The SDN Effect?

[HardRoadPaved]

So the data is out. Applicant pool size seemed to rebound this year with 2 new schools opening. However the avg applicant stats are down a little. Matriculant data paints a whole other picture... only 403 enrolled this year! Guess people are thinking twice about signing that tuition agreement form.

https://aacpm.org/wp-content/uploads/Historical-TRENDS-of-apps-2014-2023-08-2023-for-health-professions-update-1.pdf

https://aacpm.org/wp-content/uploads/Applicant-MCAT-Average-2019-2023-Apps.pdf

https://aacpm.org/wp-content/uploads/Applicant-GPA-Average-2019-2023.pdf

https://aacpm.org/wp-content/uploads/Copy-of-Applicant-MCAT-Average-2019-2023-B-2.pdf

https://aacpm.org/wp-content/uploads/Copy-of-Matriculant-GPA-Average-2019-2023-1.pdf

---

Members don't see this ad.

 

[Hybrocure]

All it takes is looking up podiatry job offers to see what they’re paying. When you google it, most are in the 90-130k range. Compare that to the cost of school and the time spent and it doesn’t look favorable.

 

[DogSnoot]

In 2024, individuals have abundant access to information, including statistics and data. This week, a brief overview of job postings with salary details is available for review, surprise it’s not great. It took me 20 minutes to gather this information, and I collected every job listing that provided open financial details. I did not selectively choose them.

Consider a quick job search. Why accumulate significant debt and invest seven years of your life when the average salary for an orthopedic Physician Assistant is $150,000 and takes two years without the additional 3-4 years of 50,000 salary of a podiatry resident/fellow.

Simply put, pursuing podiatry is not a wise investment. If you've already begun your podiatry journey, continue, but if you haven't, think carefully before committing to it financially.

 

[Feli]

All it takes is looking up podiatry job offers to see what they’re paying. When you google it, most are in the 90-130k range. Compare that to the cost of school and the time spent and it doesn’t look favorable.

Yeah, it's easy to spot a bad ROI.

I am glad they can... tuition for all kinds of programs has gone up way faster than incomes. It's important to find the few degree programs anymore that give good income and job relative to the time and $$ required to get them.

...We might see it in our lifetime that USA goes to public edu system (best students get scholarships to next levels)... nearly all of the rest of the world already does that method.

 

[PTPuser]

I hope it continues to drop with 5 schools shutting down.

 

[med2345]

I hope it continues to drop with 5 schools shutting down.

5 schools shutting down? I can’t tell if this is sarcasm or I’m out of the loop

 

[heybrother]

-I thought 2022 was supposed to have been a worse year with schools freaking out and down by 50 students. The numbers don't reflect that. I've brought it up before - the AACPM numbers do not reflect the things NY and Ohio were saying 2 years ago...

-The numbers suggest a lot of people are getting in without taking the MCAT.

-If Texas is filling, if LECOM is getting students, and total matriculation is at 400 (down from the 560-600s) - who is half empty? Is this why Kent cut tuition?

-Not reflected in this chart - I've previously posted - podiatry has been through this cycle before. This is not the first bust cycle. About 20 years ago they collapsed hard and came back. The podiatry cockroach won't die.

-400 matriculants is still too many. We need a new meme thread where we double down on podiatry.

 

[Adam Smasher]

We're giving ourselves too much credit. It's like Howard Stern and his "vote for the worst" campaigns to get the least talented and most obnoxious performers into the final rounds of American Idol. No he wasn't that influential, the general audience of American Idol just happened to vote for those singers. Likewise, I don't think we're that influential either, I think as others have noted above, pre-health students aren't stupid, they can spot a bad deal.

The podiatry cockroach won't die.

🦞

 

[GreenHousePub]

No one is using SDN anymore. Everyone migrated to Reddit years ago.

 

[HardRoadPaved]

No one is using SDN anymore. Everyone migrated to Reddit years ago.

They only come for the memes....

 

[GreenHousePub]

What I meant to say is: No one is coming here anymore, it's too crowded.

 

[Feli]

....
-If Texas is filling, if LECOM is getting students, and total matriculation is at 400 (down from the 560-600s) - who is half empty? Is this why Kent cut tuition?
...

I say it all the time, but KSUSPM Ohio will be the first pod school to fold...

...400 matriculants is still too many. We need a new meme thread where we double down on podiatry.

Yes, 400 is way too many.
That number for decades is how we got to the DPM saturation and low ROIs we're at now.

AOFAS fellows are usually around 65-75/yr (under 100 fellowship spots, many go unfilled each year).
Orthos in total are ~600 spots, Derm in total under 500 spots... and they treat head to toe skin or bone/joint.

It will take years of <400 graduating DPMs to even push the needle of DPM incomes and supply/demand. The real number should probably be around 300/yr grads or fewer (roughly 100 each at an east, west, and central pod school).

5 schools shutting down? I can’t tell if this is sarcasm or I’m out of the loop

They won't shut down voluntarily, but it's not a joke.

It'll be just like pharmacy where they have "admissions crisis" for years before they freeze opening new schools and then consolidate some of the laggard schools. Tuition money and limited students talks. There will be more recruiting (already is), more scholarships, tuition cuts... and then closings.

People can easily search and figure out podiatry school is $400k debt for likely job offers of ~$125k-150k (some higher, some lower) and 7-8yrs grad training. The days are gone where people will just trudge along at any costs for the prestige of being a "doctor" at any cost. The financials of it are just too glaring at this point.

If you read the pharma forums, their numbers for PharmDs at the tipping point were roughly $65k-$75k avg grad income for $200k debt and 4yrs grad schooling, but it's effectively same ROI as podiatry is now.

Either way, it's happening. Giddyup. 🤠

 

[med2345]

So if this was the state of applications what was the actual intent for the news schools? Not money because there’s less seats filled… it seemed like that was the answer when I asked a residency PD about it before. I’m just confused

 

[GreenHousePub]

So if this was the state of applications what was the actual intent for the news schools? Not money because there’s less seats filled… it seemed like that was the answer when I asked a residency PD about it before. I’m just confused

Money. More government backed loans. Hoping for a pharmacy-style or law-style mass amounts of students applying and getting in.

Schools could care less about the outcomes for their graduates.

 

[Feli]

So if this was the state of applications what was the actual intent for the news schools? Not money because there’s less seats filled… it seemed like that was the answer when I asked a residency PD about it before. I’m just confused

It is a business FIRST and health care training or public service as a MUCH lower priority.

The new podiatry schools were made to get money... and to make jobs for their deans/admin/faculty.

They all say they'll make residency spots locally or create more pod school apps or help the profession or blah blah... they generally do not.

You have to remember the new schools were hatched and the ideas started many years ago (pre-pandemic).
Maybe applications were higher then, maybe podiatry pay/jobs were a bit better, or maybe they just didn't pay attention.
They likely figured they would be fine based on being new or more overall student loans or whatever. We shall see.

 

[Adam Smasher]

So if this was the state of applications what was the actual intent for the news schools? Not money because there’s less seats filled… it seemed like that was the answer when I asked a residency PD about it before. I’m just confused

podiatry school curriculum is around 90% the same as for DO/MD schools so it costs very little to tack on a DPM program to an existing MD/DO program. Even if it's only 10-20 students, that's a considerable revenue flow for a university.

 

[Weirdy]

I speculate there will be an uptick in enrollment + further pumping out of DPM degrees and maybe even another school before the market gets close to self adjusting.

If you were clever, you could even use the current enrollment stats as advertising.
+less competition
+guaranteed residency spot (current student : residency slot ratio)
+longer population life span / more diabetes = higher need for DPMs

Notice how none of the above 'positive' points for premeds/prepods mention the job market or ROI.

 

[Prehealth1011]

-The numbers suggest a lot of people are getting in without taking the MCAT.

Don't all schools require it though? I remember Temple accepting the DAT before but that was years ago.

The M3's that rotate with me know how much every specialty makes. Honestly, good for them. Kids are just much more financially aware now.

 

[PTPuser]

ACFAS site shows "27" jobs listing...with 1 of them being ortho F/A...

Kids, if you're reading this, don't do this ****.

 

[icebreaker32]

In 2024, individuals have abundant access to information, including statistics and data. This week, a brief overview of job postings with salary details is available for review, surprise it’s not great. It took me 20 minutes to gather this information, and I collected every job listing that provided open financial details. I did not selectively choose them.

Consider a quick job search. Why accumulate significant debt and invest seven years of your life when the average salary for an orthopedic Physician Assistant is $150,000 and takes two years without the additional 3-4 years of 50,000 salary of a podiatry resident/fellow.

Simply put, pursuing podiatry is not a wise investment. If you've already begun your podiatry journey, continue, but if you haven't, think carefully before committing to it financially.

ROI for podiatry is typically poor when compared to midlevels when one considers the salalries and the respective cost and length of education.

Then when total compensation is considered podiatry‘s ROI takes an even larger hit.

Then there are the intangibles which further worsens the ROI.

How many of the below do most podiatry jobs offer?

Excellent health insurance
Generous vacation plus sick time
Generous paid maternity/paternity leave
Generous CME time off and allowance
Pension and/or generous 401K match
Loan repayment or PSLF
Significant admin time off such as one half or even one day off per week
Paid for taking call
Etc.

What about the intangibles like being able to find a good job anywhere at anytime. Being able to REALISTICALLY find work in different settings such as academic, administrative or working remote. The ability to work locums and pick your own schedule. The ability to easily pick up lucrative part time work on the weekends or night if desired.

Hey in podiatry we sometimes have nursing home work available. and you might get off a couple hours early on Fridays.

Organizational jobs have their pros/cons, but pay well with good benefits. They are competitive for podiatrists and not everyone can have one as demand far exceeds supply. In many other professions everyone can have an organizational job as there are numerous openings that remain unfilled in most areas.

Anyone in theory can be an owner in podiatry but it is not easy or guaranteed to be successful. There is saturation in most locations and it takes money, a period of negative cash flow, and sweet equity.

When all the above are considered podiatry as a career is much riskier than many realize.

 

[MicroPod]

Are most DPM students going into 300-400k debt? I never really asked my classmates or co-residents how much debt they were in.

 

[Hybrocure]

Are most DPM students going into 300-400k debt? I never really asked my classmates or co-residents how much debt they were in.

Yeah. That’s minimum without taking extra student loans to support a family or wife during school

 

[Feli]

Are most DPM students going into 300-400k debt? I never really asked my classmates or co-residents how much debt they were in.

Definitely... some were at those marks even 10 years ago (even higher if undergrad loans).
The costs (tuitions and fees) go up every year, and the rate of student loan interest has jumped way up in the last couple of years.

• Pod school rate is $30k/yr tuition (it is more than that at almost every pod school, but say maybe $30k/y with scholarship) = 120k (assumes 4yr graduation... far from a given at many schools)
• $20-40k living per year (housing/food/phone... plus board exams, supplies, books, travel, instruments, all kinds of ticky-tack fees, etc etc etc etc). And when we are being real, most students will borrow at or near max that they are allowed.

Assuming 60k/yr (30k tuition + 30k living), you are at over $250k by graduation. That'd be a very VERY low end figure. Then, interest, now about 7%, compounds during residency (some would as student also). Do not forget about the many people who borrow max and the many who take 5 or even 6+ years to graduate pod school.

...Even the schools themselves, which will round down on everything and try to minimize costs shown, show the high prices on their websites. UT is by far the lowest podiatry tuition and cheap to live as its location is undesirable as can be, and they still estimate well over $45k/yr just for the classroom years (goes way up in clinical/travel/interview years, as we all know). Western Pod estimates over $77k - just for first year... not bad little rake for a school that caused the last podiatry residency shortage.

 

[heybrother]

Are most DPM students going into 300-400k debt? I never really asked my classmates or co-residents how much debt they were in.

My coresidents were some version of $270-280K in debt and that 8+ years ago back when DMU was cheaper. Unless everyone is getting a huge scholarship now they would be $40K+ more in debt now.

Don't all schools require it though? I remember Temple accepting the DAT before but that was years ago.

The M3's that rotate with me know how much every specialty makes. Honestly, good for them. Kids are just much more financially aware now.

Its possible they are accepting the DAT but the even more likely possibility is they are simply waving the test. I say that based on the large difference in the MCAT vs GPA matriculant sheets and the note in the bottom that says "MCAT not required during Pandemic".

We're giving ourselves too much credit. It's like Howard Stern and his "vote for the worst" campaigns to get the least talented and most obnoxious performers into the final rounds of American Idol. No he wasn't that influential, the general audience of American Idol just happened to vote for those singers. Likewise, I don't think we're that influential either, I think as others have noted above, pre-health students aren't stupid, they can spot a bad deal.

🦞

Agreed. I don't think we are that relevant. It is though much more amusing to pretend that we are very influential...

 

[HardRoadPaved]

How many of the below do most podiatry jobs offer?

ability to call yourself a surgeon....✅
hang out in the doctors lounge after your EPF...✅
steak dinners paid for by product reps...✅

and most of all

save lives at 2am...✅

 

[bloxxeeey]

Definitely... some were at those marks even 10 years ago (even higher if undergrad loans).
The costs (tuitions and fees) go up every year, and the rate of student loan interest has jumped way up in the last couple of years.

• Pod school rate is $30k/yr tuition (it is more than that at almost every pod school, but say maybe $30k/y with scholarship) = 120k (assumes 4yr graduation... far from a given at many schools)
• $20-40k living per year (housing/food/phone... plus board exams, supplies, books, travel, instruments, all kinds of ticky-tack fees, etc etc etc etc). And when we are being real, most students will borrow at or near max that they are allowed.

Assuming 60k/yr (30k tuition + 30k living), you are at over $250k by graduation. That'd be a very VERY low end figure. Then, interest, now about 7%, compounds during residency (some would as student also). Do not forget about the many people who borrow max and the many who take 5 or even 6+ years to graduate pod school.

...Even the schools themselves, which will round down on everything and try to minimize costs shown, show the high prices on their websites. UT is by far the lowest podiatry tuition and cheap to live as its location is undesirable as can be, and they still estimate well over $45k/yr just for the classroom years (goes way up in clinical/travel/interview years, as we all know). Western Pod estimates over $77k - just for first year... not bad little rake for a school that caused the last podiatry residency shortage.

I graduated 3 years ago and me and my classmates were at about 400k loans. More if undergrad loans. With the interest rate right now (7% low end). You're paying 28k in interest alone per year. As a resident my take home is about 45k. As an attending most of us are pulling 120k before taxes so 88k after taxes. Meaning after paying just the interest on our loans we're down to 50k take home, not accounting for actually paying down the loan. So Its a little bit of a step up from residency after finishing residency.

 

[MoostashPod]

I graduated 3 years ago and me and my classmates were at about 400k loans. More if undergrad loans. With the interest rate right now (7% low end). You're paying 28k in interest alone per year. As a resident my take home is about 45k. As an attending most of us are pulling 120k before taxes so 88k after taxes. Meaning after paying just the interest on our loans we're down to 50k take home, not accounting for actually paying down the loan. So Its a little bit of a step up from residency after finishing residency.

That sounds just about right. Hence, podiatry is such a bad ROI at this time and age and it's silly if any prepods would think otherwise. Don't be tricked by the schools and by the numbers they give you. Crunch the numbers and you will see how bad of ROI podiatry can be especially with the huge saturation and pay available out there.

 

[podourology]

I graduated 3 years ago and me and my classmates were at about 400k loans. More if undergrad loans. With the interest rate right now (7% low end). You're paying 28k in interest alone per year. As a resident my take home is about 45k. As an attending most of us are pulling 120k before taxes so 88k after taxes. Meaning after paying just the interest on our loans we're down to 50k take home, not accounting for actually paying down the loan. So Its a little bit of a step up from residency after finishing residency.

Bro you aren't an attending. My attendings make 180k-300k+. Very dependent on area. Have I gotten offers 120k yeah or <25% collections, also got 150-180k job offers. Still not nearly as high as IM, who can move 2 hours outside of a metro into rural and make 300k/yr on any given week... Podiatry can bring in more $$$ then PCP with less overhead, no reason why FM salaries are guaranteed most of time even in private practice 160k+. Podiatrists have a chip on their shoulder, they were abused so they have to abuse.

My suggestion is don't buy these old guys practices, go buy all their equipment for pennies on the dollar after they close the doors.

 

[PTPuser]

Are most DPM students going into 300-400k debt? I never really asked my classmates or co-residents how much debt they were in.

I have 342K

 

[icebreaker32]

Bro you aren't an attending. My attendings make 180k-300k+. Very dependent on area. Have I gotten offers 120k yeah or <25% collections, also got 150-180k job offers. Still not nearly as high as IM, who can move 2 hours outside of a metro into rural and make 300k/yr on any given week... Podiatry can bring in more $$$ then PCP with less overhead, no reason why FM salaries are guaranteed most of time even in private practice 160k+. Podiatrists have a chip on their shoulder, they were abused so they have to abuse.

My suggestion is don't buy these old guys practices, go buy all their equipment for pennies on the dollar after they close the doors.

No one has ever denied it is impossible to do well or even very well in podiatry you. Many do extremely well and many more do not. There is no basement with good salaries, good benefits, PSLF and multiple job openings in most locations. Podiatry is riskier than many professions. Many go to offshore medical school and do well and many flunk out. The difference in podiatry is it is easy to get in, fairly easy to finish and easy to get a residency currently. The real risk is not completing the career like offshore medical school it is the risk that comes AFTER completing a residency with finding or creating a good job.

PCPs are obviously on the lower end of income for MD and DOs. They don’t worry about loan repayment with PSLF. Many did research for a couple years before being admitted (2 years towards PSLF) then went to DO school, MD or Caribbean school, then did a residency for 3 years at a non profit (3 more years towards PSLF). That leaves 5 years of income based loans at a non profit hospital system with great benefits making 210K to wipe 400K or more of loans.

Will your salalry increase much in the future In primary care? No, not unless your production increases (which often does), you move to an area outside of the suburbs where they are desperate for providers or you pick up extra hours on the side. If you are in a lucrative specialty and not primary care you might make 500K employed by a hospital or likely more if a partner in a group.

Even with all that being said many doctors in primary care often have thoughts of was giving up a decade of my life worth this versus being a PA.

The fact remains podiatry is a riskier career than many realize. If future podiatry students realize this, then who am I to tell them not to matriculate.

 

[billBOB213]

ability to call yourself a surgeon....
hang out in the doctors lounge after your EPF...
steak dinners paid for by product reps...

and most of all

save lives at 2am...

almost spit up my coke when I read this
As I’m in doc lounge right before an EPF today lol

#surgeon

 

[Forcewielder]

I graduated 3 years ago and me and my classmates were at about 400k loans. More if undergrad loans. With the interest rate right now (7% low end). You're paying 28k in interest alone per year. As a resident my take home is about 45k. As an attending most of us are pulling 120k before taxes so 88k after taxes. Meaning after paying just the interest on our loans we're down to 50k take home, not accounting for actually paying down the loan. So Its a little bit of a step up from residency after finishing residency.

I graduated a bit earlier but yeah 300k was the cheaper end and 400k was not uncommon. You did a good job explaining the interest and income numbers. I'd echo that I didn't appreciate the interest factor before taking the loans. I went in thinking something along the lines of: I'll keep loans to a minimum by living super cheap and be out with under 250k, then I'll make 150k, live off 50k like residency, and then be out of debt in 3 years. My loans are at 5%, not 7%, and I had 220k by the end of residency (paid off some principal during residency). My 10yr standard payoff is 2700/month. Granted I've been paying more aggressively, living way below my means, but most people will not want to pay more than that. It's pretty incredible how compound interest works against you.

 

[Forcewielder]

No one has ever denied it is impossible to do well or even very well in podiatry you. Many do extremely well and many more do not. There is no basement with good salaries, good benefits, PSLF and multiple job openings in most locations. Podiatry is riskier than many professions. Many go to offshore medical school and do well and many flunk out. The difference in podiatry is it is easy to get in, fairly easy to finish and easy to get a residency currently. The real risk is not completing the career like offshore medical school it is the risk that comes AFTER completing a residency with finding or creating a good job.

PCPs are obviously on the lower end of income for MD and DOs. They don’t worry about loan repayment with PSLF. Many did research for a couple years before being admitted (2 years towards PSLF) then went to DO school, MD or Caribbean school, then did a residency for 3 years at a non profit (3 more years towards PSLF). That leaves 5 years of income based loans at a non profit hospital system with great benefits making 210K to wipe 400K or more of loans.

Will your salalry increase much in the future In primary care? No, not unless your production increases (which often does), you move to an area outside of the suburbs where they are desperate for providers or you pick up extra hours on the side. If you are in a lucrative specialty and not primary care you might make 500K employed by a hospital or likely more if a partner in a group.

Even with all that being said many doctors in primary care often have thoughts of was giving up a decade of my life worth this versus being a PA.

The fact remains podiatry is a riskier career than many realize. If future podiatry students realize this, then who am I to tell them not to matriculate.

Podiatrists making 300k+ are the exception, not the rule. There's so much luck involved in landing one of those spots if you didn't go to a powerhouse residency. The Bureau of Labor and Statistics has Podiatrist median pay in 2022 at 148k (meaning half of all podiatrists are under that) meanwhile this is the breakdown of average physician income by specialty (not median). No specialty averages less than 248k on this survey.

 

[GreenHousePub]

Podiatrists making 300k+ are the exception, not the rule. There's so much luck involved in landing one of those spots if you didn't go to a powerhouse residency. The Bureau of Labor and Statistics has Podiatrist median pay in 2022 at 148k (meaning half of all podiatrists are under that) meanwhile this is the breakdown of average physician income by specialty (not median). No specialty averages less than 248k on this survey.

If you are a 1099 or own your own practice (a huge majority of podiatry btw) then that is skewed way downward.

 

[icebreaker32]

I think we can all agree we know what a typical associate salary is like. It gets much more difficult beyond that. We are not a mainstream healthcare commodity that largely follows MGMA.

Although PCPs probably think specialists make too much more than them, hospital employment has helped increase their salaries and improved their benefits. Hospitals are willing to take a loss on PCPs to make it up elsewhere. PCPs are also in demand.

It is my opinion podiatrists as a whole make less than most PCPs and with worse benefits.

Regardless of however much the average salary a podiatrist makes there is not a relatively small difference an outlier makes. A successful podiatrist can make 3 or even 4 times as much as one that is not successful. We are not only talking 5 percent doing very well or very poor. We have more outliers on both ends in our profession (probably more at the bottom than the top). We all have the same training now in theory.

Podiatry is good at the top, could be better in the middle and is embarrassing bad at the bottom. I do not believe those owners keeping their income low to receive distributions at a lower tax rate significantly changes this generalization.

 

[Adam Smasher]

I found an APMA survey on podiatry, I guess as good as anywhere else's data, despite its limitations of being an APMA survey and being responded to by people with the free time to fill out an APMA survey. 2018 data, not that the job market has dramatically changed in 6 years.

https://apma.cms-plus.com/files/2018%20Practice%20Survey%20Results_FINAL.pdf

 

[HardRoadPaved]

I do not believe those owners keeping their income low to receive distributions at a lower tax rate significantly changes this generalization.

From an S-corp standpoint, why would an owner pay themselves through their W-2 salary more than the "local average?" Better to skip those FICA wages and pay yourself through owner distributions that are taxed at the corporate profit level after you have the practice write off all the benefits you can.

 

[Adam Smasher]

Up until only a few years ago, the taxable maximum on FICA wages wasn't very different from a typical associate pay

 

[heybrother]

What's posted here:

What's posted on AACPM.

Is enrollment 592 or is it 403? I cite the GPA matriculant total because its always a larger number than the MCAT total.

Or is it 560?

 

[heybrother]

Obviously class sizes are not equivalent / students fail out / years are variable.

School	Total Enrollment	/ 4
AZCPM	143	35.75
BUSPM	249	62.25
DMU	212	53
KSU	326	81.5
LECOM	24	n/a
NYCPM	350	87.5
SCPM	334	83.5
SMUCPM	128	32
TUSPM	273	68.25
UTRG	61	n/a
WUCPM	138	34.5

 

[Prehealth1011]

It is my opinion podiatrists as a whole make less than most PCPs and with worse benefits.

I'm IM and we typically choose hospitalist vs fellowship. From the few that I know who signed PCP contracts, they're starting around 240-250k base. One signed for a bit less ~220k at an academic job (residents do everything for you). PCP work isn't for everyone but the job market seems great.

 

[Feli]

...Is enrollment 592 or is it 403? I cite the GPA matriculant total because its always a larger number than the MCAT total.... Or is it 560?

In the end, I'm not sure it matters.

It is just really hard to account for pod schools' attrition (pod students leaving voluntarily to dent or DO or SMP or whatever... and others flunking out). Because pod schools never fill and a virtually 100% acceptance rate, the number matriculating will yo-yo depending on how much marketing the pod schools do, which way the wind is blowing. Anyone who is awake knows applicant DMUPod or AZPod might reject or waitlist can simply apply to NYCPM or Kent and get in... with a scholarship.

A lower number of overall pod students/yr would press the lower quality residencies (and eventually low quality and/or overpriced pod schools) to close. Money talks. However, the schools would then hang onto nearly all students (tuition) and graduate some very poor DPMs who will probably fail boards and rep the profession poorly.

Higher matriculant numbers for pod schools mean that many continue to get low quality residency ... and the job market stays highly saturated. However, the schools would at least have some money to get decent faculty/rotations and some room to dismiss or remediate the students who have virtually no chance of passing boards or being competitive for strong residency or repping DPMs well.

...The number of grads is what will matter in the end. (spoiler: it was too high, it's now waaay too high)
Podiatry has needed residencies closed/consolidated/improved and less supply of grads for quite a long time.
There are just way too many of us and way too much disparity in training level and competence levels.
The job market has been very rough for a long time. PP has been cutthroat in nearly every major city for many decades; for hospital jobs and heavier surgery DPM jobs, it got it saturated within 5-10yrs of sizable numbers of grads getting 2yr and 3yr surgical training - pretty early in the 2000s. Now that every DPM grad is 3yr, is definitely getting harder to even cold call, go rural, try to be the surgical guy for a DPM group, find MSGs that haven't already been approached by pods, etc than ever before. Fellowships' popularity are clear testament to that.

 

[GreenHousePub]

What's posted here:

View attachment 383379

What's posted on AACPM.

View attachment 383380

Is enrollment 592 or is it 403? I cite the GPA matriculant total because its always a larger number than the MCAT total.

View attachment 383381
Or is it 560?

So 2023 was the biggest year ever for pod school enrollments. Those burner accounts from APMA guys that posted once must have really worked!

 

[dtrack22]

From an S-corp standpoint, why would an owner pay themselves through their W-2 salary more than the "local average?" Better to skip those FICA wages and pay yourself through owner distributions that are taxed at the corporate profit level after you have the practice write off all the benefits you can.

Because if you are netting $280k, you can’t pay yourself $120k in salary and $160k in dividends. Unless you would like a visit from the IRS.

No private practice owner is paying themselves $100-140k when they actually make $300k. The spread isn’t that large. Someone who is claiming to make $120k for tax (and survey) purposes might be making $200k. But that just puts them in line with Pediatricians in the world of real doctors. Meaning, you’re still at the bottom…

 

[Bored Snorlax]

This data is confusing but it appears the trend of applicants are normalizing. Is this the calm before the storm?

 

[Feli]

Because if you are netting $280k, you can’t pay yourself $120k in salary and $160k in dividends. Unless you would like a visit from the IRS.

No private practice owner is paying themselves $100-140k when they actually make $300k. The spread isn’t that large. Someone who is claiming to make $120k for tax (and survey) purposes might be making $200k. But that just puts them in line with Pediatricians in the world of real doctors. Meaning, you’re still at the bottom…

You can do it any way you choose, but for S-corp (the way most docs structure) it's generally advised by CPAs that it's done about 50/50 or 60/40 (salary / owner draws aka divi).

It all gets taxed as ordinary income regardless (whether I do 100k salary + 200k draws or 200k salary + 100k draws).
So, yes, an owner of PP could be "paying themselves $100k-140k when they actually make $300k" ($160k-200k owner draws in addition to the salary), but it just doesn't matter very much. They are making $300k regardless for taxation.

It definitely does raise chances of audit if you have an owner salary way below "reasonable salary" for one's profession, so it's best to do at least a six figure salary for owner doc as soon as that is viable based on revenue of the office consistently supporting that. It is not a huge deal as to what the exact figure is, though... they will pay taxes on money the get from their payroll/salary plus their draws regardless. Even if highly profitable, many owners just use Bureau of Labor and Statistics for their profession, pay themselves a payroll figure on the low end of that, and take the rest of their income as draws.

Early on, you can take a $0 or very low salary (roughly $35k is federal minimum for salary employees)... and that might be smart if the office is a startup expected to be minimally or not profitable due to startup (buyout) debt, equipment, marketing, construction, legal fees, low volume, etc. I have friends who are docs, CRNA, tradesmen, various entrepreneurs who did that for a year or two (weren't sure of what salary could be... just took draws). Many still take under $100k in salary from their LLC. Owner will still do have to take all profits as draws or reinvest them by year end, but it gives flexibility with low salary so you have less chance of getting crunched for bills or payroll or unexpected expenses or slow stretches early on.

...in the end, you will pay taxes on all profits the owner gets. Salary (payroll) and draws (dividend) is all going to the same tax bucket (for S-corp).
The huuuge strength to setting up PP that way is just that you can deduct anything reasonably related to the business before deciding how much the biz made (aka what draws or taxable biz savings amounts will have to be). This is where the company car, company meals, company supplies, uniforms, subscriptions, travel, etc etc come in. For those who are employed, you don't have those avenues... those things all get bought with post-tax monies. It is not free for owner to do them pre-tax, but is sure doesn't hurt... and it can effectively lower tax bracket (but owners will be in highest tax brackets 30% and above fairly fast regardless).

 

[heybrother]

This data is confusing but it appears the trend of applicants are normalizing. Is this the calm before the storm?

View attachment 383484

If you are pro podiatry you argue applications increased by 31%.

If you have the data - maybe it shows something else. No way to know without seeing the data.

For example, you are a student applying to medical school in Texas through TMDSAS. Your primary goal is MD, but you've already completed the applications packet so adding another app (podiatry) is essentially a click of a button. You aren't very familiar with podiatry and you assume that you need to submit your podiatry app at the same time as your medical school applications. In fact, the final submission data for MD/DO applications is in November and for podiatry is in March of the next year. Long term veterans of podiatry know that you should probably only apply to the 1-2 schools you want to go to because you'll be accepted everywhere ie you don't need 7 applications to get an acceptance. The end result though of people adding an app is the appearance of increasing podiatry applications and interest when in fact the interest may not truly exist. It is essentially an artifact. It goes without saying that people do ultimately choose to attend podiatry school in Texas, but part of their application cohort may have no actual interest - just as I had no interest in Barry, California, NYC etc when I applied. The applications were a result of my lack of understanding of the process - not of a level of interest. If you were to go back through applications to the Texas podiatry school and find that many of the applications did not in fact have podiatry rec/shadowing letters this might support this conjecture.

I'm indifferent. Here's the heart of podiatry. The MCAT average that is reported is strongly on the left side of the curve. 493.9 is some variation of 25th-28th percentile of the people who are taking the MCAT. This is an academically weak population. Pre-pods used to claim that in time the podiatry GPA/MCAT would match the MD values. There's no evidence to support that trend at present.

 

[Forcewielder]

The MCAT average that is reported is strongly on the left side of the curve. 493.9 is some variation of 25th-28th percentile of the people who are taking the MCAT. This is an academically weak population. Pre-pods used to claim that in time the podiatry GPA/MCAT would match the MD values. There's no evidence to support that trend at present.

Agreed. I don't know if there's still a push for podiatry to start sitting for the USMLE, but I always found it laughable our profession was pushing for it. Podiatry does awful on the MCAT so why would that change with the USMLE? Especially when we don't have the same curriculum. We may have 90% the same curriculum, but that 10% is where MD/DO students achieve their bell curve. Embrace Lobster Medicine!

 

[Hybrocure]

The truth is MDs and DOs don’t want us to be managing inpatients medically and honestly…we don’t want to be managing them medically for inpatients either. Or else we would’ve just got the MD or DO degree.

Imagine how hard it is fighting ortho imagine fighting hospitalists?

Yeah they can keep their boards. I’ll keep my sleep.

 

[Feli]

The truth is MDs and DOs don’t want us to be managing inpatients medically and honestly…we don’t want to be managing them medically for inpatients either. Or else we would’ve just got the MD or DO degree.

Imagine how hard it is fighting ortho imagine fighting hospitalists?

Yeah they can keep their boards. I’ll keep my sleep.

Agreed. I don't know if there's still a push for podiatry to start sitting for the USMLE, but I always found it laughable our profession was pushing for it. Podiatry does awful on the MCAT so why would that change with the USMLE? Especially when we don't have the same curriculum. We may have 90% the same curriculum, but that 10% is where MD/DO students achieve their bell curve. Embrace Lobster Medicine!

Yeah, the USMLE by podiatry students would be a disaster. That has been covered 100x over.

Most of the ppl who get into MD or DO school are just insanely smart folks. Their boards are actually not too hard (for them). They are just uber-smart ppl... who are usually also hardworking and good with time management.

Some of the honors grads from podiatry schools probably could have been fringe acceptances and bottom of the class in DO school (FP, Peds, Psych type residency match). They'd still be borderline to pass USMLE... much less score well on it. That USMLE for all DPM students idea was a trap all along.

...We should honestly be happy if we can get our podiatry residencies more standardized (case volume, competency) and produce grads who can nearly all pass our real board (ABFAS). That will only happen with less students, better apps, good schooling, and MUCH better average residency training and academics for DPMs. Right now, there is tremendous variance in DPM grads.. because schools take anyone and we have nowhere near enough solid residency spots. Accepting any and every applicant and keeping every crummy residency open will keep it that way, and that's what the new schools force.

This came up at ACFAS this year on a panel. Orthos have an absolute ton of reps with bone surgery, instruments, dissections, fixations, implants, med mgmt of trauma and very sick patients (even before they do a fellowship). Their boards - both USMLE and specialty - are hard AF. The end (orthopedist) product from their training is way less variable than podiatry, with DPM ever-evolving boards and highly variable residencies... now tremendously variable fellowships.