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Colleagues,
Talking to one of the posters to this site yesterday, the subject of undergraduate education came up. I'm not directly involved in education myself, but I have formed some impressions about undergraduate programmes.
But what do others think?

Putting aside student recruitment problems, which I am aware of, and focussing just on education - should the entry requirements (which are pretty low in the UK ) be raised so that a potentially better calibre of student is brought into the profession?
Also, would it be advantageous to have one common undergrad degree programme?
Regards,
David

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Will there then be sufficient applicants to fill the available places?

A perennial problem I agree.
Do we increase admission standards and risk poor 1st year recruitment?

Another question - would a higher calibre of initial podiatry programme intake eventually result in more high-quality podiatric-relevant research being published ?
How would this impact on the profession as a whole?
Cheers,
David

Do any of you still work in the NHS?

Why would we want to raise the entry requirements, when the majority of Podiatry work in the NHS in the UK still remains routine nail and callus care?

And how easy is it to go ahead and do any research in this setting?

It might be worth noting that when a student graduates from Uni now they have a lot of debt, which usually means that they have to start off working in the NHS, possibly returning to live at home, or very close to parents, in order to get some income into the bank.

I graduated 5 years ago and can look forward to paying off my student debt next year, and this is only because I started paying it off immediately.

Finances aside, I count myself very lucky to have progressed pretty far in the profession, as I have been able to move and commute to areas where more specialist work is available, due to lack of kids etc. However, some Podiatrists who graduated with me are still working at Basic Grade and Snr II level, mainly because they have been tied to one area.

Raising the entry requirments would mean a more academic candidate at undergrad level. If the situation with post-grad development remained as it is now in the NHS, then it would simply mean that more Podiatrists would leave the profession in the first five years. I graduated with a 1st Class BSc(Hons) Degree in Podiatry and instead of it opening doors for me, it closed quite a few initially as I was turned down for 2 Snr II jobs after graduating, specifically because I got a 1st and they said I would be bored!!!!!!!!

I don't think the 'problem' is undergraudate candidate selection, rather post-graduate opportunities. If Snr II's weren't shoved out into clinics in god knows where plodding through a merciless heap of routine patients, with no hope of a reprieve, they may retain enough enthusiasm to maybe do some research! I'm trying to rectify this in the areas that I'm involved in, but this is not happening nationally.

We can't expect people with higher academic abilities to be happy cutting nails 24/7...... we shouldn't be expecting this of our current graduates! If the profession is to progress, we have to harness our existing brainpower (or are we not intelligent enough?????)

Nicola Blower

Hi All

I think Nicola you have entered the 'over qualified' scenario.......whatever that is meant to mean!

regards

David

Nicola raised several important points - which have more to do with the current state of play within the UK NHS, rather than education, which is the aspect of podiatry I wanted to explore.

Student loans do need paid back at some stage, and rather detract from one of the useful features of having a good degree (that if you want a career change later in life your 1st will open doors to the likes of medicine, law etc - although you will be faced with more tuition fees ).

Anyone telling a prospective employee that they are overqualified for the job because they possess a 1st, simply does not understand the value of having someone on hand who can evaluate problems/procedures from a degree-based outlook (maybe they did understand !).

Nicola, if you were to forget the mundane work conditions and lack of national post-grad development, do you think there may be a case for raising
Admission quals?
After all, if you want to carry out research right now you can - your degree should ensure acceptance at one of our major universities as a part-time research student, something which cannot happen with a 2.2 or below.
Regards,
David

Hi David,

Raising undergrad entry requirements would not benefit the profession at this stage. The reason that you have to achieve such high A-level grades for Physio, for instance, is because the course is popular, not because you need a staggering amount of noodle. Podiatry is not popular. Within the area of the NHS that I still work in, I recently co-ordinated work experience for GCSE students. Not a single student in the area wanted to gain work experience in Podiatry, they were all with us because they couldn't get into other things, physio/osteopathy etc. If Medicine and Law weren't popular, entry requirements would be lower (this is already being seen in Medicine where they are encouraging AHP's with degrees to apply and offering a longer course of qualification - this would not be happening if the numbers of potential medics weren't dwindling).

I do think, however, that improving post-graduate opportunities will have a positive feedback on undergrad recruitment. If more newly qualified Podiatrists can be retained, more will go on to be active in specialist fields like research, diabetes, surgery, musculoskeletal Podiatry, Paediatrics etc. This may have the effect of raising the profile of Podiatry and, subsequently, increasing demand at undergraduate level. Then, maybe, entry levels might be raised justifiably.

My experience of undergrad was, on the whole, positive. I think that I was taught a broad syllabus of relevant topics and had optimum exposure to patients. It did not prepare me, however, for wanting to leave the profession after the first three months of working in the NHS!!!!!!

It is also incumbent on SCP to do something about promoting the profession positively. Or maybe even attempting to decide what exactly 'is the difference between a Shur-op-odist and a Paw-dee-a-trist?????'

I don't think the undergrads are lacking, I think the problem is far higher!

Sorry!

Hi Nicola,
The problems of wanting to leave the (UK) profession are, sadly, not new.
Even after the old diploma course I felt disheartened after 3 months or so of corn and toenail trimming .

I don't think that simply promoting a better profesion in the UK will do the profession here much good. After all, as far as the NHS is concerned, what exactly could be promoted without, at the very least, stretching the truth a little?

I agree completely that raising undergrad requirements would not carry any benefits in the short-term, and I accept that we need to look at the wider issues of the profession in conjunction with education.
You seem to have a pretty good grasp of the UK situation, especially with regard to the NHS :) .
What do others think?
Regards,
David

I am a student at Charles Sturt in Albury (2nd year) and I started last year with alot of enthusiasm for podiatry. The experience has not been a good academic experience and I've decided I won't continue next year.

It was made clear to us in first year that they wanted to create graduates of excellence. This has created a very competitive environment. It seems that many of the good students have left the course. Of 57 that started we are just 15 or 17 left. It's sad. Most seemed to have turned their attention to other allied health courses.

Do other undergrads have this problem? Is this universal?

I find the discussion about undergraduate problems in the UK of interest given that I am currently undertaking study in Australia, where it seems that we are repeating the same problems that are confronting the profession in the UK.

It is fair to say that Podiatry is not a status profession, and that the treatment of the undergraduates is doing little to motivate potential students to the area.

I feel as though the preperation for the real world is lacking. I too can see how after 4 yrs of study that soft corns and routine nail care can affect a person.

The solutions are not difficult, in that the teaching arm needs to be more in tune with the grass roots of the professions. This will given benifit in tailoring the education, and preperation to the work place.

Lofty ideals are worth chasing, but not worth it if it leaves the majority out in the cold.

Real world = soft corns and routine nail care = grass roots of the professions

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Craig Payne
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God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.

And those that do take an interest get real world treatment very quickly. Undergrad school do alot of selling of podiatry as a profession. Students soon find alot of grandiose selling of podiatry as a profession is really just alot of voodoo and professional self serving.

The only research done on this puts the blame squarely on the private practitioners that oversells the profession to prospective students....this is where expectations are raised. I can not speak for other academic units, but at LTU we go to great lengths to make students aware of the reality out in the real world ... that does not mean they listen

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Craig Payne
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God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.

Craig. How many students do you retain in your undergrad program at LTU? I know CSU talks of 'culling' students down to a certain number. Does this happen at LTU? I know a couple of students are re-enrolling from CSU to LTU next year.

Craig,

Thankyou for your comments.

The position of LaTrobe is very different from my experiences, in that getting a striaght answers was difficult.

I am not a new commer to the world of allied health, having nearly 20 years of experrience in another profession. I have found the process of teasing fact from fiction frustrating. The problems of getting real fact information about podiatry was also of concern for my fellow students, and I know it accounted for a large portion of their anxiety.

When you exit a 4 yr course with a large debt, it is easy to see why graduates feel jaded when they have been told about a golden age only to see it tarnish.

I find the recent moves by the vocational sector (TAFE) in introducing a routine nail care course an interesting developement in this debate.

I am not sure as I am only generally involved with students in the final years, but I think we retain most of them (I will get another staff member to respond tomorrow) --- I do recall seeing some figures a few years ago that we had one of the highest retention rates of students in the Univsersity...not sure if thats still the case now.
I would be surprised if CSU do that (I will let them respond to that). We don't. There are rumours like that from students that do surface from time to time (eg Physio there at LTU, a few years, ago made a mistake and way over enrolled the number of first years - there was lots of talk amoung students that the Uni needed to "cull" or fail a lot in subsequent years - it certainly was not true and did not happen)

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Craig Payne
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Follow me on Twitter | Run Junkie
God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.

That sounds a bit like how I start the biomechaics course here ...."Half of what I am going to teach you this semester is wrong .... problem is I do not know which half it is :p

The students might find it frustrating, but from a teachers point of view thats what makes it an exciting subject to teach.... it challenges and provokes the students into thinking for themselves....finding fact from fiction for yourself (rather than just committing facts to memory) is what a University education is about as opposed to a TAFE vocational training.

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Craig Payne
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Follow me on Twitter | Run Junkie
God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.

Graig,

Don't get me wrong. I find enjoyment from self directed learning, and new horizons inspire students as well as staff.

The points I make are in relation to getting factual information about the tin tacks of the job: income, job satisfaction, retention rates, turn over of practices. It is these factors that heavily influence some students.

The bottom line is that my time in podiatry has been on the whole "...trust me! It is really going to be OK." I am no novice to the idea that professions are often hard work with limited return for your effort, but a lot more honesty would not be un-welcome. If it is decided to push the bar higher in relation to entry standars then the game has to be lifted on the other side of the equation. It is very hard to attract students to a profession that has no precieved benifit for them.

To finish, if La Trobe has a high retention rate...well done!

OK - I misunderstood your frustration.

I think what you are asking for is not really available and is more the responsibility of the profession/Associations than the University's. BUT, getting hard data on that is not easy - we do have an Hons project next year on one of the issues.

The salary scales are readily available for the public sector positions. Private practice is variable.

The longer term retention rates in the profession are apparently not good, but it comes down to expectations vs reality (=cognitive dissonance) - see my comment above as to where the unrealistic expectations come from.

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Craig Payne
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Follow me on Twitter | Run Junkie
God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.

MikeB3,

Perhaps I can make comment here on retention of students at LTU as First Year Coordinator. If we consider that we enrolled 75 students in first year in 2003 and then this number reduces to 69 by the beginning of 2004 then our retention of students is negligible. The 6 students that we did 'lose' transferred to other courses or deferred for 12 months. It is not in our interests to 'cull' students but rather it is of benefit for us to graduate as many students as possible (assuming of course that they meet required competencies and standards set by the university and the profession).

I have to agree with Craig's comment here that it would be inappropriate to make comment on this but I would find it hard to believe that an institution would actively pursue the 'culling' of the student population and with the recent reforms to higher education in Australia there are now financial penalties imposed upon courses that over enrol students in the first instance.

It is probably also worth clarifying your last comment. You are probably aware of a couple of students that are applying for transfer to the Bachelor of Podiatry at LTU. Their entry is not guaranteed as you suggest by them "reenrolling from CSU to LTU".

One of the big issues for podiatry courses is the misconception of the profession that students who gain entry often have. Many students, who are exposed to the profession through opportunities such as work experience, seeking their own treatment are often under the illusion that podiatrists see complex biomechanical patients, children, elite athletes, etc. The reality, however, is one of geriatrics with routine nail and callus debridement. I spend great efforts to undo these misconceptions that are often created by private practitioners who glorify the profession into something that at the present time it is not. Sure, there are practitioners who have developed areas of special interest or expertise by working closely with specific patient groups but the reality for the majority of practitioners is that they see a significant proportion of people over the age of 65 years for routine foot care. So, the point of all this banter you ask? Well, I often believe that poor retention amongst podiatry students (and for that matter professionals) can be attributed to this delusion.

Food for thought,

Matthew Oates

__________________
Matthew Oates
Lecturer & Curriculum Coordinator
Department of Podiatry
Division of Allied Health
La Trobe University
Bundoora Victoria 3086
m.oates@latrobe.edu.au

Hi Matthew,

Thanks for your comments. It's interesting to get some idea of how other universities are going. It seems LTU is doing much better at keeping it's students. I think that the quality of education also must include a student satisfaction factor and this is very low at my uni at all years, which is why many are willing to sacrifice their progress and re-enrol at other institutions. I am amazed at your retention rates.

I think our 'culling' theory comes from our observations of how our peers have faired over the last year and a half. Most students in our year that have dropped out have done so because they have done really well in other medical, biomechanic, pracs, pharmo or physio subjects but haven't been able to get thru the basic no-brainer POD101 subjects. We tend to talk about this and we wonder about the academic process and are becoming cynical.

Hi all,

This is interesting.
As a long time private practitioner, I've always assumed that the problems with unrealistic expectations (and therefore professional retention rates) came largely from the educators. I admit to having no data to back this up however, and I'm happy to admit I may have drawn erroneous conclusions .

Obviously false expectations are being sown somewhere, and as Craig rightly states "the salary scales are readily available...".

Perhaps each body (educators, private practitioners, and professional bodies) with some exceptions, are a little guilty of gilding the lily when it comes to selling our profession?
Certainly the main professional,body in the UK paints a pretty rosy picture of our work, which perhaps does not bear too much relationship to 1st hand experiences in some sectors .
Regards,
David

Dear All,
I am to some extent "on the same team" as Mat and Craig at Latrobe, but I do have a different take on some of these things.
I was a mature age entrant to the 3 yr degree in '97, did Hons in 2000 and have been working Public, Private ,Locum and part time at Latrobe Uni since then.
Many of my cohort and of the students since, have entered Pod not because it was their first choice but because it was a health related degree that they could get into after missing out on something else. This does not auger well for retention at Uni or in the profession. I went into it after 20yrs working in various things but mostly retail, fitting boots for skiing and bushwalking. I was absolutely convinced it was what I wanted.....and I was fairly poorly informed about what I would be doing a lot of the time. But I was firmly convinced I wanted to be making orthoses myself, which I had already been doing for ski boots for years.

I work hard to give my students a warts and all idea of what my life is now like in the profession...if it was about the money who would be working in education?

Aged care has become a very satisfying part of my work, it may look like cutting corns and toe nails, which any fool can do (almost), but for many of the people I deal with through the Rehab in the Home program through a rehab hospital, these are life and death issues.
Many older, frail people want to stay in their own homes, they want to die in their own homes, if they can't make it to the bathroom and the kitchen somebody is going to take them out of their own home....this is really important to them....even if it's not to you. Keeping them ambulatory is important.
If the individual undergrad does not have a high degree of engagement with their patient base and fair satisfaction from the human contact they probably won't stick in the profession for long. But this engagement also builds over time, I don't think the school leavers are quite as able to make the connections in this regard.....you can howl me down over that one ?

Having done a fair range of other work in my life I also think this is a fairly easy and reliable way to earn a living. It's up to you and what you make of it.
Regards Phill Carter

Dear All,

Having been around Podiatry education since Noah first consulted a Podiatrist about trench foot, I will now lean back, clasp my hands behind my head, and assume a thoroughly annoying and senescent air of wisdom.

Is it not that the views promulgated by whoever (the profession or the educators - God don't you love the implied apartheid there), are typical of an adolescent profession? We are still in that awkward transition from 'palliative-only' practice, to 'palliative with some overarching theoretical paradigms' status. We are all trying so very hard to convince ourselves and others that we are no longer chiropodists, that we can't help but oversell ourselves.

And to what purpose? So that the next generation will be as hungry for change as we have been. And, although we have lost some of the vital elements of care in our quest for cure, we have indeed made some great changes in the past few decades:

Orthotics that are based on more than a wing and a prayer,
nail surgery with regional anaesthesia as a basic competence, and really messy and clever surgery for those with faster cars,
a knowledge base specific to our practice area,
and a good fistful of folks with PhDs.

So yes, we do get an awful lot of students who really wanted to do physio, and we do get a lot of graduates who say "but I'll only be working in sports medicine", and we do lose many of our colleagues to other professions - but that is because we are young, dynamic and progressive.

Sure, when our beginning practitioners discover that the finest element of medicine/podiatry is to provide comfort, mobility and indepedence to all, it can be a bit of a some down from brain surgery. But those who are willing to adapt do, and do well.

Crikey, I have been waiting SO long to be old and cranky and condescending. Great - pass me my Zimmer frame, I'm off to stare laciviously at the first year students.

Cheers,

Felicity

As usual Felicity...amusing....and relevant too.
Thanks for the entertainment factor.
Regards Phill

My lecturer in her attempt to inspire us this week said to one of my fellow students, "You're never going to pass these exames if you think the subtalar joint involves the calcaneous and talus. You've got a lot of study to do."

Now... old hands complain about the work, but if you can get thru a podiatry degree then I guess you're willing to enjoy anything that comes after.

Oh my, now that I have handed in my honours thesis I find myself posting a reply on a podiatry billboard, is this the beginning of the end??

I've found this debate quite interesting, at first I was horrified by it, but thanks to the responses posted by Phil and Felicity I think it's getting on track.

I'm in the process of completing the four year degree at LTU. I'm a 'borderline' mature age student who had completed an arts degree before 'seeing the light'.

I don't see how any podiatrist or institution is to blame for students getting irritable about "you never told us we'd be cutting toenails, blah, blah, blah". It's only the students that are to blame. If they are coming into a podiatry course thinking that primary care is not a major part of it, I think they have been researching into this course with blinkers on, or ignoring most of what they are seeing in their work experience placements.

I certainly understood that nails, corns, etc were the majority of the work that would be undertaken when I graduated, yet I have always felt that these 'simple' tasks can make a huge difference to quality of life, etc. However, whilst progressing through the course I have been challenged by the concept of how many other things you can do other than primary care can make a difference. There are a whole range of therapies that we should using as podiatrists. But we need to market ourselves - individual practitioners have to sell their services to their community and to their referring health professionals. Practitioners are totally responsible for the type of patients that their practices attract.

Practitioners have to challenge students that there is more to podiatry than nail-cutting, because there is. Scope of practice is a huge issue to this profession and in order for pods to have more 'non-primary care' patients through the door we have to inform others about the other aspects of the profession. Not every high school student that undertakes work experience is going to apply to do the course, so it's important that they walk away from the experience with a better understanding of the profession. That way in 10 years time when they get plantar fasciitis they go and see a podiatrist over a physio, etc.

Why do people drop out of the course? Well yes some didn't get into physio, but I think the major part of it is - how on earth do you expect to know at 17 what you want to do for the rest of your life?

Why does this profession keep beating itself up over the fact that people leave it? How many times do you tell somebody that your a podiatrist and have them say "that's fascinating, I've always wanted to do that?". It hardly ever happens. We just have to accept the 'shocking' concept that not everyone wants to be a podiatrist, including some of the students enrolled in podiatry courses!

Katrina

.... its sitting on my desk to be marked .... hmmmm

....when you say borderline, are you talking about your age or your marks?

Every profession seems to have a track record of "eating the young" ... as you know there is only so much the Association can do re mentoring etc etc .....my theory is that the length of time anyone stays in the profession is directly proportional to the quality of their first job (...sounds like a new 'law') ..... given the alleged current shortage of Podiatrists we have in the State at the moment, I find it somewhat paradoxical that some of those complaining the most about the shortage are those with the track record of 'eating the young' in their first jobs ...

__________________
Craig Payne
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Follow me on Twitter | Run Junkie
God put me on this earth to accomplish a certain number of things - right now I am so far behind, I will never die.

Nothing borderline about your maturity Katrina.
Best wishes for your maiden voyage into the profession.
Regards Phill

Hi Katrina,
It could well be!!


Great contribution to this thread. Many thanks.
Cheers,
David