Why Podiatry Needs Fellowships To Take Residents To The Next Level

Bradly Bussewitz DPM

The first stage in a young doctor’s career is medical school. I attended the College of Podiatric Medicine and Surgery at Des Moines University and really enjoyed it.

The first year was rigorous with little time for sleeping and outside activities. In the second year, I settled into a groove as friendships continued to evolve among classmates and I better understood how to study and take on new information. The third year was the first in-depth exposure to the foot and ankle and my quest for full understanding was under way. In the fourth year, we all left the comforts of school and got thrown into a full year of rotations (clerkships). On these rotations, one begins to understand the importance of a solid residency.

Residency, for most, is the final stage of formal training. A podiatry student's leap into residency signifies the maturing of a young physician and his or her ability to implement the science background into hands-on patient care. For young doctors, residency is a great proving ground where they can gain confidence in their medical abilities. Some find they are talented diagnosticians while others might find they possess a temperament for the operating room or for a subspecialty such as diabetic foot care. Most may find they possess a bit of all of these skill sets.

I loved my time in residency. It was a solid residency with top tier surgical numbers. I was confident in my surgical skills and in making difficult medical decisions. My co-residents and myself were prepared for the next leap in our young careers. It was during my second year of residency when I first understood I loved foot and ankle surgery, and I considered applying for a surgical fellowship to increase my surgical exposure. I did not feel anything was lacking in my residency training as it was very thorough. I simply wanted more.

Fellowship offered more. The design of fellowship is to hone one’s skills, not to create one’s skills. Residency is for creation. Fellowship should offer a polishing of created skills under expert guidance. When one has the desire to take a skill set and focus it, whether it be surgical polishing or wound care or research, a fellowship offers that opportunity.

The expectations rose and so did my skill set. I was training visiting/rotating MDs, DOs and DPMs as I myself was receiving training. My exposure to industry increased. My patient care improved and my confidence continued to rise as a result. Upon completion of my fourth post-graduate year of training, I was anxious to be finished with formal training.

Podiatry is unique and evolving. Why not take every residency and just make them four years? Isn’t that just like fellowship? No. Podiatry in its present form does not allow one to choose a surgical or non-surgical training path. All residencies are created and continue to be created to take one into a surgical experience. Unlike our allopathic and osteopathic colleagues who can choose their specialty as their skill sets develop, podiatry has made that choice for us at the end of our undergraduate education. Having a fellowship is one way to develop more of a focus in a particular area.

In podiatry’s present form, quality fellowships offer the next level of experience and training for a well trained resident. In a more distant vision of podiatry, perhaps fellowship may offer a way in which we designate certain credentials for those who have a certified fellowship distinction.

Podiatry needs fellowships.

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