Thoughts on Fellowship given job market

[air bud]

It hasn't even been that long since our last fellowship thread, lol

This is how we do things

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[619]

A fear of mine is that I end up at some crappy job where there’s not even enough volume to get abfas certified especially in RRA.

For those of you who have been through this process, realistically when I’m looking for a job, what things should I be looking for that would indicate i’d be busy enough there to not only make money but get surgical patients to meet numbers?

Hard to get both because it is contradictory. Can't make money and do tons of surgery. This is strictly for PP and not hospital jobs. In PP, the time you spend in surgery is pulling you away from clinic and clinic is where the money is at.

Let me explain more below

So let's assume you are ok with $100k base and want to do lots of surgery and get your numbers then my advise is to join an older pod or group of pods who are not interested in surgery. You will be the surgery guru for the group and they send you all the cases. You will be busy in the OR weekly but then again don't expect to hit your bonus by far. The plan is to do lots of surgeries, get your number, get certified and bounce. Unfortunately this will take conservatively 3-5 years assuming you are busy surgically from day 1 and you pass all the exams once.

On the other hand, you want to make a lot of money in PP, then find a practice with a busy clinic volume, spend more time in clinic. Become more efficient in billing and coding. Be very comfortable with office procedures and you will generate a lot of revenue in clinic. But you won't get RRA numbers. It is possible to get forefoot numbers in this scenario while still making money.

The golden goose in PP is if you can find a solid well established practice with both scenarios then you are set. I know it is not often talked about but there a few in PP who are busy surgically, busy in clinic and taking home $200k-$250K while leaving in the city of their choice.

Finally, you will get neither if you join a practice and they want you to "build it up". You wont get surgery nor money from clinic because volume is starting from zero. This is the worst situation in my opinion. A lot those big super groups are fond of hiring a new (fellowship trained) associate and opening a new clinic at a new location. They sell the new hire the idea that the area is busy, in need of a podiatrist and you can grow the new clinic. They send you to a new clinic with one staff or two at most. You are the one to pound the pavement and look for new patients. It's a long grind and you won't be there long enough to enjoy the fruit of thy labor.

 

[Feli]

A fear of mine is that I end up at some crappy job where there’s not even enough volume to get abfas certified especially in RRA.

For those of you who have been through this process, realistically when I’m looking for a job, what things should I be looking for that would indicate i’d be busy enough there to not only make money but get surgical patients to meet numbers?

If you want to do a lot of surgery in podiatry PP, you need to see a LOT of patients. A whole lot. It's a numbers game.
You will always have ingrown, derm, heel pain, various non-op patients as a DPM. Few, % wise, are surgery.

• You will need to have pretty high volume of clinic pts scheduled yourself (solo or small PP), and a few will need surgery. Plan to DIY it via volume in PP, and look for a busy gig. Be surprised if you get sent any significant amount of surgical pts by colleagues these days.
• The other option is joining a medium/large pod group that has a few C&C pods and to try to be the surgery guy - or one of them. That is getting much tougher (more and more DPMs do their own cases and/or the "surgery guy" roles will be taken), and it may or may not pay well to do that role. Unfortunately, most of the rockstar guys you can learn from in PP will not give up surgery... they do it themselves and do it well. Fewer podiatry groups in general are busy surgically as in past years due to competition moves in, especially competition for surgery pts... surgical DPMs replace C&C ones every year in every city.
• The other option is joining an ortho group with much trauma/deformity refer base. That's a great option, but that's <1% of DPMs (still try it).
• The other option is inpatient/wound work via PP or hospital employ, but that's not quality fixation/deformity cases needed for ABFAS BC. You have to try to "find" the real bone/joint surgery among the DM pus nonsense. It can work.

The Foot ABFAS numbers are not too hard in any kind of podiatry group work (or MSG). Bunions and foot fx and such walk in. You can get the basic RRA like Haglund and ankle scope. The hindfoot RRA with trauma and post-trauma OA and deformity is much harder if you don't have those refers (ortho group, large DPM group, area without much/any ortho, etc). It will usually take awhile, but it'll come as long as it's not a total C&C practice. You see what you know. Some people try to compensate or speed it up by doing surgery on non-displaced fractures, talking pts into surgery, etc... shows you how overpopulated we are. I get those new patients every week where some other area DPM was talking surgery at the first visit (even for PF or chronic ATFL or mild ankle OA or flexible minimally painful planus or whatever) and scared the pt off by not building rapport or doing some conservative. It's not a good look for podiatry. It's not necessary... but seeing a medium/high number of pts is.

@msion is dead on with that post above about being busy. He was also right on the mark that good residency is not nearly as protective as it once was... and that's not because of fellowships. It's because of ridiculous over-saturation of DPM 3yr "foot and ankle surgeons."
[I do still, and always will, highly recommend best grades/learning and the top residency one can get]

....Keep in mind,

• There was a time when DPMs didn't do residency. Almost none at all. (pre-1950s)
• Most DPMs didn't get any residency even 40 or 50yrs ago (1960s and 1970s). Of the few residencies, most weren't surgical.
• Some would get a residency later, but most still weren't surgical (in 1980s, 1990s)... or they'd cobble together a basic "surgical" one.
• 2yr surgical was best possible for awhile (1980s). Only a pretty small % of grads got that, and some hospitals were no/few DPMs.
• Slightly before me, residencies were fragmented (1990s, 2000s). Anywhere from 1yr non-surg to 3yr surg/RRA. A few grads = nada.
• I came out when all programs had just become 3 years, some RRA and some not (2010s).
• Now (2020s), we claim all are 3yr and good and surgical and prep grads for ABFAS. And we wonder why the work/jobs dried up???

Basically, the jobs/hosptials floodgate of 3yr 'surgical trained' podiatrists is still relatively new, but it has happened fast. Saturation is cumulative:

• It seems weird that the jobs dry up so fast.
• It seems weird that even top grads can be struggling... when they were untouchable 20 or even powerful 10 years ago.
• The alumni networks, even at top programs, can only accommodate so many of their own residency/fellowship grads.
• Podiatry groups looking for a guy to funnel surgery to now have tons of options, not just a few... or the spot's full.
• The create-a-job MSG and small/rural hospitals are drying up as they become increasingly occupied and cold-called.
• Fellowships pop up to try to get a job edge (and to take advantage of a worker bee)

There is a h-e-a-v-i-l-y cumulative effect going on. The number of "surgical DPM" people in the job market went exponential.
Jobs (surgical DPM jobs) were easier for 2000 or 2005 grads than me.
It was easier for me than Retro or DYK or many other SDN regulars.
They had an easier time than you this year.
There are hundred and hundreds of DPMs coming out annually now looking for surgical jobs and surgical pts and good pay.
(keep in mind that, although they do a lot of surgery, orthopedic F&A fellowships only put out around ~50-75 per year)
...The good DPM ortho group jobs and metro hospital jobs were always tough... but they got tougher with more "surgical" grads, then the medium hospitals, then DPM grads went to work on MSGs and rural ortho groups to create spots there, then the rural hospitals even got hit by the cold callers and networkers also, the VAs were suddenly fairly flooded with apps, now even the 'surgical guy' roles in DPM PP groups are competed for, and any PP group paying over 125k or 150k base or having busy schedule for the new associate is going to get hit with calls and apps. We are talking all of this within 10-15 years of "3 year surgical trained." It will NOT get any easier.

This is not 2001, when doing a good 3yr residency meant you could almost certainly get an ortho group or hospital job if you were a bit flexible on locations. At worst, you would have to drum up a MSG job or go work at a VA... or you could always dial up some alumni and easily be the surgical guy for a DPM group (usually last resort for a power program grad back then). There was the other option of meet with a bank and start or buy your own (and get surgical refers from nearby DPMs who didn't do those cases!). Those time are ooover... everyone's "3 year surgical" now.

Imagine how bad it'll be once we have 30 or 40 years (career cycle ) of churning out 3yr trained "surgical" DPMs all looking for surgical jobs. It will be completely nuts. There will be so many past years of grads seeking the same jobs. It will be nearly impossible to get a call back from a hospital for a job even with elite training... much less an interview or 2nd or offer! DPM grads will be taking out a six figure loan to buy their critical access hospital job for $100k ("retirement gift" for the DPM there) after paying $500k or $1M+ for their education?

Bottom line: it's bad now, but it'll get even more saturated. Get out there, stop accumulating debt, start getting cases, start learning how practice works instead of spending a year accumulating student loan interest and having 600 more "3 year surgical DPM"s to compete with on the cold calling and 50 or 100 job postings. I wish I was joking.

 

[Adam Smasher]

Imagine how bad it'll be once we have 30 or 40 years (career cycle ) of churning out 3yr trained "surgical" DPMs all looking for surgical jobs.

Really great post. I don't think we'll need to wait 30 years though. For me 2029 is our reckoning. By then we'll have 20 years worth of 3 year trained grads actively in practice. We'll also have the first classes from lecom and utrv finishing residency. Healthdrive gonna get a recruiting bonanza of fresh DPMs.

 

[FutureDPM323]

PA school…or a different career path sounds better and better post residency.

Even if I get a decent job post residency, I don’t plan to be there forever. So where does that leave me if I need to move and switch jobs in terms of the job market say idk 4 years from now? 7 years? 10 years? I’ll be competing with 1000s of graduates who can all say they did a “top tier residency.”

 

[DYK343]

If you want to do a lot of surgery in podiatry PP, you need to see a LOT of patients. A whole lot. It's a numbers game.
You will always have ingrown, derm, heel pain, various non-op patients as a DPM. Few, % wise, are surgery.

• You will need to have pretty high volume of clinic pts scheduled yourself (solo or small PP), and a few will need surgery. Plan to DIY it via volume in PP, and look for a busy gig. Be surprised if you get sent any significant amount of surgical pts by colleagues these days.
• The other option is joining a medium/large pod group that has a few C&C pods and to try to be the surgery guy - or one of them. That is getting much tougher (more and more DPMs do their own cases and/or the "surgery guy" roles will be taken), and it may or may not pay well to do that role. Unfortunately, most of the rockstar guys you can learn from in PP will not give up surgery... they do it themselves and do it well. Fewer podiatry groups in general are busy surgically as in past years due to competition moves in, especially competition for surgery pts... surgical DPMs replace C&C ones every year in every city.
• The other option is joining an ortho group with much trauma/deformity refer base. That's a great option, but that's <1% of DPMs (still try it).
• The other option is inpatient/wound work via PP or hospital employ, but that's not quality fixation/deformity cases needed for ABFAS BC. You have to try to "find" the real bone/joint surgery among the DM pus nonsense. It can work.

The Foot ABFAS numbers are not too hard in any kind of podiatry group work (or MSG). Bunions and foot fx and such walk in. You can get the basic RRA like Haglund and ankle scope. The hindfoot RRA with trauma and post-trauma OA and deformity is much harder if you don't have those refers (ortho group, large DPM group, area without much/any ortho, etc). It will usually take awhile, but it'll come as long as it's not a total C&C practice. You see what you know. Some people try to compensate or speed it up by doing surgery on non-displaced fractures, talking pts into surgery, etc... shows you how overpopulated we are. I get those new patients every week where some other area DPM was talking surgery at the first visit (even for PF or chronic ATFL or mild ankle OA or flexible minimally painful planus or whatever) and scared the pt off by not building rapport or doing some conservative. It's not a good look for podiatry. It's not necessary... but seeing a medium/high number of pts is.

@msion is dead on with that post above about being busy. He was also right on the mark that good residency is not nearly as protective as it once was... and that's not because of fellowships. It's because of ridiculous over-saturation of DPM 3yr "foot and ankle surgeons."
[I do still, and always will, highly recommend best grades/learning and the top residency one can get]

....Keep in mind,

• There was a time when DPMs didn't do residency. Almost none at all. (pre-1950s)
• Most DPMs didn't get any residency even 40 or 50yrs ago (1960s and 1970s). Of the few residencies, most weren't surgical.
• Some would get a residency later, but most still weren't surgical (1980s, 1990s)... or they'd cobble together a basic "surgical" one.
• 2yr surgical was best possible for awhile (1980s). Only a small % of grads got that, and some hospitals were no/few DPMs.
• Slightly before me, residencies were fragmented (1990s, 2000s). Anywhere from 1yr non-surg to 3yr surg/RRA. A few grads = nada.
• I came out when all programs had just become 3 years, some RRA and some not (2010s).
• Now (2020s), we claim all are 3yr and good and surgical and prep grads for ABFAS. And we wonder why the work/jobs dried up???

Basically, the jobs/hosptials floodgate of 3yr 'surgical trained' podiatrists is still relatively new, but it has happened fast. Saturation is cumulative:

• It seems weird that the jobs dry up so fast.
• It seems weird that even top grads can be struggling... when they were untouchable 20 or even powerful 10 years ago.
• The alumni networks, even at top programs, can only accommodate so many of their own residency/fellowship grads.
• Podiatry groups looking for a guy to funnel surgery to now have tons of options, not just a few... or the spot's full.
• The create-a-job MSG and small/rural hospitals are drying up as they become increasingly occupied and cold-called.
• Fellowships pop up to try to get a job edge (and to take advantage of a worker bee)

There is a h-e-a-v-i-l-y cumulative effect going on. The number of "surgical DPM" people in the job market went exponential.
Jobs (surgical DPM jobs) were easier for 2000 or 2005 grads than me.
It was easier for me than Retro or DYK or many other SDN regulars.
They had an easier time than you this year.
There are hundred and hundreds of DPMs coming out annually now looking for surgical jobs and surgical pts and good pay.
(keep in mind that, although they do a lot of surgery, orthopedic F&A fellowships only put out around ~50-75 per year)
...The good DPM ortho group jobs and metro hospital jobs were always tough... but they got tougher with more "surgical" grads, then the medium hospitals, then DPM grads went to work on MSGs and rural ortho groups to create spots there, then the rural hospitals even got hit by the cold callers and networkers also, the VAs were suddenly fairly flooded with apps, now even the 'surgical guy' roles in DPM PP groups are competed for, and any PP group paying over 125k or 150k base or having busy schedule for the new associate is going to get hit with calls and apps. We are talking all of this within 10-15 years of "3 year surgical trained." It will NOT get any easier.

This is not 2001, when doing a good 3yr residency meant you could almost certainly get an ortho group or hospital job if you were a bit flexible on locations. At worst, you would have to drum up a MSG job or go work at a VA... or you could always dial up some alumni and easily be the surgical guy for a DPM group (usually last resort for a power program grad back then). There was the other option of meet with a bank and start or buy your own (and get surgical refers from nearby DPMs who didn't do those cases!). Those time are ooover... everyone's "3 year surgical" now.

Imagine how bad it'll be once we have 30 or 40 years (career cycle ) of churning out 3yr trained "surgical" DPMs all looking for surgical jobs. It will be completely nuts. There will be so many past years of grads seeking the same jobs. It will be nearly impossible to get a call back from a hospital for a job even with elite training... much less an interview or 2nd or offer! DPM grads will be taking out a six figure loan to buy their critical access hospital job for $100k ("retirement gift" for the DPM there) after paying $500k or $1M+ for their education?

Bottom line: it's bad now, but it'll get even more saturated. Get out there, stop accumulating debt, start getting cases, start learning how practice works instead of spending a year accumulating student loan interest and having 600 more "3 year surgical DPM"s to compete with on the cold calling and 50 or 100 job postings. I wish I was joking.

Jobs heavy in Medicaid are surgery machines. If you take Medicaid you can get foot/RRA numbers real fast. If you're not working (and its free) might as well fix whatever is wrong. My first MSG job was full of Medicaid (wRVU so I didn't care..). No shortage of surgical volume. Got foot/RRA quickly.

I know that sounds somewhat callused. But its true.

 

[Hybrocure]

Jobs heavy in Medicaid are surgery machines. If you take Medicaid you can get foot/RRA numbers real fast. If you're not working (and its free) might as well fix whatever is wrong. My first MSG job was full of Medicaid (wRVU so I didn't care..). No shortage of surgical volume. Got foot/RRA quickly.

I know that sounds somewhat callused. But it’s true.

This is true but operating on Medicaid patients will also make your life miserable. Nothing ever goes well, nobody listens, and they all want a magic pill for the pain.

It’s basically like doing elective surgery on the pus bus patients

 

[air bud]

If you want to do a lot of surgery in podiatry PP, you need to see a LOT of patients. A whole lot. It's a numbers game.
You will always have ingrown, derm, heel pain, various non-op patients as a DPM. Few, % wise, are surgery.

• You will need to have pretty high volume of clinic pts scheduled yourself (solo or small PP), and a few will need surgery. Plan to DIY it via volume in PP, and look for a busy gig. Be surprised if you get sent any significant amount of surgical pts by colleagues these days.
• The other option is joining a medium/large pod group that has a few C&C pods and to try to be the surgery guy - or one of them. That is getting much tougher (more and more DPMs do their own cases and/or the "surgery guy" roles will be taken), and it may or may not pay well to do that role. Unfortunately, most of the rockstar guys you can learn from in PP will not give up surgery... they do it themselves and do it well. Fewer podiatry groups in general are busy surgically as in past years due to competition moves in, especially competition for surgery pts... surgical DPMs replace C&C ones every year in every city.
• The other option is joining an ortho group with much trauma/deformity refer base. That's a great option, but that's <1% of DPMs (still try it).
• The other option is inpatient/wound work via PP or hospital employ, but that's not quality fixation/deformity cases needed for ABFAS BC. You have to try to "find" the real bone/joint surgery among the DM pus nonsense. It can work.

The Foot ABFAS numbers are not too hard in any kind of podiatry group work (or MSG). Bunions and foot fx and such walk in. You can get the basic RRA like Haglund and ankle scope. The hindfoot RRA with trauma and post-trauma OA and deformity is much harder if you don't have those refers (ortho group, large DPM group, area without much/any ortho, etc). It will usually take awhile, but it'll come as long as it's not a total C&C practice. You see what you know. Some people try to compensate or speed it up by doing surgery on non-displaced fractures, talking pts into surgery, etc... shows you how overpopulated we are. I get those new patients every week where some other area DPM was talking surgery at the first visit (even for PF or chronic ATFL or mild ankle OA or flexible minimally painful planus or whatever) and scared the pt off by not building rapport or doing some conservative. It's not a good look for podiatry. It's not necessary... but seeing a medium/high number of pts is.

@msion is dead on with that post above about being busy. He was also right on the mark that good residency is not nearly as protective as it once was... and that's not because of fellowships. It's because of ridiculous over-saturation of DPM 3yr "foot and ankle surgeons."
[I do still, and always will, highly recommend best grades/learning and the top residency one can get]

....Keep in mind,

• There was a time when DPMs didn't do residency. Almost none at all. (pre-1950s)
• Most DPMs didn't get any residency even 40 or 50yrs ago (1960s and 1970s). Of the few residencies, most weren't surgical.
• Some would get a residency later, but most still weren't surgical (1980s, 1990s)... or they'd cobble together a basic "surgical" one.
• 2yr surgical was best possible for awhile (1980s). Only a small % of grads got that, and some hospitals were no/few DPMs.
• Slightly before me, residencies were fragmented (1990s, 2000s). Anywhere from 1yr non-surg to 3yr surg/RRA. A few grads = nada.
• I came out when all programs had just become 3 years, some RRA and some not (2010s).
• Now (2020s), we claim all are 3yr and good and surgical and prep grads for ABFAS. And we wonder why the work/jobs dried up???

Basically, the jobs/hosptials floodgate of 3yr 'surgical trained' podiatrists is still relatively new, but it has happened fast. Saturation is cumulative:

• It seems weird that the jobs dry up so fast.
• It seems weird that even top grads can be struggling... when they were untouchable 20 or even powerful 10 years ago.
• The alumni networks, even at top programs, can only accommodate so many of their own residency/fellowship grads.
• Podiatry groups looking for a guy to funnel surgery to now have tons of options, not just a few... or the spot's full.
• The create-a-job MSG and small/rural hospitals are drying up as they become increasingly occupied and cold-called.
• Fellowships pop up to try to get a job edge (and to take advantage of a worker bee)

There is a h-e-a-v-i-l-y cumulative effect going on. The number of "surgical DPM" people in the job market went exponential.
Jobs (surgical DPM jobs) were easier for 2000 or 2005 grads than me.
It was easier for me than Retro or DYK or many other SDN regulars.
They had an easier time than you this year.
There are hundred and hundreds of DPMs coming out annually now looking for surgical jobs and surgical pts and good pay.
(keep in mind that, although they do a lot of surgery, orthopedic F&A fellowships only put out around ~50-75 per year)
...The good DPM ortho group jobs and metro hospital jobs were always tough... but they got tougher with more "surgical" grads, then the medium hospitals, then DPM grads went to work on MSGs and rural ortho groups to create spots there, then the rural hospitals even got hit by the cold callers and networkers also, the VAs were suddenly fairly flooded with apps, now even the 'surgical guy' roles in DPM PP groups are competed for, and any PP group paying over 125k or 150k base or having busy schedule for the new associate is going to get hit with calls and apps. We are talking all of this within 10-15 years of "3 year surgical trained." It will NOT get any easier.

This is not 2001, when doing a good 3yr residency meant you could almost certainly get an ortho group or hospital job if you were a bit flexible on locations. At worst, you would have to drum up a MSG job or go work at a VA... or you could always dial up some alumni and easily be the surgical guy for a DPM group (usually last resort for a power program grad back then). There was the other option of meet with a bank and start or buy your own (and get surgical refers from nearby DPMs who didn't do those cases!). Those time are ooover... everyone's "3 year surgical" now.

Imagine how bad it'll be once we have 30 or 40 years (career cycle ) of churning out 3yr trained "surgical" DPMs all looking for surgical jobs. It will be completely nuts. There will be so many past years of grads seeking the same jobs. It will be nearly impossible to get a call back from a hospital for a job even with elite training... much less an interview or 2nd or offer! DPM grads will be taking out a six figure loan to buy their critical access hospital job for $100k ("retirement gift" for the DPM there) after paying $500k or $1M+ for their education?

Bottom line: it's bad now, but it'll get even more saturated. Get out there, stop accumulating debt, start getting cases, start learning how practice works instead of spending a year accumulating student loan interest and having 600 more "3 year surgical DPM"s to compete with on the cold calling and 50 or 100 job postings. I wish I was joking.

Here you go. Sticky this and call it "State of Podiatry 2023". This is all you need to read and know. Every prospective student needs to read this. Not an single inaccuracy. Thank you for your service.

 

[dtrack22]

Jobs heavy in Medicaid are surgery machines. If you take Medicaid you can get foot/RRA numbers real fast. If you're not working (and its free) might as well fix whatever is wrong. My first MSG job was full of Medicaid (wRVU so I didn't care..). No shortage of surgical volume. Got foot/RRA quickly.

I know that sounds somewhat callused. But its true.

Buuuuut these patients are total pieces of crap in many cases and if you want to give the ABFAS gatekeepers something to fail you on, do your best work on a medicaid patient and watch them not show up for follow up or totally trash all of your work

 

[HR91]

Wait, let him cook.

100k base for 2 patients a day not such a bad gig.

What you don't want is to start your first day with only 2 patients on the schedule, and then forced to take free call for the group at the hospitals to do pus work, and then doing your own marketing to get more patients.

Welcome to pod private practice expansion standard operating procedure. Hire a new associate and screw them while they build a patient base for the practice. Pro tip: if the other provider(s) are not booking new patients at least 3-4w out then you are going to have a typical slow painful ramp up.

Finally, you will get neither if you join a practice and they want you to "build it up". You wont get surgery nor money from clinic because volume is starting from zero. This is the worst situation in my opinion. A lot those big super groups are fond of hiring a new (fellowship trained) associate and opening a new clinic at a new location. They sell the new hire the idea that the area is busy, in need of a podiatrist and you can grow the new clinic. They send you to a new clinic with one staff or two at most. You are the one to pound the pavement and look for new patients. It's a long grind and you won't be there long enough to enjoy the fruit of thy labor.

And to top it off, some of these positions don't even offer salary to begin with... Straight percentage but having to build it up from the ground up. But unofficial "referral sources" are supposedly already in place but no immediate volume and the requirement of busting your butt doing inpatient work to start up. Long road ahead for any sort of respectable income and quality surgical volume in those setups...

 

[Susitna]

PA school…or a different career path sounds better and better post residency.

Even if I get a decent job post residency, I don’t plan to be there forever. So where does that leave me if I need to move and switch jobs in terms of the job market say idk 4 years from now? 7 years? 10 years? I’ll be competing with 1000s of graduates who can all say they did a “top tier residency.”

Are you not getting advice or leads from your current residency program? Directors?Attendings? Past residents? You appear clueless and SDN isn’t where you go for advice or leads.

 

[Pronation]

Are you not getting advice or leads from your current residency program? Directors?Attendings? Past residents? You appear clueless and SDN isn’t where you go for advice or leads.

Actually you are the one that appears either clueless or egregiously giving malicious advice. The podiatry job market is horrendous and continues to worsen yearly due to the absurd over saturation.

 

[newfeet]

PA school…or a different career path sounds better and better post residency.

Even if I get a decent job post residency, I don’t plan to be there forever. So where does that leave me if I need to move and switch jobs in terms of the job market say idk 4 years from now? 7 years? 10 years? I’ll be competing with 1000s of graduates who can all say they did a “top tier residency.”

You would need to start your job search at least a year before you actually want to leave. I was at my first job for 5 years and I was at my second for 3 years. When I left my last job I made them wait for 6 months because I want to finish the terms of my contract. I plan on staying at this current job until I retire or die while seeing while walking to my desk or I get fired then security will have to drag me out of the building. It would take a ton of money or unique job opp for me to leave now. I've experienced two other jobs and its not worth job hopping anymore looking for the perfect location or the perfect salary. I have a decent salary, the location is ok and my kids are growing up. I am not moving them again.

 

[air bud]

Are you not getting advice or leads from your current residency program? Directors?Attendings? Past residents? You appear clueless and SDN isn’t where you go for advice or leads.

I recommend PM news for leads personally.

 

[Shiyuan]

I recommend PM news for leads personally.

Or my personal favorite.... podiatry exchange 😂

 

[HardRoadPaved]

Are you not getting advice or leads from your current residency program? Directors?Attendings? Past residents? You appear clueless and SDN isn’t where you go for advice or leads.

I recommend podiatry exchange https://www.podiatryexchange.org/classifieds/positions.htm


(JINX!!! HAHA what lobster trash)

 

[DYK343]

Buuuuut these patients are total pieces of crap in many cases and if you want to give the ABFAS gatekeepers something to fail you on, do your best work on a medicaid patient and watch them not show up for follow up or totally trash all of your work

Some yes but not all. Gotta know when not to operate and weed those out.

I treat a lot of medicaid in my last job and my current job.

Definitely have some crazies but also a lot of normal people who work at mcdonalds or a gas station or wherever that qualify. Those are not career jobs so they are not afraid to have elective surgery.

 

[FutureDPM323]

Are you not getting advice or leads from your current residency program? Directors?Attendings? Past residents? You appear clueless and SDN isn’t where you go for advice or leads.

LOL

 

[Shiyuan]

LOL

I think he’s @BubbaWub in disguise 😂

 

[GreenHousePub]

What happened to experiencedDPM? You think with all that experience he could weigh in on these issues.

 

[Susitna]

Actually you are the one that appears either clueless or egregiously giving malicious advice. The podiatry job market is horrendous and continues to worsen yearly due to the absurd over saturation.

Pronation, please review my “egregiously malicious advice”; do a fellowship, get involved in research, write a paper, utilize your resources including your network from residency, don’t seek advice from SDN “attendings” on career choices.

Lee Rogers gives great insights but you all don’t want to hear it. Feli and Retro do fine work too.

 

[BubbaWub]

Pronation, please review my “egregiously malicious advice”; do a fellowship, get involved in research, write a paper, utilize your resources including your network from residency, don’t seek advice from SDN “attendings” on career choices.

Lee Rogers gives great insights but you all don’t want to hear it. Feli and Retro do fine work too.

These people are ignorant to the true power of our profession. I agree with you. I have a great practice, and I am one of the best podiatrists in the country, if not the world. There is so much opportunity. Today I saw close to 50 patients in clinic. I am desperately trying to get some of the residents into a research paper regarding novel treatment methods for onychomycosis, along with proper curettage and debridement methods, but they do not care. They are all busy being orthopedic surgeons.

Nursing homes are some of the best sources of income available to podiatrists. Every single time I bring this up to our residents, they do not care to hear about it. I love my nursing home days as they are often most rewarding and profitable.

You and I probably have very similar practices, and treatment methods. We are from a different time. Our president is from a different time.

I believe he is the key to making everything great in our profession again. We MUST continue to support him, as he is the rising star.

Thank you

 

[Pronation]

 

[HardRoadPaved]

I feel like I'm being pranked here. From subpar MCAT and 'what are my chances' thread in 2010 to "best DPM in the world" without ABFAS cert...

Bubbawub, I don't use the word 'hero' lightly, but you are the greatest hero in American history

 

[diabeticfootdr]

I feel like I'm being pranked here. From subpar MCAT and 'what are my chances' thread in 2010 to "best DPM in the world" without ABFAS cert...

Bubbawub, I don't use the word 'hero' lightly, but you are the greatest hero in American history

This is what one can expect from SDN …

 

[HardRoadPaved]

This is what one can expect from SDN …

Yes us ratting out a troll who is proud to have gotten 7 years of education to do pedicure work at a nursing home....

"I keep hearing about saturation on this forum but I am incredibly busy in my practice. I see routine care for approximately 80% of my patients, and new patients often have to wait months to see me."

 

[Adam Smasher]

I am desperately trying to get some of the residents into a research paper regarding novel treatment methods for onychomycosis, along with proper curettage and debridement methods, but they do not care. They are all busy being orthopedic surgeons.

Nursing homes are some of the best sources of income available to podiatrists. Every single time I bring this up to our residents, they do not care to hear about it. I love my nursing home days as they are often most rewarding and profitable.

First I admire your dedication to elder care. I don't want to sound patronizing, because you clearly strive to treat every patient with dignity. I truly mean it. I even agree with you insofar that people do need their toenails trimmed in the same way that their teeth need flossing and underarms need scrubbing. And if this is going to be your contribution to the world and it brings you fulfillment neither I nor anyone else should cut you down for it.

But please understand: residents are in residency to learn surgery. It is THE reason residency exists.

Nailcare is to podiatry what happy endings are to massage therapy. It's something anyone can do, and if that's your main service offering, then why spend years learning the rest of your discipline. Even your vaunted rising star president has stated on these forums that it should be in the domain of the nail tech and not the doctor.

Now I don’t expect you to agree with me, and that's totally OK, be the kind of doctor you want to be. But understand toenail-cutting is not the specialization any of us had in mind before undertaking this course of study. I've talked about this before, this is "the podiatry bait and switch," and I think it's an awful trick to play on a young person.

 

[Pronation]

This is what one can expect from SDN …

The fact that this obvious joke went right over your head…

 

[Feli]

...Nursing homes are some of the best sources of income available to podiatrists. Every single time I bring this up to our residents, they do not care to hear about it. I love my nursing home days as they are often most rewarding and profitable...

I never used to believe in this. Now, I'm not sure.

When I was 3rd year student in Miami, I met a guy from our school who was 5yrs out of a local residency (not a bad one, but definitely not a good one) who Barry U hired for maybe $100/day to teach our pod school orthotics and pedorthic materials lab. He learned us in the ways of pink versus blue plastazole and how to mix the cork with the glue. He was always saying how he did nursing homes... "those old people crack me up... I love em." He'd bring a toe amp here and there to the hospital where he did residency, but he did nail care most days.

He wasn't certified by ABPM... because it was ABPOPPM back then, so he rolled with that. He would say how he needed to find a few more nursing home contracts "before more of you new grads come out and take them first." We thought he was a little different since there were thousands of nursing homes in Florida. We also had no idea how many TFPs there were. But anyways, we were all headed off to 3yr residency to be big recon surgeons. I average over one bunion per month now. He is probably 20 years out of residency now... and retired on a beach thanks to those nursing homes. Or in jail. Either way. The point is that some people like nursing homes.

 

[FutureDPM323]

That poster cannot be real.

 

[Hybrocure]

That poster cannot be real.

I know it’s always a lot to read but I’m pretty sure Feli is real

 

[air bud]

Getting back to the whole fellowship thing in today's market and future market there is absolutely no doubt that a fellowship will make you more competitive for the rapidly decreasing surgical podiatry jobs. At least on paper. Again, a huge amount of the disinformation and lack of information out there that is just praying on students and residents is the lack of published data on what percentage of fellows are ending up in non-private practice associate type roles. This is data that could easily be collected and made part of mandatory graduation. But they are afraid to do it. Because the numbers would tell you that they are not getting automatic jobs with MSGs and hospitals. And then those fellowships and one year free labor and ego trip would cease to exist. I feel like discussed in his state of Podiatry Post, there are only more and more 3-year trained plus podiatrists coming on board and the only people who are retiring are people with limited surgical ability. It's only going to get worse costs are only going to get worse. Tuition will get worse. Cost of living will get worse. Reimbursement will get worse. Good paying job opportunities will get worse. So at this point is wasting another year of your life racking up more debt to possibly increase your chances of getting a better job worth it well that's for you to decide. Things are going to get much worse before they get better. Don't lie to yourself insane your going to do a fellow shift to get better training, 90% of fellows are not going to use any advanced training that they would learn. They're just trying to set themselves up for better position within this terrible job market .

Edit the schools are lying to you quit listening to them quit going to podiatry school. It's not worth it

Secondedit they're actually are significantly increasing employed Podiatry jobs. The problem is that there are now more people going after them with good training that are good candidates. So effectively there are 2x more jobs but 5x more applicants. From my own personal experience and others again we've talked about abfas. But still there is no doubt that other factors come into play. You can be the greatest train podiatrist but if you were born and raised in a certain metro area and you have good enough training to satisfy their job requirements they're going to pick that person instead of the person with Superior training that they made you as more of a risk. The ones where they have less and less good applicants are the ones that will take more risk and take the better trained person.

Third edit: why do you want to do a fellowship to do total ankles? Guess what in today's day and age coming out it's going to be super hard to get those patients. Any group that you're joining probably already has somebody who does them or there's some dude in your city who's doing like 50 or 60 of them a year. Just cuz you did some in residency doesn't mean you know how to do them in real life there's a learning curve. Now that you have so many people doing them and there's such risk associated with them your effing crazy if you think you should put your career on the line to do those when it's just as easy to send them to that dude doing 60 and see more other patients make more money and have less stress.
Tldr TARand fellowship not worth it. Your ego in 7 years well thank you.

Fourth edit: the schools are lying to you. The profession is lying to you about surgery. In a few years when you're overwhelmed with debt you've got young kids and you just want to have a life and not be at the bottom of the medical totem pole, you just want patience make a good living surgery isn't that cool no matter how good a surgery training you have. You just want a way to make 250 Plus Monday through Friday 8:00 to 5:00 no weekends no call. You don't need a fellowship to do that. In Podiatry people doing a ton of surgery and who don't have 20 years of experience and have a great set up with scribes PA's etc, they're not spending time with their family. Their health is suffering their relationships are suffering. It's not worth it. So now you just wasted a year of your life to do a fellowship to try and do more surgery that you probably won't do and if you do do it it's going to be for ego purposes not for quality of life.

5th edit : go to the school that will keep your cost as low as possible. Combining multiple threads you guys have no idea what these loans are going to be like to pay back one day at these crappy associate jobs that don't qualify for any type of reimbursement. Sure you can do that 20-year plan and just live your life in misery with that hanging over your head. But you're never going to make enough money to have any quality of life and pay off your loans. Again this isn't like real doctors where any of them could go knock out seven years at a good job that pays well enough with a good quality of life and all their loans will be forgiven. Those jobs in Podiatry are so few and far between that you should never count on it. That said I do have multiple friends that are ready to have a few hundred thousand and loans forgiven, I had about $60,000 in loans forgiven when I work for a place that had loan repay back but those are few and far between. Fellowship is just adding interest. You're going to make $60, 000 in fellowship, but that $300,000 in debt you have right now that's another $25,000 that just got tacked on just an interest.

7th? Edit. Anyone considering a fellowship, if there's even one fellow that went into private practice in the last 2 to 3 years of existence, why the hell are you doing that? All these new fellowships you're just free labor to them nothing more. And good for their ego.

Another edit: in no scenario should you listen to somebody who's been out for 15 to 20 years doing Big Time stuff talking about podiatry. They grew up in a different era. Those people excelled became great surgeons but they made it by doing stuff because nobody else could do it. Now everyone thinks they can. There was no competition they were able to create these jobs. Those jobs do not exist anymore. And if they do they're going to these guys that are jumping around. Nobody's going to become the next Justin Fleming in our day and age no one's going to become Justin Miller or some of these other dudes running all foor and ankle
depts organizations fellowships doing big complex stuff it was just a different era that they benefited from.

 

[Pronation]

Getting back to the whole fellowship thing in today's market and future market there is absolutely no doubt that a fellowship will make you more competitive for the rapidly decreasing surgical podiatry jobs. At least on paper. Again, a huge amount of the disinformation and lack of information out there that is just praying on students and residents is the lack of published data on what percentage of fellows are ending up in non-private practice associate type roles. This is data that could easily be collected and made part of mandatory graduation. But they are afraid to do it. Because the numbers would tell you that they are not getting automatic jobs with MSGs and hospitals. And then those fellowships and one year free labor and ego trip would cease to exist. I feel like discussed in his state of Podiatry Post, there are only more and more 3-year trained plus podiatrists coming on board and the only people who are retiring are people with limited surgical ability. It's only going to get worse costs are only going to get worse. Tuition will get worse. Cost of living will get worse. Reimbursement will get worse. Good paying job opportunities will get worse. So at this point is wasting another year of your life racking up more debt to possibly increase your chances of getting a better job worth it well that's for you to decide. Things are going to get much worse before they get better. Don't lie to yourself insane your going to do a fellow shift to get better training, 90% of fellows are not going to use any advanced training that they would learn. They're just trying to set themselves up for better position within this terrible job market .

Edit the schools are lying to you quit listening to them quit going to podiatry school. It's not worth it

Secondedit they're actually are significantly increasing employed Podiatry jobs. The problem is that there are now more people going after them with good training that are good candidates. So effectively there are 2x more jobs but 5x more applicants. From my own personal experience and others again we've talked about abfas. But still there is no doubt that other factors come into play. You can be the greatest train podiatrist but if you were born and raised in a certain metro area and you have good enough training to satisfy their job requirements they're going to pick that person instead of the person with Superior training that they made you as more of a risk. The ones where they have less and less good applicants are the ones that will take more risk and take the better trained person.

Third edit: why do you want to do a fellowship to do total ankles? Guess what in today's day and age coming out it's going to be super hard to get those patients. Any group that you're joining probably already has somebody who does them or there's some dude in your city who's doing like 50 or 60 of them a year. Just cuz you did some in residency doesn't mean you know how to do them in real life there's a learning curve. Now that you have so many people doing them and there's such risk associated with them your effing crazy if you think you should put your career on the line to do those when it's just as easy to send them to that dude doing 60 and see more other patients make more money and have less stress.
Tldr TARand fellowship not worth it. Your ego in 7 years well thank you.

Fourth edit: the schools are lying to you. The profession is lying to you about surgery. In a few years when you're overwhelmed with debt you've got young kids and you just want to have a life and not be at the bottom of the medical totem pole, you just want patience make a good living surgery isn't that cool no matter how good a surgery training you have. You just want a way to make 250 Plus Monday through Friday 8:00 to 5:00 no weekends no call. You don't need a fellowship to do that. In Podiatry people doing a ton of surgery and who don't have 20 years of experience and have a great set up with scribes PA's etc, they're not spending time with their family. Their health is suffering their relationships are suffering. It's not worth it. So now you just wasted a year of your life to do a fellowship to try and do more surgery that you probably won't do and if you do do it it's going to be for ego purposes not for quality of life.

5th edit : go to the school that will keep your cost as low as possible. Combining multiple threads you guys have no idea what these loans are going to be like to pay back one day at these crappy associate jobs that don't qualify for any type of reimbursement. Sure you can do that 20-year plan and just live your life in misery with that hanging over your head. But you're never going to make enough money to have any quality of life and pay off your loans. Again this isn't like real doctors where any of them could go knock out seven years at a good job that pays well enough with a good quality of life and all their loans will be forgiven. Those jobs in Podiatry are so few and far between that you should never count on it. That said I do have multiple friends that are ready to have a few hundred thousand and loans forgiven, I had about $60,000 in loans forgiven when I work for a place that had loan repay back but those are few and far between. Fellowship is just adding interest. You're going to make $60, 000 in fellowship, but that $300,000 in debt you have right now that's another $25,000 that just got tacked on just an interest.

7th? Edit. Anyone considering a fellowship, if there's even one fellow that went into private practice in the last 2 to 3 years of existence, why the hell are you doing that? All these new fellowships you're just free labor to them nothing more. And good for their ego.

Another edit: in no scenario should you listen to somebody who's been out for 15 to 20 years doing Big Time stuff talking about podiatry. They grew up in a different era. Those people excelled became great surgeons but they made it by doing stuff that nobody else wanted to do. There was no competition they were able to create these jobs. Those jobs do not exist anymore. And if they do they're going to these guys that are jumping around. Nobody's going to become the next Justin Fleming in our day and age no one's going to become Justin Miller or some of these other dudes running huge organizations fellowships doing big complex stuff it was just a different era that they benefited from.

I couldn't have said this better myself in less than 10 words.

Probably would need like 15 words.

But definitely could not have conveyed all of this with only 10 words.

 

[air bud]

I'm 7 years out rra certified. My salary is $260 a year I see 40 to 50 patients a week across 3 days of clinic. Have complete autonomy no boss breathing down my neck, they've given me pretty much everything I want at the hospital. I take no call do maybe three to four inpatients a month five to seven elective cases a month. I don't do anything challenging I use very little of my skill set I enjoy my day-to-day clinic. Good benefits low cost of living area. No chance at production because of patient volume.

Edit - I have been more rural and been much busier. But that was because there was nobody else to do what I could. Now others can and want to do it. And won't let me do it. Because Podiatry.

Stick my job in a metro area with reasonable COL, things for family to do and opportunities for spouse who doesn't have specialized training...I am good to go.

 

[Adam Smasher]

Saturday afternoon drunk posting, love it

 

[Hybrocure]

Saturday afternoon drunk posting, love it

 

[Feli]

I don't know which is worse, honestly:

Podiatrists now frequently doing a low-paid year of fellowship for skills they could have learned - or did - in a decent 3 year residency and knowing they're gaining no additional cert or skill or sub-specialty from the fellowship... just to *maybe* get a bit of an edge in saturated job market or try for a mediocre job with the fellowship group.​

...or...

Dentist grads paying (usually more loans, no joke) to do a year or multi-year residency... but gaining a new marketable niche endo/perio/ortho/peds etc skill and proven higher income than GP peers from doing the residency.​

...I think the dental move actually makes more sense.
It is crazy to literally pay for post-grad medical training, but with dental residency, you're spending to make more by developing unique skill. You are investing in yourself, and you are limiting your competition and getting a rare and in-demand skill set by doing it (that's the huge hole/myth in the podiatry fellowship think). It's sorta like doing MBA focus degree vs BA in business to do the dent residency, while the podiatry fellowship is just like going to private 4yr university versus public univ and hoping the name or possible connections floats you.

 

[msion]

Aside from my previous comment that fellowships seem somewhat helpful for today's job market, I still recommend against them. One year of job experience still triumphs.
Unlike fellowships in other specialties that gain additional scope of practice, fellowships in podiatry really don't achieve that. A plastic surgeon can take on a hand fellowship and then able to do ORIFs in the hands, or an IM doc can take on fellowships to perform more procedures.

I guess my point is there appears to be a misalignment of values for graduates of podiatry fellowships. Fellowship trained pods tend to think they are superior in every other way, and able to perform big complex cases and therefore demand a much higher pay. But the sad reality is they will be faced with scope issues, declining insurance reimbursements, hostility from other providers (pods or ortho), and therefore unable to practice to the scope of their added training with a reasonable pay. This in turn, creates dissatisfaction and misery.

There was one time we received a job application that basically said the candidate was willing to get paid 80k a year just to be practicing in the area as she was actually moving here with her husband. We of course didn't take that person, but you bet she did get a job in the area pretty soon. No fellowship trained pods can compete with that.

 

[podwho]

dont do the fellowship if you dont feel you need to. start a practice. dont be someone elses slave. The best part of being a PROVIDER is you can bill and generate as much as many other MD becase your a specialist. The work might suck in the begining but id rather pocket 300k and call my self a foot doctor podiatrist then 100k foot ankle fellowship trained *****. You can either be a sucker in the system or learn to play the game. Every partner/owners regret is not starting their own business earlier.

 

[Feli]

...There was one time we received a job application that basically said the candidate was willing to get paid 80k a year just to be practicing in the area as she was actually moving here with her husband. We of course didn't take that person, but you bet she did get a job in the area pretty soon. No fellowship trained pods can compete with that.

This is going to get sadly more common.

It'll be both people offering to do advertised jobs for less than advertised (since they know it'll get many apps and they are trying for some edge to get picked for the type of job or area they like)...
And also people basically trying to sell/buy organizational hospital/MSG jobs from retiring or leaving DPMs who can grease the wheels to get them an interview and inside track at the org job they otherwise might not even get a callback from due to flood of apps.

It already goes in in similar forms with people doing a fellowship year to hope to work for the sponsor group or people buying out PP offices or patient lists from retiring docs. It's going to reach the point where pretty much all good areas and facilities are occupied by "surgical podiatrist," and saturation does weird things to competition and compensation.

 

[msion]

This is going to get sadly more common.

True dat. There are people actively trying to steal other people’s jobs in this profession. It’s sad but it does happen. Some of the random resumes we got are mind blowing. Not in terms of qualifications, but the cover letter would be a sabotage against the existing doctors. Being in a private practice I can just laugh it off and die a little inside. Now imagine if this is targeted at hospital employed docs…

 

[Retrograde_Nail]

True dat. There are people actively trying to steal other people’s jobs in this profession. It’s sad but it does happen. Some of the random resumes we got are mind blowing. Not in terms of qualifications, but the cover letter would be a sabotage against the existing doctors. Being in a private practice I can just laugh it off and die a little inside. Now imagine if this is targeted at hospital employed docs…

This happens. When I was practicing at my previous hospital there were local podiatrists who contacted our HR department regularly trying to replace me. Saying they were fellowship trained and better than me. Saying they would take less money. We got a new chief of ortho who came from another hospital system in the state and had podiatry contacts from that hospital. Those podiatrists would contact this ortho regularly bad mouthing me trying to get my job. It definitely happens.

 

[Shiyuan]

Dear HR,

My two week dermpath fellowship supersedes any of your current DPM’s advanced surgical training.

Kthnxbai.

 

[ExperiencedDPM]

This is how we do things

What happened to experiencedDPM? You think with all that experience he could weigh in on these issues.

Alas, I’ve appeared.

Not much to write that hasn’t been written. There are a handful of excellent fellowships that have the potential to lead to good positions due to good connections.

And of course there are many that are just a way to fill a year or make the director money. And of course it allows you to put “fellowship trained douchebag” as your salutation.

The only potential good thing about all fellowships is that almost every orthopedic surgeon now does a fellowship. So many won’t even consider a DPM if they don’t have a fellowship. And of course these orthopods have no clue which DPM fellowships are crap or quality.

 

[Hybrocure]

Alas, I’ve appeared.

Not much to write that hasn’t been written. They are a handful of excellent fellowships that have the potential to lead to good positions due to good connections.

And of course there are many that are just a way to fill a year or make the director money. And of course it allows you to put “fellowship trained douchebag” as your salutation.

The only potential good thing about all fellowships is that almost every orthopedic surgeon now does a fellowship. So many won’t even consider a DPM even if they don’t have a fellowship. And of course these orthopods have no clue which DPM fellowships are crap or quality.

Best residencies for podiatrists are still Harvard and Yale from the outsider perspective

 

[ExperiencedDPM]

Best residencies for podiatrists are still Harvard and Yale from the outsider perspective

Exactly. You can do an incredible program at a relatively unknown hospital, but Harvard end Yale will open doors whether the program is great or weak.

 

[FutureDPM323]

i’d be so embarrassed emailing anyone to talk badly about someone. Do those people not realize it reflects poorly on them? Huge huge red flag.

But not surprised. They’re probably the same people who were gunners in school/tried to make other students look bad on externships then make their co residents look bad for the sake of benefitting themselves.

 

[Adam Smasher]

I will again point out that many fellowships are unaccredited, and therefore anything can be a fellowship. Waiting to see someone who works healthdrive and calls it the "Geriatric Mycology" fellowship.

 

[air bud]

Alas, I’ve appeared.

Not much to write that hasn’t been written. They are a handful of excellent fellowships that have the potential to lead to good positions due to good connections.

And of course there are many that are just a way to fill a year or make the director money. And of course it allows you to put “fellowship trained douchebag” as your salutation.

The only potential good thing about all fellowships is that almost every orthopedic surgeon now does a fellowship. So many won’t even consider a DPM if they don’t have a fellowship. And of course these orthopods have no clue which DPM fellowships are crap or quality.

Can you weigh in on my point about all these fellowship directors and Big Time people came up in a completely different era 10 to 15 years ago where they were able to stand out because they were the only ones filling this need. Now everybody wants to offer it and thinks they can do it and has the training for it. Podiatry fellowship has jumped the shark.

 

[ExperiencedDPM]

Can you weigh in on my point about all these fellowship directors and Big Time people came up in a completely different era 10 to 15 years ago where they were able to stand out because they were the only ones filling this need. Now everybody wants to offer it and thinks they can do it and has the training for it. Podiatry fellowship has jumped the shark.

It has certainly been diluted. I can tell you that there are some fellowship directors who commit what I consider major fraud on a regular basis and I’m sure that’s passed on to the “fellow” who perpetuates the crap.

There are others who are not competent to teach someone the alphabet. But again, regardless of quality or lack of quality, most MSGs, hospitals or ortho groups have NO clue which programs are top notch and which one sucks.

Yes, there is a saturation and dilution and that’s never good. But that’s incredibly common in this profession.

Everyone needs to jump on the bandwagon. There’s no better example than the well known 3D bunionectomy craze. Yeah, every patient needs $20,000 worth of hardware in their foot, with a very high percentage also being removed at a later date due to complications.