Please help...I'm confused!

[MystA RavE]

Up until today, I thought I had my whole life planned out. I knew I wanted to be an anesthesiologist and I was working my way towards that. I have spent countless hours in operating rooms observing this and it is something I could definitely see myself doing. At this point, I am graduating college next semester (fall) with a 3.8 and a whole bunch of extracurriculars. I haven't taken my MCAT yet but it is coming up soon. Today, it all hit me that being an MD might not be what I want out of my life. After having spoken to many people, I see that whole competitive aspect of the MD path is full of many people who are disappointed with what they are doing at a point in their lives where there is no turning back. It is also evident to me that I could end up forcing myself into this and then end up not being an anesthesiologist.

I automatically thought back to the time I shadowed a DPM, Dr.Campbell, at Maimonides Hospital in Brooklyn,NY. At the time, I hadn't taken much notice at the fact that he seemed extremely happy with what he was doing. Looking back, he is one of the few doctors I have met with that attitude (comparing him to many MDs that I have spoken to). I remember enjoying what he was showing me and how he handled his patient's presenting problems. I could see myself doing this in the future, but I would most definitely be interested in surgery as well.

My main questions are the following:

• How does the DPM system work... is the match after podiatry school highly competitive for surgery residencies? Is there a good chance of not receiving a surgical residency? (From my understanding, this comes after the regular DPM residency)
• What is the approximate salary for a DPM surgeon after residency? This should seem like an easy number to find online but I haven't been able to locate it. I'm not asking this because I am money hungry, but because I would like to know an approximate number before potentially getting myself into this profession.

Any input on the subject is appreciated. Thanks!

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[KHep]

There are several threads that discuss these issues; you can do a search. But, as far as surgical residencies, all are now surgical. You have a choice between a Podiatric Medicine & Surgery 24 month or 36 month. The 36 month programs have more ankle training to give you a very very basic explanation. You have to match to programs just the same as in MD or DO programs, but all programs are now surgical.

Salaries vary widely, but again do a search and there are some great posts on this subject.

Good Luck with your decision!

 

[NatCh]

Income really varies widely. I've seen as low as $20K per year up to guys who made seven figures. The variance is due to widely ranging levels of desire and business skill. You can choose to work part time or 100 hours per week. I believe a podiatry survey a year or two ago placed median at about $120k.

As for happiness, that's largely personal. I know that I've met both happy and unhappy docs in most specialties. Personally I am overjoyed with my choice of profession. I look forward to going to work. I work 2 - 2.5 days per week and make more than average income, plus I get a lot of emotional satisfaction from what I do. I don't have to take ER call and never get called in to work in the middle of the night. My patients are mostly healthy and tend to get better in a short period of time. They are happy, and in turn give me thanks, which gives me great positive feedback. I go home feeling as if I've done some good for someone that day.

What factors make docs happy or unhappy? I think even more important than income is feeling like one has control over his or her destiny. Most employed physicians that I know are dissatisfied to some degree. They are highly trained, work hard, are smart, but still report to someone else and don't get to run the practice how they feel it should be run. They see how much they are billing and collecting for the practice owners, and see how much less their paycheck is. One has to work significantly harder to get a little bit of bonus.

In contrast, the happiest docs I know are those who either run their own solo practice or are equal Partner in a small group (my case). We get more say in what we do. If I feel like trying something different, it's easy to make it happen. If I feel like taking a week off, I just block my schedule and buy plane tickets. If I decide I don't want to work on Mondays, I block Mondays. Each time I see a patient I know I will be getting a check for most of what I bill. I don't have someone telling me to add nursing homes and house calls in order to bump up my production. You get the idea. The downside is that if I make a bad business decision, it's all my fault. No one else to blame.

As an employed Podiatrist I had moments when I thought I'd made a bad career choice, but as owner of my own practice, I couldn't be happier.

Nat

 

[smsc2009]

Up until today, I thought I had my whole life planned out. I knew I wanted to be an anesthesiologist and I was working my way towards that. I have spent countless hours in operating rooms observing this and it is something I could definitely see myself doing. At this point, I am graduating college next semester (fall) with a 3.8 and a whole bunch of extracurriculars. I haven't taken my MCAT yet but it is coming up soon. Today, it all hit me that being an MD might not be what I want out of my life. After having spoken to many people, I see that whole competitive aspect of the MD path is full of many people who are disappointed with what they are doing at a point in their lives where there is no turning back. It is also evident to me that I could end up forcing myself into this and then end up not being an anesthesiologist.

I automatically thought back to the time I shadowed a DPM, Dr.Campbell, at Maimonides Hospital in Brooklyn,NY. At the time, I hadn't taken much notice at the fact that he seemed extremely happy with what he was doing. Looking back, he is one of the few doctors I have met with that attitude (comparing him to many MDs that I have spoken to). I remember enjoying what he was showing me and how he handled his patient's presenting problems. I could see myself doing this in the future, but I would most definitely be interested in surgery as well.

My main questions are the following:

• How does the DPM system work... is the match after podiatry school highly competitive for surgery residencies? Is there a good chance of not receiving a surgical residency? (From my understanding, this comes after the regular DPM residency)
• What is the approximate salary for a DPM surgeon after residency? This should seem like an easy number to find online but I haven't been able to locate it. I'm not asking this because I am money hungry, but because I would like to know an approximate number before potentially getting myself into this profession.

Any input on the subject is appreciated. Thanks!

I know it seems you are now interested in Podiatric Medicine, however I would encourage you to go into Anesthesia if that is what you have always wanted to do. If you do not want to be an MD but still work with Anesthesia consider getting a DDS, and going into Dental Anesthesiology. Good luck with your future endevors.

 

[MystA RavE]

Thanks for the responses.

Is a 36 month residency program the end of the road in terms of residency, or is it possible to take something more than that?

 

[dallasite]

Hey,

Try visiting to the APMA (American Podiatric Medical Assoc.) site. They have a link where they will mail you a free CD of info. It is a great introduction for inquisitive minds.

General Information:
http://www.apma.org/s_apma/sec.asp?CID=8&DID=2819

For the CD:
http://www.apma.org/s_apma/sec.asp?CID=11&DID=2822

And if those links don't work...

www.apma.org then click on "Careers in Podiatric Medicine"

Hope that helps!

 

[MystA RavE]

As an employed Podiatrist I had moments when I thought I'd made a bad career choice, but as owner of my own practice, I couldn't be happier.

Nat

If you don't mind sharing, what exactly made you feel this way?

Thanks

 

[confL]

I went through the same thing awhile back.. really examine if you are just scared and having a panic attack about MD or if you truly want to be a DPM. I thought for awhile I wanted to be a DPM then I re- examined my feelings and the reason I suddenly changed my mind was because of fear. Many MD's are grumpy and talk ish about their jobs... but if you ask them would they have changed it if they could do it all over again and the majority of them say no. DPM and MD are both great and respected professions, but make sure that you're not changing your mind because you are afraid or you met a couple of docs who were being sarcastic/ cynical with you (unfortunately many are). I've had many md/do docs complain to me until they were red in the face, but they told me that they do not regret it. Whatever you choose make sure it's for the right choice and that you'll be happy at the end. Whatever you decide you'll be encounter challenging work and a respectful professions.

 

[MystA RavE]

I contacted NYCPM and they told me they still have spots for this upcoming September, which would mean that I would be ahead a whole year as opposed to trying to get into an allopathic school. This sure is tempting...

 

[NatCh]

If you don't mind sharing, what exactly made you feel this way?

Thanks

I think much of it stemmed from not having control over how I practiced. I felt I was highly trained and had decent business savvy, but I was working for two older podiatrists who had different ideas on how I should be developing. I did not feel as if I could develop the type of practice that I could do for twenty or more years. I wanted surgery and sports medicine, but was quickly becoming "the nail care guy" at the remote rural offices.

The best career decision I ever made was to leave that practice and work for myself.

Please see my post in this other thread:
http://forums.studentdoctor.net/showthread.php?t=396294

FWIW, every dentist I've ever met seemed really happy (and drove a nice car, if you know what I mean).

Nat

p.s. - One does not need to do rearfoot and trauma surgery to be well-paid. Consider the amount of time it takes to manage the more complex cases (include unpaid post-op) then compare to the number of ingrown nails one can do in that same amount of time, and quickly the ingrowns become more lucrative and less stressful. With a handful of basic forefoot procedures (bunionectomy, tailor's bunionectomy, hammertoe repair, neuroma excision, exostectomies) in one's tool belt, one can make a very comfortable living. Pursue the rearfoot and trauma training for your own personal development rather than for the money.

 

[Feli]

There are some good threads on this. Try these...

http://forums.studentdoctor.net/showthread.php?t=284170

http://forums.studentdoctor.net/showthread.php?t=396294

To touch briefly on a couple points, the best residencies right now are PMS-36s. At present, there are a few 4yr residencies (still PMS-36s but with additional experience), and there are also many pod fellowships. By the time I finish or current incoming students finish, all residencies will probably be 3yrs or longer. With regard to salary, you'll hear a wide range due to various training levels and the issue of base salary as opposed to total net income.

I'd say that you should just take the MCAT, think about things, and apply to DPM or MD school(s) next app cycle. If you do well on the MCAT, you could probably have good options among the schools land some scholarships as well...

 

[grifgin]

how much are you paid in the 3 year residency???
do better spots pay better?

 

[KHep]

how much are you paid in the 3 year residency???
do better spots pay better?

It depends on the program. Anywhere from 20,000 to mid 40s. but, again, there is probably more to the residency to be gained than how much it pays. It seemes as if most of the 36 programs were in the high 30s to low 40s when I was looking online.

The recruitment director that spoke at Scholl said that some residencies are still unpaid, but I didn't see any PM&S 24s or 36s that were unpaid. Not that I couldn't have missed them....

 

[dallasite]

Here's my opinion... only because I debated to wait a year "and see" or to just apply and you and I have similar ex-interests.

Basically I too thought Anesthesia would be for me... I was an anesthesia tech in college and then an anesthesia medical devices rep after that...(anesth machines, Sevo... etc)... so I pretty much knew as much as one could know (besides actually being an Anesthesia provider--Dr. or CRNA). To me, it was boring as all hell (boring NOT to be confused with the importance of and how vital an anesthesia provider is!!). The entire time, he/she just sat there (which is fine for some) and did his thing before surgery and post-op and wrote a lot.. oh, and operated the bed. All the "action" was on the other side of the drape, whether it be hand, foot, lap-bands, heart surgeries... whatever.

So my opinion is to... apply now...start and get your life moving forward. IF and only IF.... you don't have the "initials behind your name complex", don't mind lower extremity medicine and know that's the part of the body you'll specialize in and treat, and realize there are going to be bumps here and there that suck (like anything else). So if you conscious of those things, why wait?

You should only wait a year if you're unsure of another branch of medicine. I waited and nothing really was solved in my head, so I'm now a year behind (not that there's anything wrong with it). I kind of wish I knew of the podiatry world long ago, have started after college and be done with my first year now!

The reasons why I'm suggesting that you try and start now is that you have shadowed a Pod, so you should reasonably know what they do. And because your questions are mainly pertaining to way down the road (residency and post-residency) or which many of the answers will change by the time you get to that point (# of residencies, pay).

So in the end, take my opinion for what it's worth. Make sure you know that a Pod does and doesn't do. And good luck in whatever you decide. Contact me if you want to know anything else.

 

[MystA RavE]

Thanks for all the helpful information. I have decided to wait and apply next application cycle. I'm only 21 so I have time to "waste." I'd rather spend a few more months thinking it though rather than be stuck with a decision I'll regret. It's a serious decision that will literally impact the rest of my life and I really don't want to make a mistake.

 

[Dr. Gangrene]

Thanks for all the helpful information. I have decided to wait and apply next application cycle. I'm only 21 so I have time to "waste." I'd rather spend a few more months thinking it though rather than be stuck with a decision I'll regret. It's a serious decision that will literally impact the rest of my life and I really don't want to make a mistake.

Good choice You don't want to make a decision you will regret. Also, if you wait till next year, you will be more competitive for what most consider the "upper tier" schools.

 

[Feli]

...there is probably more to the residency to be gained than how much it pays. It seemes as if most of the 36 programs were in the high 30s to low 40s when I was looking online...

This is very true - both financially and clinically/academically.^

You're nowhere near that point in your education yet, but try not to let residency salary play too big of a factor in your decision. Some residencies have CME (continuing medical education) allowance which will pay for books, tests, and travelling to and attending pod conferences. Some residencies also have free food, discounted housing, great insurance coverage and rates for the resident +/- family, etc.

A PMS36 which pays $45k but no CME allowance and crummy health insurance and no free food at work might not be anywhere as valuable as a PMS36 that pays $40k plus gives you a $2k CME allowance, pays for your PM-LEXIS and state certification tests, and provides great insurance. It all depends...

Most of all, just pick where you think you'll get the best training and think you'll fit. $45k might sound good now, but it's nothing compared to what you'll make if you train yourself well and make the right connections while there. Besides, most residents just defer their loans, so it's usually plenty of $ to live reasonably if you are single or have a working spouse. However, the funny thing I've noticed is that most residencies in expensive cities to live (Miami, NY, etc) pay less than ones in cheaper places (Detroit, Oregon).

 

[jonwill]

Thanks for all the helpful information. I have decided to wait and apply next application cycle. I'm only 21 so I have time to "waste." I'd rather spend a few more months thinking it though rather than be stuck with a decision I'll regret. It's a serious decision that will literally impact the rest of my life and I really don't want to make a mistake.

Very good idea.

 

[krabmas]

This is very true - both financially and clinically/academically.^

You're nowhere near that point in your education yet, but try not to let residency salary play too big of a factor in your decision. Some residencies have CME (continuing medical education) allowance which will pay for books, tests, and travelling to and attending pod conferences. Some residencies also have free food, discounted housing, great insurance coverage and rates for the resident +/- family, etc.

A PMS36 which pays $45k but no CME allowance and crummy health insurance and no free food at work might not be anywhere as valuable as a PMS36 that pays $40k plus gives you a $2k CME allowance, pays for your PM-LEXIS and state certification tests, and provides great insurance. It all depends...

Most of all, just pick where you think you'll get the best training and think you'll fit. $45k might sound good now, but it's nothing compared to what you'll make if you train yourself well and make the right connections while there. Besides, most residents just defer their loans, so it's usually plenty of $ to live reasonably if you are single or have a working spouse. However, the funny thing I've noticed is that most residencies in expensive cities to live (Miami, NY, etc) pay less than ones in cheaper places (Detroit, Oregon).

1st, the residencies in Miami do pay sh_tty for the cost of living in miami. The residencies in NYC pay pretty well even for the cost of living. Many of the programs in NYC have housing thru the hospital for less than any apartment. For example - Metropolitan thru NYCPM, residents live in Draper hall for less than $300 a month. Yes it is only a room, but <$300 a month including heat, AC, electric. In Brooklyn, Interfaith has $900 a month apartments. Wycoff pays like $60G a year. So the NYC residencies definitely pay by cost of living. Some still pay very little but many pay normal amounts.

I do not think that many people make a decision on residency based on how much money they will make. I talked to lost of people about this and no one I have ever talked to has said that it factored into their decision. I think it is something you look at before you go on externships and maybe it factors into a little bit where you'd extern and where you would interview but in the end all the places that you interview with should be places that you would potentially be willing to go. IMO.

When I finally decided on my rankings I did not even think about money. I thought about where I would get the best training.

If everything else is equal and that is the only, I mean ONLY thing that differentiates the programs then you consider the money.

 

[MystA RavE]

1st, the residencies in Miami do pay sh_tty for the cost of living in miami. The residencies in NYC pay pretty well even for the cost of living. Many of the programs in NYC have housing thru the hospital for less than any apartment. For example - Metropolitan thru NYCPM, residents live in Draper hall for less than $300 a month. Yes it is only a room, but <$300 a month including heat, AC, electric. In Brooklyn, Interfaith has $900 a month apartments. Wycoff pays like $60G a year. So the NYC residencies definitely pay by cost of living. Some still pay very little but many pay normal amounts.

I do not think that many people make a decision on residency based on how much money they will make. I talked to lost of people about this and no one I have ever talked to has said that it factored into their decision. I think it is something you look at before you go on externships and maybe it factors into a little bit where you'd extern and where you would interview but in the end all the places that you interview with should be places that you would potentially be willing to go. IMO.

When I finally decided on my rankings I did not even think about money. I thought about where I would get the best training.

If everything else is equal and that is the only, I mean ONLY thing that differentiates the programs then you consider the money.

That's because the area is terrible compared to the rest of Brooklyn. I do Park Slope EMS and I went over to Wyckoff Hospital just to see where it is and I literally saw 2 different sets of people getting searched by cops with flashlights (true story, not stereotype). If Wyckoff paid any less I highly doubt many people would go there. I'm sure Maimo pays less given that the area it's in is "better." On an honest note, I don't care how much I will make during residency. I'd rather get paid $10,000 less and end up in Lutheran or Maimo if given the choice. It's more important to me that I become highly professional to differentiate myself in some sort of way for the better, regardless of the place or money I get. In the end, I think it would pay off. Maybe I'm wrong about this given my limited scope of the field, but I think the idea is most likely the same throughout the medical field.

 

[MystA RavE]

Also, I'm kind of curious as to why there are spots still available this late in the cycle for NYCPM. I would think that spots for this upcoming September would have been filled up already. I was actually quite surprised when I read it on their website. What's the reasoning behind this? Is the supply really greater than the demand?

 

[krabmas]

That's because the area is terrible compared to the rest of Brooklyn. I do Park Slope EMS and I went over to Wyckoff Hospital just to see where it is and I literally saw 2 different sets of people getting searched by cops with flashlights (true story, not stereotype). If Wyckoff paid any less I highly doubt many people would go there. I'm sure Maimo pays less given that the area it's in is "better." On an honest note, I don't care how much I will make during residency. I'd rather get paid $10,000 less and end up in Lutheran or Maimo if given the choice. It's more important to me that I become highly professional to differentiate myself in some sort of way for the better, regardless of the place or money I get. In the end, I think it would pay off. Maybe I'm wrong about this given my limited scope of the field, but I think the idea is most likely the same throughout the medical field.

I hope you did not read one sentence and reply. Please re-read my whole post. It does not say to choose based on money. It states that NYC pays well, because Feli said that NYC paid little. Whether it is in a good area or not it still pays well. Again, not that it is important.

 

[krabmas]

Also, I'm kind of curious as to why there are spots still available this late in the cycle for NYCPM. I would think that spots for this upcoming September would have been filled up already. I was actually quite surprised when I read it on their website. What's the reasoning behind this? Is the supply really greater than the demand?

NYCPM has a large class and every year has trouble filling spots up to the last minute. If you read some of the old posts - do a search- you will find many oppinions of NYCPM. It is not held in high regard by other pods even alumni of the institution. The education is not bad, you just have to fight for it. It may be easier to get the same education at a different school.

In addition this year the school is trying to raise the stats even if it means that the class size goes down a bit. I think this is good. So the class will probably not fill at all this year.

 

[MystA RavE]

I hope you did not read one sentence and reply. Please re-read my whole post. It does not say to choose based on money. It states that NYC pays well, because Feli said that NYC paid little. Whether it is in a good area or not it still pays well. Again, not that it is important.

I did read the whole post but I combined two different ideas in my post and after having read it I can see why it is confusing. I was just adding my opinion on the subject, I wasn't going against what you said (it seems we agree on the residency money aspect).

 

[MystA RavE]

NYCPM has a large class and every year has trouble filling spots up to the last minute. If you read some of the old posts - do a search- you will find many oppinions of NYCPM. It is not held in high regard by other pods even alumni of the institution. The education is not bad, you just have to fight for it. It may be easier to get the same education at a different school.

In addition this year the school is trying to raise the stats even if it means that the class size goes down a bit. I think this is good. So the class will probably not fill at all this year.

Yeah I think it would be a great idea for them to tighten up the admissions requirements, but they are probably reluctant to do it much because they lose money. What do you mean by having to fight for the education? Does going to NYCPM put people at a disadvantage when they are matching?

 

[dallasite]

There are better people on here to answer that, but I know down here in Texas--after a little stalking research--I would say 40-50% of the Pods down here are from NYCPM. Many from Ohio, too. Texas is where I intend to practice, so I'm confident NY will be fine. Especially for matching with Texas residencies. --Just my opinion.

 

[krabmas]

Yeah I think it would be a great idea for them to tighten up the admissions requirements, but they are probably reluctant to do it much because they lose money. What do you mean by having to fight for the education? Does going to NYCPM put people at a disadvantage when they are matching?

if you are in the top of the class - no.

I mean exactly what I said - you must fight for an education it will not just come to you. you can search SDN for more info on this. I have posted several things about this.