Is 2011 competitive or easy?

[cool_vkb]

Few days back we had APMA meeting and the person said that by 2009 or something they will convert all residnecies into 3yr surgical ones.

Now that raises an interesting question! See now we have 3yrs,2yrs, 1yr residency and usually 3yrs are tough,2 yrs are medium and 1yrs are walk thru to get admission. And since 3yr program are not that many and many want 3yr program, i guess there is a decent competition.

If by 2009 all programs are 3yrs. then wudnt this decrease the whole competition bcoz now there will be plenty of 3yr programs and students wont have to worry abt its shortage. i mean whats the worse gonna be. instead of INOVA i wud still get a 3yr residency in timbaktu (compared to today, if i get lowest grade i might be sitting in 1yr program in middle of alaska). i feel this is unfair.

Then how wud it play for hardworking students who are working hard to get in three yr program. i mean i wud really be pissed if i see lowest grader in my class graduate from 3yr residency program just like me. just bcoz APMA converted all programs into 3yrs and now even the lowest or lowest can get in.

I know iam just 1st year and shudnt be worrying all this. but its just taht i think too much abt future in free time and i really wanna be the best and achieve something which no one else cant achive. and this 2009 all 3yr residency seems to be that everyone will benefit and no hardowrk will be rewarded.

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[krabmas]

Few days back we had APMA meeting and the person said that by 2009 or something they will convert all residnecies into 3yr surgical ones.

Now that raises an interesting question! See now we have 3yrs,2yrs, 1yr residency and usually 3yrs are tough,2 yrs are medium and 1yrs are walk thru. And since 3yr program are not taht many and many want 3y program, i guess there is a decent competition.

If by 2009 all programs are 3yrs. then wudnt this decrease the whole competition bcoz now there will be plenty of 3yr programs and students wont have to worry abt its shortage.

Then how wud it play for hardworking students who are working hard to get in three yr program. i mean i wud really be pissed if i see lowest grader in my class graduate from 3yr residency program just like me. just bcoz APMA converted all programs into 3yrs and now even the lowest or lowest can get in.

I think this has been discussed before. There are no more 1 year programs.

Not all 3 year programs are equal. Not all 2 year programs will be able to convert to 3 year programs - they may not have the case load or the attendings qualified to teach rearfoot.

There could actually be a shortage of programs if they all must convert or die. The APMA is doing everything they can to avoid a shortage but there are no garuntees. So just keep working hard and hope for the best.

 

[Feli]

...Then how wud it play for hardworking students who are working hard to get in three yr program. i mean i wud really be pissed if i see lowest grader in my class graduate from 3yr residency program just like me...

As Sam hinted, don't be fooled into believing that all PMS-36s are created equal.

Sadly, some residencies will be almost like 3rd year student clinic with the simple addition of scrubbing in on a few cases as a 1st year resident and assisting on a few as a 2nd and 3rd year. Even worse, some residencies are only provisionally accredited and/or get very marginal numbers. You have to be critically aware of surgical numbers, case diversity, funding, program stability, etc. Nothing would be worse than having a residency dissolve while you're in the program. You'd be stuck applying for a very limited number of advanced standing positions or having to re-do match and start all over. It might seem like I'm being highly pessimistic, but keep in mind that a residency program is a money making entity for the hospital, the directors, etc because they can see more patients with the help of low-paid residents. Thankfully, most directors and programs are genuinely interested in providing a great learning experience that is the best it can be for the residents, but others aren't always like that.

It's my belief that you really want to do your homework and then see what's out there on clerkships. It's probably true that the gap between the big high-powered residencies and the rest of the programs is narrowing now that there are more surgically trained pods out there and most/all programs will soon be 3yr, but you still want to learn from the best docs and work with the best possible co-residents IMO.

You're getting a bit ahead of yourself as a first year student, but it's good that you're thinking of these things. The classes of 2010 and beyond will be bigger and have a projected residency shortage; OCPM has drastically increased class sizes over the past couple years, AZ starts graduating this year, and other schools have grown a bit also. I think the worry is a bit overblown, though; there will still be a lot of attrition in those 2010 and beyond classes. Just keep your grades up and then work hard and read hard in clinical years, and if you do that, you'll probably have nothing to worry about and may residency options when that time arrives.

Future classes after yours will also grow, especially if AZ increases class sizes as expected and the Pomona school opens its doors. The issue of generating quality residencies is a fairly big issue in the APMA. There is talk of bringing back closed resiency programs or opening more spots at good programs with high numbers, but you have to be aware that most closed programs did so for a reason and that you don't want to water down our strong programs which generate leaders for the profession.

 

[Stafocker]

Few days back we had APMA meeting and the person said that by 2009 or something they will convert all residnecies into 3yr surgical ones.

Now that raises an interesting question! See now we have 3yrs,2yrs, 1yr residency and usually 3yrs are tough,2 yrs are medium and 1yrs are walk thru to get admission. And since 3yr program are not that many and many want 3yr program, i guess there is a decent competition.

If by 2009 all programs are 3yrs. then wudnt this decrease the whole competition bcoz now there will be plenty of 3yr programs and students wont have to worry abt its shortage. i mean whats the worse gonna be. instead of INOVA i wud still get a 3yr residency in timbaktu (compared to today, if i get lowest grade i might be sitting in 1yr program in middle of alaska). i feel this is unfair.

Then how wud it play for hardworking students who are working hard to get in three yr program. i mean i wud really be pissed if i see lowest grader in my class graduate from 3yr residency program just like me. just bcoz APMA converted all programs into 3yrs and now even the lowest or lowest can get in.

I know iam just 1st year and shudnt be worrying all this. but its just taht i think too much abt future in free time and i really wanna be the best and achieve something which no one else cant achive. and this 2009 all 3yr residency seems to be that everyone will benefit and no hardowrk will be rewarded.

first thing's first... work on your spelling... yikes.

 

[densmore22]

first thing's first... work on your spelling... yikes.

Somebody finally had to say it. I don't think I'd enjoy reading his/her notes on a patient.

 

[narkotiks]

Somebody finally had to say it. I don't think I'd enjoy reading his/her notes on a patient.

nor would i yours if you were an immigrant into my native country, trying your hardest to learn a very difficult language, yet making smallish mistakes here and there. no patience for that stuff, right??
if i remember, cool is from india. give him a break.

 

[densmore22]

nor would i yours if you were an immigrant into my native country, trying your hardest to learn a very difficult language, yet making smallish mistakes here and there. no patience for that stuff, right??
if i remember, cool is from india. give him a break.

I'm sure the prosecuting attourney will let him off easy too because he'll feel sorry that this doctor had a hard time learning the language and because he's an immigrant. Better to learn it now before a. he's graded on it and he'll lose points b. before the aforementioned scenario occurs. And it will occur sometime in ALL our careers based on statistics. I respect Cool, I appreciate his insight and advice and his willingness to learn but the system's not going to conform to him, especially the medical profession.

Cool, I apologize, I didn't mean this as an attack. I hope you take it as constructive criticism that got a little out of hand on my part.

 

[cool_vkb]

Cool, I apologize, I didn't mean this as an attack. I hope you take it as constructive criticism that got a little out of hand on my part.

Ooooooooh! iam so deeply hurt. Naah i take any criticism as learning. I kind of go easy on language when iam on forums. In real life i do use proper grammar. this whole short hand writing habbit is because of the SMS system. iam so used to SMS and chatting that no matter what i type i use that format.

Anyhow, iam always open to criticism and learning new things. So no worries.

 

[bdaddyjolley]

Somebody finally had to say it. I don't think I'd enjoy reading his/her notes on a patient.

Hey yo, what wrong is it with no speak the language english good?

 

[krabmas]

to get back to residencies.

We looked at the numbers today and from what we looked at it seems as if it this point there are 15 more students than residency spots. Unless 15 people do not graduate on time over 8 schools (2 per school) which is possible there will be a few students without spots.

I just think that the APMA/CPME should make a rule that the schools have to refund the money it costs to educate (non-educate) those students as well as take than many less students the next year for each student that does not match or scramble.

 

[cool_vkb]

I just think that the APMA/CPME should make a rule that the schools have to refund the money it costs to educate (non-educate) those students as well as take than many less students the next year for each student that does not match or scramble.

ho ho thats gonna be a big fat refund check .

 

[cool_vkb]

to get back to residencies.

We looked at the numbers today and from what we looked at it seems as if it this point there are 15 more students than residency spots. Unless 15 people do not graduate on time over 8 schools (2 per school) which is possible there will be a few students without spots.

I just think that the APMA/CPME should make a rule that the schools have to refund the money it costs to educate (non-educate) those students as well as take than many less students the next year for each student that does not match or scramble.

By the way what happens to students who dont match. i bet that must be one hell of a horryfying experience. Do you know anyone like that?

 

[densmore22]

to get back to residencies.

We looked at the numbers today and from what we looked at it seems as if it this point there are 15 more students than residency spots. Unless 15 people do not graduate on time over 8 schools (2 per school) which is possible there will be a few students without spots.

I just think that the APMA/CPME should make a rule that the schools have to refund the money it costs to educate (non-educate) those students as well as take than many less students the next year for each student that does not match or scramble.

I heard through the grapevine (reliability is in question here) that DMU will not be allowed to take more than 58 students next year. 2011 class size is 65 as of today, so that would be a significant decrease. But now that AZPOD just got accredited, they'll be able to up their class sizes. Something's got to be done.

 

[DingleBarry]

to get back to residencies.

We looked at the numbers today and from what we looked at it seems as if it this point there are 15 more students than residency spots. Unless 15 people do not graduate on time over 8 schools (2 per school) which is possible there will be a few students without spots.

I just think that the APMA/CPME should make a rule that the schools have to refund the money it costs to educate (non-educate) those students as well as take than many less students the next year for each student that does not match or scramble.

Is that for 2011? I Hope so. I'm 2009 and we were told that we were cutting it close with just a few more residencies than students. Is that still true for 2009?

 

[jonwill]

to get back to residencies.

We looked at the numbers today and from what we looked at it seems as if it this point there are 15 more students than residency spots. Unless 15 people do not graduate on time over 8 schools (2 per school) which is possible there will be a few students without spots.

I just think that the APMA/CPME should make a rule that the schools have to refund the money it costs to educate (non-educate) those students as well as take than many less students the next year for each student that does not match or scramble.

With attrition rates, there shouldn't be a problem but I agree that we are going down a road AGAIN that we shouldn't be going down. Something similar has already happened (1990's) and it really took its toll on the profession.

You would think that those leading our profession would be smart enough to say, "We have X amount of residency spots so between the 8 or 9 schools, they can only accept a total of X students." Accepting students without the promise of residency training (especially now when it is necessary to even practice) is completely irresponsible.

 

[cool_vkb]

With attrition rates, there shouldn't be a problem but I agree that we are going down a road AGAIN that we shouldn't be going down. Something similar has already happened (1990's) and it really took its toll on the profession.

You would think that those leading our profession would be smart enough to say, "We have X amount of residency spots so between the 8 or 9 schools, they can only accept a total of X students." Accepting students without the promise of residency training (especially now when it is necessary to even practice) is completely irresponsible.

Even if no one drops out then i guess the most rational solution will be that the US tax payers money shud go to welfare of US citizens (and ofcourse US PERMANENT RESIDENTS). What i mean is , in case of shortage the residnecy programs shud start giving US citizens first prefernece irrespective of GPA or class rank. And then if any position is open then they shud consider International students.

While merit is one the most important things but Nationality shud also pay.

 

[densmore22]

With attrition rates, there shouldn't be a problem but I agree that we are going down a road AGAIN that we shouldn't be going down. Something similar has already happened (1990's) and it really took its toll on the profession.

You would think that those leading our profession would be smart enough to say, "We have X amount of residency spots so between the 8 or 9 schools, they can only accept a total of X students." Accepting students without the promise of residency training (especially now when it is necessary to even practice) is completely irresponsible.

Dr. Taubman is the president elect for the APMA and he was addressed this question specifically by me and he said that he felt it was the responsibility of the schools to find the extra residency spots for the extra students (the topic was on opening up of the new school in 2009), but the concept still applies. I love what 2015 has to offer and hopefully comes through with, but I feel like they might be biting off more than they can chew. I don't think the responsibility of finding more residency spots/opening new residencies is solely on the schools. Maybe I'm just assuming that's what they (APMA) are saying, but it's not just as simple as asking a program to open up another spot and doesn't it take like 7 years from start to finish to open up a new residency? So they'll be good to go, if they started today for 2014 graduates, but what about 2011-2013? That's 3 years of students that may or may not be able to practice podiatry, pretty crappy deal. No other medical profession has this problem.

 

[EuroPhysician]

Dr. Taubman is the president elect for the APMA and he was addressed this question specifically by me and he said that he felt it was the responsibility of the schools to find the extra residency spots for the extra students (the topic was on opening up of the new school in 2009), but the concept still applies. I love what 2015 has to offer and hopefully comes through with, but I feel like they might be biting off more than they can chew. I don't think the responsibility of finding more residency spots/opening new residencies is solely on the schools. Maybe I'm just assuming that's what they (APMA) are saying, but it's not just as simple as asking a program to open up another spot and doesn't it take like 7 years from start to finish to open up a new residency? So they'll be good to go, if they started today for 2014 graduates, but what about 2011-2013? That's 3 years of students that may or may not be able to practice podiatry, pretty crappy deal. No other medical profession has this problem.

Wait a minute, you could actually go to Podiatry school, graduate with a DPM, and not practice podiatry?

 

[densmore22]

Wait a minute, you could actually go to Podiatry school, graduate with a DPM, and not practice podiatry?

If you do not complete a residency, you cannot practice podiatric medicine.

 

[karntrev]

By the way what happens to students who dont match. i bet that must be one hell of a horryfying experience. Do you know anyone like that?

I am reposting cool's question because I am curious and I don't think anyone has really answered it. What happens? Do you have to sit around and reapply for residencies the next year or do flat out not get to practice? I am not worried because I am going to bust my a$$ so that it doesn't happen to me, but it is an interesting question, especially for us who are looking to go into the field and haven't started school yet.

 

[jonwill]

I am reposting cool's question because I am curious and I don't think anyone has really answered it. What happens? Do you have to sit around and reapply for residencies the next year or do flat out not get to practice? I am not worried because I am going to bust my a$$ so that it doesn't happen to me, but it is an interesting question, especially for us who are looking to go into the field and haven't started school yet.

If you don't match, you scramble. It actually happens every year. Through the match process, there are students that don't match and programs that don't match. At 5PM on the day of the match, a list of programs that didn't match some/all of their slots goes up on the CASPR website. Students that didn't match take a look at the list and the scramble begins. Everyone ends up with a residency program although it usually isn't one of the ones the student was originally going for. The scramble is quite common in the MD, DO, and DPM world.

Of course, if the scenario were to happen where there ended up being more students than residency slots, that wouldn't be the case.

 

[EuroPhysician]

Let me rephrase my question. You mean that after I graduate from a Podiatry school with a DPM, there is a chance that I will not get into a residency training program?

 

[narkotiks]

Let me rephrase my question. You mean that after I graduate from a Podiatry school with a DPM, there is a chance that I will not get into a residency training program?

from the sounds of things, yes. i have been exploring this disheartening possibility a little bit this week, and it blows!! i have thus decided to change up my plan a little bit to try and ensure a match. the match thing can definitely screw a person, or so it sounds.

 

[karntrev]

If you don't match, you scramble. It actually happens every year. Through the match process, there are students that don't match and programs that don't match. At 5PM on the day of the match, a list of programs that didn't match some/all of their slots goes up on the CASPR website. Students that didn't match take a look at the list and the scramble begins. Everyone ends up with a residency program although it usually isn't one of the ones the student was originally going for. The scramble is quite common in the MD, DO, and DPM world.

Of course, if the scenario were to happen where there ended up being more students than residency slots, that wouldn't be the case.

Thanks jonwill, I understand the whole scramble thing but what happens to a graduate who doesn't match and is unsuccessful in the scramble. Is he/she just out of luck? Does he/she get another opportunity the next year? What actually happens to this person?

 

[jonwill]

Thanks jonwill, I understand the whole scramble thing but what happens to a graduate who doesn't match and is unsuccessful in the scramble. Is he/she just out of luck? Does he/she get another opportunity the next year? What actually happens to this person?

I've never personally witnessed this. As stated before, this is a theoretical issue at this point. There are enough residencies for the students that graduate. If trends continue and nothing is done to ensure that every student gets a residency program, it could become an issue.

If and when it does happen, I would assume it would work the same way that it works for MD graduates that don't successfully match or scramble in the desired specialty. They sit out a year and re-enter the match. Some will actually scramble to a less desired spot (many times FP) and do a year of that but still re-enter the match the next year for the desired specialty. I had a buddy that wanted anesthesia but didn't match and couldn't pick a program up on the scramble. He did a year of FP in Iowa but re-entered the match the following year and got anesthesia in MI.

The problem with that scenario is that for podiatry, there is only one residency model (foot and ankle surgery) so that really wouldn't be a possibility for us. We can't go do a year of FP or IM while waiting to re-enter the match!

Maybe this is just naivity on my part but I'm hoping that the "powers that be" in our profession work together to make sure that the schools never collectively accept more students than there are residency programs.

 

[jonwill]

from the sounds of things, yes. i have been exploring this disheartening possibility a little bit this week, and it blows!! i have thus decided to change up my plan a little bit to try and ensure a match. the match thing can definitely screw a person, or so it sounds.

Remember, not matching is not that big of a deal. This happens to a fair amount of students each year. They all enter the scramble and end up getting a program that way. It happened to a few of my buddies last year and they all ended up doing OK for themselves. Granted, they obviously didn't get the programs they were originally hoping for.

 

[Stafocker]

I've never personally witnessed this. As stated before, this is a theoretical issue at this point. There are enough residencies for the students that graduate. If trends continue and nothing is done to ensure that every student gets a residency program, it could become an issue.

If and when it does happen, I would assume it would work the same way that it works for MD graduates that don't successfully match or scramble in the desired specialty. They sit out a year and re-enter the match. Some will actually scramble to a less desired spot (many times FP) and do a year of that but still re-enter the match the next year for the desired specialty. I had a buddy that wanted anesthesia but didn't match and couldn't pick a program up on the scramble. He did a year of FP in Iowa but re-entered the match the following year and got anesthesia in MI.

The problem with that scenario is that for podiatry, there is only one residency model (foot and ankle surgery) so that really wouldn't be a possibility for us. We can't go do a year of FP or IM while waiting to re-enter the match!

Maybe this is just naivity on my part but I'm hoping that the "powers that be" in our profession work together to make sure that the schools never collectively accept more students than there are residency programs.

Great point!

Also, there are states that you can just enter practice without a required residency. Meaning, you could work for another podiatrist and get a licence, DEA number right after you graduate and get paid (not a lot, but at least get paid).

 

[cool_vkb]

Great point!

Also, there are states that you can just enter practice without a required residency. Meaning, you could work for another podiatrist and get a licence, DEA number right after you graduate and get paid (not a lot, but at least get paid).

One of them is the State of Hawai. i guess a year off sitting in the warm sun and wonderfull beaches making $30-40K a year by working for another podiatrist is not that bad

 

[jonwill]

One of them is the State of Hawai. i guess a year off sitting in the warm sun and wonderfull beaches making $30-40K a year by working for another podiatrist is not that bad

I thought Hawaii was the last state that didn't require a residency. Palliative care for the rest of my life isn't my idea of fun!

 

[cool_vkb]

I thought Hawaii was the last state that didn't require a residency. Palliative care for the rest of my life isn't my idea of fun!

Oh no, iam just saying if someone misses their residency and have 1yr free now. instead of working some odd job somewhere to feed themself. Its beter they go to hawai or some state and work like a professional till they match in resdency in coming year.

 

[Feli]

...We looked at the numbers today and from what we looked at it seems as if it this point there are 15 more students than residency spots. Unless 15 people do not graduate on time over 8 schools (2 per school) which is possible there will be a few students without spots...

Are you working with Young Members now?^

As was asked above, you're talking about 2010's current national class size, right? I think 2008 has a fair surplus of spots, and 2009 should have a few extras also? It'll obviously never be like c/o 2007 which was the lowest national graduating class in 30yrs, but I still don't think the potential big problems could arise until 2010 from what I've read...?

 

[MarquetteGuy]

Hey Dens,
Didn't we have a meeting earlier this year in which they projected there to still be a few more residency spots than students for our 2010 class?

 

[krabmas]

Are you working with Young Members now?^

As was asked above, you're talking about 2010's current national class size, right? I think 2008 has a fair surplus of spots, and 2009 should have a few extras also? It'll obviously never be like c/o 2007 which was the lowest national graduating class in 30yrs, but I still don't think the potential big problems could arise until 2010 from what I've read...?

I am not working with young members. I do still have my conections though.

I hear things through the grapevine. I was under the impression that the message that I received was for this years match as in the class of 2008. This may be for 3 year programs and so many students will end up with 2 year programs who wanted 3 year programs (not sure). But there were spots that disappeared from last year and residency programs that have closed completely.

If I was a student in 2008 I would do everything possible to match and not scramble.

 

[densmore22]

Hey Dens,
Didn't we have a meeting earlier this year in which they projected there to still be a few more residency spots than students for our 2010 class?

That was contingent on our whole 2010 class (nationally) to lose a few more students. The deans "project" an attrition rate for each year and I guess the 2010 class didn't meet the projected attrition rate, yet. So, they went from saying last year when we started that we SHOULD be ok, to, well.....now things are going to be a little more interesting. I have no idea what's going to happen now. I THINK our class will be ok, there will be a few people that won't weather boards, but I think we have to plan on it being a very competitive match for the 2010 class.

I think the stats that Krab is talking about are for the 2010 class. I keep hearing from our 3rd years that there's going to be more residencies than students for their class.

 

[JoeNamaMD]

What's the bottom line? I could complete a DPM degree, not get a residency after graduating, and not practice Podiatry but still be stuck with 120K plus debt?

 

[PODonny]

If the schools continue to increase class sizes, it certainly is a possibility to finish with a DPM degree and not get into residency that year. I sincerely hope the administrations are taking notice to this potential travesty. Anyone who completes the curriculum and passes boards has earned the right to practice. Competition for "top" residencies is just fine, but when students have worked hard to get through, and have to compete to even get a residency, there are serious issues with the process.

 

[Feli]

If the schools continue to increase class sizes, it certainly is a possibility to finish with a DPM degree and not get into residency that year. I sincerely hope the administrations are taking notice to this potential travesty. Anyone who completes the curriculum and passes boards has earned the right to practice. Competition for "top" residencies is just fine, but when students have worked hard to get through, and have to compete to even get a residency, there are serious issues with the process.

I fully agree, but the APMA's job of regulating graduate:residency ratio is not as easy as say, the ACGME. I think a large problem lies in the facts that the attrition rates are much higher in pod schools than MD/DO...

It's quite a bit easier to predict how many residency slots will be needed when you can figure that ~95% of those students who matriculate will graduate (http://www.aamc.org/data/aib/aibissues/aibvol7_no2.pdf ), and ~95% of those students who graduate will pass boards on their first try (http://www.usmle.org/Scores_Transcripts/performance/2006.html ). Supposing there were 10k US MD students matriculating this year, it's a pretty fair bet that they will need around 9.4k or more residency spots for those incoming students 4 or 5 years later.

In pod, it's not nearly as clear-cut. The schools are less selective on the front end, so there will be a fair number of students who cannot perform - either in classes, on boards, or both. There could be years with 600 incoming students of whom only 300 graduate 4 years later. If there were 450 residency spots in a year like that (150 consequently going unfilled), it sure looks like time to increase the number of incoming students, right? Well... the next year, there might be 650 incoming where 500 graduate. Attrition rate is a tough tough thing to predict. If attrition is low, you don't want to put the schools in a place where they are forced to thin out their strong classes to avoid graduates who won't get a residency. At the same time, it's even worse to say "ok, too many people have failed out, we need to let the rest graduate" in the years with weak classes and risk damaging the profession with marginally qualified DPMs.

I really don't know if there's a simple solution. Genesis of a quality residency takes a lot of time, dedicated faculty, and a mountain of paperwork. The fastest way to create residency spots would be to just bring back closed residencies or to add spots at existing residencies, but those have the inherent problems I hinted at above. If we changed a high power pod residency that takes 3 DPMs each year and gets them each 1500 surgical C cases into a program that takes 5 or 6 residents each year without adding hospitals, surgery centers, or quality attendings, then that means you've cut each resident's surgical volume, clinic volume, and face time with their teachers by nearly 50% and might have essentially made it into a mediocre program. Bringing back closed programs basically does the same thing: while creating residency spots, they are probably fair/poor ones anyways if they were unpopular and closed down. The late great "Guest" breaks these issues down well in this thread (see esp post #18)...
http://forums.studentdoctor.net/showthread.php?t=384076

The best solution is simply to find a way for attrition to be lower, and that's obviously to have some of the pod schools be more selective. When applicants with a 3.0gpa/20mcat are being waitlisted or rejected at one program yet become an above average matriculant at another program, something is a bit awry. If more pod programs had matriculant profiles like the pod programs which are fully integrated with osteopathic schools, I think that'd be a step in the right direction. That means that we need more and better applicants, or some of the schools need to accept fewer students. I am in full support of a program with a very promising track record and board pass rate, ie AZ, upping its class sizes, but if you tried to convince some of the lower end schools that their incoming class sizes need to decrease to compensate, it probably won't happen - especially the free standing pod schools which depend almost exclusively on pod student tuition to keep running.

I applaud the delegates and staff members who are working hard to analyze and solve these problems. When you realize the possible residency shortage, at first, it's easy to say "well just don't open a new pod school and don't let AZ increase class sizes because there aren't enough residency spots." Then, you quickly realize that those integrated programs are good at producing the kind of high functioning DPMs we want out there to help accomplish parity. If you don't want to stop the top programs from growing, options then become generating a whole lot of residency spots in a hurry or decreasing the class sizes at lesser programs. Neither of those options are going to be well received, so you're stuck where not everyone will be happy...

In my estimation, 1 of 2 things will happen if national graduating class sizes continue to grow:
(and neither is ideal)

1) A whole lot more DPM residency spots will be created in a hurry, but many of those will be marginal programs in terms of numbers, facilities, director/attendings, etc. Some top volume programs may also get their surgical numbers diluted a bit if they are pressured to quickly increase slots.

2) There will indeed be a residency shortage, and some of the programs in which the curriculum and standards are not prepping their graduates to be competitive residency applicants will find that some of thier low end graduates don't get a program at all. That is very tough on those graduates, but if that happens to a pod school for a few years, the school will have to learn the lesson the hard way and decrease incoming class sizes by choice or CPME mandate.

 

[EuroPhysician]

Is this the reason why some former Podiatry students are going into Osteopathic Medicine? I heard NSU gives advanced standing to DPMs in their DO school.

That being said, I also heard that many FMs and Orthopods can perform many of the procedures that a Podiatrist performs.

 

[jonwill]

That being said, I also heard that many FMs and Orthopods can perform many of the procedures that a Podiatrist performs.

Yes, I have heard that statment many times. I'm not sure where it comes from (probably insecure pre-meds that think that MD's are some type of super-doctor that is capable of treating and doing anything ) but it is completely false. The F&A orthos that are left (long story) generally just do the larger rearfoot trauma WHEN they are doing any F&A stuff at all. And concerning family medicine, I've routinely seen pods try and teach them how to do some of the in-office procedures (at seminars, etc) and I suppose that some docs do some of them. But for most of them, unless they do the procedures routinely, I don't think that they feel comfortable doing them which is why they still refer all the patients to us. And not to "bad mouth" family practice docs because 99% are competent docs who know their limits (and there are some pretty crappy pods out there that don't know their limits), but I have seen a few MAJOR screw-ups on these office procedures, one of which actually resulted in an amputation.

If the above statement were true, there would be no need for the 15,000+ pods that exist in this country, most of which are doing very well.

 

[narkotiks]

Oh no, iam just saying if someone misses their residency and have 1yr free now. instead of working some odd job somewhere to feed themself. Its beter they go to hawai or some state and work like a professional till they match in resdency in coming year.

yeah, except that trying to live in hawaii for 30-40k wouldn't get you much to eat. thats horse ****!!!

 

[PMSIII]

Even if no one drops out then i guess the most rational solution will be that the US tax payers money shud go to welfare of US citizens (and ofcourse US PERMANENT RESIDENTS). What i mean is , in case of shortage the residnecy programs shud start giving US citizens first prefernece irrespective of GPA or class rank. And then if any position is open then they shud consider International students.

While merit is one the most important things but Nationality shud also pay.

Hate to burst your bubble, but residency programs (good ones at least) simply want a good resident so the requirement that you listed above is quite absurd to say the least, when you ignore GPA, clerkship performance, interviews, and boards. To clarify the "international student" picture for you, schools sponsor their graduates with a J-1 visa for 3, which is then typically upgraded to the H1B by the hospital to provide the resident (international) with the opportunity to practice good medicine. The point I'm making is that it ultimately comes down to the better candidate in most cases - not all, but most (the VA hospitals for example do not take non-US citizens). As the previous posters already mentioned, your job as a student is to work hard, get good grades, and learn as much as you can - this will be the key to your success in landing a residency not your status as a U.S. citizen.

 

[PMSIII]

I fully agree, but the APMA's job of regulating graduate:residency ratio is not as easy as say, the ACGME. I think a large problem lies in the facts that the attrition rates are much higher in pod schools than MD/DO...

It's quite a bit easier to predict how many residency slots will be needed when you can figure that ~95% of those students who matriculate will graduate (http://www.aamc.org/data/aib/aibissues/aibvol7_no2.pdf ), and ~95% of those students who graduate will pass boards on their first try (http://www.usmle.org/Scores_Transcripts/performance/2006.html ). Supposing there were 10k US MD students matriculating this year, it's a pretty fair bet that they will need around 9.4k or more residency spots for those incoming students 4 or 5 years later.

In pod, it's not nearly as clear-cut. The schools are less selective on the front end, so there will be a fair number of students who cannot perform - either in classes, on boards, or both. There could be years with 600 incoming students of whom only 300 graduate 4 years later. If there were 450 residency spots in a year like that (150 consequently going unfilled), it sure looks like time to increase the number of incoming students, right? Well... the next year, there might be 650 incoming where 500 graduate. Attrition rate is a tough tough thing to predict. If attrition is low, you don't want to put the schools in a place where they are forced to thin out their strong classes to avoid graduates who won't get a residency. At the same time, it's even worse to say "ok, too many people have failed out, we need to let the rest graduate" in the years with weak classes and risk damaging the profession with marginally qualified DPMs.

I really don't know if there's a simple solution. Genesis of a quality residency takes a lot of time, dedicated faculty, and a mountain of paperwork. The fastest way to create residency spots would be to just bring back closed residencies or to add spots at existing residencies, but those have the inherent problems I hinted at above. If we changed a high power pod residency that takes 3 DPMs each year and gets them each 1500 surgical C cases into a program that takes 5 or 6 residents each year without adding hospitals, surgery centers, or quality attendings, then that means you've cut each resident's surgical volume, clinic volume, and face time with their teachers by nearly 50% and might have essentially made it into a mediocre program. Bringing back closed programs basically does the same thing: while creating residency spots, they are probably fair/poor ones anyways if they were unpopular and closed down. The late great "Guest" breaks these issues down well in this thread (see esp post #18)...
http://forums.studentdoctor.net/showthread.php?t=384076

The best solution is simply to find a way for attrition to be lower, and that's obviously to have some of the pod schools be more selective. When applicants with a 3.0gpa/20mcat are being waitlisted or rejected at one program yet become an above average matriculant at another program, something is a bit awry. If more pod programs had matriculant profiles like the pod programs which are fully integrated with osteopathic schools, I think that'd be a step in the right direction. That means that we need more and better applicants, or some of the schools need to accept fewer students. I am in full support of a program with a very promising track record and board pass rate, ie AZ, upping its class sizes, but if you tried to convince some of the lower end schools that their incoming class sizes need to decrease to compensate, it probably won't happen - especially the free standing pod schools which depend almost exclusively on pod student tuition to keep running.

I applaud the delegates and staff members who are working hard to analyze and solve these problems. When you realize the possible residency shortage, at first, it's easy to say "well just don't open a new pod school and don't let AZ increase class sizes because there aren't enough residency spots." Then, you quickly realize that those integrated programs are good at producing the kind of high functioning DPMs we want out there to help accomplish parity. If you don't want to stop the top programs from growing, options then become generating a whole lot of residency spots in a hurry or decreasing the class sizes at lesser programs. Neither of those options are going to be well received, so you're stuck where not everyone will be happy...

In my estimation, 1 of 2 things will happen if national graduating class sizes continue to grow:
(and neither is ideal)

1) A whole lot more DPM residency spots will be created in a hurry, but many of those will be marginal programs in terms of numbers, facilities, director/attendings, etc. Some top volume programs may also get their surgical numbers diluted a bit if they are pressured to quickly increase slots.

2) There will indeed be a residency shortage, and some of the programs in which the curriculum and standards are not prepping their graduates to be competitive residency applicants will find that some of thier low end graduates don't get a program at all. That is very tough on those graduates, but if that happens to a pod school for a few years, the school will have to learn the lesson the hard way and decrease incoming class sizes by choice or CPME mandate.

Great post

 

[cool_vkb]

Hate to burst your bubble, but residency programs (good ones at least) simply want a good resident so the requirement that you listed above is quite absurd to say the least, when you ignore GPA, clerkship performance, interviews, and boards. To clarify the "international student" picture for you, schools sponsor their graduates with a J-1 visa for 3, which is then typically upgraded to the H1B by the hospital to provide the resident (international) with the opportunity to practice good medicine. The point I'm making is that it ultimately comes down to the better candidate in most cases - not all, but most (the VA hospitals for example do not take non-US citizens). As the previous posters already mentioned, your job as a student is to work hard, get good grades, and learn as much as you can - this will be the key to your success in landing a residency not your status as a U.S. citizen.

First of all i have said that they should do it (if ever such horrible conditions arise). i never said they are doing it now. Plus at present in Medical residencies there is a shortage of positions even after all US medgrads fill it. thats why they hire foreign grads to fill those community primary care residencies. you will never find IMGs competing with AMGs over some orhopedic surgery or Dermatology. It simply doesnt happens. Majority of that J1s goes to unwanted residencies.

And its no way an absurd thought.When we can have several big positions reserved only and only for US nationals in govt, armed forces, etc (someone who is born here) no matter how many eligible US citizens are there who could better fill that position yet they cant fill the position because they were not born here. Then whats wrong in protecting the US residencies for US citizens in times when there is severe competition. Iam not saying do it now. but if there is ever severe shortage like there are 200 positions and 250 applicants. then definetly US citizens should be given preference. thats what all countries do.

If you have been reading the news regularly, you must have heard what UK did to ensure their people get first preference over foreign medical graduates. they launched a new policy which serverely limits International grads to positions. thousands of excellent well educated IMGs are now leaving UK and coming to USA. Now you can say that UKs loss is USA's gain.

iam myself an immigrant and iam all for merit. I pray that day never comes and US always remains a nation that always recognizes Merit over anything. but if the competition is so severe and US citizens are not getting resiency than like UK, US will also pass similar rule to ensure that tax payer's money is going to American Citizens. And believe me if ever when conditions like that arise in USA, US will also pass it like UK. I can close my eyes and bet with you a $1000 over this. Every country does that. You may not like it but thats how it works.

 

[PMSIII]

First of all i have said that they should do it (if ever such horrible conditions arise). i never said they are doing it now. Plus at present in Medical residencies there is a shortage of positions even after all US medgrads fill it. thats why they hire foreign grads to fill those community primary care residencies. you will never find IMGs competing with AMGs over some orhopedic surgery or Dermatology. It simply doesnt happens. Majority of that J1s goes to unwanted residencies.

And its no way an absurd thought.When we can have several big positions reserved only and only for US nationals in govt, armed forces, etc (someone who is born here) no matter how many eligible US citizens are there who could better fill that position yet they cant fill the position because they were not born here. Then whats wrong in protecting the US residencies for US citizens in times when there is severe competition. Iam not saying do it now. but if there is ever severe shortage like there are 200 positions and 250 applicants. then definetly US citizens should be given preference. thats what all countries do.

If you have been reading the news regularly, you must have heard what UK did to ensure their people get first preference over foreign medical graduates. they launched a new policy which serverely limits International grads to positions. thousands of excellent well educated IMGs are now leaving UK and coming to USA. Now you can say that UKs loss is USA's gain.

iam myself an immigrant and iam all for merit. I pray that day never comes and US always remains a nation that always recognizes Merit over anything. but if the competition is so severe and US citizens are not getting resiency than like UK, US will also pass similar rule to ensure that tax payer's money is going to American Citizens. And believe me if ever when conditions like that arise in USA, US will also pass it like UK. I can close my eyes and bet with you a $1000 over this. Every country does that. You may not like it but thats how it works.

Bet me a $1000? Please don't make statements as such unless you're on the hospital administration boards. No offence, but I respectively disagree with your argument. You cannot compare the situation with podiatric residencies with allopathic ones. For starters, all podiatric medical graduates (foreigners/internationals at least) are graduates of a podiatric medical program in the United States of America - so your example with IMG's applying for ortho or derm residencies is completely unfounded. Second, the demand and competition for the podiatric residencies is not the same as allopathic. The numbers are smaller and the number of quality residencies is thereby even smaller - so as a result, programs (podiatric) are taking (matching) only the quality or best of the best applicants that they have available. The notion of having a program to pass on an applicant with solid credentials because of citizenship status is yes, absurd! Internationals in podiatry school are all graduates from American Schools, so thereby they are given the same priority/access (as they should) to most residency programs (notable exception are the VA hospitals). Tell me, where else can these internationals get their training? Not a single DPM program in the world exists with our scope of training. In fact, there only exists one, yes ONE podiatric surgery program that exists outside of the borders of the United States of America, and its in British Columbia, Canada. If programs are to implement your line of thinking then schools shouldn't accept international applicants. That won't be happening anytime soon.

I do get your point of view, but I just don't see this happening with Podiatry because the specialty is simply not large enough (population-wise) in comparison to our MD counterpart to have the same implemented rules/regulations with respect to handling our International graduates. A decade from now, maybe the situation will be different but where we stand today, this clearly won't be the case. Don't let the matriculating number of your class fool you. My school (OCPM) has over 110 students in the incoming class of 2011. I will guarantee you by the time we reach 2011, this number will be decreased by a minimum of 20-30%. This atrition rate is common in other schools as well (not all schools though). So the population will remain consistently small on a year-year basis, until more residency spots open up to accomodate for a growing demand. At least this is what I hope for, because otherwise we'll be back to the problem we had in the 90's with more graduates than residency spots.

 

[cool_vkb]

Bet me a $1000? Please don't make statements as such unless you're on the hospital administration boards. No offence, but I respectively disagree with your argument. You cannot compare the situation with podiatric residencies with allopathic ones. For starters, all podiatric medical graduates (foreigners/internationals at least) are graduates of a podiatric medical program in the United States of America - so your example with IMG's applying for ortho or derm residencies is completely unfounded. Second, the demand and competition for the podiatric residencies is not the same as allopathic. The numbers are smaller and the number of quality residencies is thereby even smaller - so as a result, programs (podiatric) are taking (matching) only the quality or best of the best applicants that they have available. The notion of having a program to pass on an applicant with solid credentials because of citizenship status is yes, absurd! Internationals in podiatry school are all graduates from American Schools, so thereby they are given the same priority/access (as they should) to most residency programs (notable exception are the VA hospitals). Tell me, where else can these internationals get their training? Not a single DPM program in the world exists with our scope of training. In fact, there only exists one, yes ONE podiatric surgery program that exists outside of the borders of the United States of America, and its in British Columbia, Canada. If programs are to implement your line of thinking then schools shouldn't accept international applicants. That won't be happening anytime soon.

I do get your point of view, but I just don't see this happening with Podiatry because the specialty is simply not large enough (population-wise) in comparison to our MD counterpart to have the same implemented rules/regulations with respect to handling our International graduates. A decade from now, maybe the situation will be different but where we stand today, this clearly won't be the case. Don't let the matriculating number of your class fool you. My school (OCPM) has over 110 students in the incoming class of 2011. I will guarantee you by the time we reach 2011, this number will be decreased by a minimum of 20-30%. This atrition rate is common in other schools as well (not all schools though). So the population will remain consistently small on a year-year basis, until more residency spots open up to accomodate for a growing demand. At least this is what I hope for, because otherwise we'll be back to the problem we had in the 90's with more graduates than residency spots.

I hope your words about Podiatric residency and school intake are correct. Plzz dont take my post as something i stand for.Iam just an ordinary guy with my own fears and worries about a succesfull career after school. I am doing my part in studying and just getting hyper abt the after school stuff which i will stop from today as the vaccation is over and we start our school from tomorrow.

I hope that Schools and organizations take proper steps in ensuring there is an equal ratio of applicants to residencies. Be it international or national ,all are putting same effort and money. So its their job to ensure that everyone gets a residency. Because there is so much money and time involved here. if we dont get a residnecy we are scr....wed. I hope no one suffers that.