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The "profession" of Podiatry

Discussion in 'United Kingdom' started by ray the 1st, Mar 6, 2008.

  1. ray the 1st

    ray the 1st Welcome New Poster


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    Let me first start by introducing myself, I am not a Podiatry cynic nor am I podiatric political fanatic constantly delving into the many name bashing events which occur between members of the multiple “professional” societies we have here in the United Kingdom.
    I am in fact a very enthusiastic Podiatrist. Having graduated approximately two years ago with a first class honours degree in Podiatry I went straight into the National Health Service working in general podiatric practice and quickly gaining responsibility for high risk, orthopaedic and minor surgical patients. Having a great interest in Podiatric Surgery I secured a place on the MSc in Theory of Podiatric Surgery (replacing the prior Part A, B etc) which I am still currently studying for to this day. After only approximately 18 months of practice I had gained a wealth of experience and managed to secure a post as a Specialist Podiatrist in Podiatric Surgery. I am involved in Podiatry student education and visit local colleges giving talks on careers in Podiatry. I defend my profession constantly with pride against other clinicians and love doing so.

    Is it worth it?

    I have found recently that my love of this profession is slowly seeping away. This negativity has been on a low light for some time and has been kept at bay due to my enthusiasm and love for the profession, which would not let it get the better of me, until a particular event sent me over the edge.

    A friend of mine, having been influenced by hearing about and seeing the work I do decided to apply for the degree course in Podiatry. Having been offered a place on the course, he was asked to attend a departmental open day. After speaking to my friend post open day the first words out of their mouth were “if it wasn’t for knowing you I would have quit there and then”. My friend, a rather intellectual chap had already been moderately cynical after looking at the pathetic entry requirements required for acceptance onto the course. I had defended this claim noting that Podiatry, not being glamorised by sports e.g football like some professions, had a low applicant rate and so needed to drop entry requirements. Although I didn’t agree with this statement I felt the need to defend my Profession. He went on further to note the calibre of students at the open day was dreadful, most had been accepted because they failed to get into “physio”, some after attending a reflexology course, and some through shear “life experience” whatever that is?? The majority of students didn’t even know the basic job of a Podiatrist and some didn’t even know what it was”, Now that was alarming! This took me back (only a couple of years) to my first year of the degree, where a minority and I were constantly frustrated at the lack of intellectualism offered by many of my now fellow colleagues. A day wouldn’t pass by when you would hear a glum sigh around the room when person x would raise their hand to ask a question that a person with a C in GCSE biology would understand.

    Many of these intellectually challenged students went on to qualify due to the mollycoddled approach by the lecturing staff.

    Podiatry is a “profession” constantly having to defend itself from physicians, AHP’s and even internally. Yes we have come a long way, but it is inevitable that some progression has to be made over the years, have we progressed enough? NO!

    As noted earlier I initially started in general podiatric practice within the NHS, this was a real eye opener, I quickly gained responsibilities that Podiatrists who had been in place for 15 years or more were not capable of. I say “capable of” because that is exactly what it is! Some people defend these historic chippers and clippers noting that they don’t want responsibility or specialism as they are happy cutting nails. Well I’m sorry, this just isn’t acceptable. Podiatry is supposed to be a profession, improvement and responsibility is what comes with the territory. There shouldn’t be an allowance for “Audrey who doesn’t like doing nail surgery”.

    I come back again to my friend at his open day. Don’t get me wrong I have not given him a delusion of grandeur when it comes to Podiatry, he has been advised that general podiatric practice is the core and “bread and butter” of podiatric practice, but he also realises all the opportunities out there for enthusiastic and intellectual podiatrists, this is why he is one of very few people who apply for podiatry with good A-levels, degrees etc…..

    I believe the problem with Podiatry stems from recruitment, we allow people onto degree courses in Podiatry who would not be capable of achieving all those shiny stars on the employees McDonalds name badge. What would happen if we increased entry requirements, yes we might initially be left in a drought, but with a good recruitment campaign, not glamorising podiatry, just giving the facts of the job, would we not get a higher calibre of student inquisitive about studying podiatry, I would like to think so! These students would then become Podiatrists who have an interest in furthering the profession. I sometimes cringe when reminiscing about lunch breaks with my former colleagues, we would discuss issues and have general chit chat with other clinicians within the health centre, a day would not go by when a podiatrist would make a stupid remark, making me feel personally ashamed of the profession, because “us “ Podiatrists that day again looked like idiots.

    We need Podiatrists who are enthusiastic, not in it for an easy life. Intellectual not a bored middle aged housewife who attended a correspondence course in reflexology making them an expert in foot, and most of all forward thinking, not willing to sit on ones arse and let others fight there professional corner!

    I personally am no longer frustrated daily, I am employed within a surgical team with like minded people, yes this may spur the anti Podiatric Surgeon in you to rant “pretentious b**ta**s”, but it is true.

    Finally is the “profession” of Podiatry really a profession, yes of course, although the majority of people practising the art and science of it are quite frankly not professional!
     
  2. Wendy

    Wendy Active Member

    Hi
    I would like to concur with the majority of your message however I do need to take issue with
    "
    ,"

    There are a number of 'mature' students studying podiatry, I was one of them and yes I am a middle aged housewife with family however I did manage to gain a 2:1 (many of my colleagues with families managed to gain 1st class degrees). I'm also very enthusiastic about podiatry as a profession and as well as learning new business skills for my private practice I keep up with the profession by using this invaluable resource. Sometimes the more 'mature' student is able to bring a lot to a profession due to their life skills prior to uni. Please don't let your friends experience on their open day colour your view of newly qualified 'mature' podiatrists, we have had to work just as hard to get where we are as yourself.
    Good luck with your career as a podiatric surgeon.
    Wendy
     

  3. Ray the 1st:

    I really enojyed your above post. However, your message is somewhat diminished by you failing to include your real name to such a posting. I would advise that if you really are proud of being a podiatrist and do want to change the way podiatry is in your country, then you should give us your real name.
     
    Last edited by a moderator: Mar 7, 2008
  4. twirly

    twirly Well-Known Member

    Hello Ray,

    Thank you for your post,

    Also many congratulations on completing your Podiatry degree two years ago.

    I agree that Podiatry is indeed a profession to be proud of but I would strongly advise against possibly alienating mature students by ranting about middle aged housewives.

    I (like Wendy) went to university in later life (my late 20s in fact) so yes now I am ancient by your young blood standards.

    I am not thick nor was I mollicoddled by lecturers. Personally I found it was the 'older' students who regularly attended lectures & rarely missed the opportunity to interact with patients. Whereas often those less committed would avoid work by hiding in cubicles to avoid treating the patient with a condition which did not interest them.

    Also unlike some of the younger students who were often too p*ssed from the night before to attend morning lectures it was 'mature students who realised the world did not owe them a living & they had to actually apply themselves to learning.

    I believe you may find that many Pods who have been working for many years in foot health value the expertise which others on this forum provide.

    I also agree with some of the comments you made in your post RE: qualified Pods picking & choosing what they are prepared to do as part of their work.

    However, please do not demean a clinician whose skills in certain aspects of the provision of care does not match your far superior expertise.

    Surely when we are no longer capable of learning it is time to throw the towel in completely.

    Personally I never claimed to be a rocket scientist & I cringe when I read some of my initial posts here but every day I learn a little more.

    That said though at 41 I don't believe I am at the end of my learning curve.

    I would love to challenge any 20 year old to run a house, family, complete a 3 year degree course at university while holding down a job & travelling 70 miles each day.

    All the very best in your chosen career Ray, I feel sure you will make an exceptional surgeon one day, you already appear to have grasped the 'from on high' attitude.

    I also concur with Kevin in that to add your identity to your posting would surely justify your stance more professionally.

    With sincerity,

    Mandy Brooks.

    AKA
     
  5. As my esteemed colleagues, i agree to a point.

    I share your love of professional development and wish you all the best in your exalted position. However:

    This ruins an otherwise intelligent post. Enthusiastic, yes. Intellectual... not necessarily. Whilst i admire your single minded drive up the career ladder if everyone followed suit who would attend to the bread and butter of the work of the podiatrist, cut and come again routine work?

    Just because you don't fancy this, don't denigrate those on the front line of NHS and IPP who fill this vital role. It is on the shoulders of these stalwarts that the "specialists" stand. Without them we would be lost.

    As i say, i admire your drive and ambition. Tempered, perhaps, with a little humility they will make you an excellant surgeon.

    All the best
    Robert
     
  6. cornmerchant

    cornmerchant Well-Known Member

    Ray the !st
    Congrats on your firts class honours degree- I too got one of those but I dont actually feel the need to flag it up- its irrelevant to my daily practice- ok if you want to stay in the cosseted world od academia but I am out in the big wide world where I am a generalist podiatrist.

    I take issue with several of your points.
    I was a mature female student, and like twirly, juggled house , kids, travel etc and still managed to qualify.- dont think I was thick or mollicoddled. I dont have great aspirations because I choose to run a general private practise to suit me- does that make me less of a professional?
    Good for you if you want to climb the rungs and become a name in the profession- it still amuses me that a newly qualified Pod without years of exoerience , can consider themselves such an expert- in my day that was learnt over time!
    Patronising your professional colleagues will certainly not gain you credibility nor will it bode well for you in private practise. as robert says, a little humility goes a long way.

    cornmerchant
     
  7. twirly

    twirly Well-Known Member

    Dido,

    please find enclosed my thanks.

    Beautifully put.

    :drinks

    However, now your post seems to have disappeared.....

    Not to worry, I enjoyed it while it was there.

    :D
     
    Last edited: Mar 6, 2008
  8. Dido

    Dido Active Member

    My post seems to have got lost, so for those who missed it here it is again:-


    " Good Evening Ray,
    Having read your post I am wondering how long you have been suffering from a cranio-rectal inversion?
    Dido"
     
  9. William Fowler

    William Fowler Active Member

    This is a common attitude displayed by those who get into the surgical program. I would be keen to know if this attitude is:
    1) A prerequisite to get into the program
    2) Something that develops later once in the program

    Whichever it is, it certainly give them a bad name.
     
  10. Ian Linane

    Ian Linane Well-Known Member

    Hi

    Like Kevin I too enjoyed the read!

    There is much I admire about the original post: the encouragement to progress, the call for all to achieve increasingly valuable standards, the encouragement of another into the profession, the drive of the individual concerned to make the best of their working life.

    There is much I envy: the possible youth and therefore the time and space to plan out a series of career moves that for some of us are inappropriate now; the academic and intellectual confidence and (possible) relative ease of academic achievement and understanding (this is not to imply easy), it is always something I have struggled with. (obvious init!!)

    There are equally some concerns: the apparent arrogance of ridiculing those whose questions may have appeared stupid or intellectually lacking (for that is how it comes across to me). There will undoubtedly have been some who were in it for the ride but it seems that all are being tarred with the same brush.

    I learnt a lesson over 27 years ago. It was from a Welsh carpenter, who was clearly no intellectual giant, but who was kind enough to invite me and my wife for tea one day when I was a visiting preacher in their church. He showed me the carpentry projects in his workshop and when I kept asking questions (some of them clearly simpleton and stupid to an experienced person) he is reminded me that "to ask a question is to be a fool for a minute, not to ask it is to be a fool for life".

    That one lesson learnt has been more valuable to me for 30 years than any of the:

    philosophy, ethics, theology, clinical theology, ancient history from 1500 BC to 325 AD and then the rest, pastoral theology and counseling, anatomy, physiology, pathology etc etc. I mention these because over the last 30 years I have sat at the feet of intellectual giants from many different aspects of the academic world. The successful ones were those who could make the light come on in students heads without the student realising such tutorial skill and brilliance was involved.

    I am sure you are not a "podiatry cynic", I am hopeful that the tone of your post is accidental and not reflective of some of the more academic people I have come across whose brilliance may shine but whose light does not make a lot difference to lives.

    There again I am but a grand parented pod of the lowly order who would be considered to have come in the back door and clearly lack the rigors of academia to have made it the proper way ;)

    Fortunately, I frequently remember the welsh carpenter whose simple inspiration kept me going into many areas of academia, be they ever so lowly.

    Genuinely, all the best for your future and forgive an old dog his musings:drinks

    Ian
     
  11. SuzieWuzy

    SuzieWuzy Member

    As a final year Podiatry student I would like to respond to some of the comments made by Ray.

    A huge problem with Podiatry is that many people have not heard of it and those that have know very little about it and believe that they will be signing up to spend 3 years cutting little old ladies toe nails and removing hard skin! Those will a little more knowledge of the profession may chose an alternative health course to apply for such as physio as these are far more glamarous than dealing with 'feet'.

    When I started my course, there were about 55 students. Atleast half were applicants who failed to get onto the Physiotherapy course and were referred on to Podiatry. These students were made aware of Podiatry and this sparked their interest. There is not one physio applicant who remains on my course now who still wishes they got accepted onto the physio course. As for the calibre of these physio 'rejects' it is actually very good. Most have Bs at A level but due to the huge competition for Physio places they were still not accepted.

    As for the other applicants who did chose podiatry, there are a few on my course who applied straight from school, but most are mature. There isn't one mature student on my course who had not completed an access course or completed a different degree within the last couple of years to be able to gain a place. My university would never have accepted an applicant with just a reflexology qualification or life experience. There is one mature student with no previous science background, in fact they had an Art degree. They had to jump through hoops to prove they could make it on the course before being accepted.

    I agree with Ray that some students accepted have a lack of understanding of what Podiatry is but are still accepted. Myself included when I started the course, I was not interviewed and was accepted on the basis of previous higher education study and also a Science A level. They did ask that all students did a placement at a Podiatry unit prior to applying or starting the course but I'll admit they didn't enforce this.

    This brings me to the point where yes, many students start the course with little understanding of the profession or with perhaps a lack of academic skills. I guess my university wanted to try and fill the places and get the funding. But the other side to this is that while 55 students started my course, now in the final year only 25 remain. That is a huge drop out rate of 30. Those people either hated the job or simply could not cope with the demands of the course. I don't know about other universities but at mine the course is incredibly demanding. If you don't put the work in, don't have motivation and don't have quite a reasonable level of intelligence and passion for the course, you will not make it. Then there is the final clinical exam and my uni do fail students who don't meet the grade. There is certainly no mollycoddling of students at my uni!

    Ray talks about being in charge of Podiatrists trained for 15 years who only have basic podiatry skills. On my clinical placement I have experienced Pods who have been in the profession for some time who don't have a clue beyond basic podiatry. They question why I know in depth foot anatomy and biomechanics and why I am still slow debriding callus. Several times have I heard one of these Pods say to me 'you students are taught too much theory these days, Podiatry is a very practical job and you second and third years should be quick with corns and callus by now'
    In the beginning of my second year I agreed with them and felt embarrassed. But now I realise that there is no point knowing how to debride some callus quickly without being able to consider the biomechanical reason that it is there.
    So what do you do with these podiatrists? But then when I have been on placement a lot of appointments don't involve much more than corns and callus, when I attempt to look at biomechanics there is a lack of time and they are referred to the biomech specialist or often not due to the demand. So how can staff be expected to develop when this is the way Podiatry practice seems to work.
    I read an article in one of the podiatry journals about many pods leaving the profession due to their uni's teaching them all these skills and the reality in practice being that they actually do little more than basic podiatry. So you can't blame the calibre of Podiatrists for this, you need to blame the way that the profession is structured (within the NHS anyway). In my university training clinic, if someone was coming in with heavy callus or a HD I would have the time and materials to make them the necessary insole or device which in many cases increases the time between appointments or allows them to be discharged completely. On placement these type of patients come in every 8-12 weeks have their treatment and go on their way, I never have the time or the materials to make an insole, perhaps I'll have time for a silcione or some temporary padding but that's about it. So its no wonder Podiatrists often fall into this pattern of cure rather than prevention.
     
  12. twirly

    twirly Well-Known Member

    Hello SuzieWuzy,

    An insightful response indeed.

    Many newly trained Pods do indeed tread the path & cut their teeth by way of the NHS. To many it will encompass their working lives & provide them with holiday pay, sickness cover & God willing, a pension.

    I too joined the ranks of the NHS employ when I first qualified. Student loans a'knocking etc.

    In the early days post qualification I was excited by all I had learned & wanted to spread the word.... I wanted to make my mark, improve things & spread the word.

    I AM A PODIATRIST.

    But, having spent 3 years learning EG. Spanish, I now found I was expected to converse in English only.

    Disaster: self imposed granted but disaster all the same.

    I spent 9 years unlearning biomechanics etc. & number crunched my way through patient upon patient on a daily basis to complete my NHS managers expectations.

    My failing not the NHSs (as I have mentioned in previous posts, I put my books down. Nobody took them away).

    I now find myself in the unenviable position of re-educating myself.

    Forums like this provide food for the hungry. I know I am not alone, for every poster here there are a dozen lurking as guests grasping for information.

    We want to learn. Unlike the 'Rays' of the world we are aware there may be knowledge that is available to those who choose to seek & find.

    I am often bamboozled by the discussions here but I am never afraid to ask.

    Only my opinion but if someone without knowledge may ask another to share then education is achieved.

    This profession should not be about beating up those who wish to learn, it should be about shunning those who already know it all.

    Again, just my thoughts.

    Unless I am banned from this forum (or any other) I for one wil continue to put up my hand & ask questions.
     
  13. cornmerchant

    cornmerchant Well-Known Member

    Suzy

    Students always think they are going to going to change the world once they have qualified. I admire your enthusiasm to prevent rather than cure- maybe you will be able to practise in a perfect environment ,but maybe you will end up doing BASIC CHIROPODY, which is the mainstay for a lot of us.
    It is not to be sneered at , you may find one day that it is your bread and butter. It doesnt mean that we are inferior professionals- most of us have to be multi taskers- running a business entails far more than just treating the patients.
    Maybe that is one of the problems in the NHS a far as morale goes- you get a jumped up newly qualified in charge of someone who has been qualified for 15 years- doesnt make for good working relationships.

    cornmerchant
     
    Last edited: Mar 6, 2008
  14. blinda

    blinda MVP

    Dear Ray the 1st,

    I can`t really add much to the other threads, all well articulated. I really do admire your enthusiasm for driving the profession forward, but I am also concerned by your remarks as highlighted by Robert.

    Yup, you guessed it, I too am a middle aged, mother of four who left school with just a handful of O levels (they happened before the GCSE...see I am old). I did not and still do not consider myself to be `intellectual`, BUT like you, I am very enthusiastic about my second chosen career. No one was more suprised than me, ask Wendy & Twirly, when i received my classification at uni. Just goes to show how a passion can drive you, eh?

    I also undertook the `correspondance course` prior to embarking upon the degree. This served to whet my appetite for more knowledge/evidence based practice. The `calibre`of undergrad pod students is evident when that zeal for the profession continues after graduating...in whatever direction they decide to go, uni is just the first step. Experience has to be acquired to produce a truly professional, unprejudiced podiatrist.

    Just my thoughts,
    Cheers,
    Bel
     
  15. JCRTilley

    JCRTilley Member

    Waw just read all the correspondence after the inital link! But no response from the Ray?
    Tickled a whole lot of feet there!!
    J
     
  16. Dido

    Dido Active Member

    Hope he took his mind with him when he went. It's far too small to be left alone.
    Dido
     
  17. admin

    admin Administrator Staff Member

    PLEASE ALL, remember the forum rules that you agreed to when you joined.

    Please only post if you have something that adds to the issues raised and don't take pot shots at people as they contribute nothing to the discussion and will get deleted.

    The culture on other forums is to do that, but not here.

    This is part of what you all agreed to whne you joined here:
     
  18. Cameron

    Cameron Well-Known Member

    Firsts Ray - Dude

    Must be the Americans that do not like secrecy (I wonder why?). Sorry, just reading one of Dan Browns’ books on code breaking.

    > I have found recently that my love of this profession is slowly seeping away.

    Me too mate. I have had a love affair with this job for over thirty years and there are times I would gladly swing for her; and times I think she is the best thing since sliced bread. Worry not you will get your second wind or move on (and there is no harm in that). Some of the best practitioners I know have left the job and never looked back. Podiatry’s loss.

    >I am in fact a very enthusiastic Podiatrist.

    I am sure that is what bonds us all together and all the more so this cyber population.

    Rising through the ranks
    Highly commendable and all the more doable thanks to the enthusiasm of those who went before and made it possible. The silent heroes of the job are rarely remembered by the new order. Maybe that is natural?

    Gaining experience
    The first two years are usually the best (and the worst). Working through the ranks and topping up on higher degrees represents about 20% of the total graduate population, overall. Analysis of the behaviour of new grad pods would suggest the profession is following that trend. Once again the idea there is the opportunity to specialise is thanks to the many that have made it possible. Who could forget the Croydon Post Graduate Group in the UK; and the contribution Louis Smit made with his thesis on the dissipation of LA in cadavered feet. If it was not for him and the calibre of his work, pods in the UK and Commonwealth would not be able to do anatomy dissection, let alone give and injection. Each country has their own pioneering heroes but they do tend not to be spoken of, especially at recruitment days. This is a pity because it is their very ‘battling spirit ‘which may be the factor which might attract like minded individuals to the profession.


    >“if it wasn’t for knowing you I would have quit there and then”.
    Why let sentimentality get in the way of a life choice. If your friend sees it that clear then my advice is he sould get out, while you can. I would also remind him not to put the blame on a third party for staying the course. My sister suggested I would like to be a pod because they were all zany people (like me). She shared a flat with some pods. As it transpired the flat mates could bore for England which said little about my sister’s social life. My wife has never forgiven my sister for suggesting podiatry as she does not share the love I have for the job. However what I did enjoy as a pod student was being trained and trained well. The comradeship within the class cohort was strong and life bonding. Once qualified the fun of gaining as much experience as I could whilst the kids were young enough to move around the country was rewarding to me and stood me in good stead for the teaching career I would strive for later on.

    > Promoting the job to others
    This is a responsibility you need to bear stoically. Personally I avoided like the plague.

    >Teaching the students
    This is a privilege fraught with challenges and frustration, of course, but in the end a real joy. Remember it is every student’s right to be revolting and the most dangerous word in the classroom is ‘Why?’ As I used to say to my classes, ask away but be prepared to hear out the answer.

    How is it for you teacher?
    Education has its moments but teaching podiatry today under the current pressures of universities does need a lot of energy and commitment. All too sadly is this neither recognised nor rewarded. Much of the work load relates to recruitment of students not quite able to meet the modes of delivery (no disrespect to these students), but these are the breaks. Also kids pay through the nose for their education and have consumer expectation of a commodity i.e. qualification. Most university executive and administration’s tend to agree with the consumer.

    >I believe the problem with Podiatry stems from recruitment, we allow people onto degree courses in Podiatry who would not be capable of achieving all those shiny stars on the employees McDonalds name badge.

    I have certain sympathies with the statement but would also qualify the matter by adding it is not the decision of the profession but that of the university administration. Two quite different animals. One of the most common pressures on university teaching staff relates to continued need for bums on seats. No students – no funding –no centre for podiatric education – no research. The only works I know of relating to misrepresentation of the profession to potential students was written as an editorial in the Australia Podiatry Journal about a decade ago. The author briefly compared the images of practice from brochures and recruiting presentations with what the vast majority of practitioners do for a living. He found alarming discrepancies. He concluded there was a tendency to deceptively ‘talk up’ the job to potential students in the misapprehension of attracting the ‘right kind of candidate. I would agree there is potential for miss match and this crisis usually comes at the end of the second year of study.

    I have yet to meet a podiatrist who can resit a little embellishment on what they ‘can’ do for a living, Always preferring to broadcast the wider scope of practice options with no thought to what might happen if we all did ‘that kind of work ‘.

    Many of our students in WA at Curtin University were recruited after meeting practitioners and observing their work. This gave some opportunity to the student to match expectation and reality and am pleased to see this is more commonly recommended by departments.

    >These students would then become Podiatrists who have an interest in furthering the profession.

    Not necessarily so. Many exemplary graduates move out for a variety of reasons and move on. The rabble that are left do rather well but maybe not to everyones time frame, but that's life. Professional apathy is most probably the key to many of our current maladies - and thats down to the grown ups.

    Upward and onward
    toeslayer
     
  19. It is really too bad that Ray the 1st has been subjected to such comments as above for "baring his sole" here on Podiatry Arena. As Craig (Admin) mentioned earlier, if you want to disagree with Ray the 1st, then disagree with him, but don't denigrate him. Rude comments like these cheapen this professional academic website and makes those who make these types of remarks seem immature and petty.

    I admire Ray the 1st for having the fortitude to come forth and speak his mind about a profession he obviously loves and wants to see become a better profession for his podiatric colleagues and their patients. I can only fault Ray the 1st for not putting his real name on his posting so that he could say his piece in full view of his audience, rather than from the shadows of anonymity.

    If you want Podiatry Arena to remain the best podiatry website in the world, then I suggest you watch what you say and treat others like you would like to be treated yourself. Stop the rude comments!
     
  20. bkelly11

    bkelly11 Active Member

    and some through shear “life experience” whatever that is??

    Life experience is the best education you can get.
     
  21. Dido

    Dido Active Member

    If Mr Ray chooses to post here and denigrate certain sections of the profession with his arrogant, ignorant and supercilious opinions, then quite frankly he deserves to be pilloried.
    As a "middle-aged" female of over 30 years experience, I take strong exception to some of his remarks, which are based on only 2 years post-qualification experience, it seems.
    I notice that there has been no response from our Ray of sunshine.
    Ray, if you are disillusioned with the profession after only 2 years, where will you be after 32 years? The problem with reaching the top so soon is that there are fewer challenges and boredom sets in, as we have seen.
    There are few openings for podiatric surgeons, most of podiatry is concerned with giving basic bread and butter treatments. Keeping the elderly mobile and inproving their quality of life brings tremendously job satisfaction. I am sorry that you have not experienced that. I am not going to apologise for calling you small-minded because in my opionion you are - and truly unable to see the bigger picture.
    I feel sorry for you, I really do.
    Dido
     
    Last edited: Mar 7, 2008
  22. Ian Linane

    Ian Linane Well-Known Member

    Hi Kevin

    I agree about the need to keep things respectful and fair but also reasonable and whilst 1st ray was bearing their soul there are others sufficiently offended by the original post to bite back. However, I am not alone in thinking that the intellectual debates on this forum have more than sunk below the mark, at times, in the name of dealing with "snake oils" men.

    Equally, there are some on the forum, myself included, who have taken something of a sense being insulted when our comments do not appear to have the made "the grade". What will impress me about 1st Ray is not the bearing of the soul, always courageous or fool hardy, but that they come back on and further contribute. In all honesty I think the got off lightly compared to others who have felt the "Arena tooth bite".

    That said, I am not yet convinced they are not a troll in disguise who are currently laughing at our expense. I welcome and hope 1st ray comes back and contributes further.

    Cheers
    Ian
     
  23. Dido

    Dido Active Member

    Thank you Ian, for voicing what I have also been thinking - that Ray is not a real person. That thought was behind my rather caustic remarks. Let us see if he returns to contribute some more.
    Dido
     
  24. blinda

    blinda MVP

    Hi Ray,

    Please take advantage of this opportunity (if you do exist!) to debate the points raised in your posting.

    Whilst some (myself included) may have taken exception to the remarks about the `intellectually challenged, middle aged housewife`, i feel that there are also many valid ones made, in particular the self perception of pods and how to progress the profession forward as a whole.

    Cheers,
    Bel

    Just out of curiosity, could you tell me how many of those in your year, who acheived an upper second or first, were mature students? In my cohort all those who were granted a first were mature students and the majority of those with 2:1 were likewise.
     
    Last edited: Mar 7, 2008
  25. Kevin

    I agree with you that some of the comments and name calling Ray as attracted are unjustified and unhelpful.

    The irony here is that if you disagree with something somebody says so passionatly such name calling actually stunts your ability to effectively argue against what they have said.

    Having said that, let me say this.

    You have been known to defend "the profession" quite passionately against the encroachments of the snake oil posse. This is a wholesome thing and i for one admire you for it. As you have said, having devoted your career to the generation of "good science" and the search for facts / truth it is extremly annoying to see people playing fast and loose with the profession you have worked so hard on.

    I suspect a similar feeling of outrage is what has fueled some of the comments on this thread. For people who have struggled to complete a degree as adults (which is a damn hard thing to do) a post which seems so condescending to what they have acheived (and what they might WANT to acheive) and worked for is deeply frustrating.

    The political situation of podiatry in the UK is, as has been oft lamented, a complex and emotive one. There is therefore, IMO a need for us to tread carefully. Ray's post appears to have touched a few nerves. Whilst i respect his right to state his opinion, as i'm sure he would respect my right to disagree, i do feel that parts of his post were a little insensitive, bordering on offensive.

    This does not excuse name calling.

    But it does, perhaps, explain it.

    Regards
    Robert
     
  26. ray the 1st

    ray the 1st Welcome New Poster

    I didn't once degrade the work performed in general podiatric practice. In fact i do believe this should be a speciality of its own. My angst was with the practitioner within the nhs who believes it is there soul right because they have been there for many years to do general clinics and nothing else. In my own experience there have been departmental battles because a number of these people will not take on any extra responsibility and never get challenged, managers or senior clinicians usually shrug it off with the expression "they have been here for years and have lost skills". That may be the case, but as i mentioned in my post, to be a professional, in my eyes, would be to embrace re-learning these skills.

    Private practice is a different matter, private practitioners choose to work in this area (and make a good living from it!) and so have the choice to work in general podiatric practice alone. The NHS is a team effort and I being sat in my clinic seeing all the high risk patients because Mr/Mrs X won't, aggravates me!

    Yes i agree, my "rant" at middle aged persons was uncalled for, and yes i have many friends who were mature students and gained excellent grades. The problem i have (contraversial it may be) is that many mature students got these grades because they put blood sweat and tears into learning (quite rightly so), but when asked questions or challenged on things that require common sense as oppose to text book learning, they lacked substantially! As noted this is only my experience.

    I have not posted to stereotype, although yes i admit my original post did seem like that, i post to air my frustrations again at the admission to podiatry schools. Granted in a previous post the year started with 55 and ended with 25, but this shouldnt be the case, many schools have a stated pre requisite of substancial work experience but in my experience this has never been enforced. I believe raising the admission criteria would attract a higher calibre of student.

    My other concern at the amount of mature students is again a contraversial one. I have found (and i'm not applying this to everyone) that the majority of mature students i know finish their degree and after a short spell in the nhs or maybe even none at all they go into generalist private practice never to embrace research or anyhthing that would benefit the profession. On the other hand, i know a number of "younger pods" who are so enthusiastic about there chosen profession that they strive to be the best, this drive helps to promote and push the profession forward.

    As for me being arrogant, i don't believe i'm an arrogant person, but i believe a minor degree of professional arrogance is needed to have confidence as a clinician.

    Kevin, sorry, although i fully appreciate what you say about me posting my full name. I believe being a junior podiatrist and being opinionated does not bode well with my future career prospects. In some years time when i am in a position to feel as though i don't have to hide behind a screen name to voice my opinions i will tell all.
     
  27. blinda

    blinda MVP

    Your admission that your "rant at middle aged persons was uncalled for" is evidence enough for me that it is indeed your passion for the profession that was, perhaps, misinterpreted by us as arrogance.

    Thank you for recognising that both mature (and not-so mature students) do sometimes have to sweat blood and tears. This is usually, as has been pointed out by other replies, because we had to balance university life with family commitments, supplementary income to pay the mortgage, etc, etc. Surely the fact that we chose to undertake and complete, to the best of our ability, a full time degree is proof enough of our substantiation?

    I understand that what you are describing is from your personal experience; however my experience was vastly different. Our cohort was, admittedly, made up predominantly of mature students, but the students who were keen to do the extra research, question empiricism and generally think outside the box were mainly the mature students along with a few of our younger colleagues. In fact, comments were made by lecturers that we were the “think tank” of podiatry.

    I totally agree with you here. Just the issue of wasted money as a result of such a high drop out rate is unacceptable. Admission criteria does need to be enforced. I was surprised to read that Suzywuzy was not interviewed and was accepted on the basis of previous higher education, however, her enthusiasm and commitment is clearly evident in her posting. You stated earlier that the profession needs graduates who are enthusiastic and eager to move podiatry forward, this can only be determined by interviewing prospective students.

    This observation has been made by many. I would like to point out though, that it is not exclusively the mature graduates who, once having gained the experience of working in a busy NHS clinic (along with the frustrations of limited resources…but that’s another issue) decide to set up in private practice. As you have already highlighted, a good living can be made from it, but that does not mean that we stop striving to be the best practitioner or seeking to progress the profession. That is what CPD is about to my mind.

    Absolutely right! The NHS should be a team effort. That is why I work in both the private sector and the NHS. I realise the benefits that working/improving skills/undertaking group CPD alongside colleagues does bring. Both private and public sector work provides challenges for me to continue to grow as a practitioner and I enjoy it!

    I am sorry that you feel so frustrated with the lack of gumption displayed by your fellow pods, it’s a sad fact but you will find a similar attitude in the minority of all professions. Please take heart that we are not all “Audreys”!

    Cheers,
    Bel
     
  28. W J Liggins

    W J Liggins Well-Known Member

    Hello Ray

    I do understand your frustration. However, I think that it is somewhat misdirected. In my view, the problem is mainly with (ALL) the professional bodies who have consistently failed to promote and laud the profession, both to the public and in the seats of power. The result has been that we, the members of the profession in the U.K. are not automatically regarded as the first people to turn to when matters foot are considered in the media, the public arena and in the government. What you and your friend have experienced may be attributed to this fact alone.

    All professions need researchers and other high flyers, none more than podiatry, however, do be aware that some 'middle aged housewives' such as Belinda (she's actually quite young) have, like yourself, achieved a first (although she is far too modest to post the fact here). An additional problem is the isolation in which pps work. It is very difficult to carry out even a wide ranging audit when working alone, and unless the indivdual is sufficiently committed to attend branch meetings, or even be an active member of a non-aligned post-graduate group, meaningful research is next to impossible. Perhaps this is another area in which the professional bodies should lead.

    Finally, I would add that it was the very frustration from which you are suffering that led to the formation of the Podiatry Association without which you would not be studying surgery. The profession needs you and your ilk to take it forward but it also needs those who are less forthcoming.
    May I add a further plea to you to post under your own name? You will need courage, pride, committment and fortitude to go where you are going, together with a little humility which may be missing in certain people you will come across. Making your statement now would be a good start.

    All the best

    Bill Liggins
    (who did not get a first, but is a podiatric surgeon, and amongst other achievements was expelled from the Society for having the temerity to speak his mind)
     
  29. Ray:

    When I was in my Biomechanics Fellowship at CCPM in 1984-5, I was 27 years old. I was invited to attend a meeting where none other than the famous Dr. Merton Root was lecturing on foot biomechanics. He was giving a lecture on forefoot to rearfoot relationship and how important it was to draw an accurate heel bisection on the calcaneus in order to be able to order foot orthoses properly. I raised my hand, and from the back of the room asked Dr. Root how he could be so certain of the forefoot to rearfoot relationship of feet when the faculty members of the Biomechanics Department at CCPM all drew heel bisections on differently from each other. I further added that there was probably a +/- 5 degree difference between Biomechanics clinicians in how they drew heel bisections and that, if they were to be considered the experts, then where would that leave the average podiatrist or podiatry student that is not as proficient and, therefore, where would that leave the accuracy of the determination of the forefoot to rearfoot relationship that he was then lecturing on.

    Suffice it to say, this started Dr. Root on a 5 minute discourse (seemed like an hour to me at the time) as to how even a monkey could be taught to draw an accurate heel bisection and that he didn't understand why the biomechanics faculty at CCPM couldn't teach foot examination properly. As I sank further and further into my seat from the back of the room, I swore that I could see steam coming out of Dr. Root's ears as his face reddened as he continued to basically tell me, that I didn't know what I was talking about.

    I provide this little story to you so that you can see that my public questioning of authority, even though it was unpleasant at the time, didn't seem to hurt me permanently. As a matter of fact, after the meeting, two to three podiatrists told me that they thought my questioning Dr. Root was very healthy for podiatry and was a good thing, not a bad thing. Sometimes, Ray, you need to let the full light shine on you when you make a statement of your views, in order to make a change. Being constantly in the shadows will significantly lessen the impact of your intended goals for your profession.
     
  30. Ian Linane

    Ian Linane Well-Known Member

    Hi Ray

    Welcome back and I look forward to more of your postings. Coming back as you have is laudable and addressed the issue of a lurking troll out for mischief in my mind. You said:

    As for me being arrogant, i don't believe i'm an arrogant person, but i believe a minor degree of professional arrogance is needed to have confidence as a clinician.

    Interesting thought. I may be misunderstanding you but feel sure that the same can be achieved through firm self belief and self confidence. These latter two are usually welcomed, even admired by colleagues but more importantly by patients. The idea of "minor degree professional arrogance" as a foundation for confidence could lay down problems for you, in my own simple mind. No doubt others will disagree.


    "Kevin, sorry, although i fully appreciate what you say about me posting my full name. I believe being a junior podiatrist and being opinionated does not bode well with my future career prospects."

    Guess this comes back to what I just said. Do not let your inexperience or "junior" status reduce your courage to speak your thoughts, evenly strongly. Simply watch how you say them. I'm sure Kevin writes his things in Word first in order to check that he does not let his frustrations come across too much!!;). Especially with the likes of me! We all need to be shaken out of our tree and need people to do it.

    I like people who speak their mind and who have learnt how to do it well.

    Cheers
    Ian
     
    Last edited: Mar 7, 2008
  31. cornmerchant

    cornmerchant Well-Known Member

    Ray
    you seem to me to be issuing an apology on the one hand and then continuing to put down those who you see as not promoting the profession
    you said.
    "My other concern at the amount of mature students is again a contraversial one. I have found (and i'm not applying this to everyone) that the majority of mature students i know finish their degree and after a short spell in the nhs or maybe even none at all they go into generalist private practice never to embrace research or anyhthing that would benefit the profession. On the other hand, i know a number of "younger pods" who are so enthusiastic about there chosen profession that they strive to be the best, this drive helps to promote and push the profession forward. "

    It is not about the age of the graduate-it is about personal choice on how we run our practise- I personally do not want to do research, that doesnt mean I dont provide a valuable service to the public- isnt it about the outcome to the service user?

    As you say, you can only judge by your very limited and narrow experience. I suggest you listen to other pods and get some idea of the whole picture.

    regards
    cornmerchant
     
  32. Cameron

    Cameron Well-Known Member

    First Ray Dude and fellow netizens

    I was a health service manager in the late seventies and early eighties on a post teaching quest and found the nhs podiatry world in general to be much the same as you described. So (to me) your observations on the workforce are valid if somewhat, uncomfortable. My job then was to act as a change agent to build a culture that could cope with a New Order. There were no guidelines then and it took vision and a lot of hard work which involved the whole team. I ended up with a commendation from my employer and mentioned in dispatched of the Department of Health. The district had a service reasonably prepared for the major national change ahead - one of many that would take place in the ensuing decades. Although the details of change have no contemporary value the principles of change management do and hence the reason I bring it up. I returned to education, a tired but better person (I think). Fortunately for me, I wrote up my experiences in a series of papers, published in the Chiropodist circa 1981/81. Probably these were not widely read and certainly rarely if ever used as a resource now. (manual searches are so unpopular, these days). Mark Russell brought it all back in a posting to the Arena a few moons back, where I must have tried to inspire his class into getting into an ‘up and at’ em,’ spirit. That might have been the last time I got evangelistic about podiatry. Around the same time Roger Butterworth wrote a set of occasional papers on aspects of podiatry in the nhs in an independent journal called the British Journal of Chiropody. The magazine’s distribution was low and the ‘controversial’ nature of the subject ensured his work was overwhelmingly ignored. Pity because his insights then would not be out of place, today. Bare in mind I am referring to three decades ago.

    Is podiatry a hot bed of research and development?
    No and never likely to be. Podiatry is a vocational degree and whilst 20% (at best) of pod population will go into research, teaching (and development) the vast majority will continue in the workforce working within their legal scope of practice doing what their patient demographic demands. Caring for an aging population with foot morbidity a known outcome will determine where the vast majority of the public purse will go in the UK for the foreseeable future. Niche care will always be elective, fringe (healthy and lucrative as that may be it) and practised by the few. AS a comparison in Australasia where private practice prevails, the absence of an established national public service will backfire on pods and make the private sector (yet to cope with inflation here) more cut throat than it is at present. Future demographic demands in OZ will determine the prioritised need for palliative foot care for an aging population, which unless the present system changes radically, will not be provided exclusively by podiatry in the future. So the workforce in my humble opinion has a lot of important issues to contend with and what’s more is powerless to control their destiny. This makes for a very frustrated workforce and all that implies with coping with change. The behaviour you describe so well is known as ‘entrenchment’ which is a perfectly natural workforce reflex mechanism that needs carefully managed (facilitation). You have a lot of work ahead of you, me thinks.

    >Bill Liggins, wrote ….(who did not get a first, but is a podiatric surgeon, and amongst other achievements was expelled from the Society for having the temerity to speak his mind)

    We seem to have a lot in common although I am not one of the ‘slice girls.’ Too risky! But I did extricate myself from the Body, after they gave me a Meritorious Award.

    Have a fab weekend.
    toeslayer, nee Syd, Cam the Man, Cameron K and Cameron
     
  33. admin

    admin Administrator Staff Member

    My initial fears for this thread degenerating into something we do not want here were unfounded. Its actually turned into a good resource on the issues.

    Thanks to EVERYONE and thanks Ray for coming back and posting.

    :good::good::good::good::good:
     
  34. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Interesting debate, and I think Ray the 1st has some chutzpah for 'telling it like it is".

    Aside from an acknowledged and naiive slur against mature age students, the bulk of the initial comments for Ray are very valid IMHO.

    Although I recognise that one podiatrist may choose his or her 'comfort zone', and restrict themselves to some core chiropody skills, this is *not* the mark of a professional. If my accountant chose not to expand his knowledge base to keep up with contemporary tax law, and the skillset of his peergroup, he would be unemployed and facing major litigation. Continuous lifelong learning is not synonomous with 'cut and come again' practice.

    The problem, as I see it, is the disparity in scope, regulation and accreditation tha occurs amongst the Commonwealth countries. This does happen also in the US, but is far less significant - particularly with the rigours of board certification in various specialties.

    As an outsider to the UK sytem, but with experience observing some NHS podiatry services, it appears that the issue stems with the various education programs to become a provider of podiatry and quasi-podiatry services, then is compounded by the elder statesmen/women of the NHS (who perhaps never upgraded their intial skillset), who are then antagonised by the 'new breed' of motivated practitioners wishing to attempt to care for all types of medical and surgical conditions of the foot. I see the same thing in Australasia, but I don't tend to see this in the US.

    The answer? In part, 'accreditation'. In AUstralia the government has launched headlong into getting health professions into the headspace of having external bodies certify the quality of services they provide. Those with interest may like to read the latest Private Health Insurance Circular from the Commonwealth http://www.health.gov.au/internet/main/publishing.nsf/Content/health-phicirculars2008-08_08.htm

    This makes interesting reading, considering the move to National registration in this country. Notably podiatric surgeons are singled out but the rest of the profession is not !

    External (internationally recognised) accrediting bodies are going to put a (excuse the vernacular) 'boot up the arse' of those who are resting on their laurels. Watch this space...

    LL
     
  35. Cameron

    Cameron Well-Known Member

    LL

    >The problem, as I see it, is the disparity in scope, regulation and accreditation tha occurs amongst the Commonwealth countries. This does happen also in the US, but is far less significant - particularly with the rigours of board certification in various specialties.

    I completed a study tour in 2002 visiting podiatry establishments in Canada, UK and Australia. I have also worked in New Zealand, taught for many years in UK and Australia and spoken at length to colleagues from South Africa at the FIP Conference, in Copenhagen 2007. During my career I have served on several Government committees in various counties, worked with several agencies preparing podiatry competencies which has necessitated I retain a knowledge currency and am conversant with changing legislation and health care initiatives across the Commonwealth.

    All of which would lead to heartly disagree with your statement.

    From what I have read of the North American experience this remains far from uniform and whilst there are major iniatives to consolidate the situation it remains work in progress.

    What am I missing ?
    toeslayer
     
  36. George Brandy

    George Brandy Active Member

    I am late coming in onto this thread and having read all the posts I cannot help but think Ray the 1st is alluding to the new and proposed system of education that may be about to role out into our higher educational establishment "Skills for Health".

    Indeed there may be fewer undergraduates entering the degree course with higher entry qualifications but equally there will be many more entrants onto the lower skilled Assistant Practitioner course with an opportunity to hop on and off the skill escalator.

    Perhaps Ray would like to enlighten us further?

    GB
     
  37. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Cameron

    Being familiar with your many postings on this and related subjects, I am familiar with your thoughts on such matters, and was expecting you to be the first to call me up on this.

    However, I just can't reconcile any comparison between legislative/scope/sociopolitical framework that underpins (in loose terms) "Commonwealth" podiatry practice, with US podiatry practice.

    My direct experience in this area is that US trained podiatrists, though spending an equivalent amount of time in degree based training as other countries, tend to graduate, go into 2-3 year residencies, and go on to practice a wholesome scope of practice in medical and surgical foot care. Variations in US state law define the scope of practice (ie the Texas debate on where the foot 'ends'), but they sit in a system that defines them as 'physicians' under Medicare law, with broad prescribing rights, access to a full suite of covered diagnostic services, and a strong bunch of political organisations supporting the people of the ground.

    My experience of Australian and UK podiatrists (as an educationalist and clinician too, and with a deal of experience in government committees and the like) is that they tend to come out of degrees, which often spend an inordinate portion of the time focussing on nail care and removing hyperkeratosis, with a little bit of padding, strapping and orthotic care. They enter the workforce where they are dominated by the medical profession, and not remotely close to parity, whereby they either quickly settle into a predominately 'chiropody' skillset, or get interested in doing orthosis/rehab work, and tempered with the odd nail avulsion procedure. The political organisations that support them are typically underfunded, underresourced, troubled with infighting, and lacking any key stakeholder position in the health system. Just recently I had a conversation with a very high ranking government health official who was suprised to learn that podiatrists had an interest in ingrown toenails - to make a point. :bang:

    Cameron, I acknowledge your position that little separates the practice of podiatry across the globe, but I just don't buy it. In the course of treating everyday pathology, I can tell you where I would rather practice.

    Look forward to your comments and a healthy debate.;)

    LL
     
  38. perrypod

    perrypod Active Member

    15 years ago I was privileged to go on a course for foreign students at the California College of Podiatric Medicine. The level of education was very high indeed. If there was a move to replicate the standards that I witnessed there in Britain, I would be all for it. What was also refreshing, was the lack of arrogance and the presence of a natural confidence that seemed to be evident in doctors and students alike.
     
    Last edited: Mar 8, 2008
  39. twirly

    twirly Well-Known Member

    LL I believe you have identified key issues in your post.

    1). Do you believe if the UK Podiatry profession were to follow a similar educational programme (including 2 - 3 year residency programmes) as the U.S. trained Doctors of Podiatric medicine that this would resolve the problems currently happening in the UK?

    2). Certainly the case in my experience of those I worked with in the NHS, (although those graduating more recently often have the passion & drive to try to push harder to improve their skills) I have encountered many clinicians who after graduating from the degree course found the ability to even maintain skills let alone improve on them to have been placed out of reach by the very fact of past 'number crunching' as many patients as possible through the system to maintain patient contact figures to comply with health authority set goals.

    Thankfully now the HPC have CPD as a focus the NHS teans have more access to improving skills as part of their expected performance.

    3). One professional body all pushing in the same direction, now that would indeed be progress.
     
  40. Lucky:

    This is an excellent posting. However, as I said to Ray the 1st, your words would have much more impact to change your country's, and other country's, podiatry profession if people only knew who you really were.:drinks
     
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