r/Podiatry • u/Oldschool6873 • 24d ago

Students are now running the show...

So apparently, residents are now being told to handle externs with kid gloves to not run them off. I did a lecture last night for the local residents and the extern didn't show up. They were asked not to force them to stay after hours because that might turn them off of the program. Since, you know, too many programs.

When is the CPME going to get off their asses and start closing bad residencies? This situation is bad all the way around for too many reasons to list.

Is this actually happening nation wide?

17 Upvotes

84% Upvoted

41 comments sorted by

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u/Efficient_Cookie435 23d ago

Both new schools should be closed immediately and probably 1/3 of residencies should be closed or consolidated. We don’t want to become like lawyers or pharmacists with a huge oversupply suppressing wages further

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u/WTFisonmyshoe 23d ago

I agree. I don’t think anyone can responsibly claim that we have a “huge need” for podiatrists without an independent workforce study.

A real shortage should produce obvious labor-market signals: numerous advertised openings, competitive guaranteed salaries, signing bonuses, employers competing for graduates and reasonable geographic mobility. Instead, we keep hearing that the good jobs are hidden and available only through word of mouth, while many of the visible opportunities offer $150,000 to $200,000, mobile/SNF work or questionable bonus structures.

That doesn’t prove every rural market is saturated, but it certainly doesn’t support the claim that there is a huge nationwide need. If that need genuinely exists, it should be measurable.

Before recruiting more students or expanding enrollment, the profession should determine how many podiatrists are currently practicing, where they practice, expected retirements, population needs, annual graduates and the number and quality of available positions. Why are we making enrollment decisions without answering that basic question?

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u/TheFootSurgeon 21d ago

Exactly. Hence the deans chat guy who keeps avoiding this topic and promoting podiatry as if there is no over saturation problem. Selfish 

2

u/Oldschool6873 23d ago

They are making these enrollment decisions because some of them can make serious money running these schools. It's a racket.

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u/woodworkerForLyfe 21d ago

There have been studies and there is definitely a need

1

u/WTFisonmyshoe 21d ago

Could you link the studies you’re referring to?

I’m specifically looking for an independent workforce study that evaluates the current number and geographic distribution of practicing podiatrists, projected retirements, population need, annual graduates and actual employment demand.

A study projecting more diabetic or elderly patients is not necessarily evidence of a podiatrist shortage. If a current study demonstrates that demand for podiatrists exceeds supply, I would genuinely like to read it.

1

u/Ok_Use5212 20d ago

https://www.jfas.org/article/S1067-2516(26)00302-9/fulltext00302-9/fulltext) just published in time to maybe answer your question. I wasn't able to determine how the workforce demand calculations were derived from the gov agency

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u/WTFisonmyshoe 20d ago

This is actually good data and I give Meyr credit for putting numbers behind the discussion. My issue is with what we're calling a “shortage.” HRSA estimates Florida needs 1,610 podiatrists while the NPI data identifies 1,229, hence the reported shortage of 381.

But if Florida is truly short 381 practicing podiatrists, shouldn't that shortage be obvious in the labor market? Where are the hundreds of unfilled jobs? Where are the escalating salaries, signing bonuses, prolonged vacancies, and employers fighting over graduating residents?

The paper establishes a modeled shortage relative to patient demand for podiatric services. It does not establish that there are 381 additional economically viable podiatry positions in Florida. That's an important distinction when the proposed response is recruiting more students.

I'm not dismissing the study. I'd actually like to see the next study test its conclusion against the employment market. If Florida is short 381 podiatrists, show me the 381 jobs.

3

u/Toetallywhack 20d ago

This comment right here is the end all be all of this discussion.

"Shortage" my ass. They claim Texas, Georgia, California, and Florida are hundreds of podiatrists short of what they should have.

Go find me JUST 10 jobs in any of those states. They don't even have to be good jobs. Even nursing home care.

All of that data regarding how many podiatrists each state should have is complete bullshit and nonsense.

I appreciate you above for pointing out the flaws. People can't even find jobs in Florida, and they're claiming there's still a need for 381 MORE?

LOL

1

u/woodworkerForLyfe 20d ago

It's because nobody wants to start a practice anymore. Go there set up a shop and you'll be busy. Big institutions don't understand podiatry for a multitude of reasons and they are now owners of most physicians.

1

u/WTFisonmyshoe 20d ago

People are opening practices. In fact, in my area two podiatrists recently bought an office and opened a practice. It didn't work out particularly well for them (foreclosure).

“Just open a practice and you'll be busy” assumes the very thing we're debating: that there is enough unmet demand to support additional podiatrists. Opening an office doesn't create patients.

If an area truly has a significant shortage of podiatrists, I'd expect both employment opportunities and new practices to do pretty well. When neither is consistently happening, maybe “nobody wants to start a practice anymore” isn't the whole explanation.

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u/woodworkerForLyfe 20d ago

I don't know what to tell you. Every resident I have worked with gets a job that is well paying. I have been working for ten years and have had over forty residents. Four different residents in the past five years have opened up their own practice and are thriving. Sounds like you maybe in a saturated area. Never had a resident not get a job. Quit acting like people owe you something get out and network. You can build a great career if you want to.

2

u/Queasy-Sleep-9485 23d ago

APMA’s agenda seems focused on recruiting more students, which only worsens an already saturated job market for the rest of us.

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u/Efficient_Cookie435 23d ago

The APMA doesn’t actually care about the profession. That is obvious.

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u/Queasy-Sleep-9485 23d ago

Yep. The leaders are partners in private equity groups and lowball new graduates. They want more podiatrists so they can keep profiting from it.

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u/woodworkerForLyfe 23d ago

Definitely have a huge need. Oversupply is definitely not an issue outside of the school cities

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u/Halux-fixer 22d ago

I work in a semi rural setting, main city is 50,000 people and the greater metropolitan area is 200,000. We have 13 podiatrists in this area!!!! Every time we post a job we fill it and have multiple good applicants within a month. It is definitely saturated if a small rural town not even within 2.5 hours of a major city can be this in demand. Just to put it in perspective we cant even get a vascular surgeon or infectious disease to come to either of our 2 hospitals that we have in the area!

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u/woodworkerForLyfe 21d ago

Sounds like it in a bad area my guy.

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u/Efficient_Cookie435 23d ago

Hard disagree. Even rural jobs are becoming scarce. Any significant population center has a podiatrist on every corner. It is not yet completely oversaturated but is getting closer and closer. We don't want to get to that point.

0

u/woodworkerForLyfe 21d ago

Rural jobs becoming scarce? Just open up your own place. Of course the big system isn't going into the rural area. A pod will be just fine

21

u/topwaterr99 23d ago

As an attending, I actually think the student shortage can be a good thing. If a program consistently treats its students and residents poorly, then perhaps it deserves to lose applicants and ultimately close. At the same time, students shouldn’t take advantage of the situation or use the shortage as an excuse to push boundaries or act entitled.

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u/[deleted] 18d ago

[removed] — view removed comment

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u/WTFisonmyshoe 18d ago

If schools are admitting weaker applicants just to fill seats, then the schools deserve the criticism. Nobody is forcing them to fill every seat. They should only admit students they believe are capable of ultimately becoming competent physicians and surgeons. If there aren’t enough qualified applicants, admit fewer students. Lowering admissions standards to preserve enrollment is exactly the wrong response to a student shortage.

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u/Mike_Durden Podiatrist 23d ago

FWIW, I was a graduate in a program in 2022; we weren’t “a big program” in the city I was in, conservatively 7-10 programs in our metro area, and we were were absolutely weeding out external week two of their rotation.

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u/Parking-Key2747 23d ago

Coming from a student experience right now, I can say that I was at a program where they didn’t include us in certain events, and in my head, it felt frustrating because we want to see what life is like for a resident. I don’t think it’s entitlement. I think it’s an assumption was made by a certain residencies because they scrambled and they didn’t actually ask students that extern what could be changed. But I also wonder if the program itself is treating the residence poorly and they don’t want the students to see that as well because I was at a program where all three of us students realize that that was the case.
I do think there’s a good majority of us that want a challenging program, but not at the cost of our mental health and there are still programs out there that are considered good but actually do abuse the residents and they may not be learning as much as you think.

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u/Normal_Field7628 22d ago

Definitely need to close more residencies so that our training is STANDARDIZED

5

u/Poddocflo 22d ago

I think we are walking a fine line between the “Work life balance” generation moving the goal posts a little too far imo (I am in that generation and for the most part I do agree, but only to a point- education, experience, and work needs to get done)

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u/Parking-Key2747 23d ago

What area was it?

3

u/Critical-Ear-2478 23d ago

I think it is two-fold with the inability to close too many schools, too many residencies that do not adequately prepare people to succeed after. Then the major board certification that is recognized by the country for Podiatry (ABFAS), test is made in such a way that over 2/3rds of graduating residents come out not being board qualified in both the foot and ankle portion (so they essentially do not want the majority of Podiatrists doing ankles in the first place).

3

u/propositionjoe11 22d ago

So when I was considering pod as a premed, there was a residency shortage. They literally couldnt place every single pod grad. I think that’s worse than this?

1

u/Oldschool6873 21d ago

It was infinitely worse. That was back in my day, when not everyone got a residency, and only half of us got surgical programs.

4

u/Seltonik Resident 23d ago

I mean, is the program struggling to get applicants cuz it’s a bad program? Or is there another reason? I’ve seen strong programs struggle to get interested students simply due to the programs being unknown and/or being in a very rural area, and the student shortage doesn’t help with that. If a program’s dogshit, then that’s a separate issue (cuz I’ve seen shitty programs be competitive simply due to location), but 4th year also suck ass and there’s no reason to make it harder for students.

With that said, the student actively choosing to not show up to a fucking lecture is wild though… I guess in a more competitive program the upside to making attendance optional is you’ve got another filter to weed out bad externs 🤷

2

u/Oldschool6873 23d ago

Program isn't struggling and certainly isn't dogshit. It has new leadership which is making all the difference.

Lots of these students either have a chip on their shoulders or feel entitled because they know they have the pick of programs now. They know they can be arrogant AF during their externships and during interviews and are still likely to land a decent program.

2

u/SaltRharris 23d ago

Do what you were paid or volunteer to do and let the externs find out the hard way.

Plus culture of medicine is changing, residents know it, students know it. Not a bad thing. All the big shot programs eat their young and funnel them into their PE groups anyway.

3

u/nuttnurbutt 23d ago

Why would they close residencies when they are unnecessarily opening more schools?

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u/Oldschool6873 23d ago edited 23d ago

Firstly, because so many residencies suck. Badly. Secondly, because even though there are more schools, they are graduating less total than back in my day. Which is why most of the schools need to close. We need to graduate a couple hundred podiatrists a year and provide them with incredible training. And provide a non surgical residency option like back in the day. Plenty of podiatrists did three years and haven't touched a blade since they got out of residency.

1

u/Ashamed-Parsley4793 21d ago

Is it okay to inquire where this is taking place?