Emphasizing The Concerns Of Podiatry Students

I have always loved sports and knew I wanted to be able to treat athletes’ anomalies medically. I participated in many sports up through college. Whether I was playing volleyball, fastpitch games or doing a triathlon, I found that athlete anomalies typically involved the foot and ankle. I found the podiatry profession fit my life. Not only could I treat athletes and others, I could incorporate surgery into some treatments.
After I decided to pursue podiatry as a career, I started thinking about my future. I’m not alone. As the podiatric profession continues to evolve, students often wonder what the future holds for them. Many students are uncertain if they entered the right field or if things will work out. Along with their uncertainty, students entering the podiatric community also have expectations.
A major topic that fits into both areas is residencies. While we’ve all heard anecdotes (limited training, not enough spots for graduates, etc.) about how it used to be, now there are new concerns over the Central Application Service for Podiatric Residencies/Centralized Regional Interview Process (CASPR/CRIP) matching process, increasing fees and standardized training.
The CASPR/CRIP system is based on students ranking their top residency picks, which are matched with residency programs that rank their top student picks. It sounds simple but there have been some problems in the past with the system. With computers, there is a possibility of glitches such as off-matching and skipping a student’s rank sheet, which could affect where students ultimately do their residencies.
Even with the assurance that problems with the matching program have been taken care of, most students still have fears in utilizing this system. Students question what new system will be used for the process and how it will affect their matching. Whatever is ultimately decided, students expect a fair system that doesn’t require battleship-like strategies to navigate.
Another concern with residencies is the costs involved with trying to apply and interview for a position. Multiple primary and secondary applications coupled with different interview sites contribute to the rising costs of a residency hunt. Some students find it hard to budget for unknown expenses during this time. This can be a source of concern when the number of program applications may be limited.
I believe major strides in this area will extinguish some of the concern. A revision to the Council on Podiatric Medical Education (CPME) 320 document states, “The sponsoring institutions must publish a policy stating whether application fees (including amounts and due dates) are refundable.” This will help students be better informed about programs they are considering and will help us reduce expenses.
Several boards are carefully watching the rising costs of application/interview fees. The increased scrutiny should help slow some increases. The Council of Teaching Hospitals (COTH) has said fees must be reasonable and not excessive. Students know they have to pay for the costs of a program reviewing applications and travel for interviews. However, we expect this amount be held to a minimum and not be used by programs to make easy money.
Standardized training has been a hot topic in podiatry recently. The APMA House of Delegates accepted Resolution 2202, the proposed comprehensive 24-month standardized residency leading to dual board eligibility. Implementation will be gradual with any changes in residencies but will definitely have a huge impact at every level. With any proposed model, students expect quality training with adequate case numbers.
Further down the road, when we’re deciding where to practice, one of the big issues is scope of practice. A lot of students know where they would like to practice, often before they enter podiatry school. But the looming question remains, “Why would I do a three-year surgical residency that includes rearfoot/reconstructive ankle (RRA) if I can only work on the forefoot?”
A universal scope of practice would leave more options available for students, residents and physicians. Students expect this issue to be a high priority on the APMA’s list.
Students ask the valid question of whether they will do well financially and many can easily say yes. New opportunities (with unlimited potential) are opening up all around the country. The profession’s continual fight for fair reimbursement for treatments has proven successful on many fronts, which will further recognition of podiatry. Public awareness of podiatry has shown marked improvement. Perhaps the biggest reason for the pendulum swinging toward physicians is the aging population of baby boomers and their increased need for podiatric services.
These trends and the ongoing efforts of the APMA and its boards definitely make it clear that podiatry is and will continue to be great.

Megan Lawton is a third-year student at Barry University.
Dr. McCord (pictured) is a Diplomate with the American Board of Podiatric Surgery. He practices at the Centralia Medical Center in Centralia, Wash.