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An Open Letter to Prospective Medical Students
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Any views and opinions expressed are those of the author(s) and/or participants and do not necessarily reflect the views, policy, or position of Podiatry Today or HMP Global, their employees, and affiliates.
"Once in a while, you get shown the light
In the strangest of places if you look at it right"
—"Scarlet Begonias," Robert Hunter and Jerry Garcia
The calling to a medical career often originates from an innate desire to help others. Other factors also go into the decision and vary from person to person. Still, the cumulative individual drivers that lead one to commit to serving others make for an honorable decision to better society. Leave the world better than you found it. Society places great responsibility and respect in physicians. Having the knowledge, power, and authority to ease someone's pain, cure a disease, improve the quality of life for a patient, or correct a debilitating deformity is indescribably rewarding and humbling. The lure is strong despite the significant time and financial commitments to becoming a physician or advanced practice provider.
Discovering your path once you decide to pursue medicine may seem daunting. The specific career choice within health care can be part of the initial decision to go into medicine or come with exposure to the various specialties in health care to find your passion. However, sometimes the decision is made for you. For example, 60% of osteopathic medical school graduates go into primary health care, with the number entering a surgical specialty very low.1 Here is the breakdown of the post-graduate year one (PGY1) matches from the American Osteopathic Association.2
1. Family medicine
2. Internal medicine
3. Emergency medicine
4. Pediatrics
5. Psychiatry
6. Anesthesiology
7. Transitional (PGY1 only)
8. OB-GYN
9. Surgery
10. Internal medicine preliminary (PGY1 only)
11. Orthopedic surgery
12. Neurology
13. Pathology
14. Physical medicine and rehabilitation
15. Internal medicine-primary
Last year, the first-choice program match for allopathic and osteopathic medical school graduates was less than 50%.3 Additionally, only 75% got one of their top three choices.3 So, despite your true passion for a specific specialty in medicine, you may not secure that residency. The chance of getting a surgical residency for an osteopathic medical school graduate is relatively low, especially if your interest is in orthopedics. Allopathic medical school graduates fill approximately 92% of orthopedic residency slots.4 This year, 17,382 U.S. citizen and non–U.S. citizen students and graduates of international medical schools (IMGs) registered for the match. The number of orthopedic surgery residency spots was 899, with 690 being MDs and 119 being DOs.3 That's a cumulative match percentage of 5% to get into an orthopedic residency.
I offer a different approach for consideration: podiatric medicine and surgery. In podiatry, you are selecting your specialty before going into medical school. You are guaranteed to be a surgeon if that is what you want. All podiatry residencies are standardized and will comprehensively train you in medicine and surgery. But you can be just as successful in podiatry if you desire a practice that does not involve surgery.
My career has exceeded my 1986 expectations back by leaps and bounds. No need to rehash my career highlights, but my career's professional, intellectual, and financial rewards were beyond my imagination back when I enrolled in the William M. Scholl College of Podiatric Medicine and Surgery. It has been and continues to be a career that makes me proud to be a podiatrist. I have never regretted my decision. I would not only do it again, but I would also do it again enthusiastically. I am thankful for every opportunity the profession provides to me. My driving force is to pay it forward to those following in my footsteps because I recognize my success was paved by those preceding me.
Podiatry has its challenges, but so does every specialty in medicine. No career is without frustrations. Podiatric medicine and surgery will fulfill the "why" (service to others) for many choosing medicine as a career in numerous ways, from the simple (routine foot care for an elderly patient unable to do it themselves) to the dramatic (saving the life of a patient with diabetes and an overwhelming infection).
School is expensive, but not significantly more than private allopathic or osteopathic medical schools. The return on investment can be difficult to calculate for podiatry. The U.S. Bureau of Labor and Statistics listed the mean salary for a podiatrist as $157,970 based on a survey of 9,320 podiatrists.6 The bureau includes resident salaries, which significantly impacts the accurate reporting of a practicing podiatric physician's earnings, as do strategies to limit the tax burden of self-employed podiatrists.
Podiatry also provides numerous subspecialty options, including biomechanics, reconstructive forefoot surgery, reconstructive hindfoot and ankle surgery, traumatology, diabetic limb salvage, sports medicine, pediatrics, dermatology, and routine care. I love reconstructive surgical biomechanics and pediatrics.
A podiatry career offers an outstanding work-life balance that is truly rare in medicine. Finding the right professional and personal needs match can be challenging. To be successful, you have to work hard, just like any other profession, but comparatively, the work-life balance podiatry offers is outstanding.
The educational time commitment is like most primary care specialties with a 4-4-3 model—four years of undergrad, four years of podiatric medical school, and three years of podiatric medicine and surgery residency.
Key stakeholders, like the American Podiatric Medical Association (APMA), constantly strive to move the profession forward and enable podiatric physicians to practice to the full extent of their education, training, and experience while being reimbursed equitably. The profession has changed significantly for the better over my 30-plus-year career. The evolution is incomplete, but the opportunity to shape the future is exciting.
Our profession's secret sauce is when a prospective student visits a practicing podiatric physician. The conversion rate of that student going into podiatry is exceptionally high. If you are considering medicine, check out what podiatry offers here and contact a physician mentor to visit in your area. Another excellent resource is Jeffery Jensen, DPM’s blog. It may not be for you, but at least you will be thorough in your career research. I suspect if you shadow a podiatric physician, we will be colleagues one day. If podiatry becomes your career choice, you will grow to love the profession, like many of my colleagues and me.
The Bureau of Labor and Statistics estimates the profession's growth rate to be 2% per year until 2031.7 The aging population and ever-increasing number of patients with diabetes are reliable metrics demonstrating the need for podiatric physicians. Additionally, two new podiatry schools have opened or will open soon, one of which is a state-supported school demonstrating the government’s support of podiatry for public health. Finally, podiatrists serve in the military and VA Hospitals, indicating the importance of podiatric medicine and surgery in healthcare.
"The way you get meaning into your life is to devote yourself to loving others, devote yourself to your community around you, and devote yourself to creating something that gives you purpose and meaning."
—Mitch Albom
Dr. DeHeer is the Residency Director of the St. Vincent Hospital Podiatry Program in Indianapolis. He is a Fellow of the American College of Foot and Ankle Surgeons, a Fellow of the American Society of Podiatric Surgeons, a Fellow of the American College of Foot and Ankle Pediatrics, a Fellow of the Royal College of Physicians and Surgeons of Glasgow, and a Diplomate of the American Board of Podiatric Surgery. Dr. DeHeer is a Partner with Upperline Health and the Medical Director of Upperline Health Indiana. Dr. DeHeer discloses that he is a speaker for Paragon 28, and that he owns stock in and is employed by Upperline Health.
References
1. Payerchin R. Primary care the top match for osteopathic medical students. Medical Economics. Published March 23, 2023.
2. AOA Media team. First combined Match results in 6,215 DO PGY1 residents. American Osteopathic Association. Published March 23, 2020.
3. National Resident Matching Program. Results and data: 2023 main residency match. Published May 2023.
4. MedEdits. Residency match statistics: NRMP match data rates by residency specialty.
5. U.S. Bureau of Labor Statistics. Occupational employment and wage statistics: 29-1081 podiatrists.
6. U.S. Bureau of Labor Statistics. Podiatrists.
Disclaimer: The views and opinions expressed are those of the author(s) and do not necessarily reflect the official policy or position of Podiatry Today or HMP Global, their employees and affiliates. Any content provided by our bloggers or authors are of their opinion and are not intended to malign any religion, ethnic group, club, association, organization, company, individual, anyone or anything.
