Updates On Vision 2015

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G0dFather said:
Hey guys .... anyone know how any updates or what direction is this thing going towards up until now?
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One of the members of the Board of Trustees came and had breakfast with us. One student asked how the APMA is progressing on scope of practice issues. The rep said that the APMA was working legislatively to get ankles in all states. He said that for states like New York, a Pennsylvania baseline should be used initially.

In Connecticut, the APMA lobbied and won for podiatrists overseeing patients in hyperbaric chambers.

Slowly, but surely.
 
MaseratiGT said:
...Slowly, but surely.
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I agree.^ The APMA does a lot of great things: podiatry scope, training, remibursements, maintaining DPM unity for lobby power, etc.

However, this residency shortage situation is a major issue that still has potential to set our goals back quite a bit, IMO. The only real solutions I've heard are the "got residencies?" campaign (good residencies are NOT created overnight) and asking the programs with good numbers to take more residents/yr (therefore converting them from excellent/great numbers to good/ok numbers). I just don't think it's fair that the greed of some pod schools makes top programs pressured to water down their level of training. The VA system pod residencies were a nice move to fix residency shortage in the past, but even most of them are low paying and marginal training. Now, we will potentially dilute the surgery per resident and faculty:resident ratios at top programs? Obviously, it's not wise, but I guess there really is no other short term solution.

I think that until the residency spots are actually there, the most viable option is to restrict admissions a bit more. Taking away some entry level spots from the schools that don't pass boards well is probably the best way to do that. Last grad year (08), there were a handful of students who couldn't get programs, and that may happen this 09 grad year also (the 08 grads who went without also rollover to this upcoming match). We'll see. For the c/o 2010-2012, things could get a bit hairy, esp when you take into account the rollovers of unmatched grads each year. No, those people who scramble and can't get a program in the coming years maybe haven't passed boards and shouldn't have graduated in the first place, but they are still out there in a ton of debt and sporting a DPM degree despite no surgical training. That's a big issue IMO.

How is an 3-4yr trained and ABPS rearfoot certified surgical DPM on a hospital board supposed to explain to his hospital/group that they probably should not grant surgical or consult privileges to another 0-1yr trained "surgeon" with the same DPM degree, due to the vast differences in training, certifications, and ability? Kinda crazy... not something you really see in the MD/DO world.

Further reading on 2015, residency balance, etc:
http://forums.studentdoctor.net/showthread.php?p=5500158#post5500158

http://forums.studentdoctor.net/showthread.php?t=507259

http://forums.studentdoctor.net/showthread.php?t=525225
 
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When you get into clinics, and moreso on clerkships, you will see that some pod services are among the most respected services in the hospital. They round early just like IM, gen surg, etc. They consult other services and are consulted by others. They work long hours, they take call, and they publish research.

MDs, hospital admins, other staff, etc who work at a hospital that has a high quality DPM residency, or even just a lot of well trained DPMs on staff, recognize what we can do and how useful we are in optimal patient care.

The problems and the reason for 2015, IMO, are basically just the following:
1) Law and reimbursement changes lag behind real clinical practice.
2) Some states can't attract many good DPMs because those guys wouldn't want to go somewhere they can't use their training.
3) Some docs who don't have much experience with well-trained DPMs are using thinking/stereotypes of what C&C podiatry was 20-50yrs ago.
4) Some cases of flat out degree discrimination still do occur because even some ppl who know current DPM training are still stubborn (but good surg case logs can usually force even them, or their superiors, to listen)
 
Feli said:
I agree.^ The APMA does a lot of great things: podiatry scope, training, remibursements, maintaining DPM unity for lobby power, etc.

However, this residency shortage situation is a major issue that still has potential to set our goals back quite a bit, IMO. The only real solutions I've heard are the "got residencies?" campaign (good residencies are NOT created overnight) and asking the programs with good numbers to take more residents/yr (therefore converting them from excellent/great numbers to good/ok numbers). I just don't think it's fair that the greed of some pod schools makes top programs pressured to water down their level of training. The VA system pod residencies were a nice move to fix residency shortage in the past, but even most of them are low paying and marginal training. Now, we will potentially dilute the surgery per resident and faculty:resident ratios at top programs? Obviously, it's not wise, but I guess there really is no other short term solution.

I think that until the residency spots are actually there, the most viable option is to restrict admissions a bit more. Taking away some entry level spots from the schools that don't pass boards well is probably the best way to do that. Last grad year (08), there were a handful of students who couldn't get programs, and that may happen this 09 grad year also (the 08 grads who went without also rollover to this upcoming match). We'll see. For the c/o 2010-2012, things could get a bit hairy, esp when you take into account the rollovers of unmatched grads each year. No, those people who scramble and can't get a program in the coming years maybe haven't passed boards and shouldn't have graduated in the first place, but they are still out there in a ton of debt and sporting a DPM degree despite no surgical training. That's a big issue IMO.

How is an 3-4yr trained and ABPS rearfoot certified surgical DPM on a hospital board supposed to explain to his hospital/group that they probably should not grant surgical or consult privileges to another 0-1yr trained "surgeon" with the same DPM degree, due to the vast differences in training, certifications, and ability? Kinda crazy... not something you really see in the MD/DO world.

Further reading on 2015, residency balance, etc:
http://forums.studentdoctor.net/showthread.php?p=5500158#post5500158

http://forums.studentdoctor.net/showthread.php?t=507259

http://forums.studentdoctor.net/showthread.php?t=525225
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Absolutely!
 
G0dFather said:
... "the unlimted scope " for podiatrists issue ...... is it going to be the same unlimted scope that DOs now have??
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Unlimited scope for DPMs? IMO... no way. That would make no sense to me.

The knee would be the next thing up, and it's a surgical gold mine. Ortho would fight hard for it, and rightly so. ACL repairs, total knees, etc are those things in medicine that makes a ton of money and will cause lots of turf battles... LASIK, minimally invasive revascularizations, nosejobs, hand surgery, etc are others. You will notice how much MDs fight with one another over those and other procedures. Besides, DPMs simply aren't trained in knee surgery. You might assist with some knee fractures, repairs, replacements during your residency while on ortho rotation, but that's designed to give you exposure to what ortho can do, not to make you proficient in the operations that are out of your scope. Any pod who thinks he should be fixing knees (I don't care how good his OR skills are) is nuts in the first place IMO. All weightbearing joints in the body are related, but the joints of the foot, the subtalar, and the ankle joint are closely related from a functional standpoint. The knee is too big of a jump and will never be treated by DPMs. We are foot and ankle specialists... not leg-ologists. :confused:

The DPM scope should probably be bone up to the tib tuberosity and soft tissue up to the hip IMO. However, pods should only be doing what they are trained for; that is why Am Board of Pod Surgery exists. What is slowing down the nationwide acceptance of podiatry is significant differences in training from one DPM to another and a few cowboys out there making bad headlines for doing things they are not qualified for.

Real good thread on the scope topic:
http://forums.studentdoctor.net/showthread.php?p=5024817#post5024817
 
What exactly is the shortage? I mean, how many people are affected by it each year, and what are the graduates that don't get residencies supposed to do? I'm just a concerned student c/o 2012
 
Feli said:
Unlimited scope for DPMs? IMO... no way. That would make no sense to me.

The knee would be the next thing up, and it's a surgical gold mine. Ortho would fight hard for it, and rightly so. ACL repairs, total knees, etc are those things in medicine that makes a ton of money and will cause lots of turf battles... LASIK, minimally invasive revascularizations, nosejobs, hand surgery, etc are others. You will notice how much MDs fight with one another over those and other procedures. Besides, DPMs simply aren't trained in knee surgery. You might assist with some knee fractures, repairs, replacements during your residency while on ortho rotation, but that's designed to give you exposure to what ortho can do, not to make you proficient in the operations that are out of your scope. Any pod who thinks he should be fixing knees (I don't care how good his OR skills are) is nuts in the first place IMO. All weightbearing joints in the body are related, but the joints of the foot, the subtalar, and the ankle joint are closely related from a functional standpoint. The knee is too big of a jump and will never be treated by DPMs. We are foot and ankle specialists... not leg-ologists. :confused:

The DPM scope should probably be bone up to the tib tuberosity and soft tissue up to the hip IMO. However, pods should only be doing what they are trained for; that is why Am Board of Pod Surgery exists. What is slowing down the nationwide acceptance of podiatry is significant differences in training from one DPM to another and a few cowboys out there making bad headlines for doing things they are not qualified for.

Real good thread on the scope topic:
http://forums.studentdoctor.net/showthread.php?p=5024817#post5024817
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Yea I agree with you.... treating soft tissue up to teh hip will bring in more pateints too IMO and thas a goods article btw
 
JackedUp said:
What exactly is the shortage? I mean, how many people are affected by it each year, and what are the graduates that don't get residencies supposed to do? I'm just a concerned student c/o 2012
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I think most students who know anything about the shortage in residency positions are concerned.

Someone posted in another thread about 60-120 students will not get into residency this year. This is just an estimate, but we'll have to wait and see.

Also, if you dont make it the first cycle, then I think most people will try to improve their CVs by doing research and other things to try to match into residency the next cycle.

If you don't match into the 2nd cycle, then........ :scared:
 
60-120??? That sounds like a lot. Out of how many graduates?
 
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podoc123 said:
Yea that sounds pretty bad, I thought it would be more like 20-30 if any
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Yea 20-30 does sound a lot better. But I am just repeating what someone else has said in another thread.

I think he got the number from the residency coordinators at his school.

:(
 
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G0dFather said:
well i guess thats jus one of those final weed out points to end of the road
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It shouldn't be that way though, IMO. If you made it through pod school, passed all the boards, spent 150-200K on an education, then you SHOULD get a residency. I'm not saying it has to be the most prestigious ones; however, pod graduates need a residency or they cannot even practice! Gone are the days of "preceptorships."

Pretty ridiculous if you ask me. A start would be to cap class sizes at pod schools (take note OCPM) and not open up new programs without sufficient residency spots. People who successfully graduate podiatry school should not be left in the dust and residency-less.
 
zmeflyby said:
I think most students who know anything about the shortage in residency positions are concerned.

Someone posted in another thread about 60-120 students will not get into residency this year. This is just an estimate, but we'll have to wait and see.

Also, if you dont make it the first cycle, then I think most people will try to improve their CVs by doing research and other things to try to match into residency the next cycle.

If you don't match into the 2nd cycle, then........ :scared:
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:thumbup:

Estimates are very hard at this point. Programs open/close and add/remove entry level residency spots constantly. There are just too many variables: a fair number of top programs will not go to scramble (they'd rather just have a spot go unfilled than take a mediocre student). Residency programs can also change drastically... they move hospitals, add or lose key attendings, split/combine, etc.

If/when the shortage begins (I think my opinion on this is fairly obvious), the rollover of unmatched grads will also become a significant factor. Last year, I think there were around 15 more grads than entry level spots. Add in maybe another 10 students who didn't want to take the bottom of the barrel residency spots that were left, so that makes 25. Those grads probably are spending this year studying, working a job (pod assistant or other field), and they will re-try in the 2009 match. There are also a few practicing pods who did a 1 or 2yr program back in the day but now decides they want more training, and they can apply also. If you think about it, the rollover could potentially make things pretty bad a few years from now, but there is no way to tell how many more residency spots can be added. It's also impossible to predict attrition rates at the schools... c/o 2012 current size right now is basically meaningless since they still have 4yrs of classes/boards/clinics/etc to pass.

I liked krabmas' idea awhile back that the pod schools with low pass rate, poor admission standards, etc should have to pay back the student loans (with interest and additional $ for pain and suffering) of their school's grads who can't get a residency...
http://forums.studentdoctor.net/showthread.php?p=5779183#post5779183
^That'd be a big financial loss for a couple schools, and maybe it'd make them improve pretty darn fast :laugh:
 
Someone has been misinformed either myself or other posters on this forum. If I remember right there were 15-20 people who went unmatched in the 2008 match. And there were 20 something spots unfilled. So there were actually more spots than new graduates. Obviously some residency programs didn't want to scramble and take some of the students who didn't match, and I'm sure there were some students who did not want to go to some of the programs that were left in the scramble. I also believe that 60-120 number given by someone on this site is really inflated. I could be wrong, but to my knowledge the number is less than the lower 60. Since this is such an important subject to many it would be nice to have some legitimate sources cited. I do agree that it is a major disservice to have more graduates than residency spots. If anyone does research and find some actual legit numbers I would be interested to see what they find out.
 
^^ I agree. I too feel that those numbers are inflated.
 
G0dFather said:
does this happen in all the medical fields ..... more graduates than residencies ??
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Well only MD/DO and podiatry have required residencies I believe. Minimum for MD/DO is 3 years and the minimum for podiatry is 2 years. Dentistry you can practice right out of school except for like 5 states which require a 1 year GPR/AEGD (or unless you are specializing in perio/endo/OS/pedo/etc). I understand there are residencies in optometry, pharmacy, Vet, but they are not REQUIRED in order to practice.

Considering MD/DO, I heard about 25% of residencies are filled by FOREIGN medical school grads (Caribbean, Europe, etc). You may not get an opthalmology or dermatology residency once graduating medical school, but you will definitely get a residency (or scramble for one).

From what I heard there are not enough Osteopathic residencies, but DO grads can participate in the MD and DO match anyway (by taking COMLEX and USMLE). The osteopaths have been building A LOT of new schools in recent years, even having branch campuses opening up. An example would be Touro University with 3 osteopathic medical schools (New York City, Las Vegas, and Vallejo). The DO's even have a for-profit medical school now in Colorado (Rocky Vista University). I don't believe they are creating residency spots to go along with this growing student enrollment though. Maybe we will see less foreign grads taking residencies in the future, as American med school graduates will take up more spots.
 
G0dFather said:
does this happen in all the medical fields ..... more graduates than residencies ??
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I had this discussion with my father tonight (who is an MD). He told me that the issues associated with podiatry are a little different than with, say, orthopaedics. In ortho, and a lot of other medical specialties, the shortages in residency spots is because there are too many applicants for a field that is already saturated with residencies (too much demand from prospective residents). In other words, opening up more residencies to allow more people in, would create too many orthopods for the patient demand. However, podiatry is much different. There are too few residency spots to keep up with the demand for the patient. Therefore, although the number of aspiring prodiatry residents is lower than what it should be to keep up with patient demand, the number of residency spots is still too low. Therefore, over time, as the patient demand increases even further, more residencies will be created until an equilibrium is established. I would much rather be in a position where our services are needed, yet not able to get a residency as opposed to a situation (like orthopods) where they have too many applicants for residency spots that will not likely grow in the future...
 
G0dFather said:
does this happen in all the medical fields ..... more graduates than residencies ??
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Yes and no.
JEWmongous said:
...Considering MD/DO, I heard about 25% of residencies are filled by FOREIGN medical school grads (Caribbean, Europe, etc). You may not get an opthalmology or dermatology residency once graduating medical school, but you will definitely get a residency (or scramble for one)...
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This is true to my knowledge also.

Many MD grads will go without a residency this year also. It's nearly a non-issue for US trained MD and DO grads (unless they can't pass boards), and the unmatched are mostly students (including many Americans) doing their MD studies in el Caribbe. A very intelligent PhD I spoke with is now an admin/faculty member at a Miami area medical program after being faculty at a Caribbean program for years and years. It was depressing to him to repeatedly see many of his school's graduates unable to secure a US residency training program (so they either must do residency abroad, or they return to the US unable to get PG training and a license to practice). So, all things considered, there sorta are more grads than residencies.

Aside from the unmatched MDs, there will be a lot of aspiring orthos who will have to settle for an ER residency. Wannabe OBs who will end up in peds, IM hopefuls who match FP, derm gunners who end up IM, etc etc etc.

The grass is always greener... but I will tell you firsthand that pod is a great field for those who apply themselves.
 
ThetaChiNAU1856 said:
haha oh s h i t man thats funny
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Don't take this the wrong way, but I don't want to see something unfortunate happen.

Just as an FYI, in the digital age, and having been someone who has mined resumes for a large company (I'm an older applicant), I'd probably stay away from this type of language, especially considering that:

1) It's not difficult to search these boards PLUS your pic is attached to your name

2) You display your Greek affiliation proudly and thus, all of the stereotypes (founded or unfounded) that go along with it

3) You have great stats and a nice profile but attend a low tier university.

Don't give Adcoms any reasons to correlate your cussing on an online forum with the negative aspects of 2) and 3). And congrats on your score increase!
 
runner0382 said:
Don't take this the wrong way, but I don't want to see something unfortunate happen.

Just as an FYI, in the digital age, and having been someone who has mined resumes for a large company (I'm an older applicant), I'd probably stay away from this type of language, especially considering that:

1) It's not difficult to search these boards PLUS your pic is attached to your name

2) You display your Greek affiliation proudly and thus, all of the stereotypes (founded or unfounded) that go along with it

3) You have great stats and a nice profile but attend a low tier university.

Don't give Adcoms any reasons to correlate your cussing on an online forum with the negative aspects of 2) and 3). And congrats on your score increase!
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ouch man a lower tier university....you cut me deep baxter-nau is better than harvard! haha well i do think its better than ASU/UA at least lol
 
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runner0382 said:
Don't take this the wrong way, but I don't want to see something unfortunate happen.

Just as an FYI, in the digital age, and having been someone who has mined resumes for a large company (I'm an older applicant), I'd probably stay away from this type of language, especially considering that:

1) It's not difficult to search these boards PLUS your pic is attached to your name

2) You display your Greek affiliation proudly and thus, all of the stereotypes (founded or unfounded) that go along with it

3) You have great stats and a nice profile but attend a low tier university.

Don't give Adcoms any reasons to correlate your cussing on an online forum with the negative aspects of 2) and 3). And congrats on your score increase!
Click to expand...
This is good advice... kinda getting OT, but still worth thinking about.

Taking care of one's overall online profile are noteworthy also, esp when you go to apply for residency/jobs. I think I read that over two thirds of headhunters and employers at fortune 500 companies will search online networking sites (facebook, myspace, forums, etc) for more info on their employees or applicants...
http://career-advice.monster.com/job-search-essentials/How-to-Clean-Up-Your-Online-Reputat/home.aspx

I sure don't think it's career suicide to have a few pictures of you and your friends drinking a beer (if 21+), dancing, socializing, etc... but some ppl take it way too far. Once you get into pod school, you are a professional student. One dumb arrest, DUI, or even a bunch of unflattering internet pics could hurt you more than you realize.
 
Sinop said:
Someone has been misinformed either myself or other posters on this forum. If I remember right there were 15-20 people who went unmatched in the 2008 match. And there were 20 something spots unfilled. So there were actually more spots than new graduates. Obviously some residency programs didn't want to scramble and take some of the students who didn't match, and I'm sure there were some students who did not want to go to some of the programs that were left in the scramble. I also believe that 60-120 number given by someone on this site is really inflated. I could be wrong, but to my knowledge the number is less than the lower 60. Since this is such an important subject to many it would be nice to have some legitimate sources cited. I do agree that it is a major disservice to have more graduates than residency spots. If anyone does research and find some actual legit numbers I would be interested to see what they find out.
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I hope so..
 
as another 2012 graduate this is indeed concerning news....slightly more than concerning actually.

Does anyone know if the powers at hand, whoever they might be, are doing anything to keep the amount of graduates that go unmatched to a minimum here in the future?

15-20 is bad enough, but i could see how a few students from each school just simply dont match for one random reason or another.... But 60? Thats borderline ridiculous.....i cant imagine thats true. Anyone have some legit hard facts to throw out from the last few years matches maybe?
 
Feli said:
This is good advice... kinda getting OT, but still worth thinking about.

Taking care of one's overall online profile are noteworthy also, esp when you go to apply for residency/jobs...
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This is all I meant but wanted to support it. I was in no way insinuating that people at Northern AZ (or any University!) are dummies - just watching out for you.

I have personally chosen not to interview many a candidate based on online information.

Like Feli says, everything in moderation.
 
runner0382 said:
This is all I meant but wanted to support it. I was in no way insinuating that people at Northern AZ (or any University!) are dummies - just watching out for you.

I have personally chosen not to interview many a candidate based on online information.

Like Feli says, everything in moderation.
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haha you did say it was a crap uni but thats cool, im going to pod school nothing else bothers me really.
 
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