- Joined
- Apr 2, 2014
- Messages
- 4
- Reaction score
- 0
GREAT LAKES RESIDENCY GENESIS
[email protected]
A Call to Arms
Everyone has made great strides in alleviating the residency crisis. This shows the progression and forethought necessary for our profession to succeed, now and in the future.
We ask that you apply your unique talents in further problem solving this ongoing shortage.
The New Face of a Residency Program
While many make suggestions at unexplored solutions to the residency problem, it is incumbent upon the leaders of the Podiatric Community to provide the solution and implement change. This will begin an evolution of the Podiatric Residences experience.
Our Galapagos Island.
The new residency concept is very simple and meets all the requirements of CPME 320. This past summer CPME removed the stipulation that 1/6th of all training must be done within a geographic area (commuting distance) of the sponsoring institution. This should have exploded the opportunities for residency development. The removal of geographic limitations allows us to think nationally. Everyone has something to offer a training program. Whether it's one case, one lecture, or one rotation. Resources can be gathered to aggregate into a cohesive program.
Additionally, a solution has been found to eliminate time constraints faced by many doctors wanting to participate. We are centralizing the administration process of this program. This allows doctors to spend their time with their resident. Training doctors will not be responsible for all components that make a residency. These doctors can focus on parts that they enjoy, teaching.
Success
To date, we have secured the non-podiatry component of the rotations and a Sponsoring Institution. The resident will complete their non-podiatric residency the first year. Specifically, a Tenet healthcare hospital will be our first hospital within the Network. The Tenet healthcare hospital already has a Podiatry Program at their institution. We will be adding a new program at a sister hospital. Our sponsoring institution is owned by Tenet Health; they in turn have 77 hospitals nationwide. Hospitals will be utilized to satisfy the non-podiatric requirement. This first year is not a transitional year, RPR, or other variant. The Program Director decides when to best complete the non-podiatric requirements as per CPME 320. We simply believe it is best completed in the first year.
Many share this assertion. We feel the resident who has completed one year experience is better able to handle the rigors of Podiatric Medical and Surgery. Who does not believe that a resident is better prepared understanding medicine in context?
“Show Me the Money”
The Program is fully funded for all three years. This allows all to benefit. The hospital, the doctor and most importantly the resident. The largest frustration we have faced in developing this concept is the lack of domain skill some in our Profession possess in the field of GME funding, myself included. I only bring this to attention because it is essential in fix this crisis. Many programs received a misinterpretation of the current laws. Doctors we have spoken with abandoned the idea of starting a program because the local hospital did not believe it would be financially viable, although the local community supported the idea.
A three year Podiatric Residency can be fully funded without geographic concerns or the necessity of concerning the local hospital.
At the penning of this statement the “Party Line” view is that External rotation are not a payable service under CMS. This could not be further from the truth. This all changed in 2010 with the ACA. Many still have not realized this dramatic change.
Briefly, CMS pays the Sponsoring Institution for DME and IME. The Hospital then pays the resident and everybody else including teaching fees to doctors. The problem arises that many believe if the Resident rotates outside of the hospital, their funding is in jeopardy. While it is true that if a Resident rotates at another “Provider” hospital there is a problem. However, the CMS does allow for external rotation to “Non-Providers”settings. This “Non-Provider” includes surgery centers, doctors, or offices. These are sites at which or residents will train. In short, one year in the hospital two year on external rotation: full payment.
The ACA has provided a solution to our problem. The ACA will provide an uncapped amount to podiatry. So, let us look at the math and the facts only. We will have roughly 200 current qualified graduates and a projected 50 additional after this July of 2014 without a track to follow to become licensed. Granted, some of these individuals will not pass the boards. However, there are a large percent of deserving students to the tune of roughly 120 podiatrists that require us to understand our current laws to develop programs. The CMS will provide full funding at an uncapped amount to train these individuals. The sponsoring Hospital meets their own fiduciary responsibilities as they get paid $125,000 per full time equivalent. They have a net profit after expenses. The CPME and CMS have cleared the path. All we have to do is contribute minimally to any program with our time.
Who Will Get the Teaching Stipend
Our residency model is a free market advocate. Who is going to put out the better product? The resident will have a choice of approved rotation. The doctors will compete to put together the best training experience possible.
CPME does requires equal training experience for all within a Program.
Imagine a program that the best in their respective fields of podiatry is available from which to choose. A particular resident may not wish to spend months on end cutting toe nails waiting for their turn in the OR. Others my want to focus on the the palliative care and practice management, never caring to ever do an ankle fusion in later practice. Residents can have a voice. If the education experience is of no value to their education they will not rotate thru that doctor. They will have a choice of Podiatric sub specialty to focus their limited time.
We know residency training is not an economic factor in our lives, but it can be used as a barometer in the value of our training methods.
This concept of residency will be liberating to existing Programs. No longer will you have to be at the mercy of the Hospital. Local politics has nothing to do with proper residency training. Existing Programs can move the Sponsoring Institution to facilities that understand the value, while maintaining the podiatric medicince and surgical locally.
We have spoken with many physicians who have dedicated their lives to teaching. They have opened up their offices and hearts to their charges. They also possess the important Surgical numbers, which are key to opening new positions. They hold the keys to the kingdom. They should be paid. “Administration” should be a small portion of the overall teaching fees.
Our Support
In our endeavors we have spoken with the heads of podiatric education. Alan Tinkleman the Director of the Council on Podiatric Medical Education, has been advising us on this progressive approach to increasing residency positions. We will adhere strictly to the Standards and Requirement for Approval of Podiatric Medicine and Surgery Residencies detailed in the CPME 320.
AACPM's National Residency Facilitation Project has offered its continued assistance. We will offer the Project a sponsoring institution and the cases needed to meet each component of the CPME 320. Our goal is to be the “matchmaker” for these two components.
Dr. Matt Garoufalis, APMA President, has offered his support for our residency, along with members of the APMA board of trustees.
A Tenet healthcare hospital has offered to train our residents in their hospital based external rotations, as well as sponsor our program throughout the three year course of study. This sponsorship includes all resources hospitals provide residents; salaries, malpractice, library resources, administration, etc.
[email protected]
[email protected]
A Call to Arms
Everyone has made great strides in alleviating the residency crisis. This shows the progression and forethought necessary for our profession to succeed, now and in the future.
We ask that you apply your unique talents in further problem solving this ongoing shortage.
The New Face of a Residency Program
- One year at a sponsoring institution, providing the non-Podiatry requirement. In our case, a Tenet healthcare hospital
- Second year and third year Podiatric Medicine and surgery at multiple locations, both in Midwest and nation wide, outside of the sponsoring institution area.
- All three years must be completed per CPME320 standards.
While many make suggestions at unexplored solutions to the residency problem, it is incumbent upon the leaders of the Podiatric Community to provide the solution and implement change. This will begin an evolution of the Podiatric Residences experience.
Our Galapagos Island.
The new residency concept is very simple and meets all the requirements of CPME 320. This past summer CPME removed the stipulation that 1/6th of all training must be done within a geographic area (commuting distance) of the sponsoring institution. This should have exploded the opportunities for residency development. The removal of geographic limitations allows us to think nationally. Everyone has something to offer a training program. Whether it's one case, one lecture, or one rotation. Resources can be gathered to aggregate into a cohesive program.
Additionally, a solution has been found to eliminate time constraints faced by many doctors wanting to participate. We are centralizing the administration process of this program. This allows doctors to spend their time with their resident. Training doctors will not be responsible for all components that make a residency. These doctors can focus on parts that they enjoy, teaching.
Success
To date, we have secured the non-podiatry component of the rotations and a Sponsoring Institution. The resident will complete their non-podiatric residency the first year. Specifically, a Tenet healthcare hospital will be our first hospital within the Network. The Tenet healthcare hospital already has a Podiatry Program at their institution. We will be adding a new program at a sister hospital. Our sponsoring institution is owned by Tenet Health; they in turn have 77 hospitals nationwide. Hospitals will be utilized to satisfy the non-podiatric requirement. This first year is not a transitional year, RPR, or other variant. The Program Director decides when to best complete the non-podiatric requirements as per CPME 320. We simply believe it is best completed in the first year.
Many share this assertion. We feel the resident who has completed one year experience is better able to handle the rigors of Podiatric Medical and Surgery. Who does not believe that a resident is better prepared understanding medicine in context?
“Show Me the Money”
The Program is fully funded for all three years. This allows all to benefit. The hospital, the doctor and most importantly the resident. The largest frustration we have faced in developing this concept is the lack of domain skill some in our Profession possess in the field of GME funding, myself included. I only bring this to attention because it is essential in fix this crisis. Many programs received a misinterpretation of the current laws. Doctors we have spoken with abandoned the idea of starting a program because the local hospital did not believe it would be financially viable, although the local community supported the idea.
A three year Podiatric Residency can be fully funded without geographic concerns or the necessity of concerning the local hospital.
At the penning of this statement the “Party Line” view is that External rotation are not a payable service under CMS. This could not be further from the truth. This all changed in 2010 with the ACA. Many still have not realized this dramatic change.
Briefly, CMS pays the Sponsoring Institution for DME and IME. The Hospital then pays the resident and everybody else including teaching fees to doctors. The problem arises that many believe if the Resident rotates outside of the hospital, their funding is in jeopardy. While it is true that if a Resident rotates at another “Provider” hospital there is a problem. However, the CMS does allow for external rotation to “Non-Providers”settings. This “Non-Provider” includes surgery centers, doctors, or offices. These are sites at which or residents will train. In short, one year in the hospital two year on external rotation: full payment.
The ACA has provided a solution to our problem. The ACA will provide an uncapped amount to podiatry. So, let us look at the math and the facts only. We will have roughly 200 current qualified graduates and a projected 50 additional after this July of 2014 without a track to follow to become licensed. Granted, some of these individuals will not pass the boards. However, there are a large percent of deserving students to the tune of roughly 120 podiatrists that require us to understand our current laws to develop programs. The CMS will provide full funding at an uncapped amount to train these individuals. The sponsoring Hospital meets their own fiduciary responsibilities as they get paid $125,000 per full time equivalent. They have a net profit after expenses. The CPME and CMS have cleared the path. All we have to do is contribute minimally to any program with our time.
Who Will Get the Teaching Stipend
Our residency model is a free market advocate. Who is going to put out the better product? The resident will have a choice of approved rotation. The doctors will compete to put together the best training experience possible.
CPME does requires equal training experience for all within a Program.
Imagine a program that the best in their respective fields of podiatry is available from which to choose. A particular resident may not wish to spend months on end cutting toe nails waiting for their turn in the OR. Others my want to focus on the the palliative care and practice management, never caring to ever do an ankle fusion in later practice. Residents can have a voice. If the education experience is of no value to their education they will not rotate thru that doctor. They will have a choice of Podiatric sub specialty to focus their limited time.
We know residency training is not an economic factor in our lives, but it can be used as a barometer in the value of our training methods.
This concept of residency will be liberating to existing Programs. No longer will you have to be at the mercy of the Hospital. Local politics has nothing to do with proper residency training. Existing Programs can move the Sponsoring Institution to facilities that understand the value, while maintaining the podiatric medicince and surgical locally.
We have spoken with many physicians who have dedicated their lives to teaching. They have opened up their offices and hearts to their charges. They also possess the important Surgical numbers, which are key to opening new positions. They hold the keys to the kingdom. They should be paid. “Administration” should be a small portion of the overall teaching fees.
Our Support
In our endeavors we have spoken with the heads of podiatric education. Alan Tinkleman the Director of the Council on Podiatric Medical Education, has been advising us on this progressive approach to increasing residency positions. We will adhere strictly to the Standards and Requirement for Approval of Podiatric Medicine and Surgery Residencies detailed in the CPME 320.
AACPM's National Residency Facilitation Project has offered its continued assistance. We will offer the Project a sponsoring institution and the cases needed to meet each component of the CPME 320. Our goal is to be the “matchmaker” for these two components.
Dr. Matt Garoufalis, APMA President, has offered his support for our residency, along with members of the APMA board of trustees.
A Tenet healthcare hospital has offered to train our residents in their hospital based external rotations, as well as sponsor our program throughout the three year course of study. This sponsorship includes all resources hospitals provide residents; salaries, malpractice, library resources, administration, etc.
[email protected]
Last edited:
