Here's your 50

I am sick and tired of the “debate” concerning addressing this list. It is embarrassing. Whoever put this together and/or those continuing to request a response do not understand logic and debate very well. It is difficult if not impossible to disprove a negative.
The majority of the points on this list have no backing, no grounds in fact. Opinion is a matter of perspective. Therefore it is extremely difficult to provide objective arguments point by point.
Since I have a little time on my hands I will give a response even though I don’t believe any is warranted. I still firmly believe the majority of this list is BS.

MONEY

1. Poor pay in the first 5 years plus
Based on what? I was earning less than 30K/yr before school. Pay will vary from person to person. I am looking at a position with a starting offering >70K/yr with excellent benefits. (I am a 4th yr student) Knocking off 20K for loans, I am still looking at a substantial increase in my standard of living. I also expect my earnings to increase after the first few years.

2. Poor residency pay (sometimes nothing)
Some residencies do offer little pay. Nobody is forcing anyone to accept those. There are now more residencies than applicants. It is a buyers market. Expect to see an increase in the next few years as the residencies compete for applicants.

3. Embarassing "salaries" offered to graduating residents
What is this based on? I can’t argue with opinion. And again, nobody is forcing anyone to accept anything they don’t want to. If people are accepting low figures it is because they have some reason to. I.E. want to stay in a particular area, too dumb to give a counter-offer, I don’t know what else.

4. Very few opportunities for fellowships, etc.
Again, what is this based on? From what I have seen, fellowships are available. In some instances fellowships are created based on need and asking. This point seems baseless.

5. Lack of respect from insurers
Facts?

6. Lack of respect from other health providers (re: fewer referrals).
Again, what is this based on? Everywhere I have been podiatry has had many referrals from all services. In some places, there are so many that the podiatry sections will not accept referrals if certain conditions are not met. I.E. toe fractures not seen unless it is an open fx or involving nail plate. I have not personally seen any significant lack of respect from other services.

7. No loan repayment programs
This is not entirely true. I will admit that podiatry does not have the same opportunities for loan repayment that others do. BIA does offer some. The Navy also recently initiated a loan repayment program. The same opportunities are not available as with other specialties, but this is changing.

8. Inability to get on health plans without surgical training. Inability to get on some health plans despite surgical training because of limits or no need for DPM's
I can’t make any comments on this. However, in terms of debate this is pretty weak. You offer no specifics. This is most likely dependent on the area you are considering.

9. Overabundance of DPM's in areas that humans choose to live
What the hell kind of point is this? I will grant that there are few if any DPMs in the Sahara dessert. Are too many students trying to stay in oversaturated areas? Is this what you are trying to get at? Is this a problem because there are too many DPMs, or because of individual choices?

10. Lack of support from schools, organizations
Specifics please? I have had no lack of support from my school. Are you expecting the schools/organizations to find a job for you? Again, this looks like an individual problem. As far as I know, the schools never promised to find you a job.

11. Huge competition from all kinds of health practitioners (take your pick)
How am I supposed to address this objectively? Can you give more specifics? The only competition I have seen is from Ortho, and this only involves the ankle stuff. What are others doing better than you can? Seems to me that they are fulfilling a need that is not being addressed. If podiatrists can address these needs, then others won’t need to. If we can do it better than others, then there shouldn’t be competition.

12. Good hours does not equal good income (biggest myth)
How is this to be addressed objectively? Hours worked and money made is individual. I can’t make any further comment.

13. Podiatry is number one loan default group compared with other health professionals (MD's, DO's, DDS)
What are you basing this on? A website? Actually DC’s are higher, so your information isn’t complete anyway. If you look closely it isn’t as bad as you might think. Give me some more specifics any I will debate this point.

14. Podiatry is more highly scrutinized by insurance fraud departments
What are your facts on this? Mycosis has recently been under fire, but this is not the only thing that is looked at by the fraud departments. It is the one that is more visible to podiatrists though. Perhaps it has been abused. Are other podiatry procedures under fire as well? I think you might find it is only this one area. Maybe it should be looked at.

15. Lack of marketability of DPM degree vs. MD or DO
Marketing is an individual quality as well. How many MDs or DOs do you think might be able to work their way into positions with shoe manufacturers? I think a DPM would be in a better position to do so. Marketing should be goal oriented. What do you want to do with your education? If you are intent on a particular position, you should be able to convince them that you have unique skills or education that allow you to do more than others. You can market your degree very easily, just not in the same areas that a DO or MD might. There is some overlap though.

EDUCATION

17. Lack of surgical programs for all graduating seniors (but it is improving).
Yes, it is improving. There are also earlier graduates competing for some of these positions. It is not out of the question for earlier graduates to receive surgical training,

18. Embarassingly low number of applicants
This is qualitative. Can you give some objective data? My school voluntarily reduced the number of matriculating students it would accept based on APMA/ACCPM/CPME recommendations. They have maintained their requirements. In addition to this, acceptance does not mean graduation. This point may vary from school to school.
In addition, applicants have decreased for medical professions across the board. Since it is a smaller group, think of podiatry as the canary in the coal mine. We will feel it first.

19. Embarassing "criteria" that incoming students must meet.
Specifics? I think most of my class had stats equal to or better than the corresponding DO class.

20. "Residency training" is often neither a residency nor training
Boy oh boy. This sounds like a really objective statement. Do you have anything to back this up? I will say that some programs might be weak, but there are others that are quite demanding. Can you back up this statement with any facts? Do you think this is the case for the majority of the programs out there?

21. Spotty, at best, clinical training in school
Back this up with some facts. I think you are way of the mark for most.

22. Uneven training among the schools
Probably true. Can you back this up?

23. Lottery style 4th year clinicals which further leads some to be less trained.
I can’t comment for all the schools. In mine, the “lottery” only applied to our “core” programs, and everyone ended up with something they wanted. The rest of our rotations were arraigned individually. Nobody should have any reason to quibble about these. Again, this will vary from school to school.

24. Failure to adequately prepare students to function without embarassment at big hospitals when they finally do get into their "residency" programs.
Opinion. Can you back this up with any facts? I don’t think so. From what I have seen, the students from my school have been able to function toe to toe with any residents or interns from other programs. And none of them can match us when it comes to foot and ankle.

25. Totally uneven skills among DPM's reflecting wildly uneven training.
This is true, but can you substantiate it? How would you fix this?

RESPECT/ETHICS

26. Lack of respect from health community and, often, community at large who frequently question your education and title of "doctor"
I would strongly disagree with this. My experience has been that some patients wonder why we got into podiatry. As far as they know (or care) it is a medical specialty. They don’t lnow what the letters are. Even most medical professionals don’t know or care. You are a podiatrist – a foot doctor. DPM/MD/DO – they really don’t care.
Just for fun, ask them if they know that their lawyer is a doctor. He really is. His degree is a JD (Jurisprudence Doctor). Most people don’t know, and they really don’t care. If you can help them they will appreciate it, regardless of your letters.

27. The embarassing lack of original research in podiatry.
Specifics? This is a qualitative argument and subject to opinion.

28. The embarassing podiatry based magazines and periodicals
Again, specifics? And it is qualitative and subject to opinion. Depends on what you read.

29. Some schools no longer require the MCAT (and, rumor has it, an observable GPA), but in an attempt to gain some semblance of respect, some require the GRE...ARE YOU KIDDING ME!!!!!?????
Are you kidding me?? This is supposed to be an objective argument? The MCAT has a lot of problems – no real reason to go into that. The GRE does have some respect, guess you don’t care to look at that. Basing your arguments on rumors is kind of suspect too. I’ll put my MCAT score up against any MD or DO students. It’s well within the range accepted by any of those schools. This is not the only factor considered for application to any school.

30. Incredibly low admissions standards among the schools (which, in reality, may not even exist)
Are you trying to use this statement as any kind of fact, or is this opinion and speculation? Do you really expect any kind of objective response?

31. Tendency for established DPM's to "eat their young"
Opinion. No basis in fact. Talk to some nurses about their professions “eating their young”. Not something that is unique to podiatry. Also something that you haven’t backed up with any sort of facts.

32. Failure of most established pods to offer help or a reasonable salary to fresh grads
Again, this is opinion. Can you back this up at all? I think there are a number of established pods (eg. Rich Willner) that are willing to offer help.

33. Failure of schools to be upfront with the realities of podiatry.
Opinion. Can you back this up with some facts? I feel my school gave me more than enough information on the “realities” of podiatry. Do you have some alternative agenda? Seems like you think the schools are plotting against you.

34. Political style of residency matching
Opinion. Maybe so, but can you back this up with fact?

35. Lack of merit in residency match system
Again, this is opinion. Where are your facts? Don't answer this with anecdotes. Give me some facts. Doubt you can.
This is also the same point as the previous one. If you want to make 50 points, it sure is easier if you repeat a few.

36. The actual need for organized podiatry to send out a mass-mail CD-ROM to prospective med students filling it with dubious facts. That'll build respect for the profession! BLECCHHH!!
Was this an actual need or a poorly arranged campaign? Are the facts they presented actually dubious? I don’t know, I haven’t seen it. I think this may have been well intentioned, but poorly performed. I don’t think I agree with it, but I think their intentions were well placed.

37. DPM's needing the OK from an MD or DO to cut nails/calluses at nursing homes. THAT'S respect for ya!
I think this varies from place to place. Not a good indication for respect from other services. Personally, I don't plan on having anything to do with nursing homes.

38. Lack of respect of DPM degree outside the U.S
Any specifics? In Europe most journals don’t include degrees. I think the British chriopodists have a high respect for DPMs as we have more training than they do. Also take a look at the Australian journals. I think you will find that DPMs are well respected overseas.

39. Lack of respect for podiatry curricula amongst MD and DO schools (not a single unit can transfer...even overseas!).
So what? How many DO credits are transferred to MD schools? For that matter, how many MD credits are transferred between schools? How many DPM credits can be transferred from one school to another. Not many, if any. It is just not done. The schools all like their money regardless of whether they offer MD/DO/DPM degrees.

MISCELLANEOUS

40. The overwhelming negative vibe on podiatry forums (everwhere you look)
This is supposed to be objective? How do you want me to respond to this? The negativity on this forum is equal to what is happening in the profession? I don’t think so. BS argument.

41. The actual NEED for a "negativity" disclaimer on the Podiatry Forum (when no such thing exists on any other health related forum)
BS argument. Has nothing to do with the profession. Only relates to this forum, which is skewed anyway.

42. Medicare is slowly clamping down on the bread and butter of podiatry (nails and calluses).
Another BS argument. Medicare/Medicaid may be clamping down, but I don’t believe that this is all that podiatry is about. Can you substantiate this with any numbers about how many pods derive the majority of their income from nails and calluses? I doubt it.

43. The fact that most current grads act more like chiropodists than DPM's reflecting the uneven training and lack of opportunities.
Opinion. Can you substantiate this? I doubt it.

44. Fewer pods in the future translates into fewer pods joining the already sparse and ineffective organizations. This means many more future battles lost to more powerful entities.
What the hell type of argument is this? As it is opinion, there is no way to refute it. There is also no way to substantiate it. Pure conjecture. You might also argue that more pods is a problem because of competition. Well, which is it? Too many is a problem, or too few. You can't have it both ways.

45. Difficulty (if not outright impossibility) of practicing DPM's to find a reasonable PSR to complete their training.
This has to be done on a case by case basis. I don’t think there is any way of addressing this type of “agreement”. One of the residents where I am now had a previous residency before applying to this PSR program.

46. Banks less apt to grant loans vs. MD or DO
Proof? I think there are more factors involved than the degree. How many MD/DOs are trying to open a private practice? I think they would face similar hardships if they tried to do the same.

47. DPM's have almost no jobs which will pay for incidentals such as health insurance, vacation, malpractice insurance, etc., whereas most MD's and DO's have such opportunities.
Is this statement supposed to be proof? Or is it just an opinion?

48. Extreme difficulty in "pulling up roots" if one chooses to move to a different area. MD's and DO's can find jobs all over the place. DPM's can't.
Again this looks like opinion rather than proof.

49. Residencies that simply cancel the program in mid step.
This is not unique to podiatry. It does happen with MD/DO programs as well. It probably runs under your radar, as I do not expect you keep up with what goes on in their residencies. I did see a local residency close down last year, shutting out 2 pods. Of course the same hospital also shut out something like 7 or 9 MD/DO residents as well. Don't kid yourself that problems are unique to podiatry.

50. CCPM's ludicrous adventures in mismanagement!
OK. So they have some problems. Does this mean that the same is true for all of the schools?

Sadly, I know there's more.

Right. It is always easy to make more assinine statements and call them facts.