Longer than three year residency?

[GypsyHummus]

hey everyone,

So I had a question posed to me this weekend by someone looking at pod school and it got me thinking. The question was "do you see podiatry ever having a longer residency?"

The history of the profession has seen 1-2 year long ones before. To my knowlage, there are still pods practicing who graduated from a 1 and 2 year residency, and I would assume they are at a great disadvantage to new minted pods. I for sure think the standardization of a 3 year residency was a good call, bringing us on par with other medical specialties, but in the medical field, we are one of the shortest, next to family Med, internal, and peds, and non of those docs do surgery like us.

Even though we are working with a select area of the body, should we do a 4 or even 5 year residency like the general surgeons? I know fellowships exist for foot and ankle, such as limb salvage and sports Med, but those are rather few and far between.

What are yalls thoughts?

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[Weirdy]

"4 year programs are for those who can't get all their cases within 3 years"

Forgot who typed that but it was mentioned in the residents thread regarding a 4 year program.

Lot of people chimed in with reasons for and against but majority consensus seemed to agree with the above quote.

Why make it longer than it should be? If 3 years is enough for you to get all your cases to sit for PMSR/RRA Cert, gain surgical and care experience there should be no reason to make it longer. Opportunity costs.

Gen Surg has a 5 year residency for the simple reason that their scope of practice is greater.

 

[DexterMorganSK]

I believe I asked this 4-year question back in the days in the resident forum because the hospital I volunteered at, that I see myself working in, has a 4-year residency.

NewYork-Presbyterian/Queens - Podiatric Medicine and Surgery

I think as a POD, a 3-year residency should be sufficient to learn and get the required certifications.
4-year residencies do exist for Pods, and that first year is usually an intern year where you would rotate through other disciplines in medicine, like any other resident in another field. But, as a Pod, I fail to see the importance of this intern year because we will only be dealing with the lower extremity deformities.

That said, in the future when we apply for residency, we may not have an option of not including an institution that has a 4-year residency vs a 3 year because, at that point, matching is the most important thing.

 

[GypsyHummus]

People in the past thought that a 1 year residency was enough as well tho.

 

[DexterMorganSK]

People in the past thought that a 1 year residency was enough as well tho.

For sure and for that time, 1-year was probably fine too, as some did 1 and some did 2-years. But in today's world, when we are trying to compare or fight for similar compensation as the MDs/DOs, then having a set number of residency helps.

Who knows, maybe the length might increase to 4-years in the future.

 

[GypsyHummus]

But then what becomes of us who only have a 3 year residency?

For sure and for that time, 1-year was probably fine too, as some did 1 and some did 2-years. But in today's world, when we are trying to compare or fight for similar compensation as the MDs/DOs, then having a set number of residency helps.

Who knows, maybe the length might increase to 4-years in the future.

 

[KSUCPMMM]

But then what becomes of us who only have a 3 year residency?

Same thing that happened to podiatrists that only had 1 or 2 year residencies. They have continuing education and learn on the job through experience. The same thing will happen to the current generation if 4 year residencies happen in the future. It'a not like those who complete 3 year residencies will be at a huge disadvantage or anything.

Speaking anecdotally my SO is an MD in a 4 year psych residency now, he has told me that he wishes that his program was only 3 years because he says that by the middle of it you have a pretty good idea of how to practice and the latter half is really just about fine tuning skills. Take his opinion as you will.

 

[bobtheweazel]

I wouldn't say that 4 year residencies are only for when you can't get enough cases in 3 years. That doesn't make sense because (1) the number of cases required is not a lot and (2) there are programs with 3 year and 4 year spots, meaning that they do have enough cases to get by with only 3 years with the extra year being additional cases.

3 years sounds great because it's the shortest "surgical" residency out there and people generally want to get through it and get practicing. On the other hand, think of all the opportunities you get during residency that you'll never get for the rest of your career, especially later on in your residency when you can be a little more selective with your cases. Working with different specialties. Slipping into the OR to give an orthopedist or another doc a hand and learning from these people. Extending that out a year could be valuable.

Whereas when you get out of residency you're not gonna just be able to piggy back on someone else's case cause it looks fun or interesting. You'll have your own case load and quotas to worry about.

I'm not saying either is better or worse, but there are pros and cons to both sides of the 3 vs 4 debate.

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[AttackNME]

More training is always better, you will get better pay and will be more prepared. If the norm is 3 year but you are in a 4 year program yea you will feel anxious to get started but those in the extended programs will reap benefits after spending time in practice. Honestly I see future of podiatry even possibly going into 5 year programs that can triple their numbers and distinguish themselves from the minimum 3 year programs. There needs to be a separation between forefoot only vs those that can do everything. Think about it in terms of availability of procedures. Forefoot procedures are much much more common than rearfoot and ankle procedures, so naturally it takes more time to get good at it. Our minimum rearfoot numbers really should be double to triple that, and few programs can supply that within 3 years to all of their residents.