08/03/2013    William Deutsch, DPM

Unmatched Residency Placements Currently Stand at 80

When I graduated in 1976, there were 5 or perhaps
6 schools of podiatry with class size of 50-60 or
so students and there was still a residency
shortage. The difference being that there were
only a smattering of states that required
residency for licensure, and the ability to do
surgery or gain hospital privileges depended upon
your ego, chutzpah, and who you knew. You could
still make a living without surgery or even
accepting insurance if you were a good salesman
and had average skills. Surgery on a see one, do
one basis was still possible, and if you had
average luck, you could avoid an untoward event
for several years.

Obviously, lack of residencies for graduating
students is only part of the problem. Incoming
podiatry students still don't know what the hell
podiatry is all about. Podiatry itself has an
identity crisis, so how can kids entering a
school where the administration apparently acts
like an Army recruiting office, promising
recruits a choice of bogus assignments and
careers, or worse, like used car salesmen, make
rational and meaningful life decisions?

Podiatry started outside of medicine, offering a
service not provided by MDs. Those basic skills
taught podiatry schools were to provide comfort
and relief to foot pain sufferers, and are today
denied services, and improperly billing them can
even put a podiatrist in jail. Imagine dentists
being indicted for filling dental caries? The
irony is overwhelming. Third-party medicine has
essentially declared basic podiatry services
verboten, and so podiatry has evolved to become
accepted by third-party medicine by performing
orthopedic foot surgery.

The residency training and emphasis is on board
certification geared towards surgery. That's
something not all podiatry school applicants have
the ability, aptitude, or desire to perform, but
more importantly, that's not what the majority of
patients requiring podiatry care need. But it
seems to be the only legitimizing effort made by
the powers behind podiatry politics.

The question is, "do incoming students know what
makes podiatry unique, but not in a good way? Are
admission interviews honest and ethical? Are
applicants given the knowledge and opportunity to
calculate the cost/benefit of education, the
possibility of not gaining a residency, meaning
failure to gain licensure in most states, and
thus acquiring a useless degree?

Podiatry can still be a rewarding and useful
profession, but at present it seems to be
ethically flawed from the ground up.

William Deutsch, DPM, Valley Stream, NY,
woollfy1@yahoo.com

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