You’ve been made, all 10 of you

[PointyNippers]

I originally enrolled in podiatry school BECAUSE of the great information given on this forum.

Once I was in school, I realized all of the dinosaur boomer TFP podiatrists gatekeeping the profession, peddling useless products, and giving crap salaries to new associates, despite the new generation becoming much better medically and surgically trained.
This forum has given light to all of this which otherwise would have kept going under wraps. Attention needs to be brought to all of the pitfalls and shortcomings of the profession through an anonymous forum, otherwise nothing will improve and students will get scammed into sinking hundreds of thousands into a career without the full knowledge of what they're getting into.

This is a great profession to get into, if you know what you are doing. But people need to know the full extent of the current situation of the career path. The only way to truly get a gauge on this is through an anonymous forum.

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[PatchAdamsFan]

To all APMA newcomers, welcome to the Streisand Effect.

This forum will always be an important resource for pre-pods, students, residents and attendings. It is ironic that most of the posters here, including myself, are actually doing quite well in this profession, but we will never sugarcoat the grueling process it took for us to get us there. Our positions are not "standard" or "normal" by a long shot. That is the reality. The 80k associate jobs are very real and virtually everywhere. I encourage new private practice associates to post their compensation, and I will gladly explain why your investment has failed. I respect the APMA, but if there no acknowledgement of the facts as others have posted, then we are communicating within two different realities.

 

[Hallux Flaccidus]

Doug - I reviewed the AACPM numbers and I am personally glad enrollment is decreasing at this rate. Prospective students have the right to all the information beforehand, including SDN. It is up to THEM to decide if the information they are reading is accurate or not. They have the power to research. Just like anything else in life. IMO - They are making a well informed judgment based on us 10-15 regular posters whom for the majority are doing well (fair compensation, variety of practice backgrounds from PP to hospital to ortho to MSG) and even a few recent posters telling us that they are working in a predatory group.

I on the other hand, in my short time out, have been allowing and offering current students and residents to shadow me in clinic seeing a variety of pathology. From nail care to trauma to limb salvage to big recon consults. They also go with me to the OR and are able to witness the entire spectrum our profession has to offer. Offer, but not guaranteed. I also participate with a local residency program as well and have offered them my time for lectures, journal clubs, etc. and this is not paid. It slows me down, I go home a little later. So I apologize if I haven’t written chapters or do national lectures. I offer my honest opinion to the above and it’s up to them from what witnesses to make an informed decision.

I also have done PFCD surgeries from stage 2 up to stage 4. I’ve also used a variety of custom made orthotics and also OTC for patients. I don’t doubt the trademark on your brace but IMO I can fabricate something equivalent and/or OTC orthotic just as effective in buying a patient time for their PFCD pain until surgery is needed.

And for the record Dr. Rogers, we appreciate you posting about jobs but the UofM job is 1 “good” job for over 600 graduating residents. I’m sure you and Doug Richie both know there is maybe less than 100-200 (I’m being generous) well, fair compensated jobs per year for every 600 grads. While the remaining 400-500 grads accept a job making a base salary of 80-120k? Would you accept that yourself? I do not believe that’s a worthy investment. If a poster here is disgruntled by the fact they are getting a very short end of their current predatory job, how is that not valid - because that will happen to the vast majority of new grads. I understand yoj want to instill optimism in your current residents but I’m sorry, reality is majority of them will end up in a terribly compensated job. This has been discussed numerous times and I feel you keep brushing it over.

Again, you fail to substantiate your allegation that I "mis-reported" information in my blog. What information was mis-reported?

 

[Hallux Flaccidus]

PM sent.

Gotta get to work now. I'm also going to blame podiatryexchange for the podiatry job market and sign bonuses too low. Maybe I will post my resume and deadlift ORM on here later and show why I'm a voice of authority. That has worked great for the popularity and approachability many users in the past.

This forum has potential to do whatever one tries for... it has been that way for many years. Consider the positive potential instead of just the ego?

Sorry but when somebody calls me out by name, alleges that I spread mis-information and suggests that I am an old retired dinosaur out peddling "non-proprietary" braces, I will respond appropriately.

 

[newfeet]

Pardon your naivety, but no one posts salaries and benefits for these jobs. Everything is negotiated. Even for MDs. There is a range. If it’s a hospital or university job, they use MGMA. If a government entity like the VA, they still use a range. I help my trainees negotiate the best salary possible.

Hmm. Some jobs do post salaries. My former employer and its direct competitor post salaries for most positions.

That’s great you are involved in helping your residents. I didn’t get anything like that.

 

[Pronation]

I like podiatry. I like my job. I dont hate going into work in the morning - I like it. I am well trained and able to tackle just about anything that I encounter on the daily. I feel I make a difference every day and I feel really well respected by my patients, collegues, and staff. There are at least a 1000 people still walking today, who otherwise wouldnt, because of my hands and thats a humbling thing to reflect on.

I've always been pretty pro podiatry on here. If you review my posts I've typically only said positive things.

I've pointed out multiple times that all the regular posters make a good living (even if some of us got screwed early on with the whole "eat your young" thing) and have good jobs. The regular posters all know who eachother are for the most part and are all well trained/went to some of the better residency programs our country offers. Cutswfury is pretty bitter and given some of the things that have happened I dont blame cutswfury for being angry. I wouldnt be happy either. I hesitate to speak for others, but I think most of the regular 10-15 posters on here are happy with their jobs just frustrated with public perception of podiatry, leadership, and initial job offers out of residency.

My main gripe with podiatry right now is opening the new school. I do NOT think this is a good idea with the current state of admissions, quality of jobs, income, and variable residency training. It is going to further dilute an already saturated pool.

Luckily there is a low # students this year matriculating because if the schools filled all their seats it would be 2014 all over again with residency shortage. I have zero confidence UT will create enough quality residency positions to fill their class and another pending residency crisis is looming if admissions go back up.

2014 was one of the most stressful times of my life knowing 10% will not get a residency due to Western opening and creating almost zero residency positions - all under the same leadership that is now creating the texas school. How we let this happen is beyond me. The only way this happened was $$$$ and nothing else. School administrators can hand out pamphlets and tell us how great it is but its just a smoke screen. This is about $$$ and I personally dont think its being done to better the profession.

Based on my prior experience with how our profession botched Western opening/graduating their first 2-3 classes I would be very cautious matriculating into a DPM school. We dont need a larger graduating class. We're already saturated. Its very expensive to go to podiatry school. With even more dilution its not as good of a career as it was 10-20 years ago.

But now were gonna be spammed with opinions from long practicing/established/retired DPMS who dont have to worry about the current state of affairs in the job market so that the new school can fill its slots and make more $$$ for those on top.

In my mind, just like a rep presenting a new product, I can see the room of people now with the powerpoint presentation. Slide after slide about how great UT program is going to be. Some probably snoozing in the back until the last slide "and now the financials" at which everyones eyes immediately open up and suddenly become very interested in "bettering the profession".

I couldn’t agree more. Just to clarify and to reiterate the point, I am happy with my current non private practice job. I enjoy the work that I do and make great money doing it, however it is pure LUCK that I got this job where I don’t work for some sleazy podiatrist siphoning an excessive amount of money from my paycheck. I briefly started out as an associate in private practice and made a nurse’s salary.

 

[newfeet]

To all APMA newcomers, welcome to the Streisand Effect.

This forum will always be an important resource for pre-pods, students, residents and attendings. It is ironic that most of the posters here, including myself, are actually doing quite well in this profession, but we will never sugarcoat the grueling process it took for us to get us there. Our positions are not "standard" or "normal" by a long shot. That is the reality. The 80k associate jobs are very real and virtually everywhere. I encourage new private practice associates to post their compensation, and I will gladly explain why your investment has failed. I respect the APMA, but if there no acknowledgement of the facts as others have posted, then we are communicating within two different realities.

One of my co residents got a 90k offer 8 years ago… that was when I wrote off working in someone’s practice. I was willing to move before taking one of those offers. With no guidance just googling and cold calling/emailing I found something that worked for me. I don’t think that’s how it should be but that’s just me.

 

[kelef]

Student looking to matriculate here. For what it's worth, I think all the info and perspectives you guys give here is really important. I've grown up with my dad as a podiatrist, so I've never had the over glamorized view, but you've still helped me weigh my options objectively - even when it's been hard to read. I actually feel more confident wanting to pursue podiatry knowing exactly what I'm getting into. I know the road is long and hard and that I'll be more limited in my license than if I went DO, but I still feel passionate despite that. I'm grateful that people care enough to point out the flaws.

 

[PointyNippers]

Here's a wild idea:

How about creating one UNIFIED podiatric organization with a legitimate certifying process, and have that one organization promote the profession to undergraduate pre-med interested students and have the organization lobby for us to get better reimbursements from insurance companies for private practice? ...or does everyone have too much pride to do that.

Instead of blaming a forum of raising legitimate concerns about the career that are not being addressed, and instead turning into a peepee measuring contest

 

[icebreaker32]

Most that I know are doing well.

They are in all type of practices: ortho/MSG/hospital/VA/solo PP/small PP/large PP groups.

By far the most common path has been for them to work a few years for someone else and weather they were being "eaten" or the other Dr. was just not busy enough, or slowing down as much as they said etc...the result was the same. They felt they HAD to open their own office to make a reasonable living. Some were able to leave their solo practice once they were very established for Ortho, Hospital or MSG, but at that point it was basically a mutually beneficial relationship and they would have been fine to continue on their own also.

If one is OK knowing they might have to open their own practice and that great jobs are not a guarantee then podiatry is something to consider.

One final thing to consider is that with all the debt from school and the cost of starting a practice etc way too many start doing creative and questionable things to produce income. You can say I would never do that and you might not, but many do when in that situation that thought they never would.

 

[Pronation]

One final thing to consider is that with all the debt from school and the cost of starting a practice etc way too many start doing creative and questionable things to produce income. You can say I would never do that and you might not, but many do when in that situation that thought they never would.

You mean I shouldn’t be dispensing a super special patented brace for every patient that comes in with PT tendon pain?

 

[Feeter]

I do agree that students have several other careers in healthcare (cNP, CRNA, PA) they can pursue that provide same job satisfaction, work life balance and financial success today than 20 years ago.

If podiatry pay stays around 250k then you'll see an increase in application. I have no doubt that as podiatry gets more and more integrated into MSG, hospitals, academic centers and Ortho groups pay will go up with it. Podiatry associate pay is garbage right now considering 300k debt needed to become a podiatrist. This should be at least acknowledged in articles such as Doug Ritchie's. I think this is probably a big reason that leads students to look elsewhere. Other than this forum I am not sure where students can get salary data.

Salary ranges are anywhere from 100k to 350k which is absurd. I think providing prospective students with information related to salary, job satisfaction, different opportunities within the career such as leadership, research, outreach etc is difficult to do for a forum like SDN. That in my opinion should be done by APMA and ACFAS. Schools do it but they have a big conflict of interest as they want those students. If ABPM wants to get involved then let's send out an annual survey on salary, job satisfaction etc to all the DPMs and post it on this forum as part of our initiative to attract more students.

My podiatry experience has been great from financial standpoint but I acknowledge that there are big macroeconomics at play that has led to decrease in student interest.

I encourage students to go into podiatry as I think it does have a lot of upside.

 

[Boba Foot]

I think providing prospective students with information related to salary, job satisfaction, different opportunities within the career such as leadership, research, outreach etc is difficult to do for a forum like SDN. That in my opinion should be done by APMA and ACFAS. Schools do it but they have a big conflict of interest as they want those students. If ABPM wants to get involved then let's send out an annual survey on salary, job satisfaction etc to all the DPMs and post it on this forum as part of our initiative to attract more students.

Good idea in theory, except for the fact that a Board of Directors member of ABPM is also division chief faculty at the new RGV school. So still a bit of a conflict of interest.

 

[diabeticfootdr]

Good idea in theory, except for the fact that a Board of Directors member of ABPM is also division chief faculty at the new RGV school. So still a bit of a conflict of interest.

That’s not accurate information. I don’t have any faculty position or anything to do with the new TX school (except being a supporter). It is at UTRGV, 4 hours south of me. I’m at UT Health San Antonio.

 

[air bud]

What’s false?

I’m sorry you hate your profession. It seems like not the right place for you. No one is inhibiting your free speech.

I made the profession aware of this forum and the inaccuracies on it. We asked the profession to register and comment. That is my free speech.

Who would argue with more perspectives and posters?

I personally disagree with anticompetitive speech and behavior. Maybe someone out there is a better surgeon or business person than you (or me). They should be given the chance to go into this wonderful profession and make a difference.

On the wall in my academic office hangs a quote, “Life isn’t about finding yourself, it’s about creating yourself”. You can create your own path in podiatry. That’s what’s great about the profession. That’s what I teach my students, residents, fellows, and colleagues.

ABPM will continue to be a leader in board certification and the profession. We take our responsibility of protecting the public seriously and we also believe we can do it in a fair and transparent manner.

Pardon your naivety, but no one posts salaries and benefits for these jobs. Everything is negotiated. Even for MDs. There is a range. If it’s a hospital or university job, they use MGMA. If a government entity like the VA, they still use a range. I help my trainees negotiate the best salary possible.

This is a problem 100%. This should be talked about in the open. White coat investor goes on extensively about this. How can you negotiate a better deal if you don't know starting points. Numbers.

I just signed a 6 month contract with a multi state podiatry group as an independent contractor. Cold called the guy. Had a common person of interest and a guy who works there already who graduated from my program a few years below me. 18k monthly. Has all the ancillaries. I am opening a new office for them. You are telling me these super groups can't offer similar? Or less with Benny's?

 

[air bud]

I’ll go first.

I consider …

Salaried/group positions: $180k a reasonable offer, >$225k a good offer. Hopefully + incentives and good benefits.

Government practice: >$160k a reasonable offer. Usually very good benefits.

Private practice: depends if you’re the proprietor or not. If you are, then everything is up to you, but your W2 income is not representative of your entire income and is hard to judge. If you’re not the proprietor, beware. Not saying no, but this is where “podiatrist eat their young” and all the negative experiences are.

225 is good offer for hospital? I have an interview Wednesday with a semi rural hospital again would be only pod. Not taking for less than 275 base shooting for 300 and expect to bonus way above that. We make them too much money. 225 was a good offer when I came out 5 years ago. Inflation bro. Of course places are emailing you if they are signing new grads to 180k at a hospital.

 

[air bud]

I originally enrolled in podiatry school BECAUSE of the great information given on this forum.

Once I was in school, I realized all of the dinosaur boomer TFP podiatrists gatekeeping the profession, peddling useless products, and giving crap salaries to new associates, despite the new generation becoming much better medically and surgically trained.
This forum has given light to all of this which otherwise would have kept going under wraps. Attention needs to be brought to all of the pitfalls and shortcomings of the profession through an anonymous forum, otherwise nothing will improve and students will get scammed into sinking hundreds of thousands into a career without the full knowledge of what they're getting into.

This is a great profession to get into, if you know what you are doing. But people need to know the full extent of the current situation of the career path. The only way to truly get a gauge on this is through an anonymous forum.

😬

 

[DexterMorganSK]

I originally enrolled in podiatry school BECAUSE of the great information given on this forum.

I'm glad it worked out for you, but I, along with a few others, have always advised future students to take everything on these forums with a grain of salt. No one should make a real-life decision based on what is said in these forums (not just for podiatry but the other forums as well). I always advise students to shadow first and then apply. Shadowing is the only accurate way to learn about this profession (the good and the bad), and any interested student should shadow multiple DPMs. You wouldn't buy a car based on online reviews or watching YT videos; you must test drive it first.

That said, it is equally essential for students to keep an open mind and do their research before committing to this field (or any other).

 

[air bud]

What can't be stated enough is the opportunity cost of sacrificing 7 to 8 years of your life. No 401k, IRA, match compounding... You can recover from that in theory making said $250 to 300K but that's a double death blow to lose that time for 90k for a few years. Just talked to a guy who graduated a year above me wanted to stay local to where we did residency dude made $125k for 4 years straight and then finally left to decide to open up his own place. He was already a little bit older to start with. Wife didn't work. No way you ever recover from that long-term the way you want to without significant luck. Again if you could job hop and make 300K Plus no matter what you can recover from that.

 

[PTPuser]

What can't be stated enough is the opportunity cost of sacrificing 7 to 8 years of your life. No 401k, IRA, match compounding... You can recover from that in theory making said $250 to 300K but that's a double death blow to lose that time for 90k for a few years. Just talked to a guy who graduated a year above me wanted to stay local to where we did residency dude made $125k for 4 years straight and then finally left to decide to open up his own place. He was already a little bit older to start with. Wife didn't work. No way you ever recover from that long-term the way you want to without significant luck. Again if you could job hop and make 300K Plus no matter what you can recover from that.

THIS IS THE PART WHERE ALL THE PRE-POD SHOULD READ. I didn't take this part into true consideration cause I was so stuck on determining whether or not I truly even wanna practice podiatry when in end THIS post is the part that is the scariest truth alot of us will face.

 

[deleted1138023]

THIS IS THE PART WHERE ALL THE PRE-POD SHOULD READ. I didn't take this part into true consideration cause I was so stuck on determining whether or not I truly even wanna practice podiatry when in end THIS post is the part that is the scariest truth alot of us will face.

it's not an easy 7 years either... especially considering where you do residency.

 

[wakaflocka88]

Again, you fail to substantiate your allegation that I "mis-reported" information in my blog. What information was mis-reported?

The reason behind lower school applicants - it is not SDN. ABPM jumped on the bandwagon and agreed unfortunately.

 

[air bud]

THIS IS THE PART WHERE ALL THE PRE-POD SHOULD READ. I didn't take this part into true consideration cause I was so stuck on determining whether or not I truly even wanna practice podiatry when in end THIS post is the part that is the scariest truth alot of us will face.

Oh yeah throw in that extra 1-2 years of retaking the MCAT still trying to be a real doctor. Then another year for your Masters of science. So tack on another 2 to 3 years of contributions/compounding.

 

[PeaJay]

More opinions are welcome.

SDN can in some instances be an echo chamber. It is however ridiculous to think that this website accounts for the decline in enrollment.

There are several themes about our profession that are discussed on a regular basis. Any of these recent topics could be a cause.

-Variable acceptance of the profession by other healthcare providers
-High cost of training
-Highly variable training (schools and residency)
-Inconsistency in job market
-inconsistency in pay

The key to all of our discussion is that there is to much inconsistency/variability. There are no sure things in this profession. The competing fields however provide stability/flexibility, which are more palatable terms.

Edit: btw… I am far from disgruntled. I make good money. I have a schedule that allows me to be with my family. I review for our journals. I work with residents. I have multiple publications. I have lectured.

Since others are throwing out ideas for improvement, I might as well provide my take.

1. Variable acceptance - This will only be solved by solving the variability in product. We have all seen students/residents that have no business treating patients. These individuals should have never been allowed to advance through training. See #3.

2. High cost of training - This is hard to solve, but free standing private schools are not the answer. Ideally the schools should be integrated with large institutions to take advantage of synergies with other medical programs. Transitioning into state schools (subsidized) should help drive down cost as students would have the choice of attending a reasonably priced institution affiliated with other medical programs or attend an over priced private institution. Ideally under performing schools would be shuttered. Could this be a long game goal for the Texas program?

3. Variable training - While we need a critical mass of students to perpetuate the profession, there is an argument for quality over quantity. A focus on quality ideally would involve training within a school fully integrated with a MD/DO counterpart. This serves as a good screening tool as lower quality candidates would easily be screened out by failing the jointly administered examinations. MD/DO training is highly standardized and being integrated allows for a standard base of medical information for our students. Upon graduation, students should be ushered into strong residencies. Contrary to the beliefs of other posters, I believe the residency should have a strong medical and surgical training. MD/DO residents have strict quality standards for their rotations. We should have real/tangible training in Emergency Medicine, Vascular Surgery/Burn, Infectious Disease, Orthopedics (trauma/sports/hand), Internal Medicine/Hospitalist, Dermatology, and Plastics. These rotations should be standardized and quality should be heavily scrutinized. All of theses should focus on surgical/procedural experiences not shadowing for an hour and then going. Many of the high volume programs when I was a student essentially prided themselves on making a mockery of the off service requirements. There should also be increased case volume requirements. Meeting the bare minimum is a joke.

4. Inconsistency in job market - We should stop spending money to advertise to NPs/PA/PCP organizations. There should be a push to educate every system, hospital, and MSG on why it makes financial sense to have a podiatrist. The nation has a shortage of PCPs NP/PA professions have capitalized and we should have done the some. Large volumes of ER follow-ups are foot/ankle related and if directly offloaded to a podiatrist can free up valuable spots in a PCP clinic. If more systems/hospitals/MSGs posted positions, it would rase average pay and force private practice to stay competitive. More postings would foster flexibility allowing students to more easily relocate.

5. Inconsistency in pay - See #4

 

[air bud]

In the past 5 years, how many of your trainees have obtained jobs starting at MGMA expected salary (including podiatry PP).

Pardon your naivety, but no one posts salaries and benefits for these jobs. Everything is negotiated. Even for MDs. There is a range. If it’s a hospital or university job, they use MGMA. If a government entity like the VA, they still use a range. I help my trainees negotiate the best salary possible.

Check out the job offer thread. At least before it got derailed....good info on salaries benefits. Again I will restate we do significant harm to our colleagues by not openly talking about salary/benefits. It is not for bragging rights. We have none we are podiatrists. It should be to inform and educate.

 

[Feli]

...One final thing to consider is that with all the debt from school and the cost of starting a practice etc way too many start doing creative and questionable things to produce income. You can say I would never do that and you might not, but many do when in that situation that thought they never would.

Do not be jealous that some are certified with a CAQ in Keryflex and you are not.

 

[Weirdy]

Thank you for keeping this thread going in a respectful manner.

Cool it with the digs please. You know who you are.

 

[Shiyuan]

Maybe a bit of a random aside here... but i’m a “Mentor” for AACPM, but I havent had a student contact me to shadow/discuss podiatry for ~2-3 years. Maybe due to COVID... but it’s been oddly quiet. Anyone else out there an AACPM “Mentor” had this same problem?

 

[Foot&AnkleSurgeon]

I would consider a good offer right out of residency to be total compensation of 290ish. 200k in salary and the rest in benefits.

I think many established in private practice would consider taking home $300,000 pretty good. For a physician right out of residency to take home $290,000 (salary and benefits) he would have to collect on the order of $700,000 for the practice assuming 55% to 60% overhead for the practice. When I interviewed residents for a position in my practice in 2020 for a 2021 start most were asking for a salary in the $140,000 to $150,000 range for the first year. That's not unreasonable as it equates to the new hire collecting $350,000 to pay for himself (about $29,000/month or $1380/day assuming 21 working days in the month). The best incentive for a new hire is not salary, but a percentage of collections. Work hard, work harder and earn more.

 

[Pronation]

The best incentive for a new hire is not salary, but a percentage of collections. Work hard, work harder and earn more.

This is the exact line right here that pod associate mills feed to incoming indentured servants fresh out of residency. The problem is that the patient flow isn't there because the practice had no business hiring another pod... so whomp whomp, you end up making 100k for the year.

How about just work and get paid like a doctor, work harder and earn more...

 

[air bud]

This is the exact line right here that pod associate mills feed to incoming indentured servants fresh out of residency. The problem is that the patient flow isn't there because the practice had no business hiring another pod... so whomp whomp, you end up making 100k for the year.

How about just work and get paid like a doctor, work harder and earn more...

Yeah...but I mean a legit place that NEEDS to hire someone production is great. As we know the problem is people try and hire way too early.

 

[podwho]

225 is good offer for hospital? I have an interview Wednesday with a semi rural hospital again would be only pod. Not taking for less than 275 base shooting for 300 and expect to bonus way above that. We make them too much money. 225 was a good offer when I came out 5 years ago. Inflation bro. Of course places are emailing you if they are signing new grads to 180k at a hospital.

New graduate offer is very different from established doctors. And agreed, if someone is going to go rural, middle of no where, away from family and friends for money then the money better be good. I had new grad hospitalist friend who went rural 320k base 100k loan repayment, 40k sign on bonus, 20k relocation. 7 on 7 off. Not even a specialty. And it didn’t take 2 months of interviews to find out the salary because it was advertised. Not always the case.

I think many established in private practice would consider taking home $300,000 pretty good. For a physician right out of residency to take home $290,000 (salary and benefits) he would have to collect on the order of $700,000 for the practice assuming 55% to 60% overhead for the practice. When I interviewed residents for a position in my practice in 2020 for a 2021 start most were asking for a salary in the $140,000 to $150,000 range for the first year. That's not unreasonable as it equates to the new hire collecting $350,000 to pay for himself (about $29,000/month or $1380/day assuming 21 working days in the month). The best incentive for a new hire is not salary, but a percentage of collections. Work hard, work harder and earn more.

That’s a problem right there don’t you think? many want to ask for more but don’t at the risk of looking greedy or “ungrateful” because how limited opportunities are especially if they find the right location. It’s safer to get your foot in the door when there’s limited options rather than ask for 20k extra and the practice hiring the other guy for less money. Reality is many offer 30%, not 40 especially first yr. Truthfully the floor should be around 40%. If the owner can’t run an efficient practice that’s really their fault. Issue is also people taking bad jobs. Stop accepting crap offers people.

 

[Feli]

Maybe a bit of a random aside here... but i’m a “Mentor” for AACPM, but I havent had a student contact me to shadow/discuss podiatry for ~2-3 years. Maybe due to COVID... but it’s been oddly quiet. Anyone else out there an AACPM “Mentor” had this same problem?

I would get occasional calls about that shadowing/LOR back when I was in residency and practicing after in a metro with half a dozen or more bona fide universities offering pre-med/health. (or PMs through here for same). There were usually at least a couple contacts per year... many would never actually set up visits, though (tons of DPMs in Mich, assume they found one closer or changed their mind on shadowing DPM).

I'm pretty rural now... and not APMA member anymore (gave it up after a couple "young member" years when the rate then gets very high). I'm also hours from the closest real pre-med 4yr college location. I had assumed those were why no hits (along with 'virtual' shadowing from COVID), but I can check if my info is up to date or if I'm even still on the aacpm list. That's a good idea.

If you're in a metro or decent sized city with a few pre-med universities, I'd think you'd still get a call about pre-pod shadowing at least every year or two? That was my exp until I moved to BFE.

 

[heybrother]

I think many established in private practice would consider taking home $300,000 pretty good. For a physician right out of residency to take home $290,000 (salary and benefits) he would have to collect on the order of $700,000 for the practice assuming 55% to 60% overhead for the practice. When I interviewed residents for a position in my practice in 2020 for a 2021 start most were asking for a salary in the $140,000 to $150,000 range for the first year. That's not unreasonable as it equates to the new hire collecting $350,000 to pay for himself (about $29,000/month or $1380/day assuming 21 working days in the month). The best incentive for a new hire is not salary, but a percentage of collections. Work hard, work harder and earn more.

(a) Hospital money always sounds outrageous compared to private practice money. Podiatry pay is likely some variation of bimodal.

(b) Incentive based pay sounds great until you are a regular on this forum for years and never see a single contract that actually contains an incentive. 30% is the going rate over, and over, and over. Complicated non-sense structures are common. I've got a friend who collected $600K and has never touched $150K in pay.

 

[PeaJay]

I think many established in private practice would consider taking home $300,000 pretty good. For a physician right out of residency to take home $290,000 (salary and benefits) he would have to collect on the order of $700,000 for the practice assuming 55% to 60% overhead for the practice. When I interviewed residents for a position in my practice in 2020 for a 2021 start most were asking for a salary in the $140,000 to $150,000 range for the first year. That's not unreasonable as it equates to the new hire collecting $350,000 to pay for himself (about $29,000/month or $1380/day assuming 21 working days in the month). The best incentive for a new hire is not salary, but a percentage of collections. Work hard, work harder and earn more.

What I stated is a run of the mill hospital system starting package.

See my comments above on leveraging systems/hospitals/MSGs. Less than 200k in salary for a doctor is silly. I know PAs/NPs/PharmDs making 150k or more.

 

[wakaflocka88]

What I stated is a run of the mill hospital system starting package.

See my comments above on leveraging systems/hospitals/MSGs. Less than 200k in salary for a doctor is silly. I know PAs/NPs/PharmDs making 150k or more.

This. But why is it that you and us have to repeat this over and over again?

You stated it here. We all stated it in the job threads post. It’s been discussed in other posts to great lengths. Yet, us stating our high incomes and how we achieved it step by step (shout out to Feli, HeyBrother on their prior posts literally outlining how to succeed in PP) but yet we are classified as disgruntled. I don’t see ABPM ABFAS or our schools teaching this. They just know how to promote optimism but the posters above me taught me a tremendous amount on navigating the job market and how to succeed. Isn’t it odd I had to learn this on SDN via an anonymous online forum??

So, yes, Mr. Richie, with respect, I find your blog post and LinkedIn post to be filled with inaccurate reporting and not fair to discriminate against SDN which led to ABPM following suit and believing what you said without doing their due diligence to the wealth of honest, truthful information here.

 

[Feli]

What I stated is a run of the mill hospital system starting package.

See my comments above on leveraging systems/hospitals/MSGs. Less than 200k in salary for a doctor is silly. I know PAs/NPs/PharmDs making 150k or more.

Less than 200k for a podiatrist is silly.
Surgical podiatrist? maybe 250 minimum.
If it's a Foot and Ankle Surgeon, less than 300 is clearly not acceptable.
Fellowship trained F&A surgeon... nerve stuff on the CV? Sky's the limit (obviously).

Agree 100% on highly variable training and therefore DPM incomes. A lot of income potential depends on one's LinkedIn nomenclature, creative terminology, and social media pictures (the more rainbow colored plates, the better). Everyone knows this. I think you lose points for liking blogs about insoles or anything derm/nail. I could be wrong.

 

[Feli]

...The best incentive for a new hire is not salary, but a percentage of collections. Work hard, work harder and earn more.

Sometimes, but you won't get much quality without a decent base (relative to other area jobs and COL of city/area).
People have to pay their loans and basic expenses. It is hard to find that balance of comfortable income and also attainable bonus. You don't want to overpay in PP - esp for a new grad who could be unproductive/lazy, but the increasing number of hospital jobs with 200k+ guaranteed base make some of the PP offers laughable. I have seen far too many for $100k base and 25% or 30% or something like that - even post-COVID and in HCOL places. Those offers don't work, even in LCOL areas... they will attract nothing but bottom-of-the-barrel associates who aren't competitive for other hospital or better PP jobs (and even those folks probably won't stay long).

I always tell new grads - and I've seen it wisely advised to many MDs also - that the tools for success are more important than just the $. Having the staffing, volume for bonus, variety for boards/interest, marketing, tools to generate revenues, little/no call, etc... that stuff trumps just the $ or the promise of $ that'll never materialize if the office is slow or poorly run... or the tools trumps simple $$$ at the price of burnout on call/notes/etc. I bet maybe 5% of people actually listen... most just take the best base they can find (hospital or PP or whatever).

I think that's one of the biggest disconnects from the old guard to the younger DPMs (and therefore a HUGE area of dissatisfaction where most associates quickly leave their job and possibly compete with former employers solo or in a competing group). The old heads didn't deal with the loan burden, and the young grads have no idea how to generate $$ in PP and too much expectation for huge base - but hopefully all learn fast how to create win-win.

The hard fact of going from 7 pod schools teaching future DPMs to 10 of them doing that in less than 20yrs is a substantial problem also. Even if the 3 new schools are good, that's a large impact on DPM supply/demand (after no schools added in the 20yrs prior). Opportunity is always out there, but it's a numbers game for any profession/skill and in any area. It puts a bit of a drag even on the well-trained DPMs if many others will jump to do their job cheaper, and the saturation hugely impedes the bargaining power of the lesser trained.

 

[air bud]

 

[AttackNME]

Private practice: depends if you’re the proprietor or not. If you are, then everything is up to you, but your W2 income is not representative of your entire income and is hard to judge. If you’re not the proprietor, beware. Not saying no, but this is where “podiatrist eat their young” and all the negative experiences are.

@Doug Richie I appreciate you coming on here and posting. I’m curious what do you think about Dr Lee Roger’s above quote about how podiatrists eat their young in private practice?

@diabeticfootdr you have common ground with some of the regular posters on here regarding negative experience in private practice. This is refreshing to see. Can you share more of your thoughts on this situation?

 

[Boba Foot]

That’s not accurate information. I don’t have any faculty position or anything to do with the new TX school (except being a supporter). It is at UTRGV, 4 hours south of me. I’m at UT Health San Antonio.

Ok my bad, I am wrong. The RGV school will be a direct feeder school for the UTHSA residency program that has lost it's draw in the past decade and which you are affiliated. Still a conflict of interest.

What can't be stated enough is the opportunity cost of sacrificing 7 to 8 years of your life. No 401k, IRA, match compounding... You can recover from that in theory making said $250 to 300K but that's a double death blow to lose that time for 90k for a few years.

Not going to lie, it really sucked seeing friends buy houses and having families, which I delayed for a decade because I decided to do this foot thing. I don't regret it, but you really do have to delay life for a solid 7 years to pursue this career. Which is not to say you don't have to in other medical specialties, but they do mostly compensate more to make up for it. It also blows that now that I'll be able to afford a house within the next 5 years, they have basically doubled in price since I went to pod school. But what can ya do?

 

[Foot&AnkleSurgeon]

Sometimes, but you won't get much quality without a decent base (relative to other area jobs and COL of city/area).
People have to pay their loans and basic expenses. It is hard to find that balance of comfortable income and also attainable bonus. You don't want to overpay in PP - esp for a new grad who could be unproductive/lazy, but the increasing number of hospital jobs with 200k+ guaranteed base make some of the PP offers laughable. I have seen far too many for $100k base and 25% or 30% or something like that - even post-COVID and in HCOL places. Those offers don't work, even in LCOL areas... they will attract nothing but bottom-of-the-barrel associates who aren't competitive for other hospital or better PP jobs (and even those folks probably won't stay long).

I always tell new grads - and I've seen it wisely advised to many MDs also - that the tools for success are more important than just the $. Having the staffing, volume for bonus, variety for boards/interest, marketing, tools to generate revenues, little/no call, etc... that stuff trumps just the $ or the promise of $ that'll never materialize if the office is slow or poorly run... or the tools trumps simple $$$ at the price of burnout on call/notes/etc. I bet maybe 5% of people actually listen... most just take the best base they can find (hospital or PP or whatever).

I think that's one of the biggest disconnects from the old guard to the younger DPMs (and therefore a HUGE area of dissatisfaction where most associates quickly leave their job and possibly compete with former employers solo or in a competing group). The old heads didn't deal with the loan burden, and the young grads have no idea how to generate $$ in PP and too much expectation for huge base - but hopefully all learn fast how to create win-win.

The hard fact of going from 7 pod schools teaching future DPMs to 10 of them doing that in less than 20yrs is a substantial problem also. Even if the 3 new schools are good, that's a large impact on DPM supply/demand (after no schools added in the 20yrs prior). Opportunity is always out there, but it's a numbers game for any profession/skill and in any area. It puts a bit of a drag even on the well-trained DPMs if many others will jump to do their job cheaper, and the saturation hugely impedes the bargaining power of the lesser trained.

In 30 years of practice I have had two associates who started on a percentage (no base) and went on to partner. I've had several salary only hires that were "lazy", did not produce and moved on. I've been around for a while (an old head) and started with student loans. It took me seven years to pay them off working for a group practice for two years and then starting my own practice (more deferred gratification, but worth it). I believe many of the young graduates today have very large student loans. Perhaps they take these large loans with the expectation of making a large base? I agree with the above that there may be "too much expectation for a huge base". That said, there's no salary limit as one becomes established given the right circumstances.

"I always tell new grads - and I've seen it wisely advised to many MDs also - that the tools for success are more important than just the $..." Agree!

 

[CutsWithFury]

In 30 years of practice I have had two associates who started on a percentage (no base) and went on to partner. I've had several salary only hires that were "lazy", did not produce and moved on. I've been around for a while (an old head) and started with student loans. It took me seven years to pay them off working for a group practice for two years and then starting my own practice (more deferred gratification, but worth it). I believe many of the young graduates today have very large student loans. Perhaps they take these large loans with the expectation of making a large base? I agree with the above that there may be "too much expectation for a huge base". That said, there's no salary limit as one becomes established given the right circumstances.

"I always tell new grads - and I've seen it wisely advised to many MDs also - that the tools for success are more important than just the $..." Agree!

You sound like a podiatrist who has had a long a fruitful career but 30 years ago I doubt tuition for podiatry school was expensive as it is now. I also doubt cost of living was expensive as it is now. Thus allowing you to pay off these loans off in 7 years which is extraordinarily fast compared to most MD/DO/DPM/DMD of today.

I appreciate your contribution to the forum I just think todays graduates face a lot more financial burden than podiatrists who graduated 30 years ago and who still practice. There’s a huge disconnect in terms of compensation and needs.

The return of investment to become a podiatrist 30 years ago was probably very high since costs of education and training was low. It’s not the same today and is the reason for declining admission numbers. It’s financially not worth it unless you land a hospital or orthopedic group job.

Most people going into podiatry don’t want to financially double down and create their own practice and take that chance. Statistically they will be unsuccessful especially if they are practicing in a highly desirable place to live.

 

[Foot&AnkleSurgeon]

You sound like a podiatrist who has had a long a fruitful career but 30 years ago I doubt tuition for podiatry school was expensive as it is now. I also doubt cost of living was expensive as it is now. Thus allowing you to pay off these loans off in 7 years which is extraordinarily fast compared to most MD/DO/DPM/DMD of today.

I appreciate your contribution to the forum I just think todays graduates face a lot more financial burden than podiatrists who graduated 30 years ago and who still practice. There’s a huge disconnect in terms of compensation and needs.

The return of investment to become a podiatrist 30 years ago was probably very high since costs of education and training was low. It’s not the same today and is the reason for declining admission numbers. It’s financially not worth it unless you land a hospital or orthopedic group job.

Most people going into podiatry don’t want to financially double down and create their own practice and take that chance. Statistically they will be unsuccessful especially if they are practicing in a highly desirable place to live.

Some perspective... 30 years ago tuition was $28,000/year (can't remember what living expenses cost), my residency paid me $13,000/year and my first job as an associate paid $30,000/year. My associate salary was about 25% of my total student debt (about $130,000). I'm aware of the current student debt from an associate I have. It's high, however his current pay is about 80% of his student debt. With budgeting, very doable and based on the numbers I see, easier than what I had. I believe the ROI for potential podiatry students and graduates is very good.

Side note: the tuition at the UTRGV SOP is $18,000/year. That will go a long way in reducing student debt and increasing ROI.

 

[air bud]

In 30 years of practice I have had two associates who started on a percentage (no base) and went on to partner. I've had several salary only hires that were "lazy", did not produce and moved on. I've been around for a while (an old head) and started with student loans. It took me seven years to pay them off working for a group practice for two years and then starting my own practice (more deferred gratification, but worth it). I believe many of the young graduates today have very large student loans. Perhaps they take these large loans with the expectation of making a large base? I agree with the above that there may be "too much expectation for a huge base". That said, there's no salary limit as one becomes established given the right circumstances.

"I always tell new grads - and I've seen it wisely advised to many MDs also - that the tools for success are more important than just the $..." Agree!

I welcome more input from you here, very different perspective than many regular posters. And much needed.

 

[air bud]

Some perspective... 30 years ago tuition was $28,000/year (can't remember what living expenses cost), my residency paid me $13,000/year and my first job as an associate paid $30,000/year. My associate salary was about 25% of my total student debt (about $130,000). I'm aware of the current student debt from an associate I have. It's high, however his current pay is about 80% of his student debt. With budgeting, very doable and based on the numbers I see, easier than what I had. I believe the ROI for potential podiatry students and graduates is very good.

Side note: the tuition at the UTRGV SOP is $18,000/year. That will go a long way in reducing student debt and increasing ROI.

I paid 28k in 2009 at DMU.

 

[Foot&AnkleSurgeon]

I paid 28k in 2009 at DMU.

I'm thinking my total cost (tuition and living) was $28,000/year for total debt of about $130,000.

 

[air bud]

Inflation is hitting all of us. Last night I asked my 3 year old how much ice cream she wanted. She usually replies 2. Last night 10. No sector untouched.

Except new associate contracts. 85k 10 years ago and will be the same 10 years from now.

 

[shadesofgrey]

I graduated from residency in 2018 and focused my job hunt in the midwest, in an approx 3 hour driving radius from my semi-rural hometown, including several large metro areas. I was offered multiple private practice positions and none of them offered a realistic pathway to 180k, most it would have been a struggle to make 150k. The worst of the lot was 90k straight salary with no production bonus and, I'm not making this up, a $500 initial signing bonus!! How do you have the gall to offer a $500 bonus? During the recent labor shortage I routinely saw higher bonuses advertised at fast food establishments. A factory near my current practice is currently offering $30/an hour and a 5k bonus after 90 days. I had no luck applying at hospital/MS jobs in my desired area, and very few of the hospital networks even had in house podiatrists.

I went to Kent state and for the class of 2026, their website states estimated cost of attendance (tuition, fees, COL) is 78k per year. I was against the Texas school initially but I could get behind it with that low of tuition, might force the other schools to drop.

I have had several students shadow, and I normally gently suggest they consider going DO/NP/PA route. This may change if salaries increase or tuition significantly decreases, but currently most graduates will end up working as an associate and the ROI is not worth it IMO.

 

[Foot&AnkleSurgeon]

Inflation is hitting all of us. Last night I asked my 3 year old how much ice cream she wanted. She usually replies 2. Last night 10. No sector untouched.

Except new associate contracts. 85k 10 years ago and will be the same 10 years from now.

I'm hoping you're wrong on new associate contracts. Along with a change in the perspective of what new associates want, there needs to be an increase in starting salaries. Someone on this thread alluded to practice overhead and that's an excellent point. Along with patient volume (numbers) practice overhead needs to be kept at a reasonable level in order to pay a new associate a descent wage. As stated, a beginning wage of $150,000 is reasonable and seeing this number increase based on production.

With tuition of $18,000/year at UTRGV SOP I believe we will see the other pod schools finding a need to reduce tuition to compete or lose students.