PRESIDENT’S MESSAGE
Residency Development Five schools of podiatric medicine graduated DPMs in 1980, the year I became a podiatrist. Approximately 30 percent of the graduates were placed in residency programs. Graduates in 1980 who didn’t serve a residency—either by choice or because one was not available—still had the opportunity to open an office and practice. There were no state laws that required a residency to practice. Today, with the affirmation of our profession, nearly every state requires a residency for a license to practice. That’s why APMA—and the entire profession— takes the current shortage of residency positions so seriously. We began addressing the issue as early as 2005 with the establishment of the American Association of Colleges of Podiatric Medicine (AACPM) Balance Committee, but there is no panacea for the complex problem that is our residency shortage. Several variables affect the number of graduates eligible for a residency, as well as the number of available positions, in a given year. Firstly, the graduate must have passed National Boards Parts I and II to be eligible for a program. The percentage of graduates who aren’t eligible has ranged from 2% to 17%. While it is disconcerting to have any National Board failures, this unknown variable can wreak havoc on the number of available positions. Residency programs also vary from year to year in the number of CPME-approved positions they choose to fill. Most residency directors are dedicated volunteers who must balance hospital politics, finances, and operational variables. They must also maintain the highest standards for individuals
554
chosen for their institution. The hard fact is that not every graduate is qualified for every program. The fact that we are not alone (more than 500 MD graduates in the United States were not placed in residency programs in both 2013 and 2014) does not soften the blow. As of this June, there were 588 CPME-approved positions, but only 547 were made available on match day. There are numerous reasons for that, including hospitals having issues with the number of surgical cases they perform, finances, or not wanting to accept particular candidates. While the number of available positions was close to the number of eligible graduates in 2014, there were also graduates from previous years who entered the match. Thus, as of this June, 553 candidates had matched, including 509 from the class of 2014 and 44 graduates who were previously unmatched. Forty new graduates remained unmatched, along with 27 from previous years. We’ve made real progress, but we can’t forget those who remain without a program. Efforts to revive traditional preceptorships run afoul of state licensing issues, but an APMA House of Delegates resolution was passed in 2014 that allows APMA to give $25,000 in matching funds to each of our nine colleges for the next three years to create research positions for unmatched graduates while they re-apply for a residency position. This program will represent up to $675,000 from the APMA Research Endowment (to be matched by AACPM). APMA and all stakeholders are working on many levels to solve the issue of these unplaced graduates, and to ensure that such a crisis doesn’t occur again. FRANK SPINOSA, DPM President
September/October 2014 Vol 104 No 5 Journal of the American Podiatric Medical Association
Residency Development Five schools of podiatric medicine graduated DPMs in 1980, the year I became a podiatrist. Approximately 30 percent of the graduates were placed in residency programs. Graduates in 1980 who didn’t serve a residency—either by choice or because one was not available—still had the opportunity to open an office and practice. There were no state laws that required a residency to practice. Today, with the affirmation of our profession, nearly every state requires a residency for a license to practice. That’s why APMA—and the entire profession— takes the current shortage of residency positions so seriously. We began addressing the issue as early as 2005 with the establishment of the American Association of Colleges of Podiatric Medicine (AACPM) Balance Committee, but there is no panacea for the complex problem that is our residency shortage. Several variables affect the number of graduates eligible for a residency, as well as the number of available positions, in a given year. Firstly, the graduate must have passed National Boards Parts I and II to be eligible for a program. The percentage of graduates who aren’t eligible has ranged from 2% to 17%. While it is disconcerting to have any National Board failures, this unknown variable can wreak havoc on the number of available positions. Residency programs also vary from year to year in the number of CPME-approved positions they choose to fill. Most residency directors are dedicated volunteers who must balance hospital politics, finances, and operational variables. They must also maintain the highest standards for individuals
554
chosen for their institution. The hard fact is that not every graduate is qualified for every program. The fact that we are not alone (more than 500 MD graduates in the United States were not placed in residency programs in both 2013 and 2014) does not soften the blow. As of this June, there were 588 CPME-approved positions, but only 547 were made available on match day. There are numerous reasons for that, including hospitals having issues with the number of surgical cases they perform, finances, or not wanting to accept particular candidates. While the number of available positions was close to the number of eligible graduates in 2014, there were also graduates from previous years who entered the match. Thus, as of this June, 553 candidates had matched, including 509 from the class of 2014 and 44 graduates who were previously unmatched. Forty new graduates remained unmatched, along with 27 from previous years. We’ve made real progress, but we can’t forget those who remain without a program. Efforts to revive traditional preceptorships run afoul of state licensing issues, but an APMA House of Delegates resolution was passed in 2014 that allows APMA to give $25,000 in matching funds to each of our nine colleges for the next three years to create research positions for unmatched graduates while they re-apply for a residency position. This program will represent up to $675,000 from the APMA Research Endowment (to be matched by AACPM). APMA and all stakeholders are working on many levels to solve the issue of these unplaced graduates, and to ensure that such a crisis doesn’t occur again. FRANK SPINOSA, DPM President
September/October 2014 Vol 104 No 5 Journal of the American Podiatric Medical Association
