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  • So you want to become a podiatrist. You like feet, maybe a little bit too much, but hey

  • I'm not one to judge. Let's debunk the public perceptions myths, and give it to you straight.

  • This is the reality of podiatry. Dr. Jubbal, MedSchoolInsiders.com.

  • Welcome to our next installment in So You Want to Be. In this series, we highlight a

  • specific specialty or profession within medicine, such as podiatry, and help you decide if it's

  • a good fit for you. You can find the other videos on our So You Want to Be playlist.

  • And make sure you're subscribed if you want to vote for future videos.

  • Podiatry is the field specializing in the foot and ankle, and related structures of

  • the leg, both in medical and surgical management. They use principles from sports medicine,

  • biomechanics, wound healing, and various surgical techniques to treat anything from discomfort

  • and pain to discoloration or odor. Some common conditions podiatrists manage

  • include plantar fasciitis, which is inflammation of the connective tissue on the sole of the

  • foot, in-grown toenails, achilles tendonitis, structural deformities such as crossover toes,

  • nerve or vascular damage, ankle sprains, ulcers, infections such as athlete's foot, fractures,

  • and bunions. Many patients requiring podiatry care have

  • comorbidities, meaning other chronic medical conditions, such as diabetes. Because of compromised

  • blood circulation in the foot and resulting nerve damage, diabetics are particularly prone

  • to foot issues, such as neuropathic ulcers from losing protective sensation. On the other

  • hand, some of your patients may be healthy athletes, and you'll be tasked with treating

  • their ankle fractures or other acute injuries with bracing, casting, orthotics, or surgery.

  • The conditions you treat within podiatry will be both acute and chronic in nature, sometimes

  • for the same injury. For example, an acute ankle sprain, meaning soon after it occured,

  • is primarily focused on dealing with the immediate inflammatory process. If the patient continues

  • to have chronic ankle issues and repeated sprains, say one year later, the management

  • plan changes. If they have scar tissue and structural changes, for instance, surgical

  • intervention may be warranted. Podiatrists will assess neurovascular, dermatological,

  • and musculoskeletal components in making treatment decisions. While most presentations are non-urgent,

  • urgent and emergent management may be necessary for open fractures, degloving injuries, compartment

  • syndrome, and some infections. Podiatry is a misunderstood field, and as

  • I joked about at the beginning of this video, many think podiatrists have foot fetishes.

  • Maybe some do, but they probably aren't getting their kicks through podiatry, as they're working

  • with diseased feet with ulcers, fungus, calluses, and interesting smells.

  • Some believe podiatrists only cut toenails and give pedicures. While it's true that clinical

  • care may involve trimming toenails and calluses for patients who are at elevated infection

  • or bleeding risk, they do much more than that. Podiatrists run the whole gamut, from trimming

  • toenails to surgical procedures. And last, many people confuse podiatry with

  • pediatrics. We have a So You Want to Be a Pediatrician episode to clear up any confusion.

  • Podiatrists earn their DPM, standing for Doctor of Podiatric Medicine, after attending podiatry

  • school, which is 4 years, just like medical school. You'll cover some similar foundational

  • training that MD and DO students cover in the first two years, but focus more heavily

  • on podiatry in years three and four. In the U.S., there are 9 podiatry schools,

  • with roughly 1,000 students applying each year, and approximately 60% gaining admission.

  • If you thought that applying to podiatry school would spare you from the MCAT, think again.

  • Do note, however, that podiatry school admissions are substantially less competitive than either

  • allopathic or osteopathic medical schools. In 2020, the average matriculant scored a

  • 494.6 on the MCAT, which is around the 35th percentile, with a 3.4 overall GPA, more specifically

  • a 3.2 science GPA and 3.5 non-science GPA. In comparison, allopathic medical school averages

  • were 511.5 on the MCAT, which is an 88th percentile, and an overall GPA of 3.73.

  • After podiatry school, most states require a 3 year residency covering medical and surgical

  • training, although the duration does vary by state. And just like with MD or DO residency,

  • podiatrists have various general and more specialized rotations.

  • As a first year resident in your postgraduate year 1, or PGY-1, you'll spend anywhere from

  • 2 to 6 months on podiatry, and the rest of the year on core rotations, including anesthesiology,

  • orthopedics, and emergency medicine. As a PGY-2 and 3, you'll focus exclusively

  • on podiatry, both in the inpatient and outpatient settings, gaining additional autonomy as your

  • training progresses. Podiatry is more male dominated, with close

  • to 60% of matriculants being men. However, the gap has been narrowing as more and more

  • women enter the field. After podiatry residency, you can subspecialize

  • further with podiatry fellowship, which are usually each 1 year in duration.

  • Sports medicine podiatrists deal with athletes and their associated injuries. It's the

  • highest compensated, as it includes a high volume of quick procedures. Conservative management

  • is also common, including taping, padding, dressing, splinting, and casting. It includes

  • a strong biomechanics component and incorporation of physical therapy modalities and rehabilitation

  • techniques. Limb salvage and preservation podiatrists

  • work primarily with diabetic or vascularly compromised patients. You'll be preventing

  • or conducting lower extremity amputations, and therefore there is a heavier operative

  • component to this fellowship. The lifestyle may be more unpredictable, however, as you

  • may need to take call. Reconstructive podiatrists are the most heavily

  • surgical, dealing with complex reconstructions such as in addressing Charcot foot. Compared

  • to other podiatry subspecialties, complication rates are higher and compensation is lower,

  • as cases take longer on average. Public health podiatrists place an emphasis

  • on quality care and preventive medicine. This subspecialization is best suited for those

  • who want to think bigger picture about healthcare policy, clinical care, and making a wider

  • impact on quality of care. Wound care podiatrists focus on complex wounds,

  • managing infections, and limiting complications. It's highly interdisciplinary, incorporating

  • elements from infectious disease, dermatology, vascular surgery, and plastic surgery.

  • There are other fellowships too, including trauma, pediatrics, and orthopedics.

  • There's a lot to love about podiatry. It's a low acuity field with great work-life

  • balance, with podiatrists working generally 30 to 60 hours per week, depending on practice

  • type and setting. You aren't dealing with life or death situations, and outcomes are

  • generally favorable. It's less taxing when your patients aren't dying on you, but note

  • that depending on your clinical focus, some of your patients may have substantial complexity

  • or comorbidities. Depending on your interests, there is some

  • flexibility in your clinical practice. For example, you could be more or less surgical

  • depending on your preference, or subspecialize with one of the various fellowship offerings.

  • One of the other benefits of already being comparatively narrow in scope compared to

  • something like medical school is that you already know your specialty from day one.

  • That means you won't face the stress or uncertainty with choosing a specialty, or having to work

  • extra hard to match into a particularly competitive specialty.

  • Podiatry isn't for everyone. First, and most obviously, you'll need to be ok with forever

  • working on the foot and ankle for the rest of your career. Unlike medical school, where

  • you can choose highly varied specialties, the level of differentiation within podiatry

  • is comparatively limited. You won't get the same social recognition,

  • status, or compensation as going the physician route, despite spending 4 years in podiatry

  • school and 3 years in residency. The average podiatrist makes $148,000 per year, which

  • is substantially less than the average physician, yet podiatry school is roughly the same cost

  • as medical schoolapproximately $40,000 per year. With four years of medical school

  • and 3 years of internal medicine residency, you would make an average of $248,000. And

  • yes, we know your cousin's toad's sister's twin makes a million dollars per year as a

  • podiatrist, but we're speaking to the U.S. averages here. After all, you could say the

  • same about high earning outliers in just about any specialty or field of medicine.

  • There's debate between orthopedic surgeons and podiatrists. Given the 5+ years of surgically

  • focused training orthopedic surgeons receive in addition to specialized foot and ankle

  • fellowship, my orthopedic surgeon colleagues believe they are better suited for surgical

  • management of the lower extremity, and believe podiatrists are better suited for non-surgical

  • management. However, podiatrists do receive a mix of medical and surgical training focused

  • on the foot and ankle in their 3 year residency, and most podiatrists would argue they are

  • plenty qualified. I cover this more in my So You Want to Be an Orthopedic Surgeon video.

  • This leads us to the next point, which is an ego battle. If you need the ego boost that

  • comes with being a physician, podiatry may leave you unfulfilled. On one hand, some podiatrists

  • want recognition for their hard work, and want to be considered physicians and surgeons.

  • As one podiatry student writes, they have "the same education, training, and expertise

  • as MDs and DOs, yet lack the same recognition". On the other hand, many MDs and DOs find the

  • obfuscation of the term "physician" or "surgeon" to be unnecessary and believe it simply further

  • confuses patients. They raise the question, what's wrong with saying you're a podiatrist

  • that went to podiatry school, versus a podiatric physician that went to podiatric medical school.

  • How can you decide if podiatry is a good fit for you? If you want to build longitudinal

  • relationships with patients, work with feet, and want to improve quality of life without

  • the pressure of life or death decisions, podiatry may be a good fit.

  • If you are comfortable focusing on the foot, but are not sure how medical or surgical you

  • want to be, podiatry offers that flexibility. If you want to work in healthcare but aren't

  • thrilled about how cutthroat and competitive premed can be, podiatry offers a more attainable

  • alternative. If you like the idea of working within a smaller

  • community, podiatry has you covered, with only approximately 15,000 active podiatrists

  • in the U.S. Thanks to The Podiatry Journey for helping

  • me with the creation of this video. Link to their channel in the description.

  • If you enjoyed this video, check out my video on So You Want to Be an Orthopedic Surgeon,

  • or my episode on being a physician assistant. Much love, and I'll see you guys there.

So you want to become a podiatrist. You like feet, maybe a little bit too much, but hey

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B2 surgical medical ankle foot medical school residency

So You Want to Be a PODIATRIST [Ep. 27]

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    Summer posted on 2021/07/10
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