President's Perspective November 2013
The Standard is the Standard
By Jordan P. Grossman, DPM, FACFAS, ACFAS President
Since the first podiatric residency program was founded, our profession’s post-graduate training model has gone through significant and frequent changes. My family and I have witnessed its evolution ever since my grandfather
started his practice in 1932 in Washington, Pennsylvania. Over the years, the Grossman Family (including my dad, uncle, and older brother) has devoted untold time and energy to the incredible progress of our profession and its residency programs, just as many of you have as well.
When I was a student at OCPM in the early 90s, I wondered why we were one of the few medical and surgical professions that did not have one standardized residency training curriculum. When I graduated, I can remember there being four or five different “types” of residency training models -- it was a virtual alphabet soup of post-graduate training programs.
The time after graduation is stressful for students, let alone the anxiety of having to decide on the type of training program to join – a decision that will most likely define how you will practice for the next 30-35 years. D we really know at that point of our careers what type of practice we want to build and foster? Have we really been exposed to all our profession has to offer to be able to make a decision so monumental as to dictate the spectrum of patients we will be able to treat?
I believe the fact that our profession now has one standardized post-graduate training model is an enormous achievement and moves us closer to parity with allopathic surgical specialties. I also believe that the 36 month training model is a perfect time frame to allow our residents to hone their cognitive, diagnostic and surgical skills in ALL aspects of this profession, including pertinent biomechanics. It is a sufficient amount of time for residents to participate in a meaningful research study and for them to learn the value of how insightful discussion leads to an unanswered question that can stimulate a well-designed research project.
There are those who feel two years is a sufficient amount of time to achieve all that is necessary to meet the standard, but I don’t believe that’s the right answer to solve the current (and hopefully temporary) residence shortage crisis. It certainly won’t provide enough time to properly train a resident, but also, it would stop – even back track - podiatry’s current momentum to full and unfettered professional parity.
Fast forward to 2021, when my niece, Leah Grossman, will be graduating from a podiatric medical college. Currently an undergraduate freshman in Pennsylvania, she has aspirations to continue the tradition he great-grandfather started. I recently talked to her about our profession and I asked her what kind of practitioner she wanted to be. She told me she was unsure, but she did know she wanted to be trained so she could practice to her full potential. How insightful!
As a member of a large orthopaedic practice, I recently overheard one of my partners (who completed a five-year orthopaedic residency and is fellowship trained in his specialty) refer a patient to another surgeon for a procedure
well within his surgical specialty. I asked him why he was referring the patient and he explained that the patient needed a procedure he wasn’t comfortable performing. He made the conscious decision to practice within his surgical skills “comfort zone.”
Despite the fact that all of our residents will graduate from 36-month podiatric surgical residency programs, I think each and every one of them will make these same decisions we did. They will determine which patient they feel most comfortable treating, they will discover their cognitive and psychomotor skill limitations, and then build their practices accordingly. But before that happens, they must be trained to the full extent of their potential and what their profession has to offer. We owe that to them – and we owe that to our profession – past, present, and future.