I'm a tad concerned podiatrists aren't granted DO

[Podman]

the traditional problem with referrals in general is the lack of knowledge or understanding amongst the Medical Doctors regarding our education, training, and clinical realm/scope. However, over the past decade or so things have been improving significantly - our improved post graduate multi-years of training has given us a rare opportunity that wasn't available to our predecessors, which is working side by side with MD's and DO's. I'm currently on clerkships and I get to speak with many non-podiatric residents, and it amazes me how much they respect and understand our training now - compared to lets say 20-25 years ago. The progress is still not perfect, but things are certainly on the right track as it will be upto our new generation of podiatrists to maintain and set a high standard of training.

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[presby]

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[presby]

Residencies are very complex environments that can not be ranked based on two or three or four or even 10 artificially imposed criterion.

It is true that some residencies have stronger research goals and some have stronger surgical case loads, but even these are just a fraction of what a residency should teach.

All the podiatric research and surgical training in the world will not teach a student how to effectively deal with a patient who has had a procedure go awry and is considering litigation. How you communicate with a patient after you screwed up can really make or break your malpractice ins rates and save or ruin your local reputation as a podiatric physician.

Or how to deal with a prominent pillar of your local community who could tarnish your professional reputation if you get argumentative and defensive with him/her.

Our long term individual success, as future Podiatrists, relies less on academic acheievement, journal clubs, professional organizations pals etc and more on interpersonal skills and personal REPUTATIONS within our perspective communities.

In the real world, folks won't even know or care where pod X was trained. What they will care about is what their friends/family/and their primary provider say about them.

First of all, 2 and 3-year residencies are not the only ones available. Second, I can't speak of other programs but in my training we do a huge amount of revisional cases - one attending in particular regularly does difficult revisions on people coming from everywhere that your average guy wouldn't dream of touching. And even though they are often litiginous, the way you decrease your chances of being sued is by mastering good surgical technique and decision-making as well as knowing how to deal with unsatisfied patients which IS easier to obtain at the "better" programs. So the big question is what are the "better" programs? They are not necessarily the ones with the most cases/numbers, they are the ones that fully integrate you into every discipline and where you learn from the best teachers/surgeons proper technique and not how fast you can do a simple bunionectomy. If you speak honestly withe the pillars/fathers of our profession, the truly talented surgeons, you will learn that the experience you gain in the office is just as important if not more important than that in the OR.

 

[jonwill]

First of all, 2 and 3-year residencies are not the only ones available

PM&S-24 and PM&S-36 are the only two residency models that exist as of this year.

 

[Dr_Feelgood]

PM&S-24 and PM&S-36 are the only two residency models that exist as of this year.

Well technically there still are PRP and PSR-24 programs b/c they have had their on site evaultion.

 

[presby]

PM&S-24 and PM&S-36 are the only two residency models that exist as of this year.

Yes, the goal of the majority is to TRY (I repeat TRY) to make the playing field more level as far as residency training goes by having specific criteria to be met in order to qualify as whatever you are - a PM&S-24 or PM&S-36. I hope you realize there are and will continue to be huge differences in the level of training and quality of graduates from various "PM&S-36" programs with the same classification on paper. As for Presby, we are officially classified as a PM&S-36 residency by the CPME and were previously before the nomenclature change classified as a PSR24 even though way back then it took 48 months to complete the program as it does now. You can refer to my old post about our program to understand why this is so but regardless of the official classification, we have been a four year surgical program, will continue to be so, and you don't want to play that "who's got the better training game".

 

[krabmas]

Yes, the goal of the majority is to TRY (I repeat TRY) to make the playing field more level as far as residency training goes by having specific criteria to be met in order to qualify as whatever you are - a PM&S-24 or PM&S-36. I hope you realize there are and will continue to be huge differences in the level of training and quality of graduates from various "PM&S-36" programs with the same classification on paper. As for Presby, we are officially classified as a PM&S-36 residency by the CPME and were previously before the nomenclature change classified as a PSR24 even though way back then it took 48 months to complete the program as it does now. You can refer to my old post about our program to understand why this is so but regardless of the official classification, we have been a four year surgical program, will continue to be so, and you don't want to play that "who's got the better training game".

Nobody has said that all pm&s 36 are equal. Actually we quite frequently say they are not all equal. Just like all pod schools have the same minimum requirements, they are definitely not all equal.

I'm glad that you are happy with your training and feel that it has prepared you well. Maybe 4 years is beneficial but I am not convinced that it is necessary for all pods to get 4 years of training unless they want fellowship training in something specific for that extra year.

 

[jonwill]

Yes, the goal of the majority is to TRY (I repeat TRY) to make the playing field more level as far as residency training goes by having specific criteria to be met in order to qualify as whatever you are - a PM&S-24 or PM&S-36. I hope you realize there are and will continue to be huge differences in the level of training and quality of graduates from various "PM&S-36" programs with the same classification on paper. As for Presby, we are officially classified as a PM&S-36 residency by the CPME and were previously before the nomenclature change classified as a PSR24 even though way back then it took 48 months to complete the program as it does now. You can refer to my old post about our program to understand why this is so but regardless of the official classification, we have been a four year surgical program, will continue to be so, and you don't want to play that "who's got the better training game".

You seem to know a lot about the program (hence the user name) so you'd probably be able to answer this question. Why does Presby take 4 years to complete? Is it a numbers issue? I just have trouble seeing the benefit of doing such a lengthy program. I've always been curious.

 

[presby]

Like I said before - refer to my past post on 10/27/06 under the thread "UPenn-Presbyterian Residency" in which I tried to explain this. I will paste it here:

[Hello, I am currently the chief resident at Presby and can answer any questions you may have about the program. We are a 4 year program (the original 4 year program) for our training experience, not for podiatric surgery numbers. We have always prided ourselves as being a rigorously academic program. Our foot/ankle/lower leg surgical numbers are probably comparable with those of other aggressive surgical programs that include full foot/ankle/lower leg cases (I'm not sure what other program's numbers are for sure) but our program does much more primary medical management of our own patients (we admit to our service) and spend more time on outside rotations especially regarding surgical services that are not ortho/podiatry (i.e. 3 months general surgery, 3 months vascular surgery and hand/plastics...). We get primary call on all foot/ankle/lower leg trauma from our ED every day (we don't share call with ortho) - We have earned this by responding quickly to all calls and treating everything they send us from tinea/ingrown nails to major trauma. We take IN-HOUSE call 24 hours a day every day. We do not scrub foot/ankle cases with ortho as we have enough cases from our attendings. No one has had problems with numbers as of yet nor with passing forefoot and rearfoot boards on 1st attempt. We will continue to be a 4 year program to insure the integrity of the program and the complete experience, not because we are short on numbers. We do a good mix of everything surgically up to tibial tuberosity and value/respect our attendings' experience greatly. We have an open door policy regarding visiting/externing and I encourage if you are considering this residency, you are HIGHLY advised to visit. We don't set quotas on who we take/don't take and every year the selection is comparative based on the students available. Our interview involves an academic portion, a social (mixer), and a formal social interview by all attendings and residents. Please let me know if you have questions/concerns. The best way to reach us is the on-call pager which the intern carries. Hope this is helpful.]

In addition... We have traditionally taken 2 residents per year and now since being reaccredited are taking 3 per year so the CPME obviously agrees we have the numbers to support this as a PM&S-36. If you know much about some of our more experienced attendings (Michael Downey, D. Scot Malay, Alan Mlodzienski, Harold Schoenhaus) you will realize that they all do a huge number of cases of all levels and are well published. The residency is longer because of all of the non-podiatry experience we get. You can argue however you feel about that but when dealing with other specialties, if you can perform on their level you will have their respect.