m slowly realizing is that none of that matters especially in this profession. You could have graduated a top residency yet your job prospects are just the same as the person who didn’t. Yes sure I’ll have better training but will I get to even use it? TBD.

Either way my goal is to move back home to my family and friends at the end of residency. I have no problems making friends out here but it’s not the same. Unfortunately podiatry will make that even more difficult given the job market especially in the area I want to move to.

Im happy you’re able to live rurally and it’s worked out for you but that’s not for everyone.

You do have better job opportunities due to your good training. Call every hospital and multispecialty group in an X mile radius and tell them why they need you. Maybe even a "Oh wow you don't have podiatry?!" Most people don't really know what they are doing and follow regulations or confident sounding people. Be a confident person and tell them how beneficial podiatry is to their bottom line. You never know what will happen.

This year in Corpus Christi, TX a teenager obtained a hospital badge and pretended to be a Physician Assistant for 1 month. If a random teenager can be a PA with nothing but confidence you can be a doctor that people want to hire.

 

[Feli]

... Call every hospital and multispecialty group in an X mile radius and tell them why they need you. Maybe even a "Oh wow you don't have podiatry?!" Most people don't really know what they are doing and follow regulations or confident sounding people. Be a confident person and tell them how beneficial podiatry is to their bottom line. You never know what will happen...

This is fine and good advice, but isn't it sad that DPMs almost have to do this to "create" jobs and talk about cold calling as our norm?

What will the future hold for podiatry... once more and more community hospitals and MSGs and VAs are convinced they need a DPM and have hired one? Where do the jobs come from then... just go more and more rural? Work for lower pay?

...I just can't think of another legit medical specialty profession that does this. Sure, some do networking, but it's typically not the first option or only job option... "What, you don't have cardiology??? You should hire me." "Have you thought of hiring a pediatric dentist into your multi-specialty group?" "Are you in the market for an orthopaedics doc by any chance? I already have my state license."

 

[Pronation]

This is fine and good advice, but isn't it sad that DPMs almost have to do this to "create" jobs and talk about cold calling as our norm?

What will the future hold for podiatry... once more and more community hospitals and MSGs and VAs are convinced they need a DPM and have hired one? Where do the jobs come from then... just go more and more rural? Work for lower pay?

...I just can't think of another legit medical specialty profession that does this. Sure, some do networking, but it's typically not the first option or only job option... "What, you don't have cardiology??? You should hire me." "Have you thought of hiring a pediatric dentist into your multi-specialty group?" "Are you in the market for an orthopaedics doc by any chance? I already have my state license."

Exactly. What a joke. I can only imagine an admin chuckling as they crumple up your CV and toss a 3 pointer across the room into the trash bin

 

[air bud]

You do have better job opportunities due to your good training. Call every hospital and multispecialty group in an X mile radius and tell them why they need you. Maybe even a "Oh wow you don't have podiatry?!" Most people don't really know what they are doing and follow regulations or confident sounding people. Be a confident person and tell them how beneficial podiatry is to their bottom line. You never know what will happen.

This year in Corpus Christi, TX a teenager obtained a hospital badge and pretended to be a Physician Assistant for 1 month. If a random teenager can be a PA with nothing but confidence you can be a doctor that people want to hire.

You do have better job opportunities due to your good training. Call every hospital and multispecialty group in an X mile radius and tell them why they need you. Maybe even a "Oh wow you don't have podiatry?!" Most people don't really know what they are doing and follow regulations or confident sounding people. Be a confident person and tell them how beneficial podiatry is to their bottom line. You never know what will happen.

This year in Corpus Christi, TX a teenager obtained a hospital badge and pretended to be a Physician Assistant for 1 month. If a random teenager can be a PA with nothing but confidence you can be a doctor that people want to hire.

And guess what. Chances are high you can find a job in a location you like but they want to limit what you do and that advanced training doesn't matter. Because..... Podiatry.

It's all stupid. It's just a crapshoot. Y'all are idiots for becoming podiatrists.

 

[newfeet]

And guess what. Chances are high you can find a job in a location you like but they want to limit what you do and that advanced training doesn't matter. Because..... Podiatry.

It's all stupid. It's just a crapshoot. Y'all are idiots for becoming podiatrists.

 

[HardRoadPaved]

View attachment 373046

But the school gave me a 5k scholarship after scoring a 483 on my MCAT!