Options for DPMs if you don't pursue a residency?

[theanswer03]

What are the options out there if a new DPM decides not to pursue a traditional 2 or 3 year residency like most DPMs do now? Is there anyway you can still practice in any shape or form w/o the 2 or 3 year residency? What about non-practice options or other things, what options are out there?

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[jonwill]

What are the options out there if a new DPM decides not to pursue a traditional 2 or 3 year residency like most DPMs do now? Is there anyway you can still practice in any shape or form w/o the 2 or 3 year residency? What about non-practice options or other things, what options are out there?

Not very many options. Most states require residency training to practice. And as there are only 2 or 3 year residencies (soon to be only 3 years), you only really have that option whether you want to do surgery or not.

Someone correct me if I'm wrong but I believe all states require residency training to practice.

 

[theanswer03]

Not very many options. Most states require residency training to practice. And as there are only 2 or 3 year residencies (soon to be only 3 years), you only really have that option whether you want to do surgery or not.

Someone correct me if I'm wrong but I believe all states require residency training to practice.

so there are no jobs out there where you could work as a DPM without a residency?

 

[Feli]

so there are no jobs out there where you could work as a DPM without a residency?

Industry consultant, teacher, researcher, etc...

...but most of those would probably still want a licensed DPM with at least some actual practice experience, which you won't get without at least having had a license at some point (and needing 1+ year of residency to get that license).

 

[IVlamisil]

Not sure if you want to, but you could work in Canada.

 

[spo01]

I recently talked to a friend who graduated from a 2 year residency several years ago. He is not getting nearly the job offers or salary he could be had he done a 3 year one. It'd work in Australia where you have those who do a 3 year residency termed "podiatric surgeon" and those who don't do a residency "podiatrist" but not here.

You knew what you were getting into when you started. If you didn't want to do a 3 year residency you shouldn't have started.

 

[cool_vkb]

What are the options out there if a new DPM decides not to pursue a traditional 2 or 3 year residency like most DPMs do now? Is there anyway you can still practice in any shape or form w/o the 2 or 3 year residency? What about non-practice options or other things, what options are out there?

States where you can practice without residnecy

1) Hawai
2)Pensylvania
3)Ohio
4) kansas or kentucy. not sure which one exactly

If that doesnt works, go to Canada or aussie or newzealand.

 

[PMSIII]

States where you can practice without residnecy

1) Hawai
2)Pensylvania
3)Ohio
4) kansas or kentucy. not sure which one exactly

If that doesnt works, go to Canada or aussie or newzealand.

You cannot work in Ohio without a residency - in fact you cannot get licensed in Ohio without at least completing your first year of residency. I cannot speak for PA, Kansas, or Kentucky but I would imagine they'd require formal residency training as well - we're trained foot and ankle physicians and surgeons not nail techs. However, I do believe that some podiatrists who practice in those aforementioned states have been "grandfathered" into their practices without formal residency training for the simple fact that they have been practicing 40 + years and probably started their practices at times were residency training was "rare" or "optional". Today, you cannot get any hospital privileges, get on insurance plans, or get licensed without formal residency training

 

[podvamp]

Yes open a practice in Canada where you can get reimbursed $12 per patient and barely make enough money to feed yourself much less cover the overhead of your office LOL. You'd make more profit as a waiter.

 

[PMSIII]

Yes open a practice in Canada where you can get reimbursed $12 per patient and barely make enough money to feed yourself much less cover the overhead of your office LOL. You'd make more profit as a waiter.

Don't know where you're getting this information from but the podiatrists I know in Canada are all doing very VERY well. They get compensated handsomely for custom orthoses, in-office procedures, and forefoot surgeries.

 

[cool_vkb]

I agree they cant get priviledges or do surgery,etc etc. but atleast they can do basic stuff and be connected to profession rather than working as a furniture salesman or driving a cab or flipping burgers.

 

[IVlamisil]

I make custom made hamburgers...hehehehe

 

[PMSIII]

I agree they cant get priviledges or do surgery,etc etc. but atleast they can do basic stuff and be connected to profession rather than working as a furniture salesman or driving a cab or flipping burgers.

You're missing the point - doesn't matter what they choose to do after their residency training. We have standards in our profession to uphold and maintain. Not only that but those standards are requirements for state licensing. Additionally, what training do you really have after 4 years of podiatry schooling? If they have no formal residency training then these practitioners have no business doing an in-office nail avulsion. Without formal residency training, how are you going to work up the PVD, neuropathic, and complicated patients with multiple co-morbidities who may present to your office for palliative care (since you mention "basic stuff"). We have standards for a reason.

 

[janV88]

You knew what you were getting into when you started. If you didn't want to do a 3 year residency you shouldn't have started.

Definitely agree. Anyone even thinking of going into Podiatry should know that Podiatry is a surgical specialty and that the current standard is 3 years residency.

 

[podvamp]

Don't know where you're getting this information from but the podiatrists I know in Canada are all doing very VERY well. They get compensated handsomely for custom orthoses, in-office procedures, and forefoot surgeries.

A doctor (who I'd like to remain anonymous) that I was working a clinical shift with one day was telling us horror stories about a friend of his who was trying to keep a practice open in Canada but couldn't due to the ridiculously low government reimbursements. He did use the figure $12 per patient multiple times in his story and called his friend crazy for trying to pull it off. That's where I'm getting it from.

Granted I can't show you evidence to prove otherwise because it's all based on his word, but he has no reason to lie to us about something like that. He could be mistakenthough... So, If you have some kind of a link to the real stats showing actual podiatric reimbursements in Canada as compared to the U.S. I'll ignore the original story I heard and go with your stats. I'd be more concerned with looking at conservative care reimbursements than surgical if at all possible.

 

[Dental Jarry]

Without a residency, your options are narrowed down to rope or pistol

 

[theanswer03]

So is it true that there are some states where you can practice without completing any residency training? Or was this a mistake by whoever posted that earlier in the thread? If this is true, what could you actually do or what would your scope of practice be if you had no residency training in one of these states?

Another completely unrelated question - how many attempts do you get at passing the pod boards step 2?

 

[Googlymello]

my question is why wouldnt you do a residency???
if you just spent four years training to be a dpm, why wouldnt you do everything in your power to maximize your knowledge and skills?

are there really people out there that are taking up seats in the class that think its okay to not do a residency? or was this just a "what if" type of question.

 

[theanswer03]

this was a what if type question. i'm not even a podiatry student. However, I have several friends who are, and I am generally pretty interested in the field.

Do you know how many chances a student has to take part 2 of the pod boards?

 

[215353]

this was a what if type question. i'm not even a podiatry student. However, I have several friends who are, and I am generally pretty interested in the field.

Do you know how many chances a student has to take part 2 of the pod boards?

I don't think I've ever heard of a limit on the number of chances a person has to take and pass the exam but since there are more podiatry graduates then residency positions...if you don't pass any of the pod boards the first time it makes it very difficult to land a residency spot. Without residency training you are really really really really screwed.

 

[PADPM]

this was a what if type question. i'm not even a podiatry student. However, I have several friends who are, and I am generally pretty interested in the field.

Do you know how many chances a student has to take part 2 of the pod boards?

I'm very curious and just a "little" suspicious why you would be asking these questions for your "friends", and even more curious why your avatar states you a "medical student"??

 

[PMSIII]

A doctor (who I'd like to remain anonymous) that I was working a clinical shift with one day was telling us horror stories about a friend of his who was trying to keep a practice open in Canada but couldn't due to the ridiculously low government reimbursements. He did use the figure $12 per patient multiple times in his story and called his friend crazy for trying to pull it off. That's where I'm getting it from.

Granted I can't show you evidence to prove otherwise because it's all based on his word, but he has no reason to lie to us about something like that. He could be mistakenthough... So, If you have some kind of a link to the real stats showing actual podiatric reimbursements in Canada as compared to the U.S. I'll ignore the original story I heard and go with your stats. I'd be more concerned with looking at conservative care reimbursements than surgical if at all possible.

No I think he is grossly misinformed. The $12 he's referring to is probably the portion covered by the government per patient per visit regardless of what care you give them - the remaining portion (the bulk) is covered by the patient or his/her private insurance. I do not have links to actual reimbursements and frankly wouldn't think this information is available online since it is very subjective and the amount of practitioners that you're looking at is very small. I say subjective because there is no uniform standard for how much they charge per procedure or customized orthoses (for example). If you have genuine interest in this subject then I recommend actually shadowing and asking these practitioners in person. The disclaimer I will include is that the ones I know have been in practice for more than 20 years plus so they're doing extremely well. One of them uses a computerized system to cast his custom-orthoses and has a mini-C arm in his office for his procedures - I don't think he can afford this with $12 per patient.

 

[PMSIII]

So is it true that there are some states where you can practice without completing any residency training? Or was this a mistake by whoever posted that earlier in the thread? If this is true, what could you actually do or what would your scope of practice be if you had no residency training in one of these states?

Another completely unrelated question - how many attempts do you get at passing the pod boards step 2?

Realistically you don't have many attempts. The test is offered in March and June every year and typically taken during your fourth year of school just prior to graduation. If you fail the March and June editions then this translates into no residency and sitting an entire year with no school and no residency - which means you'd have to re-apply to a new cycle of residency applications and essentially compete with applicants who do not have that problem or issue of failing those boards.

 

[theanswer03]

I'm very curious and just a "little" suspicious why you would be asking these questions for your "friends", and even more curious why your avatar states you a "medical student"??

I know it probably does sound fishy, but yes, I am a medical student. I have a good friend who just graduated from Temple, and so I am asking these questions mainly to find out info about her situation. I even applied to pod school in addition to medical school, but decided on med school once I got an acceptance to a pretty good school in my home state. So, I do have a genuine interest in the field for a couple of reasons.

 

[prettypod]

I posted this in another thread to get some feed back, but I have a mentee who is trying to find if he can be a hospitalist with his DPM training, maybe you can look to that as an option

 

[dpmgrad]

So is it true that there are some states where you can practice without completing any residency training? Or was this a mistake by whoever posted that earlier in the thread? If this is true, what could you actually do or what would your scope of practice be if you had no residency training in one of these states?

In the state of Pennsylvania, one can practice Podiatry without residency training. This is the reason why all of the new residents get a full Podiatry license, when they start their residency training. However, in order to obtain the Podiatry license to practice in Pennsylvania, one must take and pass the NBPME Part III board exam. If your friend is not able to obtain residency training due to the fact that he/she has not passed Part II exam, he/she will not be able to practice in Pennsylvania. Passage of Part II is a requirement for Part III exam.

Let say that your friend did pass Part III board exam and obtain a PA state license for Podiatry, he/she will have a hard time trying to get privileges at hospital, surgery centers, nursing homes, and insurance companies, etc... Most of the credentialling committees will wonder why he/she does not have residency training.

 

[podpal]

I'm getting dumped by insurance companies. The requirement of a major insurance carrier in my location informed me by mail that they require podiatrists to have an intent to become board certified, require passage of board qualification for ABPS or ABPOPPM, and have a date set for an oral board. Another insurance carrier refuses to add me because I do not have hospital privilages. Is this normal? Are other conservative care pods having this much trouble?
There is no way I can meet these requirements without residency training. What are others doing? I could go back to clinic work but wanted to branch out to meet the needs of the community and take on house calls. Help.....

 

[PADPM]

I'm afraid you may run into this situation more and more. I serve on some insurance advisory committees and have served on several other insurance advisory boards in the past, and many are confused by podiatry. It's the lack of standard post graduate training that is always the question.

Now with the upcoming standardization (project 2015), it's getting much better and now that the majority of residency programs are 36 months.

However, that doesn't help you. Most insurance companies want you to have the ability to provide "complete" care for your patients, including the ability to have some form of hospital privileges, and naturally even if you areen't applying for surgical privileges, hospitals still want you or require you to have some post graduate training.

There is no easy answer, and this will eventually gradually have a significant economic impact on your practice if it hasn't already. Your choice is in reality going to be to give up your private practice and go back and do a residency, or find a group that will allow you to merge your practice and provide palliative services for the group. You will probably be able to get on the insurance panels as a member of the existing group.

At the moment, I can think of know other real viable options. I'm not saying whether it's fair or not, but it is reality.

 

[podpal]

There is no easy answer, and this will eventually gradually have a significant economic impact on your practice if it hasn't already. Your choice is in reality going to be to give up your private practice and go back and do a residency, or find a group that will allow you to merge your practice and provide palliative services for the group. You will probably be able to get on the insurance panels as a member of the existing group.

At the moment, I can think of know other real viable options. I'm not saying whether it's fair or not, but it is reality.

Thanks for the response! I've been trying to get into residency for a few years. It's not a welcoming climate. Many directors want graduating students. One program I was really thrilled about hung up on me. I've always been very comfortable in the OR and have had really great outcomes in the past so it's kind of disappointing. This residency path will likely take time for me to get into.

Unfortunately there is a tremendous need in my community for house calls and other pods do not have the time to do them. They are time consuming, pts are very old, you never know what you're walking into. This past week I evaluated a pt. for possible pneumonia during the visit. Last week I had a pt. c tia's and evaluated complex drug therapy that is a contributing factor and needed immediate attention. I always bring stethoscope, and am prepared to do vitals, physical exam, etc. These folks are substantially more ill than the average pt who walks into a clinic. It's a shame that insurance companies don't value us but I am a strong proponent of higher education and see their point of view. Pray that I'll get into a residency so that I can continue to do valuable work for my community. BTW...regardless of pay, I will still offer services to these lovely families who are in such dire need.

 

[PADPM]

podpal,

I know you're possibly to take this wrong, but please don't.

I appreciate the fact that you're extremely thorough and you are finding significant problems with your elderly patients during your house call visits.

However, after reading your posts in the past and the statement that a residency program "hung up" the phone on you, I'm wondering whether your "people" skills (not your clinical skills) can use some touch up.

No, I do not know you and I hope you don't get defensive. However, I've been at this business for a over 20 years and have experienced the plethora of personalities and skills. As you know I've been involved with the ABPS as an examiner and I've been a residency director, so I know all the sides of the educational process.

I will refer back to your house call skills and your findings during these visits. Once you discover an issue, what do you do? Do you call the primary and TELL him/her about your findings and the need for additional treatment, do you call the primary and DISCUSS your concerns, do you call the family and RECOMMEND the patient follow up asap with the PCP?

My point is that with the skills I'm sure you possess, there is something "missing". Maybe, just maybe it's your approach. Do you come across too agressive, do you come across as if you "know it all", do you come across as someone who "isn't teachable"??

This post is not meant as an insult. I'm attempting to try to figure out why someone with your academic background and clinical acumen has constantly been shut out. There MUST be a reason other than "unlucky". The sooner you do some self-reflection, the sooner you will obtain a residency.

I believe I'm an excellent clinician/diagnostician. Early in my career, if a patient questioned my diagnosis or didn't follow my game plan I would give them a "look" that could melt ice. I didn't realize how obvious this look was, but it cost me a number of patients who felt I was "cocky" and they were 100% correct.

When it was finally brought to my attention my one of my OWN staff, I didn't want to admit it, but I realized she was correct. Once I changed my attitude, the ball started to roll, and it started rolling fast and my practice built up quickly, but more importantly, I started to appreciate my patients and vice versa.

Do some self reflection and the answer may be at your finger tips.

 

[Podfather]

I concur. I have noticed a similar message with her posts. I believe in a previous post I suggested the same. I also believe that Podpal has limited where she has applied for residency which will significantly decrease her odds. I also mentioned perhaps doing a rotation or extended visit may demonstrate her skills and and work ethic and give her a better shot at obtaining a program as not the typical applicant.

You have to be willing to go anywhere you have a chance to be accepted. I can also understand why you may be a bit bitter but at all times you need to keep that bottled up. From your previous posts, I could see some of that leaking out. You are also making a 2-3 year commitment. It is imperative that you do just that. Put everything else on hold and plan on giving 100% or you will have a miserable residency experience. You will also have to realize that although you have experience, the residency is to train you to be a trained podiatric physician and surgeon. Even if there is a way that you have done something 1000s of times while a resident you are just that essentially a student. Humble, open minded, positive, and eager to learn.

Also from your last post I could see how you might be a great family physician. You may want to ( even at your age) consider a career change. Yes it means a longer commitment but in the end you may be happier.

As with PADPM these statements are not meant to be mean spirited but hopefully helpful.

Either way good luck!!!!

 

[podpal]

podpal,
However, after reading your posts in the past and the statement that a residency program "hung up" the phone on you, I'm wondering whether your "people" skills (not your clinical skills) can use some touch up.

No, I do not know you and I hope you don't get defensive. However, I've been at this business for a over 20 years and have experienced the plethora of personalities and skills. As you know I've been involved with the ABPS as an examiner and I've been a residency director, so I know all the sides of the educational process.

I will refer back to your house call skills and your findings during these visits. Once you discover an issue, what do you do? Do you call the primary and TELL him/her about your findings and the need for additional treatment, do you call the primary and DISCUSS your concerns, do you call the family and RECOMMEND the patient follow up asap with the PCP?

Do some self reflection and the answer may be at your finger tips.

Thanks for the response. Regarding f/u, it depends upon the situation. If there are aids in the home, or visiting nurse, I communicate my concerns to them and leave a copy of my notes so they know findings and how to address a specific podiatric concern. If there are educated family members and there is no impending major concern, vitals are good, I let them know that I didn't find anything requiring immediate attention, but that if symptoms are noted by them that cause concern that they must contact the attending, even if the pt is homebound. I always let them know that my specialty is podiatry, and while I may be able to perform an exam of the lung for breath sounds, etc., this is not my area of specialty. If there is an immediate concern, I will call the attending and forward my notes to their office. From working in nursing, pharmacy, and podiatry, I've developed a very common sense approach over the past 25 + years.

I'm a VERY NONAGGRESSIVE practitioner. This is my personality too. If anything, I feel it is best to offer many treatment options to pts and that the pt ultimately should be in control of their health to the best of that persons ability. I have been told I have a fantastic bedside manner.

I do come across as a person who loves her field of podiatry and tries hard to offer treatment options that improve quality of life. The residency program I mentioned that I was interested in did not allow me to speak with the director. Instead I got a secretary who said if I didn't apply thru CASPR they had no interest in me. I told her I had applied to this program 3x thru CASPR in the past, but since I had no luck then, and there was an opening, I would like to be considered, and asked if I could PLEASE PLEASE send my materials to her. She said she screens all calls for the director and he isn't interested. She had no way to know this. I asked to PLEASE let me speak with the director, and begged her to let me have a shot at this amazing program, and she hung up on me. I was crying.

Being rejected from so many programs, probably because the directors don't know me, and it's so hard to pick a candidate who you never saw working with pts, has been a very emotional and disappointing experience. If a program would even let me clerk/extern there they would immediately see that I'm a great pick. How does someone in my shoes get a shot at an externship? I've asked to but since I'm not a student anymore I am denied clerking, externing, or even visiting.

Also, BTW, I'm locked out of this insurance panel and there doesn't seem to be anyway to get onto it. They say I need to have intent to be Board Certified. I informed them that I DO have INTENT to be Board Certified but that I can't get into residency training.

My heart aches for the new graduates who are going to be without a program. I know what this feels like; it's gut wrenching. I didn't change fields for money, I really enjoy all aspects of podiatry/medicine. I'm going now to write a letter to beg this insurance company to let me treat homebound pts that other pods will not take. Wish me luck!

 

[podpal]

I concur. I have noticed a similar message with her posts. I believe in a previous post I suggested the same. I also believe that Podpal has limited where she has applied for residency which will significantly decrease her odds. I also mentioned perhaps doing a rotation or extended visit may demonstrate her skills and and work ethic and give her a better shot at obtaining a program as not the typical applicant.

You have to be willing to go anywhere you have a chance to be accepted. I can also understand why you may be a bit bitter but at all times you need to keep that bottled up. From your previous posts, I could see some of that leaking out. You are also making a 2-3 year commitment. It is imperative that you do just that. Put everything else on hold and plan on giving 100% or you will have a miserable residency experience. You will also have to realize that although you have experience, the residency is to train you to be a trained podiatric physician and surgeon. Even if there is a way that you have done something 1000s of times while a resident you are just that essentially a student. Humble, open minded, positive, and eager to learn.

Also from your last post I could see how you might be a great family physician. You may want to ( even at your age) consider a career change. Yes it means a longer commitment but in the end you may be happier.

As with PADPM these statements are not meant to be mean spirited but hopefully helpful.

Either way good luck!!!!

Thanks for the reply. I have absolutely NO INTEREST in entering family medicine, MD or DO fields. I love podiatry, it was over years of reflection that led me to this great profession and ultimately applying to pod school. I didn't apply to MD or DO or DDS programs, I have no interest whatsoever to apply to those fields.

I am extremely eager to learn podiatric surgical procedures. I am very eager to learn more about medical imaging, anesthesia, emergency medicine, etc. as it pertains to podiatry. I have been eager to continue training in podiatry for many years. It would be sooo cool to get into a residency program, eventually become board certified, and go on to group practice, or to practice in an underserved region like I'm currently doing, with the skills to offer even more services to the pt population!

Podiatry is an outstanding profession. I tell everyone how delighted I am to be a pod and offer encouragement to students pursuing medical careers. I'm now in a position to move, if necessary, for more training.

 

[Podfather]

If you are in a position to move now then this is your first break. Take a look at all of the programs listed. Be reasonable in picking the ones you will be applying to. Odds say a stronger well known program who gets their top picks every year has no reason to change their selection process. Look for good programs that had to scramble, and where they take all qualities of an applicant (not just grades, select only from externs etc.) into the decision.

Apply to as many reasonable programs as you can afford through CASPR. THEN I would put together a package about yourself. Why you are entering residency education now. What are your goals. Talk about what you have been doing since graduation. Send case logs as to the number of patients you have seen and what you do to stay current. Copies of CME certificates, BLS, ACLS, skills courses you have attended etc.

Finally offer to go and spend extended time with them so they can get to know you. Some programs like this others do not. Those who do not may not have a program that makes visits practicaL. Finally all communication needs to be positive. Regardless of how you may been treated in the past. Focus on wanting more training to help your patients and not on insurance/hospital exclusion. In certain cases a follow up phone call starting with the chief resident (not the director since he/she may get 100 calls from students and they just can not answer them all remember most are in practice too). If the phone call route doesn't help do not get emotional and begin preparing academically for your interviews.

 

[PADPM]

I agree with all of podfather's comments. I do have an additional comment that may also be beneficial.

You are in a unique situation, and maybe you should take advantage of that situation. As podfather has already stated, many residency directors can't possibly take all calls due to their work schedule in private practice and as residency director.

However, I don't know about podfather, but I don't allow ANYONE to open my personal mail, nor does anyone open the mail of my partners or associates. Only bills or "junk mail" gets opened by our office manager(s), but any private mail or mail addressed by doctors, etc., gets opened by ONLY the doctor that is addressed on the envelope.

And THAT is exactly my point. Since you are a "seasoned" practitioner and NOT a student, I will "assume" you have your own stationery.

Therefore, I would simply write a letter stating your case. Don't tell the director about how great you are, and about everything you've accomplished, etc. Keep it simple. Let the director know that you did well academically but unfortunately did not obtain a program. At this point you feel that you would like to have the opportunity to advance your training even though you've been out for several years. You believe that additional training can benefit you and the patients you encounter in the future. Tell the director that your past experience can only enhance your training, but DO NOT get into details about your "greatness". Let the director know that you are a team player and willing and eager to learn and your experience in practice makes you even more aware and appreciative of the need for post graduate education.

The letter will at least grab his/her attention. At that point you have nothing to lose. The director will make a decision to interview/meet with you or toss the letter in the trash. It cost you a stamp.

As a former director, I would be impressed and also understand the value of a mature resident with experience, as long as the resident FULLY understood that once the program started, it was an even playing field as per podfather's post.

podfather may disagree, but since you may be at a disadvantage due to the amount of time you've been out of school, you have to be creative and utilize any advantage you do posess. Since you probably have stationery with your name, etc., I would go that route to get directly to the residency director and grab his/her attention. As I previously stated, you've got nothing to lose and it may prove beneficial.

Good luck.

 

[Feli]

Podpal, your best bet is probably just doing a fellowship... http://www.apma.org/Members/Education/CPMEAccreditation/Fellowships/CPME800updated608.aspx

Some of those are very under-applied to and will take someone who didn't do a residency (I don't think they are supposed to, but some do), esp if it's a year where nobody who did a residency applies to the fellowship program. There are also many other non-APMA approved fellowships out there. That will give you enough accredited post-grad training to get/stay on some plans, probably get a license if you change states, and become board cert (by at least some rinky dink pod board - maybe not ABPOPPM and def not ABPS, though).

Your odds of getting a residency as a prior grad are VERY long heading into a residency shortage. Even if you were a good student, there are a ton of good students graduating who will be given preference due to the stigma (which persists since it's usually true) that an applicant rejected for residencies in the past lacked smarts, work ethic, and/or personality, etc etc qualities which chosen candidates had. Also, I don't know if you've passed NBPMEs or not, have a felony, etc that would put you at automatic bottom of the pile even if you were a current grad... but the number of current grads who have NBPME passage, etc for residency reqs will outnumber the number of PM&S spots in the coming years anyways. It's a tough time for a CASPR applicant to have any disadvantage - much less be a prior grad / repeat residency applicant with disadvantages.

Again, don't take offense, but as a past grad, your shot at getting a residency is very slim - even if you have no major application holes are flexible on location, etc. However, I'm sure some of the APMA or non-APMA fellowships out there go unfilled each year. Just make sure they will lead to one or more years of approved post grad training for state licensing, insurance plans, hospital staff, board cert, etc which is your ultimate goal. Residencies? You won't see any PM&S going unfilled in the coming years unless it's a program that is losing its accreditation anyways.

"I don't try to jump over 7 foot bars. I look for 1 foot bars that I can step over." -Warren Buffett

 

[podpal]

Podpal, your best bet is probably just doing a fellowship... http://www.apma.org/Members/Education/CPMEAccreditation/Fellowships/CPME800updated608.aspx

Some of those are very under-applied to and will take someone who didn't do a residency (I don't think they are supposed to, but some do), esp if it's a year where nobody who did a residency applies to the fellowship program. There are also many other non-APMA approved fellowships out there. That will give you enough accredited post-grad training to get/stay on plans, get a license if you change states, and bocome board cert (by at least some rinky dink pod board - maybe not ABPOPPM and def not ABPS, though).

Your odds of getting a residency as a prior grad are VERY long heading into a residency shortage. Even if you were a good student, there are a ton of good students graduating who will be given preference due to the stigma (which persists since it's usually true) that an applicant rejected for residencies in the past lacked smarts, work ethic, and/or personality, etc etc qualities which chosen candidates had. Also, I don't know if you've passed NBPMEs or not, have a felony, etc that would put you at automatic bottom of the pile even if you were a current grad... but the number of current grads who have NBPME passage, etc for residency reqs will outnumber the number of PM&S spots in the coming years anyways. It's a tough time for a CASPR applicant to have any disadvantage - much less be a prior grad / repeat residency applicant with disadvantages.

Again, don't take offense, but as a past grad, your shot at getting a residency is very slim - even if you have no major application holes are flexible on location, etc. However, I'm sure some of the APMA or non-APMA fellowships out there go unfilled each year. Just make sure they will lead to one or more years of approved post grad training for state licensing, insurance plans, hospital staff, board cert, etc which is your ultimate goal. Residencies? You won't see any PM&S going unfilled in the coming years unless it's a program that is losing its accreditation anyways.

"I don't try to jump over 7 foot bars. I look for 1 foot bars that I can step over." -Warren Buffett

Feli, this is not even remotely good advice. Fellowships DO NOT LEAD to ABPS OR ABPOPPM certification that is REQUIRED BY INSURANCE.

This is the letter I got from Insurance:

Board Certification Intent - our policy requires podiatrist to hold the degree of Doctor of Podiatric Medicine from an accredited institution, have satisfactorily completed the Board qualifying exam given by the American Board of Podiatric Surgery, or the American Board of Podiatric Orthopedics and Primary Podiatric Medicine and have a confirmed date to take the oral portion of the exam.

Fellowships will not ever lead to board cert. I WANT TO BECOME BOARD CERT in either ABPS or ABPOPPM. PERIOD. I MUST get residency training. There is NO OTHER WAY.

Obviously I've passed all of the boards, probably when you were still in high school. I've been in practice for a long time. I wouldn't be in practice if I had felony charges...LOL. I'll let you know when I get a program. Hopefully soon and hopefully not far from where I'm currently practicing. I'm still networking.

 

[janV88]

Feli, this is not even remotely good advice. Fellowships DO NOT LEAD to ABPS OR ABPOPPM certification that is REQUIRED BY INSURANCE.

This is the letter I got from Insurance:

Board Certification Intent - our policy requires podiatrist to hold the degree of Doctor of Podiatric Medicine from an accredited institution, have satisfactorily completed the Board qualifying exam given by the American Board of Podiatric Surgery, or the American Board of Podiatric Orthopedics and Primary Podiatric Medicine and have a confirmed date to take the oral portion of the exam.

Fellowships will not ever lead to board cert. I WANT TO BECOME BOARD CERT in either ABPS or ABPOPPM. PERIOD. I MUST get residency training. There is NO OTHER WAY.

Obviously I've passed all of the boards, probably when you were still in high school. I've been in practice for a long time. I wouldn't be in practice if I had felony charges...LOL. I'll let you know when I get a program. Hopefully soon and hopefully not far from where I'm currently practicing. I'm still networking.

I usually don't comment on other people's personal attitudes but I think I need to point something out to you.

Please re-read the bolded. Feli was trying to help you out. He made a mistake but he still did a good deed yet you rip him apart. You need to be careful with how you talk to people. This may be why you are having such a hard time getting a residency spot.

 

[podpal]

I usually don't comment on other people's personal attitudes but I think I need to point something out to you.

Please re-read the bolded. Feli was trying to help you out. He made a mistake but he still did a good deed yet you rip him apart. You need to be careful with how you talk to people. This may be why you are having such a hard time getting a residency spot.

Suggesting that a seasoned practitioner do a fellowship that has no hope of leading to ABPS certification is not helping. The problem is that we have a MAJOR residency shortage going on and insurance companies are dumping practitioners like me who have been practicing for years. Insurance companies do not care that individual states license us, they make up their own rules. It's a game and we have to play it or risk not getting paid for the pts we treat. Feli suggests that I may be a felon, that's not rude? It's ok for some to get residency training but not all of us? I disagree. This is an unbelievable situation to be in! I joined this forum because I thought we were all in this field together, to help each other, and support one another. This is more of a bashing than anything else. I don't need people to bash me, I'm already getting enough of it from the insurance companies. I'm really stressed out right now. I'm not going to get paid for a pile of pts I've already treated and my hands are totally tied until I complete residency training. I've been jumping through hoops to get a program and am spinning my wheels in the process. Thing is...I know that the profession is going to develop a whole lot more people just like me because they wish to graduate so many more students with no hope of getting a residency program. Wait till next year.

 

[Feli]

...This is the letter I got from Insurance:

Board Certification Intent - our policy requires podiatrist to hold the degree of Doctor of Podiatric Medicine from an accredited institution, have satisfactorily completed the Board qualifying exam given by the American Board of Podiatric Surgery, or the American Board of Podiatric Orthopedics and Primary Podiatric Medicine and have a confirmed date to take the oral portion of the exam...

Thanks for clairification. Since that letter was sent to you, I obviously didn't get the memo lol. Every hospital, insurance plan, state, etc has their own rules. You seem to write as if "insurance" is a single entity or all plans have a carbon copy contract (although most are at least loosely based off Medicare).

I just was letting you know that a fellowship might be easier to get than a residency. A fellowship year will sometimes meet the reqs for some state licenses, insurances, hospitals, etc that require 1yr of post grad training. "Seasoned practitioners" have gone back and done fellowships for that reason - as well as just to have more to offer their pts. As I said, it won't lead to ABPS and probably not to ABPOPPM either (maybe a 2yr CPME approved fellowship would?). Apparently no fellowship would help with the specific insurance plan you desire, but way to snap at someone trying to throw you a bone.

If you want ABPS, there is obviously no way around that besides doing CASPR match, getting a PM&S program, and working hard to meet their current reqs for cert. That will be an uphill battle, but I wish you GL.

 

[Black Surgeon]

Again, don't take offense, but as a past grad, your shot at getting a residency is very slim - even if you have no major application holes are flexible on location, etc.

I don't see why anyone woud make such a statement, except to be completely discouraging.The residency match process is extremely SUBJECTIVE. No one is in a position to make such an essentialist statement. Applicants like Podpal do not come around very often. It isn't as if he got a DPM and decided to eat bananas at his parent's house for five years before applying for residency.

On the contrary, I would venture to say that many PDs would be willing to give you a chance. My advice to you is to apply to as many programs as possble. I'm almost certain that more than one program will be willing to give you a chance.

Moreover, the advice you got above about not stressing the insurance/reimbursement issue, but instead, your desire to further your education in a way which will enable you to better help your patients is optimal. I'd be very surprised if you didn't get a chance at residency. I almost feel as if the profession owes it to you.

Note: I have nothing against you Feli. You are certainly a great poster, and definitely dedicate a lot of your time to helping people on this forum. I admire your dedication, and also acknowledge the fact that most of your posts are on point.

 

[dtrack22]

The Black Surgeon must have a lot of experience with CASPR to be shelling out residency advice to a pod. And why are people still trying to help podpal? It's pretty evident that she's not willing to do what it takes to get a residency. Remember all of her previous posts about admittedly not applying to enough programs and having secretary's hang up on her? It's like the thread in the pre-pod forum about getting turned down by "20" podiatrists in a row when trying to shadow. A little laziness, combined with obvious embellishment makes for a sad (if not ridiculous) story. As for the residency shortage, don't worry podpal, once again the only students not matching are those who couldn't pass their boards...

 

[PADPM]

I made what I thought was an excellent recommendation to podpal regarding her utilizing her ability as a "seasoned" practitioner to "slip in" and write to the residency director directly via the use of her stationery.

That is one way to get his/her attention, and an advantage a student does not have available. As a former residency director, I personally would be impressed by the person who tried hard enough to contact me. It would show a strong desire.

But despite my post.....podpal never commented on my recommendation. And once again, it's coming from someone who served as a residency director!!

 

[Podfather]

Suggesting that a seasoned practitioner do a fellowship that has no hope of leading to ABPS certification is not helping. The problem is that we have a MAJOR residency shortage going on and insurance companies are dumping practitioners like me who have been practicing for years. Insurance companies do not care that individual states license us, they make up their own rules. It's a game and we have to play it or risk not getting paid for the pts we treat. Feli suggests that I may be a felon, that's not rude? It's ok for some to get residency training but not all of us? I disagree. This is an unbelievable situation to be in! I joined this forum because I thought we were all in this field together, to help each other, and support one another. This is more of a bashing than anything else. I don't need people to bash me, I'm already getting enough of it from the insurance companies. I'm really stressed out right now. I'm not going to get paid for a pile of pts I've already treated and my hands are totally tied until I complete residency training. I've been jumping through hoops to get a program and am spinning my wheels in the process. Thing is...I know that the profession is going to develop a whole lot more people just like me because they wish to graduate so many more students with no hope of getting a residency program. Wait till next year.

Podpal, I truly wish you luck but after several people tried to help you, you choose to let your real reason for not getting a residency shine through once again. Your attitude. You may be "seasoned" but are untrained and inexperienced. You freely admit that you do not do surgery frequently so at the very least you are not surgically seasoned. You state that we should help each other and yet when people try to you seem to always take offense.

I know many nonresidency trained DPMs or one year trained ones who have worked hard, gained experience, and sat for the ABPS before the window closed and passed. You did not. Now somehow the profession has to solve your problems. Your problem is not a profession problem but a podpal problem. My advice: stay off the forum and step up. Give 100% and make an effort to get a residency. Follow or don't follow the advice given just do something and not half-a.... Quit whining, complaining, and attacking and do something and not just go through the motions. I can't imagine your phone calls to hospital and insurers who asked for your board certification status. Your political style is abrasive and if I were on the other end of it would make every effort to expedite you leaving my hospital or insurance panel.

Now I am sure you will use this post to demonstrate how evil we all are, uncaring, and support exclusivity. I would suggest you re-read your own posts and see why you are in the situation you are in now.


Ciao

 

[podpal]

I don't see why anyone woud make such a statement, except to be completely discouraging.The residency match process is extremely SUBJECTIVE. No one is in a position to make such an essentialist statement. Applicants like Podpal do not come around very often. It isn't as if he got a DPM and decided to eat bananas at his parent's house for five years before applying for residency.

On the contrary, I would venture to say that many PDs would be willing to give you a chance. My advice to you is to apply to as many programs as possble. I'm almost certain that more than one program will be willing to give you a chance.

Moreover, the advice you got above about not stressing the insurance/reimbursement issue, but instead, your desire to further your education in a way which will enable you to better help your patients is optimal. I'd be very surprised if you didn't get a chance at residency. I almost feel as if the profession owes it to you.

Note: I have nothing against you Feli. You are certainly a great poster, and definitely dedicate a lot of your time to helping people on this forum. I admire your dedication, and also acknowledge the fact that most of your posts are on point.

Thanks for the words of encouragement! I'm doing all that I can to get into a program THIS YEAR! Another poster suggested that I contact PDs and I've been doing that for several months. I've written to a few PDs and have friends that are involved with training residents. I'm well known and very well respected in my medical community so networking is going very well. It's shocking to be bashed by members of my own profession though. They really kick one another when they're down. If a poster doesn't immediately take their advice they bash the poster, kinda cruel, kinda embarassing, and presumptuous to think the poster hasn't already tried those methods.
I"m hangin on tight to this roller coaster and not letting go until I get ABPS board certification! I've worked so hard for so long to give up now! Thanks so much for the kind words...Hugs!

 

[dtrack22]

It's shocking to be bashed by members of my own profession though. They really kick one another when they're down. If a poster doesn't immediately take their advice they bash the poster, kinda cruel, kinda embarassing, and presumptuous to think the poster hasn't already tried those methods

lol

Now I am sure you will use this post to demonstrate how evil we all are, uncaring, and support exclusivity.

you truly are the "podfather"...or miss Cleo, either way, you called it

 

[Feli]

...don't take offense, but as a past grad, your shot at getting a residency is very slim - even if you have no major application holes are flexible on location, etc....

I don't see why anyone woud make such a statement, except to be completely discouraging.The residency match process is extremely SUBJECTIVE. No one is in a position to make such an essentialist statement. Applicants like Podpal do not come around very often. It isn't as if he got a DPM and decided to eat bananas at his parent's house for five years before applying for residency.

On the contrary, I would venture to say that many PDs would be willing to give you a chance. My advice to you is to apply to as many programs as possble. I'm almost certain that more than one program will be willing to give you a chance...

It's simply the facts. If you don't want to take my word for it, maybe you can look for other sources - ie the horse's mouth:

http://www.casprcrip.org/html/casprcrip/previousgrads.asp

 

[PADPM]

Podpal, I truly wish you luck but after several people tried to help you, you choose to let your real reason for not getting a residency shine through once again. Your attitude. You may be "seasoned" but are untrained and inexperienced. You freely admit that you do not do surgery frequently so at the very least you are not surgically seasoned. You state that we should help each other and yet when people try to you seem to always take offense.

I know many nonresidency trained DPMs or one year trained ones who have worked hard, gained experience, and sat for the ABPS before the window closed and passed. You did not. Now somehow the profession has to solve your problems. Your problem is not a profession problem but a podpal problem. My advice: stay off the forum and step up. Give 100% and make an effort to get a residency. Follow or don't follow the advice given just do something and not half-a.... Quit whining, complaining, and attacking and do something and not just go through the motions. I can't imagine your phone calls to hospital and insurers who asked for your board certification status. Your political style is abrasive and if I were on the other end of it would make every effort to expedite you leaving my hospital or insurance panel.

Now I am sure you will use this post to demonstrate how evil we all are, uncaring, and support exclusivity. I would suggest you re-read your own posts and see why you are in the situation you are in now.


Ciao

Facts, and nothing but the facts and truly words of wisdom. "Spot on".

As per my original post in this thread, I stated that perhaps her "people skills" and not her clinical skills can use some touch up. I stand by that statement, and now it's more apparent that ever.

 

[cg2a93]

I used to do home visits when I first started and the majority of my patients were medicare patients. I was not on BCBS or any other plans. I didnt need to be just to do home visits or even nursing home work.

 

[podpal]

I used to do home visits when I first started and the majority of my patients were medicare patients. I was not on BCBS or any other plans. I didnt need to be just to do home visits or even nursing home work.

I didn't think I would need to be on other plans either. Problem is Medicare is now being outsourced to other plans, including bcbs. Another BIG problem I ran into is one of the homes I do has a high number of rehabilitation pts. Many have private insurance that I have no hope of getting onto. As more and more Medicare pts go onto these other insurance subscribers I'm getting into more and more of a billing nightmare. In this new climate of practice it's imperitive to have board certification to get onto and continue to be on insurance plans. I'm making getting into residency a full time second job...LOL. I'm actually leaving days empty to work on residency issues.