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06/13/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2
RE: Unmatched Residency Placement Currently Stands at 92 (Usman Akrum, DPM)
From: Lawrence Kansky, DPM, JD
If it is true, as per Dr. Usman Akrum, that there are 92 qualified podiatric graduates unmatched to a 3-year residency program, and if each of these said doctors spent approximately $250,000 to obtain their DPM degrees, then approximately $23,000,000 of earnest money was wasted.
A class action lawsuit against those responsible for this epic professional disaster would not be unwarranted. Possible causes of action could be theft by deception, fraud, conspiracy, negligent misrepresentation, unjust enrichment, breach of contract, restraint of trade, and tortious interference with potential future contracts, etc. A large law firm in a major city would be best equipped to handle such a monumental professional legal case.
Regardless of any lawsuit, this residency crisis screams to those in podiatric power that our profession would exist best as a specialty of the MD world, where residencies would face less political malfeasance.
Lawrence Kansky, DPM, JD, Wilkes-Barre, PA, Larry.Kansky@gmail.com
Other messages in this thread:
07/26/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2
RE: NY Podiatrist, 70, Allegedly Fondled and Harassed 22-Year-Old
From: Michael Forman, DPM
I was distressed to read about the podiatrist who was accused by one of his podiatric assistants of inappropriate behavior. I was distressed for both the doctor and for the assistant. First, the charges are just charges until he is proven guilty. PM News, by re-publishing this story, defames the physician and besmirches his name. If he is guilty - shame on him. If he is innocent, shame on his assistant and shame on PM News.
Michael Forman, DPM, Cleveland, OH, im4man@aol.com
Editor's comment: PM News did not originate this story. We hate to print such stories and do so only to warn podiatrists of the potential legal minefields that exist in today's environment. Responsible media generally use the "probable cause" standard in deciding which stories to publish. Of the hundreds of legal stories we have republished in the last 19 years, only two alleged charges we are aware of have been disproven, meaning an accuracy rate of over 99%. Unfortunately, there is no way to guarantee 100% accuracy in anything. We are always happy to print stories of exonerated podiatrists.
06/19/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2
RE: Unmatched Residency Placement Currently Stands at 92 (Lawrence Kansky, DPM, JD)
From: Michael M. Rosenblatt, DPM
Recently, a DPM/JD suggested that a large law firm would be able to sustain a class action lawsuit against various defendants regarding the damages to the 92 DPM graduates who will not be able to qualify for state licensure due to no residency position for them.
There is an "automatic" and naïve assumption from the potential defendants that this will be impossible because new graduates are poor and cannot afford representation. But this a fallacy. There are large investment firms that...
Editor's note: Dr. Rosenblatt's extended-length letter can be read here.
06/11/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2
RE: Unmatched Residency Placements Currently Stand at 92
From: Usman Akram, DPM
I want to point out the injustice done to podiatric medical graduates. As of the last report, there still are 92 qualified graduates who remain unmatched but deserve a residency slot. Several practicing podiatrists have voiced their acknowledgement of this unfair scenario.
I am a graduate of 2012 who passed his NBPME steps 1 and 2 in my first attempt and stand in the middle half of my class. I was not successful in attaining a residency spot last year or this year because of the extreme shortage of residency spots. I believe I prepared myself really well for interviews this year and had 24 interviews. The residency directors who interviewed me told me how well I had performed in the interviews. However, I still did not match. This is all due to the drought of the number of enough residency positions. I understand that this has happened in the past, but the podiatrists could practice without residencies back then. Not so anymore.
I believe all the podiatric organizations and the schools are to blame for this debacle. Something has to be done for the 92 graduates. These graduates are in $250,000 debt, on average. All of us have no way of paying back our student loans or gaining residencies that we were promised if we passed our board exams and graduated from podiatric schools.
Usman Akram, DPM, Evanston, IL, utakram@gmail.com
06/07/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2
RE: NY Podiatrists Named to Head Residency Program
From: Jeffrey Kass, DPM
Congratulations to both Drs. Hertz and Gordon on their new positions. Honesty, integrity, and ethical conduct have finally been restored.
Jeffrey Kass, DPM, Forest Hills, NY, jeffckass@aol.com
05/28/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2
RE: We Walk in a Tripod Fashion: CA Podiatrist (Robert Phillips, DPM)
From: Kevin A. Kirby, DPM
To further add to the excellent points made by Dr. Phillips about the importance of weight- bearing function of the metatarsal rays, I believe that the biggest misconception most podiatrists have about the metatarsals is that they somehow have a “locking position”, where they will not dorsiflex further under increasing dorsiflexion loading forces. This is certainly not the case, and, unfortunately, seems to be a myth that is perpetuated from one generation of podiatrists to the next.
The metatarsal rays do not “lock”, like the ratcheting wrench, in a “fully dorsiflexed position” where they remain in...
Editor's note: Dr. Kirby's extended-length letter appears here.
04/30/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2
RE: 104 Applicants Not Matched for Residency Positions
From: Narmo L. Ortiz, Jr., DPM
According to the National Resident Matching Program's website, "The NRMP Main Residency Match® final data results show 99.4 percent of positions were filled, the highest position fill rate in NRMP history." I also found an interesting article by Jay Greene from Crain's Detroit Business where he quotes a report from the NRMP: "By the end of Match Week, 452 more U.S. seniors had obtained positions, leaving 528 with no position. Overall, 97 percent of U.S. seniors obtained positions in the 2013 Match, compared with 98.5 percent in 2012 when 262 had no position."
"There are many reasons why applicants don’t match. Some over-estimate their qualifications and apply only to very competitive specialties. If they don’t apply to and rank programs in less competitive specialties, they are in danger of not matching," an NRMP spokesman said. A full report on the 2013 Main Residency Match will be available in early May 2013 at nrmp.org.
Narmo L. Ortiz, Jr., DPM, Marietta, GA, nlortizdpm@embarqmail.com
04/26/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2
RE: 104 Applicants Not Matched for Residency Positions (Brian Kiel, DPM)
From: Jeff Kittay, DPM
I am sitting in my office, once again open-mouthed at what I am reading in PM News. Did I really just read posts from established doctors that state outright that some/most of the unmatched 104 are unqualified to be doctors and should consider another line of work? To my knowledge, every one of these 104 graduated from an accredited school and passed all sections of the National Boards, thus establishing themselves as qualified doctors.
In any group, there will be students at the top of their class, and those who, for a variety of reasons, do not perform as well academically. Regardless, they are all called "doctor". To place the blame for the unmatched students on their quality, or lack thereof, is patently unfair and does them a genuine disservice. "Realizing that perhaps medicine was not for you" is elitist in the extreme and atypical of Dr. Kiel's usually accurate comments.
No one is condemning the entire profession, only those in positions of authority for years who knew that this problem was coming and did little to prepare for it. While they may be suffering some embarrassing slings and arrows at the moment, the 104 are stuck with a degree and title they cannot use and insurmountable debt they cannot pay.
Jeff Kittay, DPM, Boston, MA, twindragons2@verizon.net
04/25/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2
RE: 104 Applicants Not Matched for Residency Positions (Jeffrey Kass, DPM)
From: Robert Scott Steinberg, DPM
Here's an idea. I suggest CPME start calling each residency director and ask what it would take for them to add another residency position. Prior to those discussions, CPME needs to make up their minds that they must find a way, before July 1, to solve this crisis. If the push back from residency directors is whether their existing resident might not make their CPME minimum case numbers, then CPME should be ready to reduce those numbers, at least in the short-term.
Getting a preceptorship is not a solution. It won't get them licenses, and it would just put them one year farther away from their goals. If CPME does not do something, this problem will just grow, with at least another 104 not being matched next year, and so on.
Robert Scott Steinberg, DPM, Schaumberg, IL, doc@FootSportsDoc.com
04/20/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2A
RE: 104 Applicants Not Matched for Residency Positions
From: J. Marshall Devall, DPM
I am sitting on my patio on my day off, reading Podiatry Management. Barry Block's editorial focuses on a fact we all at residency programs already know: over 100 graduates are scrambling for residency positions this year. We have received some heartbreaking correspondence pleading for positions. Some students must have e-mailed every program.
Scott & White was approved for two more positions, going from four to six, which we also feel we could manage with excellent training. We continue to expand our program by leaps and bounds, not only at...
Editor's note: Dr. Devall's extended-length letter can be read here.
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.
04/17/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2
RE: 104 Applicants Not Matched for Residency Positions
From: Judith Rubin, DPM
I received over twenty emails from these stranded applicants. I too think that they should go to residencies and offer their services for no pay. Sometimes, residents drop out for reasons of all kinds and you will already be there. There are many other professions who intern for a year or two without pay. As long as you get that certificate, with equal training, it is worth it. Believe me, I made $7,800 my first year and $12,000 the second year.
If you have loans from school, you can apply for a two-year hardship deferment. That is what I did, and then I got two more years at interest only. It is do-able. Be proactive, strong, and persevere. I promise you will make it. To the class of 2013, I give you all my best wishes. I know how hard you all worked.
Judith Rubin, DPM, Houston, TX, jrubinfoot@aol.com
04/15/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2
RE: MI Podiatrist Sentenced to Prison in Healthcare Fraud Scheme (Deborah S. Wehman, DPM)
From: Carl Ganio, DPM
I have practiced in Florida for 23 years, and have had the opportunity to see Medicare EOBs that patients have shown me from their podiatrists "up North", when they are visiting our community during the winter. I have seen it all. My patients would show me the debridement codes, avulsion codes, etc. and ask me to bill the same way (which, of course, I do not). I am sorry, fraud is fraud... and many of you have been knowingly doing it for years to maximize reimbursement.
I remember during my internships and residency trying to learn what medical and podiatric pearls I could from my Chicago mentors... but I did see many students hover around the front desk and office learning how to bill. Certainly, trying to figure out whether to bill an exostectomy vs. condylectomy vs. resection of the base of a phalanx may cause one to compare reimbursements and RVUs in order to improve reimbursement... but to knowingly bill an avulsion code spraying ethyl chloride on a nail margin has always been fraud.
I agree, that what we get paid is criminal. Look at the most recent poll on how many of us were unhappy with podiatry. Perhaps the really happy are performing more avulsions.
Carl Ganio, DPM, Vero Beach, FL, drcarlganio@veropodiatry.biz
04/13/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2
RE: 104 Applicants Not Matched for Residency Positions
From: Robert Kornfeld, DPM
There is a character in Chinese that means "crisis" which is composed of two characters that represent "danger" and "opportunity." The Problem: We have 104 unmatched graduates – the crisis. Urgent: These grads need to be placed in a training program and make money – the opportunity. Pervasive: There is a huge potential for lawsuits if they are not placed – the danger. Reparations: To assist in the “bailout” of our graduates, each licensed DPM, all colleges of podiatric medicine and our state and national associations offer a tax-deductible donation to create a program that can put these unmatched DPMs on the road to being trained.
My Offer: I am offering all the unmatched graduates a “pre-residency” fellowship in integrative podiatric medicine. I propose a one-year program that will thoroughly train them didactically and clinically in understanding the mechanisms of foot and ankle pathology (i.e., why and how patients cross the morbidity threshold), train them to identify these mechanisms, and establish thoughtful, patient-specific protocols to address these issues. This will give them a very strong background in the medical issues they will be called upon to treat as licensed podiatrists - the solution.
Rationale: This opportunity is for the 104 DPMs and an opportunity for us all to commit to supporting this program, the details of which I am already working on. Following the philosophy of collegiality, I welcome your input (DPMs, educators, and administrators).
Robert Kornfeld, DPM, Manhasset, NY, Holfoot153@aol.com
04/11/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2A
RE: 104 Applicants Not Matched for Residency Positions
From: Jeff Kittay, DPM
Editor's Note: The American Association of Colleges of Podiatric Medicine (AACPM) has just released an article titled "Residency Shortage: Continued Efforts to Find a Solution." This article can be read here.
As usual, Drs. Jacobs and Markinson have hit two nails on the head with one hammer. The gall that CPME, AACPM, and the collective colleges have to continue to recruit innocents, take their borrowed money, and then put them on the street with a half-hearted "well, we never promised you a rose garden", is nothing short of criminal. APMA and the ridiculous Projects 2015, or 2020, or 3000 just don't get it. Not every DPM wants to be a surgeon, and no one should be required to become one.
The state societies which have lobbied state legislatures to pass restrictive (and, I believe, unconstitutional) laws requiring 3-year surgical programs while there are insufficient...
Editor's Note: Dr. Kittay's 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.
04/10/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2A
RE: 104 Applicants Not Matched for Residency Positions (Robert Eckles, DPM)
From: Bryan Markinson, DPM
Dr. Robert Eckles is a scholar and a gentlemen whom 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...
Editor's note: Dr. Markinson's extended-length letter can be read here.
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
04/09/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2A
RE: 104 Applicants Not Matched for Residency Positions (Robert Eckles, DPM, MPH)
From: Allen Jacobs, DPM
In the movie Office Space, there is a classic scene wherein Peter (Rod Livingston) is explaining to Joanna (Jennifer Aniston) that he and his friends are merely diverging fractions of a penny as a rounding off measure to his bank account. "So, you're stealing" says Joanna. "No, we are taking the rounding off of the fractions of a penny," responds Peter. "So you're stealing," responds Joanna again.
Dr. Eckles' letter, in response to the residency shortage concern, was certainly exculpatory for the APMA, CPME, and COTH. Assurances were made by Western that, if approved as a school, residencies were already in place to compensate for the increased demand, for everybody. Nobody is to blame. The system is great. It is a well-oiled machine, just like Initech in the movie.
But we are still short 104 residency positions for our graduates. It happened under the watch of those responsible to assure us that no such problem would occur. Thank you for the explanation. Everybody has done everything correctly. That should certainly be reassuring to any unmatched graduate. No one is at fault. It was a rounding error. But Dr. Eckles, here's the reality: "So....you're still short 104 residencies." Like Jennifer Aniston in the movies, the answer is " yes."
Allen Jacobs, DPM, St. Louis, MO, allenthepod@sbcglobal.net
04/02/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2A
RE: 104 Applicants Not Matched for Residency Positions
From: Patrick J. Nunan, DPM
I think, unfortunately, that it is a sign of the times that residencies are shrinking. Hospitals are closing or merging at a rapid rate. It was not long ago when there were "certified preceptor ships" that students who did not match with a residency could get. I was fortunate thirty years ago to get a two-year residency. I knew quite a few very bright people who did not match. To say "follow a PA" is insulting and ludicrous. They will never have the technical skill that all of us have. Unfortunately, Obamacare will force many of us out of practice entirely. How about opening up certified preceptorships again to let many of us educate and give skills to the students who want them.
Judith Rubin, DPM, Cypress TX, Jrubinfoot@aol.com
It is interesting in how many people want to return to non-standardized training for our graduates. If we want parity with allopathic and osteopathic physicians, then we MUST have the minimal number of years that they require for residency - which is 3 years! Now we want to go back to the confusion of 1 year, 2 years, 3 years, and then throw in preceptorships? For those who have been on hospital credentialing committees, taught in residency programs, and were section chiefs, we got really tired of trying to explain all of our differences to other professions, who for the most part control the hospitals. Sorry folks, the answer is not going backwards!
Yes, this is a tragedy that never should have happened. Too many schools with too many graduates. The only solution now is for the colleges and others to step up and provide training for all. We have made great strides in this profession. We need to solve this problem together, and make sure it doesn't happen again.
Patrick J. Nunan, DPM, Huntington, WV, pjndpmrun@aol.com
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 2A
RE: 104 Applicants Not Matched for Residency Positions (Lawrence Oloff, DPM)
From: Michael Zapf, DPM, MPH, Neil H. Hecht, DPM
I am thoroughly dismayed at this situation. No one really disputes the necessity of modern post-doctoral residency training for podiatry. The details aside, I believe Dr. Oloff has made the only practical suggestion: the colleges of podiatric medicine must provide the required residency training to their graduates who do not match other residency slots in order to allow for licensure. Failure to do so might have legal consequences, but certainly the immorality of failing to do so is obvious, distasteful, ugly, and unacceptable.
CPME must immediately credential the colleges for these residency slots. AACPM must revamp its matching requirement to allow for college-based programs. Do it, and do it now. The unmatched graduates must have an immediate pathway to licensure. How can the colleges admit anybody to their current freshman classes without this?
Neil H. Hecht, DPM, Tarzana, CA, drhecht@drneilhecht.com
The fact that 104 of our graduates could not find a residency is appalling and unconscionable. At the time of enrollment, our podiatric medical schools should either guarantee that all students who graduate in good standing will find an approved residency or agree to refund their entire tuition if they do not. Without this guarantee, why would any prospective student take a chance on being one of the 10% who cannot use the degree they just earned?
Michael Zapf, DPM, MPH, Thousand Oaks, CA, mazdpm@gmail.com
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 2A
RE: 104 Applicants Not Matched for Residency Positions
From: Jeff Kittay, DPM, Jeanne M. Arnold, DPM
So here we are, again, discussing the untenable and immoral situation of having recruited bright, enthusiastic students, turning them into doctors, and then telling them, sorry, no place for you at the table, good luck paying off those loans. When some of those bright new doctors begin to sue the schools, APMA, and AACPM for selling them a bill of goods, that will be the beginning of fixing this self-created mess. Of course, a school or two must close. Of course, there must be a reduced pool of graduates, since it is unlikely that the number of residencies is going to increase significantly any time soon. Of course, states requiring a 3-year residency must relax their rules.
This is not just eating our young, it is preying on them so that the schools can survive - a ridiculous concept. Have we become so enamored of our exalted status that it's just too bad for those 104 unfortunates and those to follow next year? AACPM, where are your morals?
I have been following with interest the discussion concerning the 104 students who did not match a residency this year. I don't usually get involved in the politics of podiatry, but this is the biggest 'foul' I think I've seen in almost 30 years of practice as a podiatrist and am finding it hard to keep quiet. I understand that there are not enough residency programs, I understand that sometimes someone does not qualify for a residency, and I know not every graduate wants to be a surgeon. But to let 104 new graduates without a pathway to practice and pay back $100,000+ in student loans is not just a travesty, it should be criminal. Don't tell me that no one saw this coming. And don't tell me it's every podiatrist's fault because we don't all have a residency program of our own. Maybe our leaders shouldn't spend so much time with their heads in the proverbial sand.
Even more interesting are the solutions...
Editor's note: Dr. Arnold's extended-length letter can be read here.
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.
03/26/2013
RESPONSES / COMMENTS (NEWS STORIES) - PART 2A
RE: 104 Applicants Not Matched for Residency Positions
From: Eric M. Hart, DPM, Mark K. Johnson, DPM
Is anyone surprised that we need "comprehensive podiatric healthcare reform"? Everyone involved in podiatric medical training must share in the blame and must set aside their selfish interests to protect our profession. Practicing without a residency is not the solution and is not legal in many states. Cutting matriculation is a must, but not a solution alone. Raising standards within the schools is key. Admissions should be competitive, but realistic to forecasted residency slots (not hoped for residency slots). So please get together and have lunch - CPME, AACPM, APMA, and each school dean.
I am proud to call myself a podiatrist, but I want my profession to be continually defined by "Today's Podiatrist" and not by yesterday's chiropodist. What was "good enough in the past" is not "good enough for the future" in any field of medicine. Let's pick ourselves up, pull our hands out of students' pockets, and evolve our profession together. As a father, I want my children to be better than me in every way... why should I want any different for our profession's upcoming generation?
Eric M. Hart, DPM, Bismarck, ND erichartdpm@gmail.com
As I read the disappointing news that fares not so well for 104 podiatric students, I was reminded of our graduating year from TUSPM (PCPM) in 1983. That particular year saw NO MATCHING SYSTEM in place for CASPR, and, having been unsuccessful in obtaining a residency, I spent a year preceptorship with Dr. Jeff Yale in Ansonia, CT. I was grateful for that opportunity, but re-applied and was accepted to the PSR-24 at the former Kern residency in Warren, Michigan.
While preceptorships can provide great general podiatry/surgery/management training, I believe residencies should be available for all graduates. Does it have to be three years? Perhaps it is time to reconsider the number of graduates, the demand for three year trained graduates in the future, and the options. Why does it have to be all or nothing regarding foot surgery? What is wrong with 12-24 month programs that teach solid forefoot/midfoot surgery, wound care, etc.? Is there no middle ground in podiatry now?
Could not the three-year route be an OPTION for sub-specializing for those podiatric physicians who wish to do ankle/rearfoot/lower leg procedures? Perhaps it is time for the APMA to step back and consider the alternatives. Maybe another vision? I don't have all the answers, but these questions should probably be asked.
Mark K. Johnson, DPM, West Plains, MO, ddr004@centurytel.net
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