Unmatched c/o 2013 by School

[dtrack22]

Most recent "official" report from the AACPM was 56 students left from 2013. That number is a couple of students lower as of now, since that was reported at the end of May.

There should be one final number published now that residency has started for the class of 2013. With that number I really hope the AACPM will publish the average GPA of the unmatched student cohort. They won't because the number makes them look bad, and it would make a lot of people less sympathetic to the current unmatched students...oh well. You can't always get what you want.

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[jonod1107]

Most recent "official" report from the AACPM was 56 students left from 2013. That number is a couple of students lower as of now, since that was reported at the end of May.

There should be one final number published now that residency has started for the class of 2013. With that number I really hope the AACPM will publish the average GPA of the unmatched student cohort. They won't because the number makes them look bad, and it would make a lot of people less sympathetic to the current unmatched students...oh well. You can't always get what you want.

Are you saying that the students that didn't match was due to their low GPA? I may not know the all the GPAs of the unmatched but I do know that there were several students in the top 20% of the class at Temple that didn't match.

 

[MaxillofacialMN]

Are you saying that the students that didn't match was due to their low GPA? I may not know the all the GPAs of the unmatched but I do know that there were several students in the top 20% of the class at Temple that didn't match.

Were they super awk?

 

[dyk343]

Anyone click on the CASPR/CRIP "where residencies are offered" link lately? There are a lot of new programs popping up.

There are also a lot of established programs that have "I" for incomplete. I hope this is because they are increasing their R1 positions, and not dissolving.

 

[dyk343]

Most recent "official" report from the AACPM was 56 students left from 2013. That number is a couple of students lower as of now, since that was reported at the end of May.

There should be one final number published now that residency has started for the class of 2013. With that number I really hope the AACPM will publish the average GPA of the unmatched student cohort. They won't because the number makes them look bad, and it would make a lot of people less sympathetic to the current unmatched students...oh well. You can't always get what you want.

I know of several who have matched in the last month.

 

[dtrack22]

Are you saying that the students that didn't match was due to their low GPA?

For a majority of the students, I'm sure it hurt them a lot. Especially in a "scramble" type situation where the program is judging your qualifications largely on paper.

Even if there were a million spots, there could easily be a couple of good students (academically) who wouldn't get a spot. I've heard of students not getting program A because of what they did at program B after those two programs "talked". It's definitely the exception, but entirely possible and has happened.

I'll admit, I was one of those people saying a shortage wouldn't happen. I was wrong. But when you've been hearing about a "shortage" for 3 straight years, none of which experienced said "shortage", it's easy to dismiss it. Plus, I think it was perfectly reasonable to take historic attrition and pass rates into account when making the assumption that myself and many others did. Had those numbers held true, we wouldn't be talking about any of this right now. But we are, and I think most people are doing everything in their power to fix it. Hopefully pre-pods and students start asking schools the hard questions and holding them accountable. The CPME is currently working on making it mandatory that schools publish pertinent matriculation, attrition, board pass and residency placement rate data. It's long overdue. There is not one program in the country that can graduate and place over 100 students. There simply aren't enough applicants...

 

[ldsrmdude]

Anyone click on the CASPR/CRIP "where residencies are offered" link lately? There are a lot of new programs popping up.

There are also a lot of established programs that have "I" for incomplete. I hope this is because they are increasing their R1 positions, and not dissolving.

I looked at it yesterday, and I didn't really notice that many new programs. It looks like a few here and there. Probably some places added spots too, but I didn't really notice much change. Then again, I can't say that I pay as close attention to the list of residencies anymore.

 

[jonod1107]

I looked at it yesterday, and I didn't really notice that many new programs. It looks like a few here and there. Probably some places added spots too, but I didn't really notice much change. Then again, I can't say that I pay as close attention to the list of residencies anymore.

Looks like only 5 new positions since May 15.

7/10/13 Massachusetts is accepting applications for one entry level PMSR position that will start sometime before January 2014. Email your CASPR application to rscardina at partners.org. 1
6/11/13 DVA-MD Healthcare System is accepting applications for one entry level PMSR/RRA position. Email your CASPR application to rickey.adams at va.gov. 1 FILLED
6/7/13 Forest Hills Hospital is accepting applications for an entry level PMSR/RRA position. The minimum GPA is 3.0. Email your CASPR application to Ggrubman at nshs.edu. 1 FILLED
6/6/13 Coney Island Hospital is accepting applications for an entry level PMSR position. Email your CASPR application to glenn.donovan at nychhc.org 1 FILLED
5/15/13 Silver Lake Medical Center is accepting applications for an entry level PMSR/RRA position. Email your CASPR application to (updated) slmresidency4 at gmail.com. 1 FILLED

 

[ldsrmdude]

Looks like only 5 new positions since May 15.

7/10/13 Massachusetts is accepting applications for one entry level PMSR position that will start sometime before January 2014. Email your CASPR application to rscardina at partners.org. 1
6/11/13 DVA-MD Healthcare System is accepting applications for one entry level PMSR/RRA position. Email your CASPR application to rickey.adams at va.gov. 1 FILLED
6/7/13 Forest Hills Hospital is accepting applications for an entry level PMSR/RRA position. The minimum GPA is 3.0. Email your CASPR application to Ggrubman at nshs.edu. 1 FILLED
6/6/13 Coney Island Hospital is accepting applications for an entry level PMSR position. Email your CASPR application to glenn.donovan at nychhc.org 1 FILLED
5/15/13 Silver Lake Medical Center is accepting applications for an entry level PMSR/RRA position. Email your CASPR application to (updated) slmresidency4 at gmail.com. 1 FILLED

I think he's talking about the list of all residencies, not the place programs can offer updates on open positions. Basically you look at the list of programs and compare it to last years list. Just off the top of my head, only a few programs sounded new, but like I said, I haven't paid really close attention to the list.

 

[dyk343]

I think he's talking about the list of all residencies, not the place programs can offer updates on open positions. Basically you look at the list of programs and compare it to last years list. Just off the top of my head, only a few programs sounded new, but like I said, I haven't paid really close attention to the list.

Yeah I was looking at the new residencies that they are opening. From my memory I think I saw 3-5 new programs on that list. And a few well established programs with an "incomplete" status which I again hope means they are accepting new residents.

I think I originally said "a bunch" which might be incorrect terminology.

 

[dyk343]

Looks like only 5 new positions since May 15.

7/10/13 Massachusetts is accepting applications for one entry level PMSR position that will start sometime before January 2014. Email your CASPR application to rscardina at partners.org. 1
6/11/13 DVA-MD Healthcare System is accepting applications for one entry level PMSR/RRA position. Email your CASPR application to rickey.adams at va.gov. 1 FILLED
6/7/13 Forest Hills Hospital is accepting applications for an entry level PMSR/RRA position. The minimum GPA is 3.0. Email your CASPR application to Ggrubman at nshs.edu. 1 FILLED
6/6/13 Coney Island Hospital is accepting applications for an entry level PMSR position. Email your CASPR application to glenn.donovan at nychhc.org 1 FILLED
5/15/13 Silver Lake Medical Center is accepting applications for an entry level PMSR/RRA position. Email your CASPR application to (updated) slmresidency4 at gmail.com. 1 FILLED

I know of several programs who matched "under the table" if you will. Those programs took residents from my school but I never saw anything for those programs posted on CASPR/CRIP. This is not unique to my school, its happening everywhere. My point is a lot more have matched than what is posted on CASPR/CRIP.

Also I have visited several programs who stated they have the numbers and are doing everything they can to add a second/third position. Most of them seemed pretty confident the hospital would approve.

 

[jonod1107]

I know of several programs who matched "under the table" if you will. Those programs took residents from my school but I never saw anything for those programs posted on CASPR/CRIP. This is not unique to my school, its happening everywhere. My point is a lot more have matched than what is posted on CASPR/CRIP.

Also I have visited several programs who stated they have the numbers and are doing everything they can to add a second/third position. Most of them seemed pretty confident the hospital would approve.

Are you saying that there are programs that took additional residents but are not listed on CASPR/CRIP? For example, Program ABC lists 3 positions on CASPR/CRIP but actually have 4 residents.

Or are you saying that that some programs were in the scramble but quickly went to filled because they took students in under the table?

 

[Telekinesis]

Do you guys think the problem will get worse in 4-5 years?

This is my worry as well.

 

[dyk343]

Most recent "official" report from the AACPM was 56 students left from 2013. That number is a couple of students lower as of now, since that was reported at the end of May.
.

Are you saying that there are programs that took additional residents but are not listed on CASPR/CRIP? For example, Program ABC lists 3 positions on CASPR/CRIP but actually have 4 residents.

Or are you saying that that some programs were in the scramble but quickly went to filled because they took students in under the table?

Both, but I'm not really sure how the programs availability status are being released online, but we originally started with over 100 shortages and as of May is at 54. There have not been 50+ positions posted on CASPR/CRIP.

 

[dtrack22]

The over 100 # included students from previous years. If you include them now it's just over 80 who don't have a program. So 20-ish spots that have opened up since the match.

 

[hematosis]

Do you guys think the problem will get worse in 4-5 years?

Just came from a meeting about this. About 80 people still need a residency. Class of 2014 is projected to be somewhere between 560 to 580 (class of 2013 had ~562 Eligible candidates). Currently there are spots for about 530 ? ( As of May 31, 2013). That means there will be about 650 to 660 students applying for 530 spots (unless new programs opens up for these students this year). This could potentially leave 120 to 130 students without residency. Again, roughly estimating but the actual numbers are not going to be drastically different unless Ed Wolf can magically open up 80-100 spots over the next few months.

Doesn't look like there will be enough spots for the 2014 graduating class.

It's starting to look like about 89-90% of each class will match and the remainder gets thrown on this pile which will just accumulate for the next few years. 80 for c/o 2014, 120-130 for c/o 2015, etc.

 

[shenanigans327]

Just came from a meeting about this. About 80 people still need a residency. Class of 2014 is projected to be somewhere between 560 to 580 (class of 2013 had ~562 Eligible candidates). Currently there are spots for about 530 ? ( As of May 31, 2013). That means there will be about 650 to 660 students applying for 530 spots (unless new programs opens up for these students this year). This could potentially leave 120 to 130 students without residency. Again, roughly estimating but the actual numbers are not going to be drastically different unless Ed Wolf can magically open up 80-100 spots over the next few months.

Doesn't look like there will be enough spots for the 2014 graduating class.

It's starting to look like about 89-90% of each class will match and the remainder gets thrown on this pile which will just accumulate for the next few years. 80 for c/o 2014, 120-130 for c/o 2015, etc.

Those are some scary numbers...

 

[rainynights]

It's starting to look like about 89-90% of each class will match and the remainder gets thrown on this pile which will just accumulate for the next few years. 80 for c/o 2014, 120-130 for c/o 2015, etc.

Ouch...these numbers are very frightening.

 

[MaxillofacialMN]

Lol those of us in 2017 are SCREWED. Haha let the best man win??

 

[JEB88]

I see class-action lawsuit(s) coming if the problem gets worse over the next 2 or 3 years.

 

[MaxillofacialMN]

Yeah, and at least from my perspective of reading different things and listening to the podcasts, it honestly looks like no real action (other than the continuation of Dr Wolfe's work) is being pursued by anyone in power (other than making step 1 bat**** insane - just kidding, sorta). This problem is just festering and no one is doing anything about it.

The APMA either needs to fund the residencies themselves, or remove the three year requirement. It's obvious the profession isn't ready to handle the three year requirement and sticking to it is only more embarrassing. It's like in poker: if someone calls your bluff, you don't call their wager to save face, you fold your cards to save chips. Now is the time to either call the wager and have the APMA fund the re-buy-in, or fold our cards and let the qualified doctors get residencies/jobs

 

[shenanigans327]

Yeah, and at least from my perspective of reading different things and listening to the podcasts, it honestly looks like no real action (other than the continuation of Dr Wolfe's work) is being pursued by anyone in power (other than making step 1 bat**** insane - just kidding, sorta). This problem is just festering and no one is doing anything about it.

The APMA either needs to fund the residencies themselves, or remove the three year requirement. It's obvious the profession isn't ready to handle the three year requirement and sticking to it is only more embarrassing. It's like in poker: if someone calls your bluff, you don't call their wager to save face, you fold your cards to save chips. Now is the time to either call the wager and have the APMA fund the re-buy-in, or fold our cards and let the qualified doctors get residencies/jobs

I agree 100% with Max. It's easy for people to say "oh, so and so didn't get a spot for reason x" but it's not unqualified people not getting residencies, we have students from across the spectrum getting screwed over...

The very real possibility that a person can take 200k in loans, pass all necessary exams, graduate and still not get a spot is very scary. I personally think people coming into this profession need to weigh the risks/benefits very carefully, and if they still choose to follow through, have some kind of back-up plan, just in case...

Though, hopefully COTH/CPME/whoever can develop some spots in time to soften the blow.

 

[JEB88]

200k? More like 300K and tuition has gone up every year for me!

 

[ldsrmdude]

Yeah, and at least from my perspective of reading different things and listening to the podcasts, it honestly looks like no real action (other than the continuation of Dr Wolfe's work) is being pursued by anyone in power (other than making step 1 bat**** insane - just kidding, sorta). This problem is just festering and no one is doing anything about it.

The APMA either needs to fund the residencies themselves, or remove the three year requirement. It's obvious the profession isn't ready to handle the three year requirement and sticking to it is only more embarrassing. It's like in poker: if someone calls your bluff, you don't call their wager to save face, you fold your cards to save chips. Now is the time to either call the wager and have the APMA fund the re-buy-in, or fold our cards and let the qualified doctors get residencies/jobs

I agree 100% with Max. It's easy for people to say "oh, so and so didn't get a spot for reason x" but it's not unqualified people not getting residencies, we have students from across the spectrum getting screwed over...

The very real possibility that a person can take 200k in loans, pass all necessary exams, graduate and still not get a spot is very scary. I personally think people coming into this profession need to weigh the risks/benefits very carefully, and if they still choose to follow through, have some kind of back-up plan, just in case...

Though, hopefully COTH/CPME/whoever can develop some spots in time to soften the blow.

I've said it before and I'll say it again. IMO, going away from 3 year residencies, even short term, would be a huge mistake. 3 year residencies are the minimum in allopathic and osteopathic specialties. They should at least be the minimum for us. The other issue that I don't get is funding. There seems to be this thought that the transition from 2 years to 3 somehow killed funding for programs and made it so they couldn't survive anymore. It allowed the federal government to fully fund the third year of residency programs since it is now a requirement. If we dropped the requirement back to 2 years, all those programs that are 3 year would only get the federal government to cover half of the cost of the third year instead of the whole 3rd year. That would really cost us programs. APMA funding residency programs is not feasible. This is a very serious problem, probably the most serious problem facing the profession currently, and while we should demand improvement and effort towards an ultimate solution, I don't think either of these proposals is the answer. Just my opinion, and I've been wrong (many, many times) before.

 

[ldsrmdude]

Your reasons are basically why residencies should not be a requirement. You said yourself that the APMA can't fund enough spots itself. If there are fewer spots available than there are graduates, wouldn't it be common sense to make it a non-requirement? There is no reason why podiatry needs to compete with MD/DO, so there's no need for this requirement. I don't think pride is worth having 100+ students without a job. It just makes podiatry look like a joke.

I see what you're saying, but do you really think podiatry would look like less of a joke if we didn't require residencies? I think more education is better than less in almost every case and especially in this one. Yes, there is some pride involved, but it goes beyond that. To me we would have to make the choice to regress in terms of the procedures and techniques we offer as a profession in order to remove the requirement of a residency. If we want to go back to a non-surgical profession, then I can see removing the residency requirement. If we want to continue to offer surgical treatment for our patients, we have to have that in place. I don't believe that dividing the profession any more into surgical and non-surgical based on residency training is the right choice. It's a big question, and I think you can clearly see what side of the argument I take, but it's a discussion that we should have (and are having) as a profession.

 

[jonod1107]

Your reasons are basically why residencies should not be a requirement. You said yourself that the APMA can't fund enough spots itself. If there are fewer spots available than there are graduates, wouldn't it be common sense to make it a non-requirement? There is no reason why podiatry needs to compete with MD/DO, so there's no need for this requirement. I don't think pride is worth having 100+ students without a job. It just makes podiatry look like a joke.

I think you should look at the history of how Podiatry used to be perceived on a legal and peer level. Back when there was no residency requirements, and only very few surgical residencies, Podiatrists had a very hard time getting hospital privilege, and acceptance with the MD/DO peers. Nobody wants to go back to those days.

I think the only way to stem this is for schools to accept less students or create more residencies.

Edit: My bad, there was 40 student accepted in the first class but I guess only 22 graduated. But each subsequent years, there will be closer and closer to 40 students from Western.

 

[heybrother]

http://forums.studentdoctor.net/showthread.php?t=993897

Vince, you posted this before and got a great response from someone more informed than you.

 

[jonod1107]

The podiatrists that do residencies will get hospital privileges and the ones that don't will not. Why can't it just be like that?

It is not that easy. This will open a WHOLE can of worms.

Off the top of my head..

1. Legal. I believe all states require a residency to be licensed to practice Podiatry. Good luck changing that. It'll take years and years.

2. Insurance. Many medical insurance companies will require you to have hospital privileges to qualify to be part of their medical network.

3. We will be going back to the past where our healthcare colleagues and patients will not know why one Pod can do surgery but the other one only cuts nails.

 

[that1guyfromFL]

it honestly looks like no real action (other than the continuation of Dr Wolfe's work) is being pursued by anyone in power (other than making step 1 bat**** insane - just kidding, sorta). This problem is just festering and no one is doing anything about it.

In all seriousness, this is completely unhelpful. The very last thing that is needed is more talking by people uninvolved in the process.

The APMA either needs to fund the residencies themselves

They cannot legally do this.

or remove the three year requirement.

First, this has nothing to do with the APMA or any other podiatry related organization. This is based on each individual states current practice act. Second, it would solve absolutely nothing: the surgical minimum volumes are the same for 3 year residencies now as they were for the old 2 year residencies.

If you are suggesting the requirement for residency of any kind be removed nationally to get a license.....well, no, I'd rather not go back to chiropody, thanks.

It's obvious the profession isn't ready to handle the three year requirement and sticking to it is only more embarrassing. It's like in poker: if someone calls your bluff, you don't call their wager to save face, you fold your cards to save chips. Now is the time to either call the wager and have the APMA fund the re-buy-in, or fold our cards and let the qualified doctors get residencies/jobs

While you are certainly entitled to your opinion, your perspective on this problem, and your ideas of how to best fix it, indicate a fundamental lack of understanding about how we got to this point and the viable routes forward.

It's great that you are engaged and want to see this problem solved, I would encourage you to get in touch with the stakeholders in our profession if you really want to be a part of the solution.

 

[pod101]

A lot of finger pointing going on.

Solutions I have read so far are:

1) Get rid of 3 year residencies (don't see that happening, forget MD/DO comparison... state laws will start taking surgical privileges away and further limit the scope of practice)
2) APMA needs to fund new residencies (legally impossible)
3) Schools need to enroll less students (result: a) Schools will close b) Tuition will increase dramatically)
4) Make the board exams more difficult (flunking out more students) - I see this one probably happening.

No matter which option you pick Podiatry gets a Black Eye. Therefore none of these "solutions" are acceptable.

My question is the lack or 3 year residencies due to:
a) lack of funding ?
b) lack of interest in podiatry services?
c) lack of surgical numbers?

If it is option
a) What are ways that podiatry can legally raise capital, what does the business model look like, can 3rd party organizations potentially get involved (invest?).

b) This one would be the scariest. A strong advertisement campaign is the only solution I know.

c) Perhaps do a 4 year residency (an extra year to hit your numbers) or Create a new 3 year residency that is not "as" surgically focuses (not ankle certified etc. and focuses more on general medicine? ).

 

[pod101]

I also want to say thank you to the people responsible for helping out 20+ pod school graduates in getting a residency. I have a strange feeling that a lot of personal sacrifices were made behinds the scenes to get that to happen.

 

[MaxillofacialMN]

1.In all seriousness, this is completely unhelpful. The very last thing that is needed is more talking by people uninvolved in the process.



2They cannot legally do this.



3First, this has nothing to do with the APMA or any other podiatry related organization. This is based on each individual states current practice act. Second, it would solve absolutely nothing: the surgical minimum volumes are the same for 3 year residencies now as they were for the old 2 year residencies.

4If you are suggesting the requirement for residency of any kind be removed nationally to get a license.....well, no, I'd rather not go back to chiropody, thanks.




5While you are certainly entitled to your opinion, your perspective on this problem, and your ideas of how to best fix it, indicate a fundamental lack of understanding about how we got to this point and the viable routes forward.

It's great that you are engaged and want to see this problem solved, I would encourage you to get in touch with the stakeholders in our profession if you really want to be a part of the solution.

1. I'm a pre-pod. I'm pointing out the fact that all ANYONE is doing is just pointing fingers. I am in no position to do anything about this crisis except drop out of school and pursue an MD instead.

2. Sure they can. If you honestly think it is legally IMPOSSIBLE for the APMA to sponsor residency programs/use their money to fund programs, you are sorely mistaken. Also, I would like a source/reasoning behind the reason it is illegal they sponsor a program.

3. (I'll break this down like you did...) First: Yes, it does. The APMA is the leading organization of podiatrists. While you are correct in stating it is up to the states to determine who they license, each state follows their commands from the governing body in this aspect. The podiatry community as a whole made a conscious decision to move all residencies to three year programs. While you can argue that it is really up to the states to decide who can practice/get licensed, it isn't relevant. We both know who made the decision to move all residencies to three years.

Secondly: This is only relevant if surgical volumes are absolutely necessary to be a podiatrist AND if absolutely no resident reaches his numbers before 3rd year. If it is conceivable that a resident would reach his volume before third year, then your point is moot.

4. Perhaps you wouldn't like to go back to chiropody - then don't become one. However, I'm willing to bet the 86 people without residencies this year would LOVE to be a "chiropodist" instead of a podiatrist's lackey for an indefinite time period, or if that doesn't work out, then he/she can also resort to their undergrad biology degree and $250k of debt... You are approaching this issue as if we absolutely need HUNDREDS of casualties to move the profession forward. I disagree with this notion, and I'm willing to bet the vast majority of the unmatched agree with me too.

5. I've followed this issue closely, and I have a clear understanding of this issue. But I'm given to understand people feel better about themselves when they belittle their opponent online before closing their post. So, in following suit: it is clear you have a fundamental lack of understanding about how we got to this point and the viable routes forward.

 

[MaxillofacialMN]

Okay, so I guess that the only solution is to lower enrollment? Too bad schools are too greedy for that. Looks like best case scenario is that the residency placement numbers stay the same in coming years and worst case scenario is that within 10 years, less than half the students will be matching and podiatry will be a dying profession...

Am I interpreting this properly? If not, please correct me because I do not want this to happen.

This is apparently what people on these forums want: casualties to ensure the advancement of the profession....

 

[that1guyfromFL]

1. I'm a pre-pod. I'm pointing out the fact that all ANYONE is doing is just pointing fingers.

I don't think progress is being made at the pace we would all would like, but saying that "all anyone is doing is pointing fingers" just isn't factually accurate.

2. Sure they can. If you honestly think it is legally IMPOSSIBLE for the APMA to sponsor residency programs/use their money to fund programs, you are sorely mistaken. Also, I would like a source/reasoning behind the reason it is illegal they sponsor a program.

No, they can't. My source is a member of the APMA Board of Trustees, feel free to share yours.

3. (I'll break this down like you did...) First: Yes, it does. The APMA is the leading organization of podiatrists. While you are correct in stating it is up to the states to determine who they license, each state follows their commands from the governing body in this aspect. The podiatry community as a whole made a conscious decision to move all residencies to three year programs. While you can argue that it is really up to the states to decide who can practice/get licensed, it isn't relevant. We both know who made the decision to move all residencies to three years.

You suggested that the APMA could " remove the three year requirement." to help ease the residency shortage. As I stated before, they cannot do this. It would require the legislature in each state that has a residency requirement to open up and modify the existing practice act.

Secondly: This is only relevant if surgical volumes are absolutely necessary to be a podiatrist AND if absolutely no resident reaches his numbers before 3rd year. If it is conceivable that a resident would reach his volume before third year, then your point is moot.

I honestly can't figure out what you are trying to say here.

4. Perhaps you wouldn't like to go back to chiropody - then don't become one. However, I'm willing to bet the 86 people without residencies this year would LOVE to be a "chiropodist" instead of a podiatrist's lackey for an indefinite time period, or if that doesn't work out, then he/she can also resort to their undergrad biology degree and $250k of debt... You are approaching this issue as if we absolutely need HUNDREDS of casualties to move the profession forward. I disagree with this notion, and I'm willing to bet the vast majority of the unmatched agree with me too.

Your original idea of reverting to a national policy of no residency requirement to practice podiatry (by the way, a few states still don't require a residency to be licensed, which is why a lot of unmatched grads have recently flooded those states with requests for a license) would not affect only those who don't have a residency program. See others posts in this thread on this topic.

5. I've followed this issue closely, and I have a clear understanding of this issue.... it is clear you have a fundamental lack of understanding about how we got to this point and the viable routes forward.

I think you genuinely mean well, but you are exceptionally misinformed.

 

[dtrack22]

2. Sure they can. If you honestly think it is legally IMPOSSIBLE for the APMA to sponsor residency programs/use their money to fund programs, you are sorely mistaken. Also, I would like a source/reasoning behind the reason it is illegal they sponsor a program.

It is illegal for the APMA, AOA, or AMA to financially support their respective residency programs. There is no other way to put it, but you are wrong. I'll add a link/explanation when I can find something that will suit your demands.

3. (I'll break this down like you did...) First: Yes, it does. The APMA is the leading organization of podiatrists. While you are correct in stating it is up to the states to determine who they license, each state follows their commands from the governing body in this aspect. The podiatry community as a whole made a conscious decision to move all residencies to three year programs. While you can argue that it is really up to the states to decide who can practice/get licensed, it isn't relevant. We both know who made the decision to move all residencies to three years.

Secondly: This is only relevant if surgical volumes are absolutely necessary to be a podiatrist AND if absolutely no resident reaches his numbers before 3rd year. If it is conceivable that a resident would reach his volume before third year, then your point is moot.

No, states follow state legislature. You cannot simply tell a state to remove the residency requirement to practice, and then magically have it become law. The entire profession decided to move to 3 years, in part because it was the smart thing to do to advance our training and continue the evolution of our profession. Maybe an even bigger reason was funding. As long as 2 year programs existed, the final year of any 3 year program would not be fully funded. Meaning the hospital would be stuck with the tab. Meaning the podiatry residents would have to generate enough additional income to justify the $100K or so they each cost the hospital. Unfortunately we are not one of those specialties who make hospitals money during residency. So by allowing programs to go back to a 2 year model, you completely gut the viability of many of the 3 year programs and your suggestion just shut down more programs than it opened.

Also, why do people think allowing 2 year programs would somehow open more spots? As if podiatrists want to be directors or attendings at a new program if their residents are only there for 2 years, but not if they're gonna stay for 3? Or that somehow a hospital who doesn't want to fund ANY new programs would somehow fund a 2 year program instead of a 3? Or that the staff necessary to run a program (med ed dept, secretaries, HR, etc.) would somehow become more available and affordable for a 2 year vs a 3 year program?

5. I've followed this issue closely, and I have a clear understanding of this issue. But I'm given to understand people feel better about themselves when they belittle their opponent online before closing their post. So, in following suit: it is clear you have a fundamental lack of understanding about how we got to this point and the viable routes forward.

The only viable route forward is for some of the 12.000+ podiatrists who are not involved with our education or training to become involved. The problem will not be fixed over night, but the CPME has approved entire programs in as little as 2 months. So you can't say the "organizations" everyone likes to rag on (when most are ignorant as to what the organization actually does) aren't busting their butts to fix the problem.

The naivety in this thread is borderline overwhelming at times. Get rid of residencies, lower to 2 years, ask organizations to break the law, nobody is doing ANYTHING, NBPME is probably failing people on purpose...You all have to remember that you chose or are choosing a profession that has historically taken sub-par applicants out of necessity. Not much has changed, and because of that you have wildly fluctuating attrition and board pass rates. It makes stabilizing any post graduate training virtually impossible. Just like any other profession in the world, jobs are not guaranteed. You have to earn one. Times are tough right now and will be for a few more years, so nut up and go get a residency until the problem is fixed.

 

[pipetman]

Please please please listen to the meet the masters thread I posted. It goes over all of this and what people are doing.

Boards: they can't make it so difficult that people fail it and are not eligible for residency. The powers that be now know that it's not a weeding out tool, it's a test of minimal competency (which it is). people will pass it and add to the pool. eventually. While you can look up in any state how many times you can try to pass the exam and get a liscence for the usmle and dental boards (max usually five) there is not one for podiatry. that's one "fix" I haven't heard mentioned.

Medicare cap: if you do a search for residency shortage MD vs pod, the AMA is lobbying to congress to reduce the Medicare cap for residencies that was established...in 1996 or 1997 I believe. (Don't quote me on that, look it up). The APMA is appealing to its own members. That's a problem.

Qualified: a student/graduate is qualified for an entry level position if they have their DPM and passed parts one and two. There is no stipulation based on GPAS, class rank or how many times you took the exams. They could change the language now, but legally for , those that came before it won't apply. So whether anyone likes it or not, past graduates still can "earn" a spot. You can't just tell these graduates to stop applying and give up. they are still a part of the equation and how to handle that, no one knows. Yes, residency directors can not take them, but its only a matter of time before someone seeks litigation based on...I don't know, labor laws and discrimination. No one likes to hear that, but think about it.

Capping students: how many schools graduate all the students they accepted? They don't. It's not the number, it's how proactive they are in enticing alumni to become residency directors themselves, so the school has programs that take their students. That would be a bigger help than having class sizes that are smaller. Think about that too.

APMA: can they fund residency positions? No. They could take their "emergency funds" and lobby to congress like the AMA are doing, or fund the PPM preceptership program, or use some of the funds to entice podiatrists to start up the process and pay for their travel etc to go to hospitals to start a program. Or, even better, instead of relying on volunteers to spear head the residency genesis, PAY someone that will handle the phone calls, the paperwork, the questions prospective residency directors have. No one wants to go through red tape if they are dealing with their own staff, making a living, etc. Remember, podiatrists that sit on these committees are doing it on their own time, they are not getting paid. Again, I haven't heard that mentioned either.

But like a fan who sits on their couch and yells at the umpire for a bad call, saying they could do a better job themselves, all of what i have heard and read here is just that. The discussion is good; I think what we can all agree on is students etc are getting shafted in some way and there is no clear cut accountability.

Think about the housing crisis back in 2008. There was a lot of pointing fingers on those who took out those loans, a lot of derogatory name calling of the homeowners and a lot of responsibility thrust on them (read: students) until years later economists agreed that it was the holding of revenue by the .01 percent (insert who here) and predatory lenders (insert whoever you want here) coupled with a a system that worked during the 80s and was no longer sustainable because it didn't trickle down like Greenspan hoped (insert another name here) and what happened? Heads rolled. Businesses collapsed. Here, there is no accountability, and the burden falls back on the students and graduates.

Something to think about.

 

[dtrack22]

Pipetman's post was good, but it is a good example of how even a seemingly informed individual can spread misinformation. Podiatry does not fall under the GME cap that MD/DO programs do. So there is nothing for the APMA to even "lobby" for, except for the student loan, title XIX, local/state scope, certain ACO inclusion issues, etc. that they already are.

 

[MaxillofacialMN]

Isn't licensure decided by the state boards? I'm fairly confident I've read (at least my home state's law), and it said podiatrists are legally allowed to practice if they are licensed by the board association, or whatever. These state boards are the ones not licensing podiatrists and therefore not allowed to practice. I really don't think each states house of reps needs to re-vote on podiatrists training requirement... Just the overseeing licensing committee.

Pipeman said what I was trying to say: all funds are fungible. Perhaps the apma cannot literally give a hospital $1 million to start a residency, but they can sure as heck is their nearly ten million in emergency funds to help solve this crisis.

Also, sure programs have been approved in less than two months, but that doesn't mean they ever accept students. I remember reading/listening to Dr Wolfe and he said they approved a ton of programs, but at the time, only something like six spots opened because of it.

In regards to two year programs:

a) it doesn't make sense to keep a student for three years if he can accomplish the surgical numbers in two. 1guyfromflorida: you said two year residencies would have the same surgical requirement as three year, which is fine. But is they can complete it in two years that literally HAS to save money somehow.

b) it literally has to save money somehow to allow two year programs. From what y'all have said it seems like if two year programs are offered then three year programs lose funding. If that's the case it might be worthwhile looking into distinctions between licenses/qualifications/titles of two year and three year residencies graduates. Surely family medicine residencies don't "lose funding" because integrated plastics residencies require more years... Right?

I think the problem a couple of you have is creativity and ambition to solve a problem. I like to think in terms of "It's possible." It's possible the APMA can help solve this crisis with money, it's possible to lobby Congress for extra residency funding, it's possible to not make three year residences mandatory. By saying things like, "this isn't the way it has been in the past, so it's not a viable option for the future" sounds unfortunately narrow minded in the solutions to this problem.

In regards to finger pointing, I think we have to remember this is SDN.... that's literally all anyone does here. No sublime idea to solve the crisis is going to magically come from these boards. They are just away to communicate and voice opinions and ideas.

Also, realistically, those 86 (?) people didn't get a residency for some reason or another. Is it a bummer that they are "qualified"? Sure. But personally I'm going to make sure that WHEN the class of 2017 only matches 50% of graduates, I'll be one that matches. This is America, and as much as we don't seem to like it anymore, I still hold on to the dream of laissez-fair capitalism that allows the smartest, best connected, and highest achieving student to get a residency. This residency mess is like government construction bidding. Ten companies might submit plans for a bridge, and all plans meet the qualifications, but at the end of the day only one gets selected (pretty sure the other nine get compensated by uncle Sam for putting in the work of designing a plan, but whatever).



Side bar: (I think pipe man?) it was NOT the 1% that caused the financial crisis, and it didn't take the economists years to figure it out. Austrian economists predicted the housing bubble about a decade before it happened. Keynesian economists called for a housing bubble (I'm looking at you Paul Krugman). You can read tons of people on online Austrian economic forums from the early 2000s talking about the housing bubble. Ron Paul stood before congress and told them about the housing bubble in 01 and 02. It was caused by the congress forcing lending companies to make bad deals AND because of the moral hazard provided to them by the us government. The 1% acted rationally and to blame them is foolish. You need to look no further that Capitol Hill to see the problem.

 

[jonod1107]

Isn't licensure decided by the state boards? I'm fairly confident I've read (at least my home state's law), and it said podiatrists are legally allowed to practice if they are licensed by the board association, or whatever. These state boards are the ones not licensing podiatrists and therefore not allowed to practice. I really don't think each states house of reps needs to re-vote on podiatrists training requirement... Just the overseeing licensing committee.

Pipeman said what I was trying to say: all funds are fungible. Perhaps the apma cannot literally give a hospital $1 million to start a residency, but they can sure as heck is their nearly ten million in emergency funds to help solve this crisis.

Also, sure programs have been approved in less than two months, but that doesn't mean they ever accept students. I remember reading/listening to Dr Wolfe and he said they approved a ton of programs, but at the time, only something like six spots opened because of it.

In regards to two year programs:

a) it doesn't make sense to keep a student for three years if he can accomplish the surgical numbers in two. 1guyfromflorida: you said two year residencies would have the same surgical requirement as three year, which is fine. But is they can complete it in two years that literally HAS to save money somehow.

b) it literally has to save money somehow to allow two year programs. From what y'all have said it seems like if two year programs are offered then three year programs lose funding. If that's the case it might be worthwhile looking into distinctions between licenses/qualifications/titles of two year and three year residencies graduates. Surely family medicine residencies don't "lose funding" because integrated plastics residencies require more years... Right?

I think the problem a couple of you have is creativity and ambition to solve a problem. I like to think in terms of "It's possible." It's possible the APMA can help solve this crisis with money, it's possible to lobby Congress for extra residency funding, it's possible to not make three year residences mandatory. By saying things like, "this isn't the way it has been in the past, so it's not a viable option for the future" sounds unfortunately narrow minded in the solutions to this problem.

In regards to finger pointing, I think we have to remember this is SDN.... that's literally all anyone does here. No sublime idea to solve the crisis is going to magically come from these boards. They are just away to communicate and voice opinions and ideas.

Also, realistically, those 86 (?) people didn't get a residency for some reason or another. Is it a bummer that they are "qualified"? Sure. But personally I'm going to make sure that WHEN the class of 2017 only matches 50% of graduates, I'll be one that matches. This is America, and as much as we don't seem to like it anymore, I still hold on to the dream of laissez-fair capitalism that allows the smartest, best connected, and highest achieving student to get a residency. This residency mess is like government construction bidding. Ten companies might submit plans for a bridge, and all plans meet the qualifications, but at the end of the day only one gets selected (pretty sure the other nine get compensated by uncle Sam for putting in the work of designing a plan, but whatever).



Side bar: (I think pipe man?) it was NOT the 1% that caused the financial crisis, and it didn't take the economists years to figure it out. Austrian economists predicted the housing bubble about a decade before it happened. Keynesian economists called for a housing bubble (I'm looking at you Paul Krugman). You can read tons of people on online Austrian economic forums from the early 2000s talking about the housing bubble. Ron Paul stood before congress and told them about the housing bubble in 01 and 02. It was caused by the congress forcing lending companies to make bad deals AND because of the moral hazard provided to them by the us government. The 1% acted rationally and to blame them is foolish. You need to look no further that Capitol Hill to see the problem.

The APMA may not be able to fund residencies, but schools def. can. I believe all the schools have residency programs of their own. One thing that isn't mentioned on here is that Western graduated 40 students this year and when they opened the Pod program 4 years ago, they reassured that there will be enough residences to go around. On that note, Western should fund a residency and/or add on more positions.

 

[heybrother]

The APMA may not be able to fund residencies, but schools def. can. I believe all the schools have residency programs of their own. One thing that isn't mentioned on here is that Western graduated 40 students this year and when they opened the Pod program 4 years ago, they reassured that there will be enough residences to go around. On that note, Western should fund a residency and/or add on more positions.

Western graduated 22 students. The longer this thread goes on the more likelier we are to forget important points that were brought up at the beginning. Like when Dtrack pointed out that something like ~40 spots were dropped/withdrawn for whatever reasons (economics).

I don't know what the resolution to any of this will be, but as an uninformed fortune-teller who can prophesy on the internet without fear of consequences, I suspect we will have the makings of our own applicant shortage down the road and another cycle of disparity between applicant:residency spots shall continue.

 

[MaxillofacialMN]

I don't know what the resolution to any of this will be, but as an uninformed fortune-teller who can prophesy on the internet without fear of consequences, I suspect we will have the makings of our own applicant shortage down the road and another cycle of disparity between applicant:residency spots shall continue.

That's true. A ton of incoming people freaked out when they saw the match data. When it gets worse next year, people will actually probably act and drop out prior to registration or not apply at all... Sad

 

[dtrack22]

I don't think the kids who actually want to be a podiatrist and have high entrance scores will be phased at all. What would they be scared of if they did their research and knew the applicant pool? If anything you'll lose some of those kids who applied because there was pressure to become a Dr. and this was their only option. I still don't think the applicant pool will take a hit. If pre-pod students cared about certain aspects of our education and training, there would be schools that wouldn't have over 100 students to admit. But pre-pods don't care. They get to be doctors...

 

[MaxillofacialMN]

I don't think the kids who actually want to be a podiatrist and have high entrance scores will be phased at all. What would they be scared of if they did their research and knew the applicant pool? If anything you'll lose some of those kids who applied because there was pressure to become a Dr. and this was their only option. I still don't think the applicant pool will take a hit. If pre-pod students cared about certain aspects of our education and training, there would be schools that wouldn't have over 100 students to admit. But pre-pods don't care. They get to be doctors...

I care.

 

[shadesofgrey]

I don't think the kids who actually want to be a podiatrist and have high entrance scores will be phased at all. What would they be scared of if they did their research and knew the applicant pool? If anything you'll lose some of those kids who applied because there was pressure to become a Dr. and this was their only option. I still don't think the applicant pool will take a hit. If pre-pod students cared about certain aspects of our education and training, there would be schools that wouldn't have over 100 students to admit. But pre-pods don't care. They get to be doctors...

I think it could affect the applicant pool because most applicants find podiatry rather late in their career search. The majority of my classmates decided they wanted to do something in a medical field first and then discovered podiatry. Very few started out saying I want to be a podiatrist. If during their research students see podiatry as unviable they aren't going to consider applying, and to be honest perhaps they shouldn't. I have no idea what the solution is, but we can't keep adding 50+ qualified graduates to the "scrap heap" every year. Somehow the profession has to stop the bleeding; we need to at least open up enough spots for the graduating class. If the recent graduates can't beat out previous unmatched grads that is fine, but this thing is gonna snowball if its not stopped. I really wish I would have believed those who saw this coming before I applied. I expect to match when my time comes, but this is not a challenge we should have to face.

 

[that1guyfromFL]

Isn't licensure decided by the state boards? I'm fairly confident I've read (at least my home state's law), and it said podiatrists are legally allowed to practice if they are licensed by the board association, or whatever. These state boards are the ones not licensing podiatrists and therefore not allowed to practice. I really don't think each states house of reps needs to re-vote on podiatrists training requirement... Just the overseeing licensing committee.

Licensing is handled by the state board, but there are state statutes that govern scope and actual practice. For example, each state statute will always require a license (that I know of) and should have a stipulation about the required (or, in a few states, not required) minimum residency training.

Pipeman said what I was trying to say: all funds are fungible. Perhaps the apma cannot literally give a hospital $1 million to start a residency, but they can sure as heck is their nearly ten million in emergency funds to help solve this crisis..

You meant to type "all funds are fungible" but you somehow accidentally typed "If you honestly think it is legally IMPOSSIBLE for the APMA to sponsor residency programs/use their money to fund programs, you are sorely mistaken." in your other post directed at me?

In regards to two year programs:

a) it doesn't make sense to keep a student for three years if he can accomplish the surgical numbers in two. 1guyfromflorida: you said two year residencies would have the same surgical requirement as three year, which is fine. But is they can complete it in two years that literally HAS to save money somehow.

I said that the current 3 year residencies have the same surgical MAV as the old 2 year residencies. Every good surgical program now has at least 2-3x the MAV. It's pretty common sense that more surgical volume = better.

b) it literally has to save money somehow to allow two year programs. From what y'all have said it seems like if two year programs are offered then three year programs lose funding. If that's the case it might be worthwhile looking into distinctions between licenses/qualifications/titles of two year and three year residencies graduates. Surely family medicine residencies don't "lose funding" because integrated plastics residencies require more years... Right?.

That is an absurd analogy. How about this: All orthopedic surgery residencies are 5 years long. If you complete a rotating internship year and then match ortho, the hospital only gets funding for 4 of your 5 years of ortho surg residency training. Why? Because funding is tied to the minimum number of training years required to complete residency in that specialty. It also has absolutely nothing to do with any other specialties residency training requirements.

I think the problem a couple of you have is creativity and ambition to solve a problem. I like to think in terms of "It's possible." It's possible the APMA can help solve this crisis with money, it's possible to lobby Congress for extra residency funding it's possible to not make three year residences mandatory. By saying things like, "this isn't the way it has been in the past, so it's not a viable option for the future" sounds unfortunately narrow minded in the solutions to this problem.

Again, it is not legal for the APMA to fund residency programs or financially facilitate their creation and it is pointless to lobby congress for extra residency funding when we do not have a GME cap.

While it can be a great resource, the biggest problem on SDN in general really is the staggering amount of inaccurate information that gets passed around and eventually regarded factual by the uninformed.

 

[MaxillofacialMN]

1.

I said that the current 3 year residencies have the same surgical MAV as the old 2 year residencies. Every good surgical program now has at least 2-3x the MAV. It's pretty common sense that more surgical volume = better.

2.

That is an absurd analogy. How about this: All orthopedic surgery residencies are 5 years long. If you complete a rotating internship year and then match ortho, the hospital only gets funding for 4 of your 5 years of ortho surg residency training. Why? Because funding is tied to the minimum number of training years required to complete residency in that specialty. It also has absolutely nothing to do with any other specialties residency training requirements.


3.

Again, it is not legal for the APMA to fund residency programs or financially facilitate their creation and it is pointless to lobby congress for extra residency funding when we do not have a GME cap.

1. I understand that more volume is better residencies. However, not everyone can be the best. Are you suggesting we give 80% of the people phenomenal residencies and kick 20% to the curb, instead of giving 100% of the people a residency that vary in exceptionalism?

2. I think you missed my point: create two podiatry specialties. While it might not push the profession forward like many have hoped, it's obvious the three year mandate isn't working.

3. I guess if you want to give up on support from the APMA....


4. SDN is hilarious and awesome. This isn't the council of presidents. This is like Whose Line Is It Anyway: where the rules are made up and the points don't matter.

 

[pod101]

Well now I feel thoroughly depressed. Thank you Dtrack.

 

[jonod1107]

To my understanding from what I have read in another thread on SDN, there is a governing board (the APMA?) that set a max number of students each school can enroll.

So is there any talks of enrolling less students in the near future classes? I know no school wants to that since more student means more money. But this has been done before ( not sure if it was voluntary or by force) because 10-15 years ago, some schools had 1.5x the number of students compared to now.

 

[pacpod]

The naivety in this thread is borderline overwhelming at times. Get rid of residencies, lower to 2 years, ask organizations to break the law, nobody is doing ANYTHING, NBPME is probably failing people on purpose...You all have to remember that you chose or are choosing a profession that has historically taken sub-par applicants out of necessity. Not much has changed, and because of that you have wildly fluctuating attrition and board pass rates. It makes stabilizing any post graduate training virtually impossible. Just like any other profession in the world, jobs are not guaranteed. You have to earn one. Times are tough right now and will be for a few more years, so nut up and go get a residency until the problem is fixed.

It makes me worry when some are so quick to suggestions such as trashing residency requirements or lowering requirements of residency. You have to step back and realize you are (will be) taking care of people. Patient care shouldn't take a back seat to letting everyone who just wants to be a doctor do so. These would be a huge step backwards for us as a profession that would take a long time (if ever) to recover from the damage.

It stinks that there are not enough spots but dtrack22 hit the nail on the head. Get out and show the programs that you should be chosen as their resident. In my opinion, the mentality of "residency entitlement" is way off. No where in the terms of matriculation does it say one is guaranteed a residency.

 

[MaxillofacialMN]

It makes me worry when some are so quick to suggestions such as trashing residency requirements or lowering requirements of residency. You have to step back and realize you are (will be) taking care of people. Patient care shouldn't take a back seat to letting everyone who just wants to be a doctor do so. These would be a huge step backwards for us as a profession that would take a long time (if ever) to recover from the damage.

It stinks that there are not enough spots but dtrack22 hit the nail on the head. Get out and show the programs that you should be chosen as their resident. In my opinion, the mentality of "residency entitlement" is way off. No where in the terms of matriculation does it say one is guaranteed a residency.

Like I've said in previous posts: I believe the most qualified candidate should get the residency, etc etc. But you have to admit that it is scary to think that the profession has turned its back 86 people...