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

Other messages in this thread:

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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

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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