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04/09/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2B
RE: 104 Applicants Not Matched for Residency Positions
From: Robert S. Schwartz, CPed, Ivar E. Roth DPM, MPH
104 podiatrists could learn pedorthics and gain valuable experience in conservative foot care they will use throughout their podiatric career. They can get internships at pedorthic and other healthcare facilities and sit in and fit retail shoe stores, earning income while learning how to use pedorthic products and techniques to help people. Pedorthists help manage the most extreme mechanical foot deformities and disorders, a great training for every podiatrist. Perhaps it’s time to review the curriculum and make room for pedorthics.
Robert S. Schwartz, CPed, NY, NY, rss@eneslow.com
Having completed three years of surgical residency almost 30 years ago gives me some perspective on this matter. The more quality surgical training, the better. We ARE the experts of the foot and ankle, and all of us must be prepared to handle any problem with great skill and dispatch. Three years of training is never wasted, BUT the new graduates have to be realistic that if they enter private practice, it could be slow for quite a while.
Emphasis still needs to be given to providing and possessing great office skills, and this is where office rotations, working in a podiatry clinic, and working up ALL patients is still needed. During a residency, the diagnostic skills for surgical work-up or conservative care are very much required. There are many fabulous opportunities in our profession. All providers need to do is open up their eyes and make it happen. If we sit back and complain, nothing will happen. Meanwhile, the powers that be must be held accountable to provide the programs that are necessary for this training. Where there is a will, there is a way; now make it happen.
Ivar E. Roth DPM, MPH, Newport Beach, CA, ifabs@earthlink.net
Other messages in this thread:
04/20/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2B
RE: 104 Applicants Not Matched for Residency Positions
From: Jeffrey Kass, DPM
I was wondering if there was any update on the residency crisis other than CPME offering to allow existing programs the ability to increase their residents if they wanted. This "solution" is at best anemic as evidenced by the response the current programs have given. Is this the best and only response we as a profession can offer?
Fellowships are typically offered after residency programs. I propose we do things backwards as after all, this is how we seem to have gotten into this quandary. Offer these deserving students fellowships. I propose mandating the podiatry schools open one-year fellowships for...
Editor's note: Dr. Kass' extended-length letter can be read here.
04/10/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2B
RE: 104 Applicants Not Matched for Residency Positions
From: Thomas Graziano, DPM, MD
This discussion may go on indefinitely because the leadership in our profession has failed to address an important key issue. Podiatrists are limited license practitioners. Our model should parallel that of another limited license profession that has done well for quite some time, namely dentistry. The powers that be have painted our profession with a rather broad brush stroke. They are working toward a mandate that everyone who enters podiatry school have a 3-year residency program and be a "surgeon."
Any of us who have been in the business long enough realize that...
Editor's note: Dr. Graziano's extended-length letter can be read here.
04/02/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2B
RE: 104 Applicants Not Matched for Residency Positions (Bryan Markinson, DPM)
From: Brian Kiel, DPM, Hilaree Milliron, DPM
Dr. Markinson was absolutely correct in his assessment of the residency "crisis." This is a self-made crisis instituted by the "leaders" of our profession. No one and I repeat, NO ONE needs a 3-year surgical residency to be a successful podiatrist. It is necessary if one wants to perform extensive, complicated surgery but honestly, how many of those procedures are presented to anyone in a given year? Obviously not enough for all these surgeons to make a living. Post-school training is a necessity, but there must be various levels of that training and concomitantly various levels of licensure. Why should one need to have 3 years of surgical training to perform an arthroplasty or a bunionectomy? Why would one need to have 3 years of surgical training to cast a patient for orthotics or a Richie brace?
I have been in practice for 38 years and have done thousands of surgical procedures, but if I depended on surgery to provide an income, I would no longer be in practice. We are not by definition "surgeons." We are podiatrists, and one part of what we do is surgery. To pretend otherwise is to be blind to the fact that we are slowly destroying our profession and the service we provide to the public.
Brian Kiel, DPM, Memphis, TN, footdok4@gmail.com
Let’s say there is an imminent nuclear attack on the United States. Mass panic occurs throughout the nation. What do you expect your leadership, the President, to do? The citizens would demand some form of public address with a plan of action in response to that imminent threat. This may seem like a melodramatic metaphor for our residency shortage predicament, but on a scale of zero to bad, this is very bad for our profession. Our leadership needs to step up and go public with a specific plan of action now.
Desperate people often do desperate things. Just look at the panic...
Editor's note: Dr. Milliron's extended-length note can be read here.
03/28/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2B
RE: 104 Applicants Not Matched for Residency Positions (Lawrence Oloff, DPM)
From: Richard A. Simmons, DPM, Victor S. Marks, DPM, MPH
From what I have read about this problem, it appears that the entire business model concerning podiatric residencies has been changed, yet the profession seeks the same results. It used to be that upon graduation, DPMs could matriculate into a residency program that paid the doctor a stipend. With all of the cutbacks occurring in medicine, it may be that some graduating podiatrists may need to pay for their residency training. As regrettable as this may seem, it may be inevitable. Perhaps, some of the programs that had to close because of funding could present this option to those who are graduating this year without any hope of a residency program. It is definitely time to think outside of the box.
Richard A. Simmons, DPM, Rockledge, FL RASDPM32955@gmail.com
I am in favor of reducing the length of residency required for licensure. This problem has been going on for too long, and is getting worse, not better. A mandatory 3-year program just isn't necessary and seems to be unattainable for all. Too many lives have already been unnecessarily shattered.
Further, when reporting such data, it's appropriate to give a denominator (i.e., 104 out of how many total students). Percentages give a more accurate picture.
Victor S. Marks, DPM, MPH, Scarsdale, NY, vicsmarks@aol.com
Editor's note: the number 104 represents current and recent graduates who were qualified, but did not match. 79 of those 104 are current graduates. The graduating class size is 576, so the percentage of non-matched grads is 13.7% (not counting those who did not pass Part II of the Boards).
03/27/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2B
RE: 104 Applicants Not Matched for Residency Positions
From: Lawrence Oloff, DPM, Robert Kornfeld, DPM
The residency shortfall this year is a crisis of monumental proportions. 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...
Editor's note: Dr. Oloff 's extended-length letter can be read here.
Podiatry has a short history as a specialty in medicine, but a long history of doing things ass backwards. In our angst to become credible as a profession, we have tossed aside many brilliant and talented podiatrists. First, it was the elimination of board certification without a residency. Then, it was the elimination of licensure without residency training. Now, it is an even bigger, more pervasive problem then ever before. We are graduating podiatric medical students and not providing the "required" training that enables them to become licensed to go into practice.
Creating more residency slots is of utmost importance as a symptom management, but
Editor's note: Dr. Kornfeld's extended-length letter can be read here.
06/07/2011
RESPONSES / COMMENTS (NEWS STORIES) - PART 2b
RE: Reflexology Massage Can be a Good Thing (Charles Morelli DPM)
From: Robert Scott Steinberg, DPM
While I can see Dr. Morelli's position, to a point, how then does his referral not give huge credibility to all the things reflexolgists do? Does he believe there is a benefit to those adhesive detox pads reflexologists push? He states that he does not believe that rubbing the foot will improve the condition of the liver. Does he give his patients a list of dos and don'ts when they visit the reflexologists?
Robert Scott Steinberg, DPM, Schaumburg, IL, doc@footsportsdoc.com
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