08/26/2013    Juliet Burk, DPM, Muskogee, OK

I Want to Work as a Podiatrist (Brian Kiel, DPM)

Brian, I’m sure you meant well, but ascribing a
professional failure as a possible personality
problem is absolutely not helpful or kind. You
have no way of knowing if it is or isn’t true,
and it serves no benefit to say, unless it is to
absolve yourself of personal guilt for the
current situation in podiatry, as well as to
unnecessarily hurt someone’s feelings. I for
one, struggled very hard to carve out a niche
professionally.

I was personable, graduate with distinction, and
did not even attend match in my graduation year
because, as a female, I had other priorities.
One, I wanted a residency within driving
distance of my husband (men don’t usually have
to be as accommodating, but for women, it’s a
big deal). Two, I had an infant. This meant that
I would only personally accept a residency in a
town where I had access to family so my child’s
upbringing was not compromised. (Again, not a
personality issue, but a female/family one).

It turns out there was only one residency in the
country that matched my criteria, and they
didn’t participate in match, and I knew in
advance they didn’t want me. I was lucky enough
to get it anyway. But only one of my two
criteria was met. My husband was in residency
in Utah, and I was in New York. But my child was
taken care of. He is now 18.

Had I not “matched” with my one program, I don’t
know if I would ever have practiced. Females
have a lot more things we care about other than
being called surgeon. It would have been safer
to assume that Dr. Montgomery was a caring
female, and put others first, rather than she
had a personality problem. In fact, it probably
makes her a better potential doctor than most.
Most doctors struggle with putting greed first,
rather than patients first, which brings me to a
second observation about what I think has ruined
podiatry.

The whole three-year residency requirement has,
in my estimation, ruined podiatry. I’m not sure
it is fixable unless we make drastic changes
fast and reinstitute one year non surgical
options. First, podiatry cannot shake its stigma
as the place to go when you can’t get
into “real” medical school. It had a chance,
when it valued non surgical palliative care
(yes, chiropody, gasp!), biomechanics, and
surgery existed only as a subspecialty. It could
have carved a real niche of expertise that older
podiatrist still maintain. However, no one in
their right mind would enter podiatry now as a
profession with a significant chance of wasting
a six figure investment.

People who are smart, who enter podiatry for the
sake of the craft (in which group I place
myself) won’t do it. From year one of podiatry
school, I was constantly fielding questions as
to “Why didn’t I go to medical school? You mean
you could get in and didn’t go? Are you crazy?”
and looks of incredulity combined with “You
don’t want to do surgery?”

At that time, the two top students in school
(myself and another female) were attracted to
the NON surgical aspects of podiatry and both
expressed no desire to do surgery. I can’t speak
for her (my co-graduate with distinction), but I
have never performed an osseous surgery and have
never once missed it. Nor has my income or self-
esteem suffered for the lack. But alas, I am a
dinosaur. And I would never have enrolled in
podiatry school to become a surgeon. I would
have gone to medical school. And I certainly
could have.

Podiatry as a first choice profession was
possible in the mid-90’s. Now, because of
vision 20-20 (or whatever the heck the
podiatrists with short man syndrome are calling
it these days), podiatry is exclusively a third
tier medical school choice (After MD and DO).
THAT is the result of three-year residencies.
Now we really are just wannabe orthopods. We
have thrown out the chiropodists and
biomechanists and wound care
specialist “only’s.” Congratulations.

I went into podiatry because I would rather
enjoy the mechanics of the feet than have to
deal with sick people, sore throats, and rectal
exams.

I have put away a nice little college savings
plan for each of my children (who I was able to
put first as a non-surgical podiatrist), and
only have one caveat: they can use it to pay for
any college they want, as long as it isn’t
podiatry school.

Juliet Burk, DPM, Muskogee, OK, juliet-
burk@cherokee.org

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08/28/2013    Ron Raducanu, DPM

I Want to Work as a Podiatrist (Brian Kiel, DPM)

Dr. Kiel does not seem to really
be "in the loop" with these poor colleagues of
ours who have been left out in the cold. Firstly,
this year there was an overflow of 59 graduates
re-entering the residency hunt. This is extremely
taxing on the system we've implemented.
invariably, some get programs, while others don't.

Those who don't get a program are faced with a
situation where they are no longer immersed in
the academia of podiatry, and in many cases they
can't even practice because there are only a
minority of states that don't require a residency
before granting a license to practice.

So what are they to do? Well, they find a job to
make ends meet and hope to land a residency in
the next cycle. They teach college courses, are
medical assistants, surgical assistants, and some
even get clerking jobs, or Starbucks if they have
to. They have student loans to pay back!

The other issue is they don't get face time with
residency directors as much anymore. Sure they
can go to conferences and meet and greet at the
programs they hope to get, but it may not be as
beneficial to them as a student who is there for
a month, externing. If the program has a slew of
quality externs and have to chose, do you think
they are going to take a chance with someone who
only visited a couple of days and already has the
stigma attached that they didn't get a program
the first time around? These non-matched doctors
also can't go there and stay and serve as an
Extern because of malpractice issues.

Do you think they can afford to pay for
malpractice if they don't even have a practice or
are not making a living in podiatry? As a
student, it's inherent through the school, but
once you are a graduate, you don't qualify for
that malpractice any more.

Academically, you should be very sharp during
your 4th year in school. Use it or lose it is the
old saying, and even though these unmatched
graduates can keep up with their academics, it is
difficult to compete.

I've been there, done that. I didn't match with a
surgical program the first time around and was
VERY lucky to have landed an excellent program
which was only looking for those of us with a
year of medicine residency. There is not that
option anymore, and it should be.

There are so many issues to face. Let's help
these guys and gals out. There is no reason not
to. In my blog, I offered a very reasonable
solution that I feel is attainable. Many of us
have a lot to offer in our offices and can
certainly give these unmatched graduates the
tools needed to succeed even if they won't be
surgeons. There is a need. We just have to make
it happen with the APMA and CPME's help.

Ron Raducanu, DPM, Philadelphia, PA,
kidsfeet@gmail.com