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02/17/2020 Allen Jacobs, DPM
What Kind of Podiatrist Do Today's Residents Want to Be? (Martin M. Pressman, DPM)
In 40 years of working alongside podiatric residents as a residency director and mentor, never have I heard any resident tell me that primary care practice represented their first choice. Never. Particularly now when we have outstanding three-year residencies and fellowships, I have yet to meet a resident who desired non-surgical practice at the completion of such training. I have long been a strong advocate of advancing education in the non- surgical aspects of podiatry and continue to do so. However, the comments of Dr. Sherman and his alleged survey results are simply not consistent with my experience in working with residents to this day.
I should further like to point out that as a result of the excellent training which our residence now receive, most of the residents with whom I personally have worked have an excellent understanding of primary care podiatry and aspects of general medicine such as rheumatology, dermatology, vascular disease, biomechanics and kinesiology, endocrinology, and internal medicine, and neurology as these sciences relate to the daily practice of podiatric medicine. The three-year residency experience in my opinion has been a tremendous success, and one of the best additions to our profession that I have witnessed since starting in the practice of podiatry in 1975.
As Dr. Pressman pointed out, these “kids“ are receiving the best training In foot and ankle surgery that is available. I personally enjoy lecturing and leading discussions in areas of primary care podiatry given the fact that numerous other opportunities are available for advancing knowledge in the surgical arena. To reiterate, I believe I have greatest appreciation of the medical aspects of our profession. I thoroughly enjoy office practice. However, the suggestion that a substantial percentage of our current graduates do not seek a surgically based practice is likely not correct.
Allen Jacobs, DPM, St. Louis, MO
Other messages in this thread:
02/17/2020 Michael M. Rosenblatt, DPM
What Kind of Podiatrist Do Today's Residents Want to Be? (Martin M. Pressman, DPM)
I read with interest the recent polls of newly graduated residents, in which the majority answered that they want to practice mostly surgery in their work. I understand this. Many years ago, I felt the same way. Because I owned my own Medicare Certified Surgical Center, there was (I suppose) a financial incentive for doing more surgery. But that is not how it turned out. The physical aspects of surgery require an enormous amount of energy that, as you age, you become less able and willing to exert. I was also a co-resident director and shared responsibility for teaching new podiatry residents surgery.
I had a surgical program at a VA hospital where I was exposed to a great deal of surgery, besides foot and ankle procedures. Even now, I am astonished at the RESPONSIBILITY that podiatrists have as physicians. I don't think I appreciated it when I was in podiatry school. REAL podiatry practice is very different from what you see as a student. Naturally surgery practice increases that responsibility. I did a great deal of surgery, including gastrocnemius recessions, sub-talar implants and even ruptured Achilles tendon repairs. I did a small amount of fracture surgery. In my years, that was less common for podiatrists. I shared DPM responsibility for various tendon transplant procedures. Some younger doctors had more experience than I did, so I took a secondary position.
At the end of many days, I WISHED FOR ROUTINE FOOT CARE. I actually enjoyed doing it. "It just came out of my hands." The energy expenditure was much less than for most procedures, excepting hammertoes and ingrown nails, my all-time favorite.
I would advise younger graduate doctors to allow so-called routine practice into their purview. It is interesting and frequently unpredictable. Orthopedic, dermatological and even nail care are gratifying. I might not be the best example of a "complainer.' For me, podiatry was the best choice I ever made. I enjoyed it immensely and found it ALL interesting and gratifying. I have been retired for many years. I still miss it and occasionally have "dreams" I am still working.
I encourage young surgeons to keep their options open for other realms of podiatry. There will be times when they look forward to it, not the least reason that they are really TIRED after a long day of multiple surgeries. I've been there. Many times.
Michael M. Rosenblatt, DPM, Henderson, NV
02/13/2020 Alan Sherman, DPM
What Kind of Podiatrist Do Today's Residents Want to Be? (Martin M. Pressman, DPM)
In response to Martin Pressman, DPM’s comments on my Article “What Kind of Podiatrist Do Today's Residents Want to Be?”, I can’t help but agree that the original survey response was small at 58 out of 1000 invited. I have more information now that 127 responses have come in. The percentages have stayed about the same. 88 out of 127 or 70% intend to be advanced foot and ankle surgeons, while 38 out of 127 or 30% intend to be general practice podiatrists. If the Dual Track 3rd Year were offered, 95 or 75% would choose the advance foot and ankle surgery track and 30 or 25% would choose the general practice podiatry track.
These additional data strengthens the case that as many as 25% of podiatric residents are being given training that they don’t wish to or intend to use, including working on cases that could have been given to those residents destined to be advanced foot and ankle surgeons who would so greatly benefit from the additional cases. What I found even more compelling than the answers to these multiple choice survey questions was the additional comments that they sent in, which I would invite you all to read at: The Results Summary— https://prsnte.com/here The Individual Responses—https://prsnte.com/here2
Look, I don’t wish to make the task that current or future residency directors have any more arduous than it already is. I feel for them. But I also feel for the 25% of residents who are spending time in operating rooms during their 3rd year of training when they would be far better served by working in clinics or offices learning to do the predominantly office based general practice podiatry that they’ll be practicing for the next 40 years. Alan Sherman, DPM, Boca Raton, FL
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