04/29/2013 Robert Kornfeld, DPM
104 Applicants Not Matched for Residency Positions (Brian Kiel, DPM)
Dr. Kiel points out that there are some podiatric
medical school graduates that are not qualified
to do a residency. I do not think this is the
point. On this thread, there are those who have
made valid points, those who have blamed the
leaders, those who have called for change, those
who say we need to decrease enrollment, etc.
However, I have not seen anyone coming forward
with a plan to address this in real time.
I personally offered the 104 a pre-residency
fellowship in integrative podiatric medicine on
this forum. This would be a grand undertaking on
my part, but with the help of all DPMs, colleges,
state associations and APMA, it is not only
possible, but will train these DPMs in the
eventual and unavoidable paradigm shift in
medicine. I received many e-mails from interested
graduates who would like to become Fellows.
I sincerely wish to extend my invitation to this
profession to lend their support to my efforts. I
have partnered with a non-profit organization and
any donations made to our cause will be fully tax
deductible. Over 14,000 DPMs who read PM News
every day. I am willing to turn my life in a
totally different direction to give back to this
profession by creating a serious and
comprehensive training program for these
podiatrists. But I cannot do it alone. I need
this profession to rise to the need and partner
with my efforts.
This is a great profession. Just think how you
would feel if you were one of the 104. Let's do
this together and make it a win for podiatry. As
I said in an earlier post, I welcome conversation
and inquiries from all in this profession.
Robert Kornfeld, DPM, Manhasset, NY,
Holfoot153@aol.com
04/15/2013 Simon Young, DPM
104 Applicants Not Matched for Residency Positions (Robert Eckles, DPM, MPH)
I reviewed Dr. Eckles comments and beg to
disagree with his conclusions and comments.
Firstly, I do believe there are too many colleges
of podiatric medicine matriculating too many
students. In my opinion there is no shortage of
podiatrists, at least not in the NYC area. In the
NYC area, I can count no more than 20 orthopedic
foot and ankle surgeons. For example, the spinal
surgeons are all thriving. They are thriving
because there aren't many in the market to
provide their services and they have a strong MD
and hospital referral base.
Dr. Eckles feels with about 400 DPMs in the NYC
area, that there is a shortage- I strongly beg to
differ. I still feel there is no shortage in
these truly hard economic environment with
increased overhead, decreased patient flow,
decreased reimbursements and decrease income.
There is nothing wrong with a profession being in
demand which allows its members to better thrive
in challenging times of this medical
metamorphosis.
The new NYS scope of practice law will impact
only a certain few and will have minimal impact,
especially with dwindling insurance
reimbursements.
Dr. Eckles, being a faculty member of the NYCPM,
argues and implies that colleges are not tuition
driven and that certain faculty members earn
market rate incomes. I know many of the schools
have low level faculty members who do not earn
significant sums of monies. A select few do very,
very well. I believe all the schools of podiatry
are tuition driven and subsequently place our
future graduates in economic trauma and hardship.
I beg to disagree with Dr. Eckles that NYCPM or
any podiatry school is excellently competency
driven. I would like to hear from the current
students. My personal experiences and
observations have been different.
I agree with Dr. Eckles about abolishing the abcs
of residency. I feel mandating a PSR-36 for
everyone would fail since in my opinion there are
not enough rearfoot/ankle cases to graduate
hundreds and hundreds of competent podiatrists.
In, NYC with its restricted laws, it can not be
done without orthopedic foot and ankle
participation. I see no problem with reverting to
a majority PSR-24 and select PSR-36 format. It is
simple, non-confusing, and will fulfill our
professional needs.
This shortage in residency positions is a
travesty. We need information from federal,
state, and local governments as to what their
long-term goals are, and which hospitals are in
jeopardy of closing. We will solve the problem by
closing some schools, matriculating less students
than there are residency slots, improving our
education in podiatry school and residency, and
reverting to PSR-24 and PSR-36 formats, which
will result in more competent practitioners.
Simon Young, DPM, NY, NY, simonyoung@juno.com
04/10/2013 Bryan C. Markinson, DPM
104 Applicants Not Matched for Residency Positions (Robert Eckles, DPM)
Dr. Robert Eckles is a scholar and a gentlemen
who I have known for several years. Regarding
his explanation on how all involved are doing
what they can, he states "It is a personal
affront to hear how we all care so little about
our students when few making these comments have
even been to a DPM college in the past 10
years." I, in fact do deal with former and
current students at many schools regularly. He
goes on to catalog efforts at NYCPM to
encourage, remediate, and support the students,
while creating a friendly environment for a
great student experience. I am sure this is
true, and I am sure all the colleges' respective
administrations feel similarly about their
efforts.
Be that as it may, admitting any prospective
student to any college of podiatric medicine
before they sign on the dotted line without full
disclosure of what they may be facing upon
graduation, and then bringing them into the
freshman class, is absolutely NOT CARING. Dr.
Eckles, and all well-meaning officials like him
across the country do not have the right to be
personally affronted until the disclosure I
describe is made. Once disclosure is made, and
students accept the risk (yet another question
of who would), then everything he states is
beautiful and just and correct. However, until
such routine disclosure, what he describes is
like promising to lead them to OZ and then
having an earthquake swallow up the yellow brick
road at the 'one more mile' marker.
Bryan C. Markinson, DPM, NY, NY,
Bryan.Markinson@mountsinai.org
04/08/2013 Joseph Borreggine, DPM
104 Applicants Not Matched for Residency Positions (Robert Eckles, DPM)
Finally, a voice of reason and clarity. Dr.
Eckles is the only person who makes sense. I
suggest that Dr. Eckles attend and speak at
every upcoming major DPM convention this year.
You need to speak to the masses. He has
summarized everything that should have been said
weeks ago when this happened.
He is right. I was one of the first critics who
responded to this matter on PM online and did
not have anything good to say because I was
reminiscing more about what happened to me 25
years ago. I did not have any facts to back up
what I was saying. For that, I sincerely
apologize for my ignorance on the matter.
You should make sure that these facts are
resounded by the APMA and CPME to the membership
and/or anyone who may know the facts. Silence
has been the mantra of these two organizations
as a response to this "so-called" crisis. Yes,
they both recently responded in a format letter
to the membership to explain what they are doing
for the profession in regards to policies
already in place regarding podiatry residency
programs. However, this did not even come close
to what you provided in your recent post.
Just one question? What took you so long? This
knowledge and impeccable wisdom you have on this
subject is exquisite to say the least.
I have been trying to establish new in roads in
downstate Illinois to develop podiatric
residencies ever since I was president of the
Illinois Podiatric Medical Association in 2009-
2010.
In the coming weeks, the IPMA and myself will be
trying to establish a meeting with the acting
CEO of the HSHS Medical Group, Melinda Clark
(mclark@hshs.org).
HSHS is the Health Sisters Hospital System
(www.hshs.org) and is 13 hospital system in
Illinois and Wisconsin that has the ability to
have multiple 3 year podiatric residency
programs. This would be a great success for not
only the profession, but for Illinois if this
were to happen.
I have been an active staff member at one the
hospitals affiliated with HSHS since 1999 which
is St. Anthony's Memorial Hospital located in
Effingham, Illinois. There are two other
podiatrists on staff there, but they do not do
as much surgery as I do since one of them does
more at a local surgery center and the other is
involved with the hospital's wound care center.
I probably do on average 2-3 cases a week which
is probably not enough to support a podiatric
surgical residency, but if we were to combined
the cases of two other hospitals that are within
the HSHS system this may be feasible.
The other hospitals of which I speak of are St
Mary's Hospital in Decatur, IL and St. John's
Hospital in Springfield, IL. These hospitals are
located in much larger metropolitan area and
have many more on staff podiatric surgeons that
would increase the number of surgical cases
necessary to establish a 3-4 position 3 year
podiatric surgical residency.
Therefore, I strongly urge and suggest that you
assist me in this endeavor and send an email
correspondence to Melinda Clark at HSHS and to
one of her colleagues Peter Mader
(pmader@hshs.org) educating them on exactly how
and why a podiatric surgical residency program
should established at HSHS.
As a side note, Melinda Clark is an RN, BSN and
is quite knowledgeable of the podiatric
profession and its importance in health care
because was a affiliated with a podiatric
residency when she work in Texas as a hospital
administrator.
There are also other opportunities in Champaign,
IL that could be another place for a podiatric
residency, but for some reason none have ever
been established.
There are leaders in our profession who
currently practice in Champaign, IL that have
yet establish a podiatric residency. Drs. Kim
Eickmeier (PICA board member) from the Christie
Clinic and Sean Grambart (ACFAS Board member)
from Carle Foundation Hospital who I have tried
to contact on many occasions in the past few
years regarding this matter, but to no avail
there has been little or no action or response
on the matter.
If you could also help me in educating these
individuals by contacting them personally, I
would greatly appreciate it.
Another concern that is currently affecting
Illinois podiatrists is the legislation that was
passed in July 2012 to help save $7.9 billion in
the Public Aid program. This law called the
SMART act restricted the ability for DPM's in
Illinois to only see children from ages 0-19 and
only diabetics from 20-64.
This restriction of patient access has
unfortunately eliminated the ability for the
podiatric residencies to see these patients and
hence has decreased the number of potential
surgical cases that may be seen by a podiatric
residency as compared to a year ago.
This is unfortunate and could be damaging to
currently established or the potential
development of new podiatric residency programs
if it is not remedied.
The IPMA is currently working to solve this
issue by trying to carve out any hospital or
teaching institution from the SMART act that is
currently training and/or educating podiatric
students or residents. This will allow these
institutions to see public aid patients without
restriction of age or disease and be reimbursed
fully for the services provided. It will also
provide the ability for those patients requiring
care to receive proper, timely, resolute, and
cost-effective care by our profession.
Again, I thank you for clarifying what is and
has been happening regarding the podiatric
residency shortage along the pertinent facts and
necessary solutions to this situation. I look
forward to your response and assistance in
developing residency genesis in Illinois.
Joseph Borreggine, DPM, Charleston, IL,
footfixr@consolidated.net
04/03/2013 Robert Bijak, DPM
104 Applicants Not Matched for Residency Positions
Numerous opinions have been proffered to solve
podiatry's educational problem except the
correct one. The correct solution is to realize
that the foot and/or ankle is too narrow of an
anatomical/disease entity to necessitate the
present number of graduates and residents.
The answer is to change the DPM to a full scope
specialty emphasizing lower extremity and gait
uniquely, as Osteopathy is full scope with its
unique philosophy of musculoskeletal-nervous
system etiology. This will immediately make the
graduates useful to hospitals and patients who
in reality need residents deemed to be FULLY
medically educated for the myriad of disease
entities and trauma seen in the real world, not
ELECTIVE, MINOR medical conditions and surgery
that makes up MOST of podiatry now.
This is not a new concept, and has been heralded
by the majority of the profession with the
exception of the colleges and APMA, who choose
to cling to their anachronistic fiefdoms.
Perhaps then, the American Board of Podiatric
Medicine can have more relevance than being a
consolation prize for those who didn't qualify
or pass the surgical boards.
Calling ourselves physicians is not enough. We
must actually become physicians. Podiatry is
like dentistry in many ways, and it is just as
inappropriate to tell students they're becoming
physicians as it is for a dentist to introduce
himself as a physician at a cocktail party.
Let's become real doctors, or stay podiatrists,
accept our limitations, and shut up. We can't
straddle the podiatrist- doctor fence any
longer. Jump on one side or another.
Robert Bijak, DPM, Clarence Center, NY,
rbijak@aol.com
04/03/2013 Leslie Levine, DPM
104 Applicants Not Matched for Residency Positions
Call me cynical, but here is my take on the 104
unmatched students. It's all about playing in
the insurance company reimbursement sandbox.
First, we need a little history. Back in
late '60s or so, a group of podiatric surgeons
from the American College of Foot Surgeons
grandfathered themselves in as Fellows, and in
doing so, convinced insurance companies that
they should be allowed to form panels.
A short while later, the sandbox was getting
full. The Fellows then formed the American Board
of Podiatric Surgery, guess who were
grandfathered in as Diplomates?
When it became obvious that the sandbox will
soon be crowded again, the state podiatry
associations which are usually top-heavy in
ACFAS and ABPS members managed to lobby various
state legislatures that it would be in their
constituents best interest to require
podiatrists to have a 3-year residency. The fact
that the public was served quite well for years
with non 3-year residency podiatrists did not
concern them.
Now enter the formation of the Podiatric Medical
Assistant. What a wonderful thing - the 104 non-
matched students and future non-matched students
can now work for a podiatrist. They can earn a
living (how they are supposed to pay back their
students loans is of little interest) but not
crowd the sandbox.
Leslie Levine, DPM, Orangeburg, NY,
LILevine@aol.com
04/03/2013 Chuck Ross, DPM
104 Applicants Not Matched for Residency Positions
I have been following the ongoing discussion
relative to the residency shortage and would
like to supply a little historical perspective
as I have not yet seen this appear.
Approximately 15 years ago, I was fortunate to
have been employed at NYCPM and was asked to
participate in a meeting of a coalition of
podiatric organizations that met in Washington,
DC to cover a variety of important issues.
My most memorable experience was being chastised
by one of the members representing the APMA, who
later became one of or Presidents. (I absolutely
knew from where this was coming and it was not
taken as a personal chastisement). The discourse
went as follows (please allow some
editiorialization due to the passage of time).
Q: What is NYCPM doing to reduce the number of
new students as we are faced with a tremendous
shortage of residency programs? (remember this
was 15 years ago and the 3-year mandated model
was not even a pipe dream).
A: I am unaware that there were restrictions
that were required to reduce the number of new
students. (Also remember that ALL the colleges
were tuition-driven at that time with several
experiencing some financial difficulties)
Q: Can you speak for your president?
A: How can anyone in this room speak for their
president in making a decision to reduce the
number of students? (How could I be expected, as
an Associate Professor in Biomechanics &
Orthopedics and a newly assigned Dean for
Student Services, be expected to make such a
monumental decision for my president. How could
I possibly know all the inner workings of the
College and why would the president assign me
that task-not that I would expect that he would).
So you see, we had a problem 15 years ago and
this is not new. What transpired during that
time may best be left for the greater minds in
Podiatry to ponder as to what may have been done
differently. Like everyone else, I too have my
own opinion but shall remain silent as I do not
believe many wish to hear what I have suggested
for a long time.
This is not meant as a condemnation of anyone
involved, but merely as a point of historical
information of what occurred 15 years ago with
no apparent long term proposals. Perhaps no one
could have anticipated this outcome but I
believe that there were always some visionaries
who could have created change if those in
authority cared to listen with an open mind.
Chuck Ross, DPM, Pittsfield, MA,
cross12@nycap.rr.com
04/01/2013 Alan Sherman, DPM
104 Applicants Not Matched for Residency Positions (Bryan Markinson, DPM)
It is remarkable how often I agree with Dr.
Markinson – and his last comment on this topic
is no exception. Going back to a preceptorship
model is just wrong, we do need a lot more
podiatrists, but we don’t need to train more
advanced podiatric surgeons. There is a catch-22
situation in podiatric training that isn’t
discussed much (I’m not sure why) but it is
the “elephant in the room” during every
discussion on podiatric post-graduate education.
It goes like this:
In order to get on insurance panels, you must be
on a hospital staff. In order to be on a
hospital staff, you must be board certified or
board eligible. In order to be board certified
or eligible, you must do a recognized residency
program
So in effect, in order to get paid by insurance
companies, even for non-surgical services, you
must do a surgical residency and get trained as
a surgeon. So in recent years, since the change
to the 3-year PM&S model and now Vision 2015,
all podiatric residency programs are now
surgically-oriented and there is a shortage of
them. What we need is advocacy to hospitals that
a podiatrist needn’t be a reconstructive surgeon
to be a valuable member of the medical staff.
I think that with the growth of hospital
affiliated wound care centers, they would
understand that every staff podiatrist doesn’t
need to do reconstructive surgery or
amputations. And then we need to develop the
infrastructure of podiatric medical training
programs – not because there isn’t enough
surgery, but because we need more podiatric
physicians.
Alan Sherman, DPM, Boca Raton, FL,
asherman@presentelearning.com
04/01/2013 Mark A Caselli, DPM
104 Applicants Not Matched for Residency Positions
As a former professor of orthopedic sciences,
director of both residency and fellowship
programs, and concerned podiatrist, I
respectfully submit this emergency plan to
provide our current unmatched graduates a
residency program that will qualify them for a
state license to practice podiatry.
1) The CPME must re-instate the RPR/PPMR/POR/PSR-
12 one-year residency programs. The guidelines
are already established.
2) The CPME must permit the colleges of
podiatric medicine to sponsor one-year residency
programs. The colleges already have qualified
faculty/clinicians to train the residents as
well as having established clinical rotations
into which the residents can be placed. Even
though this would be a tremendous amount of work
for the colleges, they have a moral, ethical,
and potential legal obligation to place their
students. This would also be financially
advisable for the colleges by protecting their
recruitment and enrollment of new students as
well as retaining their current students who may
now be thinking of leaving. Hospitals as well as
other health care facilities should also be
encouraged to pursue this path.
3) These new residency positions must be ready
to take in students in July, 2013 in order to
decrease the compound effect of the residency
shortage for future graduating classes.
4) The ABPM must provide a provision for
graduates of these one year programs to obtain
board certification.
5) This emergency plan must remain in effect
until there is at least a slight surplus of 3
year residency programs.
This proposal may not provide the ideal
residency experience for all, but it would
provide an educational experience at least as
good as that attained by the numerous (probably
majority) of competently practicing podiatrists
who are products of one of these one year
programs. In addition to aiding our students, it
is vital that this residency situation be
immediately resolved to maintain the credibility
of our profession.
Mark A Caselli, DPM, Ramsey, NJ
markcaselli@gmail.com
03/30/2013 Joseph D. Pasquino, DPM
104 Applicants Not Matched for Residency Positions (Jeanne M. Arnold, DPM)
In an answer to certain of the concerns about
the Residency Shortage raised in the letter from
Dr. Arnold, I direct PM News readers to
Resolution 13-13
(http://www.apma.org/files/secure/index.cfm?
FileID=22091)presented to the March 2013 APMA
House of Delegates by the Pennsylvania Podiatric
Medical Association and seconded by the New
Jersey State Podiatric Medical Association. This
Resolution is on the APMA website and it
contains the most up to date facts concerning
residency development that we could determine.
If the current programs in development are
authorized, we are told that will have a
sufficient number of first year residency
positions within 12 to 18 months. That period of
development, however, will cause there to be
well over one hundred prior graduates who are
not matched.
The purpose of this Resolution was to foster the
development of educational opportunities which
would keep those hundred plus graduates involved
in podiatric education until they can match.
This Resolution calls upon all stakeholders in
this profession to contribute to this effort to
create opportunities for these graduates. We
need the APMA to publicize this effort, we need
the AACPM and the CPME to define the
requirements for opportunities which would be
effective and we need practitioners to open
their doors, undertake these opportunities and
help these graduates.
AAPPM has created a model. This may not be the
only one, but it is a demonstration that relief
can be manufactured. Last year their program
served over 20 graduates and the vast majority
of those participants matched a residency this
year.
Many of Dr. Arnold's other points are quite
valid and should be employed in an examination
of the lack of foresight that led us to this
point; however, right now we need to press
forward and solve this shortage as well as care
for the disenfranchised graduates who will need
opportunities in the next three years.
What we MUST convey to the students is that the
profession knows about this problem, cares about
this problem and is doing something to eliminate
it. Discussion such as this is an important
element in conveying that message to the future
of this profession.
Joseph D. Pasquino, DPM, President, Pennsylvania
Podiatric Medical Association,
jdpasquino@comcast.ne
03/30/2013 Michael J Marcus, DPM
104 Applicants Not Matched for Residency Positions (Lawrence Oloff, DPM)
About six years ago, a college grad called my
office and asked me if he could shadow me. He
spent several weeks with me. In time, he became
turned on to our profession. He applied to the
colleges, was accepted to Scholl, and did
satisfactory in his didactics. As March 20th
approached, I spoke to him and wished him luck.
At the same time, a student from Temple is
rotating in my clinic. He too was anxiously
awaiting the big day. The fourth year student
from Chicago didn't get a match.
My present student was fortunate to get a good
solid program. He was ranked in the top 20% of
his class. However, he has told me that some
students who had ranked even ahead him didn't
match. These students are frustrated,
discouraged, mad, and in a financial bind.
It appears that this calamity has caused many of
us to write in our thoughts. I have read my
respected friend, Dr. Larry Oloff's words
carefully-- his frustration and disgust about
this situation is apparent. This situation not
only affects these unmatched students-it affects
us all.
For more than twenty years, I have been involved
in residency training. In the last few years, I
have been increasingly impressed with the
quality of the surgical residents. However, I
didn't always feel this way.
Something needs to be done now to help these
unfortunate students, and something needs to be
done to prevent this from happening again
A task force needs to created ASAP to see if
positions or new residencies can be established.
I personally have worked with a program that is
closing. Why? Possibly, they should be contacted
and encouraged to continue to offer positions.
Dr. Oloff's suggestions should be considered.
The colleges need to reduce class sizes, either
through matriculations procedures or by
increasing requirements for college acceptance.
It is evident that there are too many graduating
students with not enough residencies - as a
profession. The association that most of us pay
handsomely to, must make a decision--do we want
quality or quantity? An explanation from our
association would be appreciated. I too am
discouraged, saddened and surprised by this
apparent lack of vision and consideration to
these students.
Michael J Marcus, DPM, Montebello/Irvine, CA,
ftmed@aol.com
03/29/2013 Parent of Podiatry Student
104 Applicants Not Matched for Residency Positions (Lawrence Oloff, DPM)
I am disturbed that the student’s point of view
has not been discussed. As the parent of a
current student, I have to bring up what is
happening in the schools now. The students are
freaking out over this. The rumors flying around
are that the pathway to fixing this problem is
to fail as many of them as possible, if not
through the 4 years, then by making the boards
harder to pass. This is totally unacceptable.
They are stressed enough getting through the
rigorous curriculum without having to worry
about residency shortages.
When our child was applying, we were told time
and again that “everyone who passes the boards
gets a residency.” First, we have to make sure
that someone is overseeing this to protect all
of our students. We need transparency: we need
to know the number of students who entered each
class (for the last 6 years or so), how many
dropped out, how many were added after the class
began (for example, failed one year and re-
entered), how many graduate, how many passed the
boards and how many got a residency and how many
residency applicants are applying from prior
year classes. We also need to know how many
approved and functioning residency positions
there are.
As to solutions:
1. The first step is to immediately move back
the requirement for 3 years of residency until
such time that there are enough positions.
2. Change Vision 2015 to Vision 2020. Include in
Vision 2020 the need to closely link admission
rates to number of residency positions.
3. Or perhaps consider changing the 3 years
of “residency” requirement to 3 years “post
graduate training” – which would allow 1 of
those years to be a preceptorship. Change some
of the 3 year residency programs back into 2
year programs and link them to a preceptor year.
4. Put a temporary limit on the number of
students accepted into the schools until the
residency shortage resolves, and ensure that all
current students will not in any way be
sacrificed.
5. It is not acceptable to “fix” the problem by
failing current students at a higher rate than
previous years. This is not the fault of the
students.
6. The schools must accept responsibility and
not accept students just to get increased
revenue from tuition. If there are too many
students, why accept more students in January?
This problem should be addressed by the schools
with honest, open discussions with the students.
All students get PM News and are reading about
this problem. They should be assured by the
schools that there will be no attempt to fail
students to solve this problem.
Finally – there are rumors that schools are
handling this problem differently. Some schools
are intentionally trying to force students out
by lowering grades so more fail, but other
schools take the opposite track – inflating
grades so their graduates have a better chance
of getting a residency.
Parent of Podiatry Student
03/27/2013 Lawrence Oloff, DPM
104 Applicants Not Matched for Residency Positions
The residency shortfall this year is a crisis of
monumental proportion. I don’t think that candy
coating this does anyone any good. I have read
remarks like “finger pointing will not help.” I
disagree. Until you can clearly define why this
happened and who is responsible, there will be no
way to safeguard against this happening again in
the future. This is a travesty for the students
who now have to make sense out of the tens of
thousands of dollars and countless hours of
studying that they devoted to a career choice that
has led to a dead end. This is a travesty to a
profession that has worked diligently to seek
recognition and parity by allopathic medicine.
Remember, we always seem to be judged by our
weakest parts, not by our superstars. What will
this do to the recruitment efforts of the
colleges? What will this do to the quality of the
future applicant pool? Let me remind everyone what
the defined purpose of a residency is as published
by AACPM:
“Post-graduate training provides an orderly
progression from student doctor to competent,
independent clinician. Residency programs expose
the podiatric medical graduate to structured
learning environments and experiences in general
medical patient management along with training in
the diagnosis and care of podiatric pathology.
Similar to other medical specialties, this
training process occurs in teaching hospitals or
academic health centers throughout the country.”
So now, we will no longer be “similar to other
medical specialties” because twenty percent of our
graduates have not benefited from the type of
training that exists in allopathic medicine. It is
like in a split second our profession had taken a
giant step back in time. I am not intending to
understate the concerns about these students, who
are clearly the biggest casualties of this
problem, but also please understand how this
affects every one of us. The actual numbers of
unmatched students I am told are even worse then
published because it does not take into account
previous unmatched students from last year.
I would like to offer a suggestion to the mix of
suggestions offered by others. I think the schools
need to play a pivotal and immediate role here.
Each school needs to assume responsibility for its
unmatched students. We did this at CCPM back in
the early nineties when we recognized that the
pipeline for education is not four years but is
actually seven years. The schools’ role in
education should not stop with graduation because
education is not complete after four years. The
school has rotations for its students. These
rotations can be expanded for residency positions.
The residents can take a deeper level of patient
responsibility on these rotations then the
students. These positions do not need to be
funded; hence they can be initiated without
budgetary constraints. Having the ability to gain
licensure would be well worth it all things
considered. APMA should make some funds available
to initiate this process. These funds could be
used as discretionary funds to pay allopathic
medical facility faculty stipends to teach these
residents on their hospital/surgery center
rotations. There is ample time to make this
happen.
Final words. This should never, never happen
again. Part of the solution should also be to look
forward and correct the problem, whoever is at
fault. I can not think of any greater
responsibility for our associations and colleges.
Lawrence Oloff, DPM, Redwood City, CA,
lmop11@comcast.net
03/25/2013 Trevor Neal, DPM
104 Applicants Not Matched for Residency Positions (Ivar Roth, DPM, MPH)
I agree that preceptorships could be the answer,
but here’s the problem. Most states do not allow
preceptorship for licensure. They were removed
when there were enough residencies for every
graduate. And even though it was still “on the
books” in Michigan, I had to go before the State
of Michigan Board of Podiatric Medicine to get a
preceptorship approved.
After fighting to get a preceptorship approved
and having my preceptee complete a 2-year
preceptorship, she was able to get a full
license to practice, but unable to participate
with many of the Blue Cross policies because
they require you to be board eligible with ABPS.
To be board eligible, you have to have completed
a residency. Since 75% of our patients have some
form of Blue Cross either as their primary
insurance or supplemental it has put this young,
energetic and talented physician in a tough spot.
In addition, getting her hospital privileges was
a fight and at one of the hospitals she was not
granted privileges.
I have begun the process of starting a
residency, however the absolute soonest that
would be available is July of 2014. And even
that may be optimistic.
So, what happens with all these graduates who
have NO POSSIBLE WAY to practice with their
$250,000,000+ in school loans due? If the ABPS
would be willing somehow to make an exception
for graduates who have completed an approved
preceptorship that would go a long way.
Preceptees could then be designated as board
eligible and able to get hospital privileges, as
well as on provider panels for insurance
companies. They could then start acquiring cases
and ultimately become board certified. This was
the case years ago when there weren’t enough
residencies.
I have all the documentation that I presented
before the State of Michigan Board of Podiatric
Medicine which allowed my preceptorship to be
approved. I am willing to share this
documentation with anyone who would be
interested in attempting to get a preceptorship
approved in their state. Just e-mail me.
Sure it’s better if every graduate completes a 3-
year residency, but this situation is doing more
to damage the credibility of podiatry than
having these graduates who didn’t get
residencies out there with preceptorship
training.
Trevor Neal, DPM, Sturgis, MI,
balisong2000@hotmail.com
