So you want to consider a fellowship?

[diabeticfootdr]

Fellowships aren’t for everyone and you shouldn’t need one to be competent in normal podiatric medicine and surgery. But some individuals are driven to achieve levels beyond standard competence and strive to make the profession a better place.

I did a fellowship with Prof. David Armstrong 2006-2007 at the Scholl College of Podiatric Medicine in Diabetic Limb Salvage and Research.

I did it to be mentored by Dr. Armstrong and gain experience in academics and research. I can honestly say that it has greatly benefitted me throughout my career, in opportunities and income.

I’m sure this thread will generate comments from the standard SDN-naysayers who will belittle fellowships. But they don’t have much positive to say about anything.

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Members don't see this ad.

 

[Pronation]

Really cool story. Thanks for sharing this with us.

Remember when ABPM email spammed all of its members whining about SDN speaking the truth?

Would ABPM be willing to send out an anonymous survey to all of its members asking if they did a fellowship and how much they made annually at their first job out of fellowship?

 

[Sweatshirt]

They have their time and place. In a perfect world fellowships would be reserved for those bottom 10% who got poor residency training and legitimately need an extra year, and the other 10% that wants to do advanced nerve anastomosis muscle flap charcot recons. However a lot of people abuse them for CV purposes

 

[diabeticfootdr]

UTHSCSA fellow 2022-2023 discusses why he became a fellow.

 

[Shiyuan]

The derm nerd in me would love to see Markinson, Vlahovic, Lipner or another good derm institution form another dermatology fellowship. 😎

 

[air bud]

Fellowships aren’t for everyone and you shouldn’t need one to be competent in normal podiatric medicine and surgery. But some individuals are driven to achieve levels beyond standard competence and strive to make the profession a better place.

I did a fellowship with Prof. David Armstrong 2006-2007 at the Scholl College of Podiatric Medicine in Diabetic Limb Salvage and Research.

I did it to be mentored by Dr. Armstrong and gain experience in academics and research. I can honestly say that it has greatly benefitted me throughout my career, in opportunities and income.

I’m sure this thread will generate comments from the standard SDN-naysayers who will belittle fellowships. But they don’t have much positive to say about anything.

You are 100 percent correct. However due to how the profession is marketed, everyone thinks they are going to be a hotshot surgical orthopedic podiatrist trained in ninjaplastics. So from an early stage they think they need a fellowship....and then it becomes a self fulfilling prophecy.


A great theoretical thing to do would be to eliminate the possibility of doing a fellowship if you go to a certain subset of residencies. Why does a graduate of Hutch/Franciscan need to go do Cotton/Prissel/etc fellowship??? The altruistic thing to do is have the Wykoff residents go do those fellowships. Instead people are doing them to get into industry/podium douchebag circuit.

 

[diabeticfootdr]

They have their time and place. In a perfect world fellowships would be reserved for those bottom 10% who got poor residency training and legitimately need an extra year, and the other 10% that wants to do advanced nerve anastomosis muscle flap charcot recons. However a lot of people abuse them for CV purposes

Why would fellowships take someone who was in the bottom 10%? That’s not the purpose of a fellowship at all and not the perfect world. A fellowship is not a remediation of residency.

 

[air bud]

The derm nerd in me would love to see Markinson, Vlahovic, Lipner or another good derm institution form another dermatology fellowship. 😎

 

[air bud]

UTHSCSA fellow 2022-2023 discusses why he became a fellow.

Cool so he is going to abandon his training in a few years?

 

[wakaflocka88]

UTHSCSA fellow 2022-2023 discusses why he became a fellow.

Did you break the news to your fellow that the chances of him coming out of fellowship and doing these “exciting” cases will be slim? It’s funny you try to belittle us nay-sayers when we are the same group that actually speak the truth, provide you with real world data - including personal income and numbers and have real world working experience across a variety of institutions and private groups collectively.

For the record, you may have seen an increase in your income after the fellowship but I hope you don’t tell your fellows to expect the same as well. May you also please reply to my other questions in other threads as well? Do you prefer DM? Or a snail mail?

 

[air bud]

Did you break the news to your fellow that the chances of him coming out of fellowship and doing these “exciting” cases will be slim? It’s funny you try to belittle us nay-sayers when we are the same group that actually speak the truth, provide you with real world data - including personal income and numbers and have real world working experience across a variety of institutions and private groups collectively.

No, those guys are in the circle of trust. They will be fine.

 

[icebreaker32]

Where is Cuts?

 

[MalleableMan]

I’m glad I completed my fellowship. For me, personally, I’m getting lifelong mentorship and it cemented principles that may have taken me a few more years to obtain without it. Supposedly it made me a strong candidate for my job at my current hospital.

 

[PatchAdamsFan]

Why would fellowships take someone who was in the bottom 10%? That’s not the purpose of a fellowship at all and not the perfect world. A fellowship is not a remediation of residency.

I.... actually agree with that. Can you imagine Prissel or Hutch standing there with a straight face while the new fellow is learning how not to skive the skin? It would be a complete waste of the fellowship's time. I sympathize with those with poor training, and I agree it seems counterintuitive to get fellowship training at a similar level to one's residency, but I do not think it makes sense for the "top" fellowships to take that 10% on the other side of the spectrum.

 

[icebreaker32]

The reason to do a fellowship is to get a hospital job and leave those PP jobs for the regular podiatrists.

 

[Boba Foot]

UTHSCSA fellow 2022-2023 discusses why he became a fellow.

He’s essentially saying that he’s going to be in PP in the somewhat near future, so fellowship is mostly a waste of time and a year of lost income for him. He will make more seeing 20-30 patients in office than he will doing one or two of the Charcot cases he’s doing fellowship for. This video is essentially reinforcing what most on this board are saying.

 

[Feli]

...I did a fellowship with Prof. David Armstrong 2006-2007 at the Scholl College of Podiatric Medicine in Diabetic Limb Salvage and Research.

I did it to be mentored by Dr. Armstrong and gain experience in academics and research. I can honestly say that it has greatly benefitted me throughout my career, in opportunities and income...

...standard SDN-naysayers who will belittle fellowships...

Yes, but truth be told, you did a very low quality residency.... you've posted about that yourself here on SDN before.
Of course a fellowship is then going to be a boon to those who don't do a high quality DPM residency. It certainly won't hurt.

What is often said here is that residency is paramount. Fellowship becomes a personal decision afterwards.
If one does a good quality residency, they will tend to pass all boards, get good skill, and do well regardless.
If one doesn't do a good residency, then a fellowship is often to try to make up for lackluster residency training.
And yes, of course, someone can do good residency and good fellowship if interested.

It is good that fellowship worked for you.

 

[Feli]

They have their time and place. In a perfect world fellowships would be reserved for those bottom 10% who got poor residency training and legitimately need an extra year, and the other 10% that wants to do advanced nerve anastomosis muscle flap charcot recons. However a lot of people abuse them for CV purposes

Yes, the main reasons for fellowships seem to be:
-bad residency training... need more surgery and training (most common reason, OP reasoning)
-ok residency but didn't find a job, not sure what to do... do a fellowship (not a good reason typically)
-fellowship is a large group and basically only hires from fellows (pretty insane... essentially an internship after 7yrs school + residency)
-good residency training but want to teach or lecture or try to get a job with fellowship attendings (superfluous but not crazy reason)
-genuinely want to get more or unique skill and like the fellowship attendings (optimal reason... but by far least common)

As has been said again and again, the best surgical DPM fellowship spots go to grads of good/great residencies who don't really need them. Nobody does a VA residency and gets consideration for an elite DPM fellowship, and that's just the way it is.

The good DPM residencies give you plenty of surgery and diversity and all of the tools one needs. I sure wish there were more of the good residencies and spots.... probably would be if fellowship attendings brought those cases to residents

 

[heybrother]

Anyone read the recent article about salaries of female graduates of fellowships?

 

[MalleableMan]

What is the point of this forum anyway?

I would’ve thought this thread should invite current residents to ask questions about fellowships.

Instead it’s a circlej*** of people who didn’t do fellowships making assumptions about others’ training and intentions.

Do y’all copy and paste your comments from other threads?

 

[Feli]

Anyone read the recent article about salaries of female graduates of fellowships?

Link if you have one?

There are a fair number of articles on fellowship economics for ortho and other MD specialties. Those are obviously a little different since they create a sub specialty cert, board/society, etc whereas DPM fellowships do not.

It would be great to have more lit for DPMs.

 

[MalleableMan]

Link if you have one?

There are a fair number of articles on fellowship economics for ortho and other MD specialties. Those are obviously a little different since they create a sub specialty cert, board/society, etc whereas DPM fellowships do not.

It would be great to have more lit for DPMs.

The Financial Implications of Podiatric Foot and Ankle Fellowship: Is Another Year Worth It? - PubMed

For prospective applicants many variables can factor into the decision to pursue fellowship level training. The purpose of the present study was to give prospective applicants an idea of the financial implications of podiatric foot and ankle fellowship. To calculate the net present value (NPV)...

pubmed.ncbi.nlm.nih.gov

 

[Feli]

What is the point of this forum anyway?

I would’ve thought this thread should invite current residents to ask questions about fellowships.

Instead it’s a circlej*** of people who didn’t do fellowships making assumptions about others’ training and intentions.

Do y’all copy and paste your comments from other threads?

It's up to you to read or comment or participate, man.

I have said may times that if I was a vampire living 500yrs, I would've done a fellowship with a cool attending. As it stood, I felt I had good skill, only have ~30 or whatever years of practice, didn't want to do a fellowship for various reasons. Also, if you think about it, assuming you did a decent program, then you already had more cases/training just in your residency than almost any DPM fellowship director did in his/her residency. If most of the ACFAS guys, program directors, text authors, etc did 3yrs or less... why do we need 4yr+ now if it leads to no additional cert/specialty? Again, individual decision.

 

[air bud]

The Financial Implications of Podiatric Foot and Ankle Fellowship: Is Another Year Worth It? - PubMed

For prospective applicants many variables can factor into the decision to pursue fellowship level training. The purpose of the present study was to give prospective applicants an idea of the financial implications of podiatric foot and ankle fellowship. To calculate the net present value (NPV)...

pubmed.ncbi.nlm.nih.gov

Ah yes the great Dr. Rushing. Lecturing as a fellow on physician burn out. Consulting endlessly as 1st year attending because he was in the circle of trust. Don't get @CutsWithFury started....

 

[air bud]

The Financial Implications of Podiatric Foot and Ankle Fellowship: Is Another Year Worth It? - PubMed

For prospective applicants many variables can factor into the decision to pursue fellowship level training. The purpose of the present study was to give prospective applicants an idea of the financial implications of podiatric foot and ankle fellowship. To calculate the net present value (NPV)...

pubmed.ncbi.nlm.nih.gov

Let's have a fellow write a paper justifying his fellowship....

Here is one for you

The Return on Investment of Orthopaedic Fellowship Training: A Ten-year Update - PubMed

The recent trend across all medical specialties has been for increased fellowship training and subspecialization. There are numerous reasons to pursue fellowship training, both personal and financial. This study presents an updated estimate of the financial impact of fellowship training in...

pubmed.ncbi.nlm.nih.gov

Methods: Using described techniques of financial analysis, net present value (NPV), internal rate of return (IRR), and break-even point were estimated over the average working career length of an orthopaedic surgeon. Compensation data were drawn from the American Medical Group Association physician compensation surveys. Seven fellowships were studied and referenced to a career in general orthopaedic practice.

Results: Fellowship training in spine surgery yields the highest return on investment with a break-even point of 5 years. Adult reconstruction has a positive NPV and IRR, but when corrected for number of hours worked per week offers no productivity advantage to general practice. Sports medicine and trauma offer neutral returns, but when corrected for work hours, NPV and IRR both become negative. Hand, pediatrics, and foot and ankle never break even following the loss of compensation realized during fellowship year.

 

[diabeticfootdr]

Yes, but truth be told, you did a very low quality residency.... you've posted about that yourself here on SDN before.

Don’t put words in my mouth. The Saint Vincent (formerly St. Joseph’s) program was one of the best in NY at the time. Yes, there were outside attendings that didn’t know what they were doing and needed residents to do the surgery, which is (was) the same as all NYC programs. But the training I got in diabetic foot and even Charcot recon ex fix was fantastic. I published from cases from there, including the first Charcot from HIV.

 

[Pronation]

Yes, there were outside attendings that didn’t know what they were doing and needed residents to do the surgery

Sounds like some pretty awful residency training. Thanks for reinforcing what we all already knew, that a majority of the NY programs should be shut down or turned into chiropody programs because they are awful.

 

[diabeticfootdr]

What is the point of this forum anyway?

I would’ve thought this thread should invite current residents to ask questions about fellowships.

Instead it’s a circlej*** of people who didn’t do fellowships making assumptions about others’ training and intentions.

Do y’all copy and paste your comments from other threads?

It’s the same for any of the 3 SDN podiatry forum or threads. The same 10 people who are wishing for the death of the podiatry and would be delighted to stand on the grave of the profession belittling anything positive.

The point of this thread was to provide insight into why some people choose fellowships and we all see how each thread gets derailed by those loudest.

Cicero said, “Orators are the most vehement when they have the weakest cause.”

 

[wakaflocka88]

The same 10 people who are wishing for the death of the podiatry and would be delighted to stand on the grave of the profession belittling anything positive.

Please don’t put words in my mouth. I never wished for podiatry to ***. Us 10 posters have provided more data and insight, good or bad, than APMA or a publication by a fresh fellow will ever provide. I’m glad I have met great mentors right here on SDN throughout my journey and I’m thankful I’m where I am today because of their honest guidance.

 

[diabeticfootdr]

Sounds like some pretty awful residency training. Thanks for reinforcing what we all already knew, that a majority of the NY programs should be shut down or turned into chiropody programs because they are awful.

Actually that’s not awful training, if you have good core faculty.

When you do some outside cases, you get experience operating with more autonomy and you’re pretty comfortable when you leave the program.

Look you and I are cut from different cloths. I look at what’s positive and build on that. I see what’s challenging and try to fix it.

The world is not crashing down on podiatry, despite the commiserating coffee klatsch of the disgruntled that use SDN as an outlet.

 

[DYK343]

It’s the same for any of the 3 SDN podiatry forum or threads. The same 10 people who are wishing for the death of the podiatry and would be delighted to stand on the grave of the profession belittling anything positive.

The point of this thread was to provide insight into why some people choose fellowships and we all see how each thread gets derailed by those loudest.

Cicero said, “Orators are the most vehement when they have the weakest cause.”

Come on man. Ive asked you a few hard questions and you ignore them. Are we really trying to burn the profession to the ground? Or pointing out issues youre sweeping under the rug.

Low Compensation for grads
Over saturation
Looming residency crisis (this is my personal #1, as im sure you know).

If you just taught us all the great things APMA is doing to solve this we would all have to eat crow. Youre sitting on a golden throne here. You have the ultimate ability to shut us all up and prove to the world were a bunch of crazies. But all you do is say were naysayers over and over. It appears there is no solution unless you would have given us one.



Regarding fellowships its a lost year of income. I came out pretty well trained so I didnt feel I needed one. But I dont see why most residents shouldnt at least entertain the idea of a fellowship. All my fellowship friends are doing well in good hospital/ortho jobs.

 

[bloxxeeey]

The Financial Implications of Podiatric Foot and Ankle Fellowship: Is Another Year Worth It? - PubMed

For prospective applicants many variables can factor into the decision to pursue fellowship level training. The purpose of the present study was to give prospective applicants an idea of the financial implications of podiatric foot and ankle fellowship. To calculate the net present value (NPV)...

pubmed.ncbi.nlm.nih.gov

If you calculate it out a non-fellowship podiatrist averaged 100k a year over their career and a fellowship trained podiatrist averaged about 140k a year over their career. Assuming 30 year career. So you're doing better than the average fellowship trained podiatrist if you pull over 140k a year.

 

[de Ribas]

I know pods who only did 3 year residency and are doing exceptionally well financially even in their 1-2 years out and know about fellowship-trained working as associates or in unsuccessful PP practices.

 

[air bud]

I know pods who only did 3 year residency and are doing exceptionally well financially even their 1-2 years out and know about fellowship-trained working as associates or in unsuccessful PP practices.

ancedotal. irrelevant.

 

[de Ribas]

ancedotal. irrelevant.

True

 

[heybrother]

Do orthopedic generalists doing total knees hate the fellowship joint trained orthopedist down the hall? I don't know, but I doubt it. Both will probably do great. The heart of most of the issues that come up continuously on this forum is scarcity.

The feeling that fellows steal cases that should have gone to 3rd years - scarcity
The feeling of well trained people that fellowship trained people are out to undeservedly steal the hospital jobs - scarcity.

If everyone who graduated could simply find a hospital job in the town of their choice I don't think anyone would care whether people had 3 or 4 years of training.

I'm mostly not bothered by fellowships. I'm even open to the idea that you could do a good program and still wonder how someone somewhere else does the same thing. Forever ago I was somewhere ...maybe Regions/West Penn, I don't remember but let's just assume it was somewhere legit. The PD essentially said something to the effect that they wished they were still a 4th year student so they could travel the country and see how other like minded surgeons addressed the same case. I don't think that's unreasonable - I find myself at times thinking the same thing about programs I visited my 4th year - did they do a lapidus differently than me - I wish I could remember how they did it etc. If you graduate in 3 years or you graduate in 4 years and start at >$200 you are still going to do great. Someone can model your income over time and say "he lost a whole year of income" but in the end if it was worth it to you - so be it.

On a negative day I wonder things like:
-Aren't we usurping the real meaning of the word fellowship. It means something real in the MD/DO community. For us it means, a year of extra training, potentially focusing on something specific but not necessarily
-How do we as a profession have practice management fellowships
-Wouldn't the world just be better off if all our residencies were good.
-Why does everyone who goes to West Penn do a fellowship and what does that say about our profession.

In regards to the "female fellow" article. I feel like they have taken a complicated question which they've tried to answer with data. However, if the question was simply "how is your income post fellowship" is really just - did you land a hospital job post fellowship. I would almost argue that if you simply queried 2 populations and only asked "are you hospital employed" - you could likely answer the question of which population has higher income. Your success at achieving organizational employment in this field determines your income for your first 5 years.

2 final things

-Fellowship as a form of remediation. Interestingly, this was something that came up on here through the years and was bantered about. Whether it was ever the case - I don't know.

-Orthoplastics. This is just something that comes up non-stop on here. Its funny. Maybe its because of where I clerked, but I never heard anyone talking about it when I was a student or a resident.

 

[Feli]

Don’t put words in my mouth. The Saint Vincent (formerly St. Joseph’s) program was one of the best in NY at the time. Yes, there were outside attendings that didn’t know what they were doing and needed residents to do the surgery, which is (was) the same as all NYC programs. But the training I got in diabetic foot and even Charcot recon ex fix was fantastic. I published from cases from there, including the first Charcot from HIV.

It is good you try to view and spin your training in a positive light, but fellowship that won't lead to anything but more cases or maybe some networking is not for everyone.

Simple SDN search function (and my memory as a student at the time) shows that you posted repeatedly during or after your residency training:
-your residency program was not good
-NYC scope was a detriment to podiatry overall and especially podiatry training
-NYCPM was an embarrassment to the profession
-you saw suspect billing/care in NY during training

It is obvious that you either scrambled or voluntarily took a low quality NY residency program for some personal reason as you ended up there even despite a decent pod school and a grad year with laaarge surplus of residency spots unfilled. It all fine and good, and the past is the past... but it is also no small wonder that you sought fellowship.

Residency is NOT "what you make of it." The programs either have good cases and academics and good attendings... or they do not. One can read more, but they certainly can't dream a little dream and improve their surgical logs (without fraud) or have good attendings magically appear. There are no good programs in NY - then or now... none of them ever make the lists of top flight DPM residency programs. Many NY programs scramble year after year for the same reasons.

...The majority of podiatry students do NOT scramble, won't graduate bottom half of their class, and won't opt out of ABFAS cert process. Fellowship is not always a good choice for them or a necessary choice if they secure quality residency training. I think it's inaccurate to use your personal choice to suggest fellowships. Many of the regulars here who matched and completed high quality programs and acheived BQ/BC for surgery are also worthy of advising - possibly more so.

With the way pod school grads to program ratio will be headed, it is scary. I sure hope every pod student works very hard to get a good residency program and that very few are stuck with a program where fellowship needs to be seriously considered for reasonable volume or competence. Fellowship is not a bail-out, whether it worked for a few people or not.... if we suggest so, that shows us how questionable our overall residency program offerings for DPMs are.

 

[diabeticfootdr]

It is good you try to view and spin your training in a positive light, but fellowship that won't lead to anything but more cases or maybe some networking is not for everyone.

Simple SDN search function (and my memory as a student at the time) shows that you posted repeatedly during or after your residency training:
-your residency program was not good
-NYC scope was a detriment to podiatry overall and especially podiatry training
-NYCPM was an embarrassment to the profession
-you saw suspect billing/care in NY during training

View attachment 363087

If you can’t argue the merits, try to attack and discredit the person. I get it. I’ve served as an expert in many cases, it’s what lawyers do.

I still think my residency was far from the best in the country. I never said it was the best. But look what I did with my training. And after, I continually improved. I invented or improved procedures. I wrote about it. Then I became a part of the process in our profession to change what I thought could be improved about podiatry.

NY is one of the worst places to practice full-scope podiatry. No surprise to anyone.

I’m working on fixing that too.

The motivated, good pods that stay in NY do so for geographic desires.

SDN has turned into a place where professional self-loathing pods come to hijack every thread and the moderators sit by and watch. I can’t post anything helpful without personal attacks and the threads being derailed by the same people.

Look what you guys did to Dr. Doug Richie, a true advocate for podiatry and educator. Told him he was a dinosaur that peddled a brace, if memory serves on SDN. Now he doesn’t post any longer, because, why would he?

You can’t have polite discourse? It’s no wonder why some of these people who post aren’t happy about their opportunities. With that kind of unprofessional behavior and communication, who would give you an opportunity?

SDN certainly isn’t a place living up to its mission and values statements for podiatry.

Some good rules to live by would be:
- to be respectful
- to learn all you can
- to improve peoples lives with your skills
- and to try to leave podiatry better than you found it

Podiatry is a profession. It’s not a job.

 

[DYK343]

If you can’t argue the merits, try to attack and discredit the person. I get it. I’ve served as an expert in many cases, it’s what lawyers do.

I still think my residency was far from the best in the country. I never said it was the best. But look what I did with my training. And after, I continually improved. I invented or improved procedures. I wrote about it. Then I became a part of the process in our profession to change what I thought could be improved about podiatry.

NY is one of the worst places to practice full-scope podiatry. No surprise to anyone.

I’m working on fixing that too.

The motivated, good pods that stay in NY do so for geographic desires.

SDN has turned into a place where professional self-loathing pods come to hijack every thread and the moderators sit by and watch. I can’t post anything helpful without personal attacks and the threads being derailed by the same people.

Look what you guys did to Dr. Doug Richie, a true advocate for podiatry and educator. Told him he was a dinosaur that peddled a brace, if memory serves on SDN. Now he doesn’t post any longer, because, why would he?

You can’t have polite discourse? It’s no wonder why some of these people who post aren’t happy about their opportunities. With that kind of unprofessional behavior and communication, who would give you an opportunity?

SDN certainly isn’t a place living up to its mission and values statements for podiatry.

Some good rules to live by would be:
- to be respectful
- to learn all you can
- to improve peoples lives with your skills
- and to try to leave podiatry better than you found it

Podiatry is a profession. It’s not a job.

OK but as president of the APMA I have some questions for you:

1) What is being done to prevent a residency shortage in 4 years?
2) What can be done to prevent oversaturation with 2 new schools opening up?
3) What can be done to help our young graduates obtain quality jobs upon graduation?

Were looking out for younger generations on here you just dont see it.
I know for a fact were triggering discussions at APMA delegates meetings.
Hopefully the above are being worked on by APMA. When western opened APMA/AACPM looked absolutely foolish. They had 4 years and did almost nothing.

 

[Feli]

If you can’t argue the merits, try to attack and discredit the person. I get it. ...

Exactly. ^^

You attempt to publicly attack and discredit SDN forum members, you try to blame them for podiatry shortcomings with applicants or board certifications or other issues, you even try to recruit others to do the same (with very little success). Do you dispute that? Anyone got the emails, newsletters, etc.

Are you then surprised by the events unfolding as such?

I believe you do know that I have met and spoken with many of your DMU podiatry school classmates I've known as SDN users, my chiefs, other local residents during my training, other residents on externships, meetings, etc. Podiatry's a small world, and you do have a way of alienating yourself again and again and again, man. In many ways. This has been going on for over a decade; nothing new.

So, it's good you have the titles you do, and that's cool. It is still not wise to poke others and then cry foul. Nobody will feel sorry for you. It hasn't worked before and probably won't now either. If you try to impose your will or opinions, prepare to be corrected or unpopular or a pariah. Have a good weekend, man.

 

[wakaflocka88]

If you can’t argue the merits, try to attack and discredit the person. I get it. I’ve served as an expert in many cases, it’s what lawyers do.

I still think my residency was far from the best in the country. I never said it was the best. But look what I did with my training. And after, I continually improved. I invented or improved procedures. I wrote about it. Then I became a part of the process in our profession to change what I thought could be improved about podiatry.

NY is one of the worst places to practice full-scope podiatry. No surprise to anyone.

I’m working on fixing that too.

The motivated, good pods that stay in NY do so for geographic desires.

SDN has turned into a place where professional self-loathing pods come to hijack every thread and the moderators sit by and watch. I can’t post anything helpful without personal attacks and the threads being derailed by the same people.

Look what you guys did to Dr. Doug Richie, a true advocate for podiatry and educator. Told him he was a dinosaur that peddled a brace, if memory serves on SDN. Now he doesn’t post any longer, because, why would he?

You can’t have polite discourse? It’s no wonder why some of these people who post aren’t happy about their opportunities. With that kind of unprofessional behavior and communication, who would give you an opportunity?

SDN certainly isn’t a place living up to its mission and values statements for podiatry.

Some good rules to live by would be:
- to be respectful
- to learn all you can
- to improve peoples lives with your skills
- and to try to leave podiatry better than you found it

Podiatry is a profession. It’s not a job.

I believe I’ve respectfully asked you at least 3 times in separate threads on questions an elected president of a governing board can answer. That way, I can learn all I can. And then from there, I can improve the future generation of students’ lives with my knowledge and skills based on your answers. And ultimately, leave podiatry better than its current state because I can say the president of APMA addressed my and DYK’s questions that concerns the profession as a whole. Thank you.

 

[de Ribas]

Can anyone explain this? This DPM went to a good residency, then went to 2 full fellowship programs plus 3 others overseas. Is he the most qualified DPM in US? What was the goal? Does that really lead to better patient care, ROI, or achieving anything? When does one stop?

This just begs some questions:

1. Was really residency training not enough so he did so much fellowship training?

2. Was training enough but DPM never got confident enough to get out and practice?

3. Was it driven just by trying to stand out among peers or catch the eye?

When enough training is enough?
Yhis is not the only example. There are more that I have seen list multiple fellowship trainings. Everyone mentions that their residency or fellowship program was "one of the prestigious in the country" or "top in the nation".

 

[DYK343]

View attachment 363094


Can anyone explain this? This DPM went to a good residency, then went to 2 full fellowship programs plus 3 others overseas. Is he the most qualified DPM in US? What was the goal? Does that really lead to better patient care, ROI, or achieving anything? When does one stop?

This just begs some questions:

1. Was really residency training not enough so he did so much fellowship training?

2. Was training enough but DPM never got confident enough to get out and practice?

3. Was it driven just by trying to stand out among peers or catch the eye?

When enough training is enough?
Yhis is not the only example. There are more that I have seen list multiple fellowship trainings. Everyone mentions that their residency or fellowship program was "one of the prestigious in the country" or "top in the nation".

I dunno training in greece and swirzerland would be a good time (not so sure about russia then or now...)

 

[Feli]

Can anyone explain this? This DPM went to a good residency, then went to 2 full fellowship programs plus 3 others overseas. Is he the most qualified DPM in US? What was the goal? Does that really lead to better patient care, ROI, or achieving anything? When does one stop?

This just begs some questions:

1. Was really residency training not enough so he did so much fellowship training?

2. Was training enough but DPM never got confident enough to get out and practice?

3. Was it driven just by trying to stand out among peers or catch the eye?

When enough training is enough?

Some ppl are just degree collectors, man... can't really explain it.
It happens in all professions.

We had an ortho F&A in Mich who had done Ivy league med school, Ivy ortho residency, and then two F&A fellowships... 1yr Myerson and 1yr Sig Hansen both. So, he had basically the best ortho F&A training one could *on paper*. There was another F&A who did ok residency and then 1yr Sig Hansen followed by Dror Paley 1yr. They were both hospital employ docs.

The funny thing was, both of the other local community ortho F&As whose work I saw regularly in my office or at the surgery centers had done more of regular average name ortho residencies and F&A fellowships. They both could operate circles around the two double fellowship ones... much better XRs, faster OR times, and better outcomes from what I ran across... and were also in PP as opposed to academia and a TON busier and better rep among the OR/ASC staff and from talking to local refer PCPs. Also, being in PP, I'm sure they were probably 2x the paychecks or thereabouts, lol.

Gotta take the training wheels off some time

 

[de Ribas]

Some ppl are just degree collectors, man... can't really explain it.
It happens in all professions.

We had an ortho F&A in Mich who had done Ivy league med school, Ivy ortho residency, and then two F&A fellowships... 1yr Myerson and 1yr Sig Hansen both. So, he had basically the best ortho F&A training one could *on paper*. There was another F&A who did ok residency and then 1yr Sig Hansen followed by Dror Paley 1yr. They were both hospital employ docs.

The funny thing was, both of the other local community ortho F&As whose work I saw regularly in my office or at the surgery centers had done more of regular average name ortho residencies and F&A fellowships. They both could operate circles around the two double fellowship ones... much better XRs, faster OR times, and better outcomes from what I ran across... and were also in PP as opposed to academia and a TON busier and better rep among the OR/ASC staff and from talking to local refer PCPs. Also, being in PP, I'm sure they were probably 2x the paychecks or thereabouts, lol.

Gotta take the training wheels off some time

True.

 

[air bud]

I dunno training in greece and swirzerland would be a good time (not so sure about russia then or now...)

That person got some fantastic training

 

[DexterMorganSK]

So, did anyone here actually do a fellowship except for Dr. Rogers? If so, please share your experiences. I would advise the others to take it down a notch in the derailing.

Happy Friday!

 

[de Ribas]

If one wants to be good at rear foot surgeries and wants to focus their practice at least 50% on rear foot. Are there pod fellowships that expose fellows only to rearfoot procedures like TARs, pilons, ankle fx, ex fixes, IM nails, arthroscopy, various OCD repair options, calc fractures, major reconstructions? Are there fellowships that really expose their fellows to rearfoot all day every day?

If one is exposed to all of these surgeries and in sufficient amount graduating residency with around 2000 surgeries (half of them are rearfoot), would they need to do fellowship? If not, how would they sell themselves without fellowship?

 

[air bud]

If one wants to be good at rear foot surgeries and wants to focus their practice at least 50% on rear foot. Are there pod fellowships that expose fellows only to rearfoot procedures like TARs, pilons, ankle fx, ex fixes, IM nails, arthroscopy, various OCD repair options, calc fractures, major reconstructions? Are there fellowships that really expose their fellows to rearfoot all day every day?

If one is exposed to all of these surgeries and in sufficient amount graduating residency with around 2000 surgeries (half of them are rearfoot), would they need to do fellowship? If not, how would they sell themselves without fellowship?

TARs - yes there are fellowships for this, and a good reason to do a fellowship - but are you going to find a good job where you also can do these...~50 percent chance maybe
Pilons - you won't be doing these....lets say 2% of pods do pilons
Ankle Fx - any good residency will teach you this....will you do them when you get out.....not guaranteed
ExFix - yes there are fellowships for this, and decent reason to do a fellowship - contact Lee Rogers to get in the circle of trust
IM nails - a very good residency will teach you this, but they aren't that hard to figure out yourself with enough experience in rearfoot/ankle fusions it is just a different form of fixation. The hardware company will bring in an expert to walk you through your first few cases
Scope/OCD - a good residency will teach you this
Calc Fx - even very good residencies may be hit or miss on this....lets say 5% of pods will do these
Major Reconstruction-A good residency will teach you this

Bonus - SMO - lets go back to 2% of pods will do this

Do a good residency

 

[deleted682934]

The Financial Implications of Podiatric Foot and Ankle Fellowship: Is Another Year Worth It? - PubMed

For prospective applicants many variables can factor into the decision to pursue fellowship level training. The purpose of the present study was to give prospective applicants an idea of the financial implications of podiatric foot and ankle fellowship. To calculate the net present value (NPV)...

pubmed.ncbi.nlm.nih.gov

The methodology of this paper is deeply flawed and the data is worthless. Fellowship trained DPMs probably end up making more than non-fellowship trained DPM, but the results of this "study" are worthless.