ABPM Credential/Privileging

[DPMFoot]

Has anyone experienced challenges with hospital credentialing/privileging with ABPM certification? If so, does reaching out to the board and furthering the process with mediation help? Has it been successful?

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[HardRoadPaved]

This is by in large based on hosptial bylaws. Ask for a copy when talking to hosptial credentialing. If you have any issues you can get assistance from ABPM.

 

[DPMFoot]

Thank you! I'll ask for a copy once I start working.

 

[Pronation]

This is by in large based on hosptial bylaws. Ask for a copy when talking to hosptial credentialing. If you have any issues you can get assistance from ABPM.

Agreed. ABPM seems to fights hard (and seems to win) for privileges for those that are unable to obtain a surgical board cert from ABFAS and need an alternative board certification.

 

[diabeticfootdr]

Thank you! I'll ask for a copy once I start working.

You’re entitled to a copy if you’re even considering applying. Ask the medical staff office for the medical staff bylaws and delineation of privileges (DOP) form.

 

[newfeet]

Has anyone experienced challenges with hospital credentialing/privileging with ABPM certification? If so, does reaching out to the board and furthering the process with mediation help? Has it been successful?

I am only ABPM. Every hospital I've applied for has accepted ABPM as my boards. My current hospital list ABPM and ACFAS as acceptable boards in the bylaws. So you should ask for your bylaws.

 

[Shiyuan]

I am only ABPM. Every hospital I've applied for has accepted ABPM as my boards. My current hospital list ABPM and ACFAS as acceptable boards in the bylaws. So you should ask for your bylaws.

Samesies.

 

[Feeter]

My previous job and current ones accept ABPM or equivalent. Have full privileges but only do general podiatry and limb salvage cases including ex fix and in fix for Charcot's. I don't do trauma and TAR and flatfeet recon etc. Haven't had a y issues with certification. Rather had issues creating a DOP that worked for everyone that worked in podiatry and including Ortho. Every hospital seems to have their version of how you get privileges and can be one of the most stressful thing even if you are ABFAS certified.

 

[air bud]

When I had by laws changed at my previous hospital, I had ABFAS put in as it requirement along with a case requirement of maybe 25 RRA cases in the last two years....granted I was the only Podiatrist there (and within 150 miles....).

 

[DPMFoot]

I checked. My contract doesn't mention a specific board. However, the onboarding paperwork only mentions ABFAS 😐

 

[icebreaker32]

I checked. My contract doesn't mention a specific board. However, the onboarding paperwork only mentions ABFAS 😐

This is above my pay grade for anymore advice.

Best of luck.

 

[Shiyuan]

Contract trumps paperwork IMO.

 

[newfeet]

I checked. My contract doesn't mention a specific board. However, the onboarding paperwork only mentions ABFAS 😐

That is why you need to check the bylaws. But I would go with the contract over the paper work like @MusicManMike said.

 

[icebreaker32]

I agree the contract is legally binding and will likely stand on it's own. Do other communications come into play if there is pushback on privileges?

He still needs to see bylaws and DOP and see if he will have a battle for privileges or not. Hopefully not. If their bylaws say ABFAS only then how quickly will that move even it is something that can be won by ABPM.

Should he tell them about the situation or not and if so when? I have no idea.

Will they be cool and just say get ABFAS in 5 years or will they look for a way out? I have no idea, but hopefully they would be understanding temporarily as long as there are full privileges without too much drama. Most places don't want to start over if they have already selected someone.

If or when should an attorney look over contract? I have no idea.

The right first step seems to be getting the bylaws, DOP and contacting APBM. What to do after that becomes less clear. I am not giving advice on that part, because I don't want to give wrong advice.

 

[diabeticfootdr]

If or when should an attorney look over contract? I have no idea.

Before you sign it is ALWAYS the right answer.

 

[Feli]

Getting on staff and getting privileges you want are often two very different things.

ABPM qual/cert will probably get you on staff for consult/wound almost anywhere.

For operating room, it entirely depends on the facility. Some will be ok with ABPM and logs, some will want mainly just ABFAS, some ABFAS and logs, some will not even really, require either, and some won't give a DPM certain/any OR privileges no matter what. Some have flexibility and some do not.

As mentioned, ABPM essentially functions as an alternative board, and we all know that. That's how it has always been. Yes, theyre both APMA-recognized boards. Be that as it may, if we see a podiatrist CV with ABPM but no ABFAS, we know they almost invariably didn't pass ABFAS. It's ultimately up to each facility and dept head how they treat that, consider logs, etc.

The bottom line is to not limit oneself... BQ for ABFAS out of residency, cert ABPM. Drop ABPM later if you cert ABFAS, or keep both. Try to keep all avenues open. Nobody wants to be known as that tool who didn't meet the hospital criteria yet sued and forced their way in.. wont exactly be Mr. Popular in the cafeteria. Just pass the most appropriate boards you can, study and re-take if needed, have good logs, and stay free of any facility or state discipline regardless. 👍

 

[Pronation]

Nobody wants to be known as that tool who didn't meet the hospital criteria yet sued and forced their way in..

Yea that would be sad. Could you imagine if one of our great leaders did something like that??

 

[heybrother]

Getting on staff and getting privileges you want are often two very different things.

ABPM qual/cert will probably get you on staff for consult/wound almost anywhere.

For operating room, it entirely depends on the facility. Some will be ok with ABPM and logs, some will want mainly just ABFAS, some ABFAS and logs, some will not even really, require either, and some won't give a DPM certain/any OR privileges no matter what. Some have flexibility and some do not.

As mentioned, ABPM essentially functions as an alternative board, and we all know that. That's how it has always been. Yes, theyre both APMA-recognized boards. Be that as it may, if we see a podiatrist CV with ABPM but no ABFAS, we know they almost invariably didn't pass ABFAS. It's ultimately up to each facility and dept head how they treat that, consider logs, etc.

The bottom line is to not limit oneself... BQ for ABFAS out of residency, cert ABPM. Drop ABPM later if you cert ABFAS, or keep both. Try to keep all avenues open. Nobody wants to be known as that tool who didn't meet the hospital criteria yet sued and forced their way in.. wont exactly be Mr. Popular in the cafeteria. Just pass the most appropriate boards you can, study and re-take if needed, have good logs, and stay free of any facility or state discipline regardless. 👍

In general most people don't talk about their failures on here but I'm just going to say this - its f&*ing hard to stomach the idea of taking these tests again after you fail them. I'm a pretty damn good test taker. Great MCAT. Great grades. Got an award for being #1 in a class. Destroyed most of my in-service stuff like - got perfect scores a plural number of times. Passed ABFAS qual didactic/CBPS first try - apparently a fluke. Bought Board Wizards. Did like like 99% of the practice CBPS cases - hilariously had only done like 5-10 CBPS cases when I passed part 1. Reread a bunch of stuff just in case. When I walked out of the boards I called my wife and told her I was pretty sure I'd never have to take another test at a facility again. Failed BOTH new CBPS Foot and Rearfoot. I didn't think either was challenging or hard. There was the usual poorly executed classic podiatry stupid on it but it was minimal and I never ran out of PE, always found the diagnosis/findings, found all the "hidden" diagnoses that you need an MRI or a CT for even though the x-ray looks clearly normal. On all the cases where they show you what you should have done - I had picked that as my answer.

This idea of taking another 2 days off work (seriously, it easily could fit in 1 day) and giving these douchebags another $1000+ dollars is just unreal. The real issue - I don't believe I was wrong. We talk about these tests as if they have virtue - as if in some way they test your actual knowledge or something meaningful about how you act or what you know. The simple truth of everything in podiatry from school to now is the right answer is always just whatever the test writer believes or wants to ask and nothing more. This is not a profession of analytical people. When I passed didactic the first time around the thought that kept crossing my mind was - that test had no resemblance to anything I'd ever studied or read. When I passed the first time I flattered myself - you are smart or capable. No. I just guessed what some idiot podiatrist was thinking for that moment in time. The next moment they will think something different.

 

[bloxxeeey]

In general most people don't talk about their failures on here but I'm just going to say this - its f&*ing hard to stomach the idea of taking these tests again after you fail them. I'm a pretty damn good test taker. Great MCAT. Great grades. Got an award for being #1 in a class. Destroyed most of my in-service stuff like - got perfect scores a plural number of times. Passed ABFAS qual didactic/CBPS first try - apparently a fluke. Bought Board Wizards. Did like like 99% of the practice CBPS cases - hilariously had only done like 5-10 CBPS cases when I passed part 1. Reread a bunch of stuff just in case. When I walked out of the boards I called my wife and told her I was pretty sure I'd never have to take another test at a facility again. Failed BOTH new CBPS Foot and Rearfoot. I didn't think either was challenging or hard. There was the usual poorly executed classic podiatry stupid on it but it was minimal and I never ran out of PE, always found the diagnosis/findings, found all the "hidden" diagnoses that you need an MRI or a CT for even though the x-ray looks clearly normal. On all the cases where they show you what you should have done - I had picked that as my answer.

This idea of taking another 2 days off work (seriously, it easily could fit in 1 day) and giving these douchebags another $1000+ dollars is just unreal. The real issue - I don't believe I was wrong. We talk about these tests as if they have virtue - as if in some way they test your actual knowledge or something meaningful about how you act or what you know. The simple truth of everything in podiatry from school to now is the right answer is always just whatever the test writer believes or wants to ask and nothing more. This is not a profession of analytical people. When I passed didactic the first time around the thought that kept crossing my mind was - that test had no resemblance to anything I'd ever studied or read. When I passed the first time I flattered myself - you are smart or capable. No. I just guessed what some idiot podiatrist was thinking for that moment in time. The next moment they will think something different.

1000+ dollars is insane maybe if we double podiatry admissions they can cut it down to 750 dollars and still increase profits?

 

[Adam Smasher]

I remember 2-3 years back a CBPS patient who was a 30-something male with some problem in his foot but also complaining of back and knee pain. In the real world, how many of our patients have back and knee pain? Like half of them? But no, I figure this is a test and they're trying to f me over somehow. So I check the lab panel and all the rheumatoid arthritis labs (RF, ANA, etc) that don't normally appear were there. Sure enough, pt had RA.

Just like in real life, right folks?

 

[icebreaker32]

The simple truth of everything in podiatry from school to now is the right answer is always just whatever the test writer believes or wants to ask and nothing more.

Definitely true. Spend a reasonable amount of time on material, but never fail to study for the test itself.

You need to practice sample questions and know certain labs, imaging some of which you may seldom use in clinical practice. The format is always changing on if you get penalized for ordering too many tests or not etc. You need to know that. You need to do a bit more than nail diagnosis and treatment. You can lose lots of points on workup of patients also.

ABFAS is one of the first tests that sometimes trips up smart people (but they barely fail most often when they fail). You have to go in looking at it like I would probably win a best out of 3 series and hope you had a good day, and hopefully have another year left just incase. The weaker students (you are obviously not one of them) usually get destroyed unless they log some serious study time (both material and studying for test format).

ABFAS is no longer the badge of honor it used to be. More are getting it and ABPM is enough for many. Most should get board certification, it has been that way for most specialties for a long time (but was not always that way decades and decades ago). With ABPM we can say most are getting board certified between the two. Does passing this test directly make you a better podiatrist...no. If ABFAS was the only path to board certification we would have to make it easier or raise admission standards or boards might be as large as a problem as saturation.

 

[deleted1138023]

In general most people don't talk about their failures on here but I'm just going to say this - its f&*ing hard to stomach the idea of taking these tests again after you fail them. I'm a pretty damn good test taker. Great MCAT. Great grades. Got an award for being #1 in a class. Destroyed most of my in-service stuff like - got perfect scores a plural number of times. Passed ABFAS qual didactic/CBPS first try - apparently a fluke. Bought Board Wizards. Did like like 99% of the practice CBPS cases - hilariously had only done like 5-10 CBPS cases when I passed part 1. Reread a bunch of stuff just in case. When I walked out of the boards I called my wife and told her I was pretty sure I'd never have to take another test at a facility again. Failed BOTH new CBPS Foot and Rearfoot. I didn't think either was challenging or hard. There was the usual poorly executed classic podiatry stupid on it but it was minimal and I never ran out of PE, always found the diagnosis/findings, found all the "hidden" diagnoses that you need an MRI or a CT for even though the x-ray looks clearly normal. On all the cases where they show you what you should have done - I had picked that as my answer.

This idea of taking another 2 days off work (seriously, it easily could fit in 1 day) and giving these douchebags another $1000+ dollars is just unreal. The real issue - I don't believe I was wrong. We talk about these tests as if they have virtue - as if in some way they test your actual knowledge or something meaningful about how you act or what you know. The simple truth of everything in podiatry from school to now is the right answer is always just whatever the test writer believes or wants to ask and nothing more. This is not a profession of analytical people. When I passed didactic the first time around the thought that kept crossing my mind was - that test had no resemblance to anything I'd ever studied or read. When I passed the first time I flattered myself - you are smart or capable. No. I just guessed what some idiot podiatrist was thinking for that moment in time. The next moment they will think something different.

Sticky this post @DexterMorganSK

 

[Sweatshirt]

We need an entire shift in the narrative. Honestly at this point for me, if I see people willingly continue to go for ABFAS after residency (they force you to go for it in residency), I think lesser of you. Continuing to throw thousands and thousands of dollars at this terrible board shows you have some screws loose in your head and I question you as a practitioner, your medical decision making, and I feel sorry for your future patients

 

[Pronation]

If ABPM is used as a certifying board for surgical privileges, should there be a case review process similar to other surgical boards outside of podiatry? Should hospitals be aware of the differences between ABPM and ABFAS?

 

[Feli]

... ABFAS is one of the first tests that sometimes trips up smart people (but they barely fail most often when they fail). You have to go in looking at it like I would probably win a best out of 3 series and hope you had a good day, and hopefully have another year left just incase. The weaker students (you are obviously not one of them) usually get destroyed unless they log some serious study time ....

Yep, I forget who said it in another thread, but ABFAS exams are the first real gatekeeper most DPMs encounter. Absolutely.

The student/national boards pt1 is an uber weak one that most students pass without sweating. There are usually those one or two hard classes at each pod school that can bust up a 4.0gpa or even fail someone. Those are the 5% of professors who actually care that the students know the material and are set for board prep. They're generally not too popular with students - or school admins who want to keep class sizes plump. Other than that, pod school is mostly easy in, reasonably easy graduation.

MDs have been facing gatekeepers in the form of MCAT, almost every class, USMLE (scored... imagine if NBPME was!) , specialty board, etc.

It is always about studying for the tests... for any test. ABFAS didactic is pretty straightforward, CBPS cases is academic but also knowing the choice lists. Cases review cert is rough since it's basically having the documentation...and ability to recover/produce it all.

 

[Weirdy]

It is always about studying for the tests... for any test. ABFAS didactic is pretty straightforward, CBPS cases is academic but also knowing the choice lists. Cases review cert is rough since it's basically having the documentation...and ability to recover/produce it all.

I've seen some extremely bright and well prepared individuals still fail the latest one.

When do pass rates release?

 

[icebreaker32]

Yep, I forget who said it in another thread, but ABFAS exams are the first real gatekeeper most DPMs encounter. Absolutely.

The student/national boards pt1 is an uber weak one that most students pass without sweating. There are usually those one or two hard classes at each pod school that can bust up a 4.0gpa or even fail someone. Those are the 5% of professors who actually care that the students know the material and are set for board prep. They're generally not too popular with students - or school admins who want to keep class sizes plump. Other than that, pod school is mostly easy in, fairly easy graduation.

MDs have been facing gatekeepers in the form of MCAT, almost every class, USMLE (scored... imagine if NBPME was!) , specialty board, etc.

It is always about studying for the tests... for any test. ABFAS didactic is pretty straightforward, CBPS cases is academic but also knowing the choice lists. Cases review cert is rough since it's basically having the documentation...and ability to recover/produce it all.

I think USMLE is now pass/fail

 

[Feli]

I think USMLE is now pass/fail

Yes... Part 1 changed to pass/fail for the first time last summer after being scored for decades and decades. That was always basically the day MD students found out what residencies might be open/closed to them... pre class of 2024.

Either way, usmle pt1 is still a very tough test and a formidable gatekeeper regardless of scored or pass/fail. Thats why AOFAS, AAOS, etc keeps baiting podiatry with it. Their residencies might use GPA, school, references, step 2 score, interview, etc more now.

I've seen some extremely bright and well prepared individuals still fail the latest one.

When do pass rates release?

It says 6-8wks, and it was roughly that last year.

I'm sure BQ didactic and CBPS could be flipped in a week, but maybe they curve a bit or toss misunderstood questions.

Cases BC is obviously much more manual review and subjectivity. They really need to bring back f2f.

 

[Poddy2Hotty]

We need an entire shift in the narrative. Honestly at this point for me, if I see people willingly continue to go for ABFAS after residency (they force you to go for it in residency), I think lesser of you. Continuing to throw thousands and thousands of dollars at this terrible board shows you have some screws loose in your head and I question you as a practitioner, your medical decision making, and I feel sorry for your future patients

lol someone salty

 

[DPM TRUTH]

As a old man in the profession for 35+ yrs I had to Google salty because i didnt know what it meant.

What does salty mean? Salty is a slang term for irritated, angry, or resentful, especially as a result of losing or being slighted.

I had to then reply, because after 35+ years in this profession....that term describes 1 thing I have seen consistently with the acfas/abfas crowd. How you ask?.....come to Chicago evey September to AOFAS. That's the MD foot and ankle conference.

The dpms in the crowd sure seem "salty" that not 1 dpm is presenting there EVER. Wonder why? I thought the abfas/acfas was the "respected board"? Noone (having a ortho MD foot and ankle wife) at AOFAS knows or cares about podiatry boards. I get it though, they will say they didn't go to medical school and cant go to AOFAS...right?

 

[deleted1138023]

I've seen some extremely bright and well prepared individuals still fail the latest one.

Because it’s a scam

 

[619]

Getting on staff and getting privileges you want are often two very different things.

ABPM qual/cert will probably get you on staff for consult/wound almost anywhere.

For operating room, it entirely depends on the facility. Some will be ok with ABPM and logs, some will want mainly just ABFAS, some ABFAS and logs, some will not even really, require either, and some won't give a DPM certain/any OR privileges no matter what. Some have flexibility and some do not.

I think you are fear-mongering. I know you are 100% pro ABFAS but can you name the facility that won't give a DPM "any OR privileges no matter what".

I think it's far fetched.

Maybe the DPMs in such facility willingly choose not to do surgery. Nothing wrong with that. I am a pro-clinic guy and don't really care much about OR surgery.

 

[Feli]

I think you are fear-mongering. I know you are 100% pro ABFAS but can you name the facility that won't give a DPM "any OR privileges no matter what"...

It's not really a quote when you change the content, but no matter...

Yes, there are tons. Hundreds of places that won't give DPMs what they're trained for or full scope or says no ankles or whatever. Some dont let DPMs operate at all. It can be due to state scope or Ortho or whatever. Most are univ hospitals; others are not. A lot are southern, but it happens everywhere.

And can DPMs sue or push their way in? Maybe... and they'll miraculously find they get few or zero bone/joint refers (maybe only the worst diabetes pt fx or deformities) or they can't ever get OR time or get amazingly little support. Quite a few places have politics that still want DPMs doing wounds and nails or forefoot or just diabetic stuff and that's about it... and quite a few DPMs take those jobs.

 

[Boba Foot]

It is always about studying for the tests... for any test. ABFAS didactic is pretty straightforward, CBPS cases is academic but also knowing the choice lists. Cases review cert is rough since it's basically having the documentation...and ability to recover/produce it all.

The didactic exam still has zero to do with surgical skill and quality of outcomes, the CBPS is pure garbage, and you’re admitting that the case review is 80% about superfluous documentation and x-rays which still arguably only marginally displays surgical skill and barely outcomes.

You post so much quality stuff on here, I don’t understand why you’re such a homer for such a flawed board.

 

[DexterMorganSK]

Sticky this post @DexterMorganSK

It's a great post from heybrother but unfortunately, I can't sticky a single post. We don't have that option. I can sticky this thread as we get more replies.

 

[Sweatshirt]

lol someone salty

View attachment 369394

Salty ABFAS has failed podiatry, yes very much so. Just as everyone should be

 

[icebreaker32]

Salty ABFAS has failed podiatry, yes very much so. Just as everyone should be

There was a period when ABFAS helped many get surgical privileges at hospitals when it was difficult to do so. Now many do most of their cases at an ASC.

Now that residencies are standardized you would expect a higher pass rate than what it is. What is the solution? Make the test better or make it easier? What is the cause is it poor students or poor residencies? Should we see if there is a correlation to a low MCAT or ACT/SAT of those that have failed (not sure we even could)? Should we put residencies with low pass rates on probation? What about cases? Collecting materials sucks but ortho requires cases. Do they have easier requirements? Is it we complain more or are we victims of associate jobs and hospitals medical records not being as helpful for podiatry as ortho? I am not giving ABFAS a free pass. I think an honest look is needed at why we don’t have at least an 85 percent initial pass rate.

ABPM is now often enough most places with the standardized residencies. You have to accept it is not a surgical board, but if it is enough who cares?

Do you know there was a period of many years where non PMSR 3 year trained residents (highly competitive at the time) could not get ABPM despite the CPME asking them to help? Those that did not get ABFAS for one reason or another had no alternative options. I know some doing fine that are on staff at hospitals, but might have problems if they ever moved (doubt they will) and others only at surgery centers because of this. The truth is one can do a lot better now most places with a standardized residency and ABPM than in the past.

I doubt we we would be complaining as much about boards if there were non surgical jobs open everywhere for 200K and 300K surgical jobs open everywhere.

As someone else said most of us complain on here too much, myself included. This is partially the nature of the internet. Most sacrifice more after residency than we should have to to make it, but most end up doing well. Yes podiatry does, no doubt, ruin a few people’s lives also and this is nothing to take lightly. Most of us doing well on here don’t take this lightly and get called complainers because we admit this,

One can do extremely well in podiatry, but there are definitely safer career choices as far as ROI and a much better job market. That is just the nature of our profession…..most do well eventually and some do not. Podiatry is saturated.

 

[MicroPod]

At one of the main hospitals we take call at in my residency, the ED has a paper printed out and posted in several areas with an illustrated human body that delineates who to consult for different parts of the body. Can anyone guess where they draw the line for podiatry consults?

Hint: hospital has an ortho F&A that hates podiatry

 

[Pronation]

At one of the main hospitals we take call at in my residency, the ED has a paper printed out and posted in several areas with an illustrated human body that delineates who to consult for different parts of the body. Can anyone guess where they draw the line for podiatry consults?

Hint: hospital has an ortho F&A that hates podiatry

Haha I love it. Is the line generously drawn at the MTP level or do they have a printout of my avatar with the line drawn at the IP joint level?

 

[icebreaker32]

Haha I love it. Is the line generously drawn at the MTP level or do they have a printout of my avatar with the line drawn at the IP joint level?

Toenail replacement surgery only, definitely distal to IPJ. Most practical fellowship ever.

Unless call is paid for podiatry, then who wants it anyways unless a residency?

 

[Pronation]

Unless call is paid for podiatry, then who wants it anyways unless a residency?

You already know the answer. Desperation and thirst. Saturation. Prosperity. Shrinking.

 

[dtrack22]

Collecting materials sucks but ortho requires cases.

They operate over the entire body and require half as many cases

Do they have easier requirements?

Yes. They only log for 6 months, they only have 12 cases to upload, the actual case documentation requirements are less onerous, annnnd they get to go over their cases with the reviewer(s) in person.

Is it we complain more or are we victims of associate jobs and hospitals medical records not being as helpful for podiatry as ortho?

It’s not associate jobs or victim status, it’s a legitimately bad process.

This is so incredibly simple to fix but it will never happen. Watch…

We have one board, the ABPMS. We have a part I didactic exam, no CBPS because we have case review. Ortho doesn’t have a CBPS section. Just get rid of it. You have to stay at your first job prior to sitting for boards, but you only log for 6 months at the end of year 1 through the beginning of year 2. ABFAS homers can even keep their RRA superiority designation. I would get rid of it entirely but I’m willing to compromise. Let’s say RRA procedures CAN be (not “must” be) logged all year round. This helps the candidate have adequate number of RRA procedures for case selection. Everything else is only required for 6 months. No diversity requirements. 12 cases are pulled for everything, RRA included, and amputations are fair game. Why are we not testing/reviewing one of the most common categories of procedures that your average Podiometric Surgeon is actually performing on a regular basis? Case review is done in person.

There. I just came up with a solution that is perfectly fair and reasonable. I mostly copied ortho, so how could it not be? 5 minutes, that’s all the time it took. It’s a system that allows for nearly all podiatrists to get certified at the end of their second year in practice. It doesn’t penalize people who have wound/limb salvage heavy practices. Truly bad podiatrists would still fail so we “protected the public,” well we didn’t but the gatekeepers like to pretend that’s why we do all of this…why shouldn’t this be implemented tomorrow?

 

[DYK343]

Last hospital I was at required ABFAS for privileges. It could be challenged im sure but it was written in ABFAS qualified/certified

Current hospital I am at same thing though they did seem open to considering a candidate we wanted to hire with ABPM but "had to have a special meeting about it".

Subsequently that person "never took the job."

I have no idea what really happened. But I am curious if it was board cert issue. They were pretty concerned about it and called/asked me what the difference was. I kept my mouth fairly shut. I didnt bad mouth anyone. I just said theyre two different boards who have different certification paths.

They did ask me which board was considered superior and well... ABFAS.

 

[Feli]

...Now that residencies are standardized you would expect a higher pass rate than what it is...

We keep saying this, but does anyone actually believe this? I sure don't.

I mean, we all did clerkships, right?
We all talked to classmates, co-residents, etc about what they saw on rotations?
We all go to meetings and have colleagues and other local DPMs with wiiide variance in practice/competence?
And I'd assume we realize this isn't the norm in other medical specialties... 99% ENT do tonsils, 99% OB do c-sec, 99% ortho do femurs, etc.

I would maintain that the board pass results are almost directly correlated to the wide variance in residency qualities/volume.
There are a lot of DPM residencies out there that don't prepare grads (academically or reps/exp/practically) for many aspects of F&A surgery.
Those are also the programs that tend to match/scramble the lower DPM grads who had trouble in school, further compounding the issue.
Most of those need to be shut down, spots reduced, or combined with others to give full F&A surgery training/exp. But that's unlikely.

So, the residencies are standardized in length only... and now a fair amount of attendings/cases also pull out to "fellowship."

dtrack is100% that the boards process can improve, but the DPM post-grad training needs to be addressed and improved and truly standardized regardless. It was not long ago that only those who did surgical programs - almost always top half of their class - took ABPS (ABFAS). Now that "all programs are surgical" and "all programs are 3 year 'standardized' ," we have a bunch of issues with boards and pass rates. That's not coincidence.

 

[icebreaker32]

So the solution seems to be make process much easier and shut down half of the residencies. Has my vote.

 

[Weirdy]

I would maintain that the board pass results are almost directly correlated to the wide variance in residency qualities/volume.
There are a lot of DPM residencies out there that don't prepare grads (academically or reps/exp/practically) for many aspects of F&A surgery.

You're assuming too much.

There are residencies who prepare grads in both aspects- and those grads can still fail ABFAS boards due to how unreliable it is.

You can have grads from poor programs with little reps/exp/practicality/academics- and still have them beat ABFAS boards.

Taking the test means you beat the test. It has almost little to no correlation regarding program training and real life work.

 

[Winograd1717]

So the solution seems to be make process much easier and shut down half of the residencies. Has my vote.

I can tell you right now that a very large amount of residencies are closing a lot of their spots. The bad part of this, is that it is mostly decent/better programs. This will lead to people just scrambling into the NYC programs which literally (some programs have 3-4 open spots EVERY year) should not exist and lead to more unqualified pods

 

[icebreaker32]

I can tell you right now that a very large amount of residencies are closing a lot of their spots. The bad part of this, is that it is mostly decent/better programs. This will lead to people just scrambling into the NYC programs which literally (some programs have 3-4 open spots EVERY year) should not exist and lead to more unqualified pods

Why are they closing?

 

[Feli]

You're assuming too much.

There are residencies who prepare grads in both aspects- and those grads can still fail ABFAS boards due to how unreliable it is.

You can have grads from poor programs with little reps/exp/practicality/academics- and still have them beat ABFAS boards.

Taking the test means you beat the test. It has almost little to no correlation regarding program training and real life work.

I agree there are exceptions to every rule: good program grads who just don't test/study well or lesser programs' grads who study solo a ton and pass.

That exists in MD also, but they almost universally had the reps and board prep in residency to set them up for success. They are very seldom missing exp/volume in procedures common to their specialty

Podiatry doesn't have that uniformity or prep due to hasty expansion and creation and re-branding of residencies, but we do owe it to everyone who does "three year surgical residency"... that's all I was saying.

...I think a real opportunity was missed to settle on 2/3 grads do PPMR 1yr and 2/3 do PSR or whatever (basically dent model... based on no demand for 400-500+ "F&A surgeons" every year), but that's neither here nor there. We are to the point where not everyvDPM has to do big/any surgery, but we're saying they know and are competent for it. A whole lot of programs thus need improvement in volume, diversity, academics, etc.

 

[DYK343]

...I think a real opportunity was missed to settle on 2/3 grads do PPMR 1yr and 2/3 do PSR or whatever (basically dent model... based on no demand for 400-500+ "F&A surgeons" every year), but that's neither here nor there. We are to the point where not everyvDPM has to do big/any surgery, but we're saying they know and are competent for it. A whole lot of programs thus need improvement in volume, diversity, academics, etc.

I get 20+ patients a day trying to make appointments to "have my toenails clipped". I dont even live in an area thats under saturated. There are plenty of DPMs around who do nail care. There is still a lot of demand for DPMs just not really surgical DPMs (IMO).

If you want to run a 9-4 C&C practice as a DPM with no weekends, coach your kids teeball team, and have time to be the town mayor while making 200-300k a year those opportunities are readily available (once escaping the 1st-3rd year typical DPM associate job).

F&A surgery jobs are not readily available.

ABPM private practice "bunion once a month at surgery center" makes tons of sense.

ABFAS for heavy surgical oriented/trauma pods who need to be tested for competance/weeded out.

There is a reason most hospital/ortho want ABFAS. It is harder. A lot harder. They want to see that you can pass the exam.

Is the exam unfair at times and do dumb dumbs still get through? Sure. But its not a walk in the park and you do have to understand rheumatoid arthritis or how to manage an open fracture or how to identify a benign vs malignant tumor, etc.