I'm currently a third year pod student. After going through all of the didactic classwork and beginning hospital rotations, I'm having second thoughts about practicing podiatry. I think I may have gone into the profession for the wrong reasons and have stayed in school because of my stubborn nature/loans/hoping I would like things better with time. What options would I have with a DPM if I do not complete residency? I think pharmaceutical/medical device sales may be an option. Does anyone know a person who has been in this situation? Any advice? Thanks!
DPM options without residency
- Thread starter bunny25
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At this point in the history of the profession I would say your chances of practicing podiatry without a residency would be slim to none. In my podiatry school class there was another student who decided that podiatry was not for him. He completed his schooling and then reapplied and became a DO.
I saw a movie yesterday in which one of the characters asked, "When backed into a corner and there is no way out what should you do?" The response was, "go in deeper." Have you considered getting an M.D. or D.O. degree?
I saw a movie yesterday in which one of the characters asked, "When backed into a corner and there is no way out what should you do?" The response was, "go in deeper." Have you considered getting an M.D. or D.O. degree?
What makes Podiatry different from any other medical specialty though? and just out of curiousity why do you believe that podiatry is not for you? Is getting an MD or DO going to help? You'll probably wind up with more loans and a loss of time.
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practice in a state that does not require one
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That's good in theory but in practicality it would be unlikely to succeed. I think most hospitals and insurance companies nowadays require board certification or board qualification, which you cannot achieve without a Residency. The OP could go through with school, try to get a job clipping nails at a nursing home maybe, but if he or she is unfulfilled now then picture how bad it would be five or ten years out. If you are CERTAIN that podiatry is not for you, then I think it'd be better to cut your losses now and do something else.
By the way, you mentioned that you are having second thoughts now that you are "beginning hospital rotations." Keep in mind that private practice podiatry is not anything like hospital podiatry (or doesn't have to be). Do you know what it is specifically that is turning you away? Podiatry is one medical specialty that allows an awful lot of freedom in how you practice.
I recall sweating my head off in a few skanky VA wound care clinics thinking, "this sucks -- no really -- s-u-double-k-ucks" but my current practice couldn't be any more 180 degrees away from those days changing out rancid Unna boots on guys with maggots falling out of their dressings.
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I used to babysit for a guy who, after finishing med school at a top 10 program, decided he wanted to go to law school. He is now working as a patent lawyer in San Fran and is making the big bucks. A friend of my advisor also works in patent law and has his PhD in chem. He is making more than 6 figs a year (he is also very miserable....eek)
Pharm sales is a pretty lucrative career and your science background will definitely help you IF you can land a job. If I were an employer I would question your determination if you decided not to finish pod school/go onto residency. Everyone and their mother wants a job in pharm sales so good luck getting a job!
Pharm sales is a pretty lucrative career and your science background will definitely help you IF you can land a job. If I were an employer I would question your determination if you decided not to finish pod school/go onto residency. Everyone and their mother wants a job in pharm sales so good luck getting a job!
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my friend knows a guy who sells shoes after graduating from pod school..
I know of a guy too. He is doing pretty well selling shoes.
W
whiskers
2 years ago I would have given you much different advice like, cut your losses and run.
But the economy is very bad and there are lots of very skilled people unemployed right now or ones settling for low pay doing menial jobs due to downsizing.
My advice for you today is to continue on and do a residency since you need an income and more school at this point in your life is too costly.
That is the reality, you may not like what I have to say, but the unemployment lines are full and you have an almost guaranteed income/job waiting for 3 yrs when you graduate.
Will it be hard long hours? Yes, probably, but it will beat the alternatives.
I don't think you have many options available right now you are at a point in your life where your age and debt determine your options... It doesn't get any better as you search for jobs and realise that you will have to move to where the jobs are and that might be 3000 miles away from everything you have ever known.
Good luck.
But the economy is very bad and there are lots of very skilled people unemployed right now or ones settling for low pay doing menial jobs due to downsizing.
My advice for you today is to continue on and do a residency since you need an income and more school at this point in your life is too costly.
That is the reality, you may not like what I have to say, but the unemployment lines are full and you have an almost guaranteed income/job waiting for 3 yrs when you graduate.
Will it be hard long hours? Yes, probably, but it will beat the alternatives.
I don't think you have many options available right now you are at a point in your life where your age and debt determine your options... It doesn't get any better as you search for jobs and realise that you will have to move to where the jobs are and that might be 3000 miles away from everything you have ever known.
Good luck.
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"Almost guaranteed," emphasis on "almost." Health care is more insulated from economic downturn than many fields but it's not impervious. I'm hearing from many practices in town that numbers are down, as patients put off elective procedures and self-treat a bit longer. The hospital went from 40 cases per day to 10. Even the big ortho groups here are hurting (so I'm told). I don't know who would be hiring new docs right now.
Hopefully in 3 years all will be well again, so one may as well hide out safely in school as long as financing is available.
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My advice is to cut your losses and run.
I used to know a guy who started out as a chiropractor, then furniture store owner, who entered podiatry school while completing a law degree, became class valedictorian, landed a top notched surgical program, quit midway through, became a computer engineer during the dot.com era, quit again, and got into real estate before the whole mortgage housing crisis. I have no idea what he is up to nowadays.
I used to know a guy who started out as a chiropractor, then furniture store owner, who entered podiatry school while completing a law degree, became class valedictorian, landed a top notched surgical program, quit midway through, became a computer engineer during the dot.com era, quit again, and got into real estate before the whole mortgage housing crisis. I have no idea what he is up to nowadays.
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podmeister this is the sort of thing that happens to 1/100000 i mean come on this is like not common...dont be discouraged OP or whoever was advised to cut and run
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True, the case I stated is quite uncommon.
However, why continue down the same path if you are unhappy?
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i agree about being unhappy. Unhappy is one thing, being too picky and indecisive is another, you have to be mature and well informed before you make a life-changing decision. Or in this blokes case, many life-changing decisions.
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Medical students who come to the realization that patient contact is not their cup of tea may choose to move in the direction of radiology, pathology, research, or nuclear medicine, whereas podiatry students are left without such viable choices. If a podiatry student hates biomechanics and orthotics, hates wound care, hates surgery, or has such poor eye hand coordination, then he is totally screwed.
Again, cut your losses and run.
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i suppose you are right about if you hate the profession to leave and try something else, but honestly how do you get THIS far and then quit? I mean really the guy/gal onlyy has 1 year left right? just complete your residency and pay your loans off. You really want to be over 100K in debt and quit NOW be you don't wike it? don't make an incredibly poor economic decision.
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You may have hit a professional midlife crises - a little early I grant you ! After 18 years in Podiatry, I can think of few who have not felt the same way, at some time or another. Mostly, you get over it, in time. This will affect most professionals. Find something to pre-occupy yourself until the moment passes. Focus on a podiatry topic you really get a kick out of and feel passionate about. If that doesn't work, console yourself with a hobby. Podiatry is a wonderful profession. There is something for everyone. I enjoy surgery and I don't much care for the wound clinics either.
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Exactly...and I feel really really sorry for anyone in this difficult dilemma. I don't recall anyone dropping out of my class beyond the first year.
I'm not really sure about this but couldn't the OP get the DPM degree and teach at a Podiatric medical school or even get a dual degree such as DPM/MPH and something with that. Are you required to go through residency to teach?
Thank you for for your advice. I am now in my fourth year, and graduating in June. I am a very stubborn person, and I entered health care originally due to a combined interest in science and wanting to help people. At the time, I thought I wanted to do surgery, which is one of the reasons I entered podiatry school. However, I have come to truly despise participating in surgery and its complications, etc.
At this point, I plan on doing a three year residency bc I feel it is my only viable option. I have developed a larger interest in wound care. Do you know any podiatrists who specialize in wound care/limb salvage only? How would I develop my career so as to sub-specialize? I wish I could skip learning all of the rearfoot/ankle procedures and just go directly into wound care.
At this point, I plan on doing a three year residency bc I feel it is my only viable option. I have developed a larger interest in wound care. Do you know any podiatrists who specialize in wound care/limb salvage only? How would I develop my career so as to sub-specialize? I wish I could skip learning all of the rearfoot/ankle procedures and just go directly into wound care.
I am now in my fourth year of pod school, and graduating in June. I am a very stubborn person, and I entered health care originally due to a combined interest in science and wanting to help people. At the time, I thought I wanted to do surgery, which is one of the reasons I entered podiatry school. However, I have come to truly despise participating in surgery and dealing with its complications, etc.
That being said, I have developed a larger interest in wound care. Do you know any podiatrists who specialize in wound care/limb salvage only? How would I develop my career so as to sub-specialize? I wish I could skip learning all of the rearfoot/ankle procedures and just go directly into wound care.
That being said, I have developed a larger interest in wound care. Do you know any podiatrists who specialize in wound care/limb salvage only? How would I develop my career so as to sub-specialize? I wish I could skip learning all of the rearfoot/ankle procedures and just go directly into wound care.
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That is my specialty. It is really a surgical subspecialty. Most of my patients require surgery.
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It seems like you could focus on wound care while still performing other office procedures to supplement income until you find a position focusing on wound care. You could also always refer patients away which are in certain need of surgical operation & have them return afterwards. I'm sure it will work out & you will find your niche.
Also, I am an RN who has also had a career in device sales. I actually sold surgical implants to ortho's & pod's. Spent much time in the O.R.
While the money was good & work was easy.......(point and talk during the cases)......The income was also very unsteady. Ex: If you lose one or two docs to another company....your income might be cut in half in one day !!
Ultimately, I feel that Podiatry work will be a "steady" thing for years to come, has many paths to take which make it enjoyable & is more rewarding than many jobs out there today.
Also, I am an RN who has also had a career in device sales. I actually sold surgical implants to ortho's & pod's. Spent much time in the O.R.
While the money was good & work was easy.......(point and talk during the cases)......The income was also very unsteady. Ex: If you lose one or two docs to another company....your income might be cut in half in one day !!
Ultimately, I feel that Podiatry work will be a "steady" thing for years to come, has many paths to take which make it enjoyable & is more rewarding than many jobs out there today.
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If you don't like surgery, I don't know how you can do complete wound care. My program has a wound care clinic, and even most of the office/bedside stuff is procedure oriented and semi-surgical (debridements, biologic dressings, VACs, deep cultures, etc). Unless you found a facility where you could just do simple office wound care and had a local limb salvage/recon surgeon like Dr. Zgonis, LCR, Roukis, Catanzariti, Steinberg, Armstrong, etc etc to punt your surgery to, your treatments you can offer the pts are pretty limited. Referring docs or the hiring doc/hospital might quickly start to go with another pod, vasc, etc surgeon who can offer more complete wound care.
As for complications, any limb salvage center that makes a lot of big saves will also have some disaster complications on other cases. Most limb salvage pts have many comorbidities (noncompliant, HTN, DM, renal, obese, etc), and that means MANY complications: failed flaps/grafts with huge defects, bad DVTs/PEs due to frames and IM rods, Charcot recurrence after recon, cast/brace/incision complications due to fragile skin, cure osteo in the heel only to discover you also have tib/spine/etc osteo, failed saves going on to BKA, AKA, death, etc. The "good" thing is that in trauma/ischemic/infectious limb salvage situations, the expectations are low (if you prep the patient that way pre-op), but the complication rates are high.
The mirror image (which it sounds you really want to avoid) would be clean elective recon surgery where pts are healthier and complications are significantly lower but pt expectations are much higher... and complications therefore usually much harder for pt and family to deal with. It might help you to go into heavy trauma or limb salvage residency where fair/high % of complications are almost expected and you begin prepping pt/family for them pre-op, but you will need to learn to deal with them nonetheless. Nobody bats 1.000
If you truly don't want to do surgery, I'd still stay the course, do a 3yr program. It never hurts to be overtrained and have doors open to you if you gain confidence/interest in F&A surg later in your career. Then, if you still hated surgery, you could try to join a DPM group practice where the other DPMs do surgery and you can refer it internally without losing (too much) money. You can still make a fine living, help a lot of ppl, and sleep pretty easy doing injects, orthosis, routine C&C, basic wounds, and other simple stuff in the office. Yeah, the 3yr residency seems like a waste if you're never going to get board cert and do surgery, but that's how the profession is geared now: learn everything a DPM can offer to the pt and be able to practice at or near full scope if you want to.
As for complications, any limb salvage center that makes a lot of big saves will also have some disaster complications on other cases. Most limb salvage pts have many comorbidities (noncompliant, HTN, DM, renal, obese, etc), and that means MANY complications: failed flaps/grafts with huge defects, bad DVTs/PEs due to frames and IM rods, Charcot recurrence after recon, cast/brace/incision complications due to fragile skin, cure osteo in the heel only to discover you also have tib/spine/etc osteo, failed saves going on to BKA, AKA, death, etc. The "good" thing is that in trauma/ischemic/infectious limb salvage situations, the expectations are low (if you prep the patient that way pre-op), but the complication rates are high.
The mirror image (which it sounds you really want to avoid) would be clean elective recon surgery where pts are healthier and complications are significantly lower but pt expectations are much higher... and complications therefore usually much harder for pt and family to deal with. It might help you to go into heavy trauma or limb salvage residency where fair/high % of complications are almost expected and you begin prepping pt/family for them pre-op, but you will need to learn to deal with them nonetheless. Nobody bats 1.000
If you truly don't want to do surgery, I'd still stay the course, do a 3yr program. It never hurts to be overtrained and have doors open to you if you gain confidence/interest in F&A surg later in your career. Then, if you still hated surgery, you could try to join a DPM group practice where the other DPMs do surgery and you can refer it internally without losing (too much) money. You can still make a fine living, help a lot of ppl, and sleep pretty easy doing injects, orthosis, routine C&C, basic wounds, and other simple stuff in the office. Yeah, the 3yr residency seems like a waste if you're never going to get board cert and do surgery, but that's how the profession is geared now: learn everything a DPM can offer to the pt and be able to practice at or near full scope if you want to.
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There were definitely times in pod school when I thought "I'm never doing surgery. There must be other ways to treat things, and look at all these complications. And their feet don't even look that great"
I just kept chugging along though and went away, far away from school for externships, and saw what podiatry could be.
My advice is to get the best residency you can, go for it full force and work hard while you are there, learn as much as possible.
Then once you finish you will have the option to pursue practicing podiatry if you choose. Or walking away.
If you walk away and then think you made a mistake it is much harder to go back and apply for a residency after a year or so off.
Best of Luck.
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After residency, you can go for one of these fellowships with focus on wound care/limb salvage. If surgery is ur only concern about podiatry, then other options are podiatric sports medicine and podiatric research fellowships.
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As Feli said, wound care consists of minor surgical procedures as well, if this is not an issue for you then try to "swallow" a 3 yrs residency and then u can do a wound care fellowship after that. Other options, if u r not interested in surgery are podiatric sports medicine or podiatric research..feollowships available for this as well.
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Sports medicine is very surgically oriented. I think Saxena would be offended to see that you think otherwise. I'm not sure and don't want to speak for him, but I think he would consider himself a surgeon.
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thread merged with "Dislike for surgery... Wound care residency?" extremely similar topics with repeated postings/responses.
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