Student Doctor Network

Ask Me Anything (AMA) With A Podiatrist: Dr. Christina Pratt

This is a transcript of the Ask Me Anything with a Podiatrist: Dr. Christina Pratt. We encourage you to watch the entire conversation here.

Laura Turner: Okay, great. Well, I want to welcome everyone here to this Ask Me Anything webinar. We have Dr. Christina Pratt with us, and we’re very excited to talk to her about what she does. Dr. Pratt received her undergraduate degree from John Carroll University, and thereafter, obtained a master’s degree in medical ethics from Case Western Reserve University before going on to earn her medical degree at the California School of Podiatric Medicine in Oakland, California. Here, she served as the school’s national delegate to the American Podiatric Medical Students Association.

Dr. Pratt’s three years surgical residency with reconstructive rearfoot and ankle training was completed at the Cleveland Clinic, Mercy Health, and Akron General Hospitals. Dr. Pratt served as chief resident in her third year and was actively involved throughout her training in the Northern Ohio Foot and Ankle Foundation. After serving her alma mater as an assistant professor in the department of podiatric surgery at the California School of Podiatric Medicine and as a staff physician at Highland Hospital in Oakland, California, Dr. Pratt returned to her hometown to join the faculty at Kent State University College of Podiatric Medicine and to see patients in private practice.

She currently serves as a primary course instructor for second and third-year medical students and was awarded the KSUCPM Faculty of the Year Award in her first year as faculty. She is an American board of foot and ankle surgery, board qualified foot and ankle surgeon with training in both foot and reconstructive rearfoot and ankle surgery specializing in elective forefoot surgery. Her hospital affiliations include Cleveland Clinic, Fairview Hospital, and Lutheran Hospital as well as St. Vincent Charity Hospital and UH Pharma.

Thank you very much, Dr. Christina Pratt, for joining Student-Doctor Network today for this Ask Me Anything webinar. For those of you who are joining us, you can put in your comments on either YouTube or Facebook, wherever you’re watching this, and we’ll be able to ask those questions directly to Dr. Pratt. Again, thank you for joining us. Dr. Pratt, is there anything else that you wanted to add to the bio?

Dr. Christina Pratt: Oh my goodness, I feel like you covered it as we’re reading through it. The read-through was a lot.

Laura Turner: No problem. Again, we’re very excited to have you here. The first comment is from Aiden who says that Kent State is their top choice.

Dr. Christina Pratt: Nice to see.

Laura Turner: That’s nice to see. We’ll go ahead and get started with questions. Again, enter your questions in the comments and we can bring them over just like we did with Aiden’s comment. I’m going to go ahead and start with this first one, which is, “When did you first decide to become a podiatrist, and what made you choose podiatry?”

Dr. Christina Pratt: Yes, I feel like this is such a common question for podiatrists, specifically, because it’s such a hidden gem within medicine, I think. I, unfortunately, do not have one of those cool stories of having had foot and ankle issues when I was a child, seeing a podiatrist, and knowing that that’s what I wanted from the beginning. It took quite a while for me to go through this pre-medical curriculum to understand and appreciate what was out there and what I really fit best into. I didn’t get a lot of exposure to exactly what podiatry was specifically as an undergrad.

I was part of a pre-health profession major when I was an undergrad, and it really, really strongly led people towards an MD or a DO route. I didn’t hear too much about podiatry until I actually got into my master’s program. I would say, for me, getting my master’s degree in medical ethics was just a pivotal point in my career all around. It’s what really exposed me to what health professions were out there and what each one really, really truly involved by getting me into a hospital, getting me doing clinical rotations, learning about different professions, following different people around the hospital. That’s where I really learned the most about podiatry and what it was.

I think that was a point in my life where I also was learning a lot about myself, and anyone who knows me really well knows that I’m an incredibly detailed person. I sometimes focus on details so much to the detriment, maybe, of losing the bigger picture sometimes. In that process of learning about health professions and learning about myself at the same time, realizing that something very, very detail-oriented, very specific, very technical was going to work well for me in the long-term, and fortunately enough, that happened to coincide with the time that I really discovered podiatry. I found how hands-on it was, how technical I could get as a surgeon, how detail-oriented, and obviously, body-specific it was. It ended up being a really good fit and ended up being a good fit career-wise down the road, going through it now.

Laura Turner: Great. Well, we have a lot of questions here. I’m going to go ahead and pull one of these over here. I’m going to start with this one, from Kay Jay, and they are asking, “Did you ever doubt yourself while in school and how did you cope?”

Dr. Christina Pratt: Oh my gosh, I doubt myself every day, all the time. I think that that retrospectively is good. I think that it’s consistently pushing you forward and making you want to be better. Absolutely, I doubted myself as an undergrad. I would say, if you are in this pre-med, pre-health professions track and you don’t feel at least a little bit of this imposter syndrome, you’re probably lying because we all get to that point where we really say, “Is this something we can actually handle? Is this something that we can make it into, that we can make it through?”

Yes, I think that doubting yourself can actually be a good thing as long as you’re using then in a positive spin to then retrospectively look back and continue to say, “What did I maybe not do well here, or can I do this? If I’m not sure how, let me figure it out.”

Oh my gosh, I doubt myself every day, all the time. I think that that retrospectively is good. I think that it’s consistently pushing you forward and making you want to be better.

Laura Turner: Great. I’m sure everybody always feels, “I think a lot.” Oh, let me pull that one back off here, and we’ll go ahead and have a question here specifically about Kent State. Paulina’s asking, “How well does Kent State prepare their third and fourth years in terms of clinical experience?”

Dr. Christina Pratt: At Kent State, you really get into a clinic as I think at most schools in your third year. You’re really starting in not only some general clinical experiences with internal medicine rotations and things like that, but you’re also really taking a clinical dive into podiatry, specifically. Fortunately enough, at Kent, we have a clinic. It’s called Cleveland Foot and Ankle Clinic that’s associated with the college. That clinic has two locations. One of those locations is actually within the college, on the first floor. The other location is serving an entirely different patient population in Midtown, which is very close to Downtown Cleveland.

Being that we have this clinic associated with the school directly, our students are running that clinic, and that’s a big deal. That’s a big deal as a student to really have the opportunity to not just shadow but actually step into a role where you have then direct supervision from resident physicians, from attending physicians, to really start to work up patients.

As a professor, even though I’m directly teaching students, I still love a teach-down approach. It’s really nice to see clinics full of second, third, and fourth-year students, where we have fourth-year students teaching third-years, third-years teaching second-years. I think that there’s a lot of benefit to that. I think at KSUCPM, we do a fairly good job at getting students ready clinically then to go out onto externships and really have to perform more so in front of people and with a lot less spoon-feeding or oversight.

Laura Turner: There’s a lot of questions here from different topics. One that I think is interesting from Kimia is, “What is one problem about podiatry today in your opinion?” You mentioned that you didn’t really get a chance to learn about it until your master’s degree program. Is it just a lack of knowledge do you think is the primary issue, or is there something else?

Dr. Christina Pratt: I think one of the problems about podiatry that’s becoming less and less of a problem is just in education from patients, from the general public about who I am and what I do on a daily basis. I think that there’s a lot of this preconceived notion or maybe the prior perception of you think of the podiatrist and you think of the 65-year-old, white male who practices in a small little house with a shingle out front that says foot and ankle.

It’s entirely different than that. I mean, I spend most of my days in the hospital, in the operating room. I am as much a person or a physician that takes care of routine care patients and does nail debridement and callus debridement as I am in the operating room fixing a bunion or doing an ankle fracture next to my orthopedic colleagues.

I think probably the biggest problem is still a perception problem, an education problem, and I think that that changes the more that we do things just like this, which is why this is so amazing. I think that that just takes a lot of young leaders, a lot of young people joining this profession, coming into it, realizing what it is and the training that we have, which is just outstanding when you compare it to some side-by-side surgical subspecialties, and really just pushing that forward, and pushing the envelope and working literally aside with your MD and DO colleagues.

Laura Turner: I think a good thing to transition to from here would be an overview of what a typical day looks like for you so you can get a sense of what you do, and I think that’ll help drive some additional questions as well since maybe some folks don’t have as much background on what day-to-day life looks like for a foot and ankle surgeon.

Dr. Christina Pratt: Yes. I mean, mine probably looks a little bit different maybe than most just because I’m in academics, and that’s probably not one of the most common paths to take especially– I still hope I can consider myself young, as a young physician.

Coming out of residency, I went directly into academic medicine, becoming a professor first at CSPM, which was my alma mater out in the Bay Area, and then, now at KSUCPM. My day looks maybe a little bit different than some or a lot different, I should say, than someone who’s employed by a hospital because I not only do academic medicine but I also work as well in private practice. I will spend my week between, gosh, now what is five clinic locations.

I have two locations that I work in, I see patients in, I operate in for the school, which is the Cleveland Foot and Ankle Clinic associated with KSUCPM, and then, I work also in private practice, which is CLE Specialists here in Cleveland, Ohio. We now have two and are opening a third office location. My week, if I have inpatients, those patients have to get rounded on in the morning before clinic starts. Clinic typically starts around 8 AM. If we’re doing academics, which we do academics between both the college and then my private practice group separately, those academics are usually anywhere from 6:30 to 7:30 AM. We’ll do Zoom academic sessions, we’ll get ready for clinic, prep for patients for the day, start clinic somewhere around 8:30.

I usually divide my days into halves. I have the morning shift, which may be clinic, and then, afternoon shift, which may be in the operating room. I also have admin time at the college. I do teach classes so I have to lecture prep, I have to grade exams, and do all of those fun professor things that come with that. Depending on the day, depending on the week, it’s changing. My OR schedule is something that I’ve tried, for the last few years, to really hone down into one or two days. That’s what being a surgeon can really make your life crazy in the sense of trying to squeeze cases in at 7:30 AM this morning before you run to clinic, trying to squeeze a case or two in before you make it to lecture.

The OR is just a place that’s so incredibly variable, and you’re at the mercy of the hospital, the operating room, your patient, the staff, how the case goes. It’s hard to plan around that so I’ve really tried over the last few years to hone down my OR time into one if not two days a week. I don’t think I really gave a fantastic answer for that, but I guess my answer to that, in general, is it’ll start at 6:30, 7:30 in the morning. It’ll usually finish around 5:00, 5:30, and then, I come home, and on the weekends, I chart and I chart and I chart.

Laura Turner: That does sound like you’re quite busy between teaching and working on surgery in the hospital and then the clinic time as well.

Dr. Christina Pratt: Yes. What day is it, and where am I?

Laura Turner: Okay. I’m going to hop over here to another question from Aiden. They’re asking– They recently started shadowing a podiatrist, and they know it varies from state to state, but what’s the average salary for a DPM if that’s something that you know?

Dr. Christina Pratt: Yes. I’m not trying to be vague on purpose, but gosh, this is so incredibly variable. It’s probably less variable from state to state and more variable in the position that you take as a podiatrist. I think that for the majority of working podiatrists, our salaries are in some way compensation-based, based upon production and that may be based upon the revenue that we bring into practice or that may be RVU based, based upon the types of procedures that we’re performing or how often we’re operating, the volume that we’re seeing if we’re hospital employed.

I think that it’s a fair salary. It probably is somewhere in the range of anywhere from 100,000 to 300,000 a year depending on how much you’re doing, what you’re doing. Again, somebody who is employed by a big health system in a big hospital, who may be in a more remote or rural location, may be looking at 250,000 a year. Somebody who’s in private practice, who is really hustling as far as patient care goes, may see a year where it’s 75,000, 80,000 and may see a year where it’s 350,000. That really really varies depending on what you’re doing. I see a ton of pluses and minuses as to being hospital employed, a ton of benefit as to being private practice employed. It just really has to fit your lifestyle and what you’re going for.

Laura Turner: Thank you. That’s a really detailed answer, breaking down the different things that factor into what the salaries are. We have a question here from Paulina, who’s asking if there are opportunities to conduct one’s own research during the first two years or to be involved in research?

Dr. Christina Pratt: Yes. I’m assuming this means during the first two years of podiatry school. Absolutely. It’s something that we love as a profession because, again, going back to that whole issue of perception and education of what podiatry is, how do you put yourselves out there within a medical community? You publish in peer-reviewed journals. For students to come in and want to do research, we love to see that. At KSUCPM, we try to foster that as much as we possibly can.

We have someone who works full-time as a research director, who is coordinating all of the ongoing research projects at the college, who is getting students actively involved. On one hand, she will have a whole list of students who want to be actively involved in research, on the other hand, you have all of these faculty with projects and ideas that they want to start with ongoing projects, and then, students that she can then match to jump on those projects. I would say, for the most part, at least at KSUCPM, we have a ton of open-minded faculty, who if we had students that came to us with really good ideas and had plans and proposals as to wanting to conduct their own research, absolutely, I’m going to be on board and want to help that go forward.

Laura Turner: Great. We have a question here from Minh, and I’m thinking this is referring to COVID, specifically, about issues with clerkship rotations for classes. How’s your organization handling canceled or delayed rotations due to COVID?

Dr. Christina Pratt: I’m probably too low on the totem pole to be involved in those discussions, but it’s just an issue nationwide. It’s an issue beyond just podiatry as we all navigate through these unchartered waters with COVID. Our students this past year I think got really, really affected by not having the chance, getting externships canceled last minute, not having the chance to go visit programs that they are going to potentially commit themselves to for three years, and that’s hard. I mean, there’s no way around that. That’s difficult especially when you’re– All of our residencies in podiatry are three-year surgical residencies at this point. Some of these students are making commitments for three years, a little bit sight unseen as far as the programs that they go to.

I know that our administration, I know that administration at other schools that I’ve talked to, they’re actively trying to do whatever they can to get students into and back on these externships as fast as possible, but it’s not necessarily just up to the school. I mean, if you think about it, getting one of your students into a rotation means getting them into a certain hospital or health system in that area, and that is really up to those local, regional hospital-specific guidelines that they’ve got set up in place.

It’s not necessarily KSUCPM or any university holding students back from going. There are just hospital-specific issues as far as the number of bodies in the hospital available PPE and things like that that are holding students back from being able to get in there. I know at least from our school perspective, this is something that is in constant conversation.

Laura Turner: Yes, it’s definitely, and with all the changes with the different variants that are coming on, I’m sure it’s a moving target you’re trying to hit.

Dr. Christina Pratt: Right.

Laura Turner: This is a question about what it’s like to be in academia and private practice at the same time. Mason’s asking that seeing as you’re in academia, as well as being in private practice, what advice would you give to someone who wants to follow a similar pathway?

Dr. Christina Pratt: Do it. It’s the best.

That’s the advice I would give. I guess to elaborate as to why I love that variability, it keeps me on my toes. I initially thought that I’m too young. I’m too young to go straight into academics. I need to get my feet on the ground and get some years, some research, some cases behind me before going into this. It took a little while to get into it and think, “You know what, I actually have a lot to offer because I just went through this. I know exactly what it’s like. I know exactly what was really useful for me and what really helped me get through certain points in my third year, going into my fourth year to pass step two of boards, getting into residency interviews.”

Getting into academics was initially, for me, a little bit scary, but I think that it’s something if you want to take a path like that, know that you have a lot to offer, and you have a very, very unique perspective from a lot of other people that have probably been in academia much, much longer, I would say go for it. I love the variability that I have of getting to lecture to students one day, and then, get away from them another day and go into my private practice where it’s just me and my patient and we’re having those one-on-one conversations because that means a lot to me too.

It is just the coolest, though, when you get to be with a student who is seeing their first patient, doing their first procedure, throwing their first suture, and watching those lightbulb moments click where they’ve learned it in class and you just can’t appreciate or understand why you threw a screw this way, or why you would put the wire in this direction, and then, all of a sudden, you’re in a lab and you say, “Oh my gosh, it makes so much sense now.”

Watching those moments is really neat and you get that perspective that I never thought how much I would appreciate that, and that full circle has just made this career that means more to me. I would say just go for it, know that you have a lot to offer, but you have to be somebody who’s going to be okay with going in every which direction, constantly being on your toes. The students will keep you on your toes all the time. They will call you out consistently, as they should. It’s a fantastic just direction to take a career.

Laura Turner: Great, and obviously, somebody has to be able to switch gears pretty easily since you’re constantly changing what you’re doing each day. Speaking of which, we’ll switch gears here to a question about board prep. This is from Emily, who’s a current Kent State MS-1, how did you feel board prep for both 1 and 2 was, and maybe talk a little bit about your board prep in general.

Dr. Christina Pratt: Well, I am not very involved in board prep for part one because that’s a lot of preclinical sciences. Hi, Emily, I’m sure I’ll see you soon in class at some point. Part 1, I can’t give you too much info on as far as what– I’m assuming this is a question about what KSUCPM does specifically for board prep for Part 1 and Part 2. Part 2, I get a little bit more involved with, especially on the clinical aspect and on the surgical aspect.

I know that we offer a lot as far as sessions that you can go to where they’re constantly bringing faculty in to go over and give Cliffs Notes versions basically on their specific specialty or subspecialty within the profession. I think taking advantage of all of those is really important because it’s very easy to– Kent, in general, just offers so much. I think that’s one of the big benefits of KSUCPM, specifically, is there’s such a vast amount of resources because we’re a big college and we’ve got a lot to offer, but it’s really– The onus is on the student to really take advantage of it.

For Part 2, specifically, I know that there are months and months of review sessions available. One of the things that– I guess as a caveat to that, that I am most proud of in my career is, along with two of my colleagues, that we have been together since going through undergrad and are all now podiatrists working together in private practice, started a non-profit foundation for student education and podiatry. It’s called STEPS. It’s Student Transatlantic Education in Podiatric Surgery.

We really took that during COVID time when students, especially our fourth years, were trying to prep for boards, were out of clinic, didn’t have any of that opportunity to really get in-person prep. We started putting videos out there on YouTube. We started basically getting limbs donated into our private practice, doing live dissections. One of us with the GoPro, the other one, dissecting, the other one, live streaming it, posting it, and really tried to put boards prep stuff out there, interview prep stuff out there. It’s all out there. It’s available. It’s just up to you to utilize it.

Laura Turner: Great. Maybe if you could share in the chat what that link is if you have that handy so we can share it out to everybody who is on the call. That would be awesome to give them, excuse me, that resource.

Dr. Christina Pratt: sure.

Laura Turner: What would you say makes KSU unique compared to other podiatry schools?

Dr. Christina Pratt: I kind of just mentioned that it’s the resource. I mean, Kent being tied to, obviously, what is a very large university in Kent State, we’ve got all of the access, we’ve got all of the research support, we’ve got all of the faculty staff and personnel that are there to really support students. I think that one of the nice things about Kent is that we are all together on one campus. I came from CSPM, which was a health professions school. The benefit there was I was constantly interacting with other health professions students at the same time, but we were also on campus so our class was split up and we were all over the place.

Here at Kent, we’re all in one building. We see each other a lot, we get to know each other well despite the fact that these are big classes, and just the clubs, the support, the tutoring that’s available. I think that our students do a very good job at that teach down approach where fourth-years are helping third-years are helping second-years, and a lot of that is fostered by the fact that we are all together all the time on one campus. I think there’s a lot of benefit to that.

Laura Turner: Here’s another question about KSU. Pauline is asking about the grading policy if it is unranked pass-fail. Is the school still keeping track of internal ranking like many other schools are doing?

Dr. Christina Pratt: We are not completely on pass-fail. There is still a GPA situation. There are some classes and increasingly more classes that we have had discussions about. I am not on the curriculum committee at KSUCPM, specifically, so I’m probably not the best person on faculty to speak on this, but it is not just an unranked pass-fail curriculum. The ranking comes from a GPA basis.

Laura Turner: Switching gears here to a question from Kimia, who asks, what was a challenging issue that you’ve had to face as a podiatrist?

Dr. Christina Pratt: Gosh, I can think of so many. I guess just as– This is less so as a podiatrist, and this is more so as a young female physician, is just gaining rapport with people because, I’ll tell you, it does not come automatically when I walk in a room as it does for some other people. I went through residency having been trained by some really great people, and I got the opportunity to really get this fly-on-the-wall perspective of watching them enter a room and watching patients, excuse me, just say, “Okay. Okay.” That trust or that rapport was automatically there.

I don’t necessarily have that. That can be a challenge sometimes with patients, and I think that I overcome that with education and I overcome that with hopefully a relatability with patients where I can actually take the time and explain to them. I tell students this all the time, “Your patient education is just as important as your patient exam. If not, more so.”

I really, really spend a lot of time on that patient education component, and that can be a challenge sometimes when you are sitting there face to face with someone who clearly doesn’t trust you, or maybe someone who has already seen an established orthopedic surgeon, who has been in practice for the last 35 to 40 years, and they’re coming to see me for a second opinion. I come in the room, and they take one look at me, and they say, “When’s my doctor coming in?”

It’s a little disheartening sometimes, initially, but then, I look at that every single time as a challenge. This is another challenge for me to prove why I’m here and why I’m doing what I’m doing, and that I’m also pretty darn good at what I do. It’s that daily challenge that I’ve grown to like, I guess, as weird as that can be. I think that that’s just a continual issue that I notice.

I come in the room, and they [patients] take one look at me, and they say, “When’s my doctor coming in?” It’s a little disheartening sometimes, initially, but then, I look at that every single time as a challenge. This is another challenge for me to prove why I’m here and why I’m doing what I’m doing, and that I’m also pretty darn good at what I do.

Laura Turner: Okay. We’ll switch gears again, going back to another question about Kent State. This is about the board pass rates on the first try. I don’t know if that’s something that you would know.

Dr. Christina Pratt: You guys are really quizzing me on this KSUCPM stuff. I do not know what the actual percentage of the board pass rates are. I do know that we were on or above the average this year for the first-time board passing rate for Boards Part 1. I think that, in general, this year, from what I understand anyway, the Part 1 pass rate was decently lower than what it has been in the past. Unfortunately, I think a lot of that gets affected by COVID.

If you think about our first and second-year students, those are students that need to be in the lab. They need to be doing gross anatomy dissections, they need to be doing lower extremity-specific dissections, and not having that ability is hard. Again, I was talking early about just learning surgical skills. Being told it, watching it on a slide on a PowerPoint is one thing, but actually hands-on, seeing it, doing it is another as far as learning and memory. I think that we were at average or above average as far as first-time pass rates this past year. I’m sorry, I don’t have a specific percentage for you.

Laura Turner: Yes, you’ve definitely been getting a lot of the questions about the school. Well, here’s one that’s a little different. This is from Isaac, and he’s asking about the pros and cons of being employed by a hospital and going into private practice for someone who’s about to finish up their residency and going into their career.

Dr. Christina Pratt: Yes. Well, if you want to take the private practice route, you definitely have to be okay grinding every day, all day, being willing to have early mornings, late nights, take cases whenever you can get them in outside of your clinical patients, establishing rapport is something that takes a while. I think that that’s a lot of the mistake that some residents tend to make because you finish your third year of residency and you’ve been doing all of these probably what are pretty big hindfoot and ankle cases.

They’re making you feel like, “Look, I’m going to come out, and I’m going to hit the road running, and I’m really going to just go for it surgically,” and then, all of a sudden, day one, those patients are not lined up at your door. It’s the nail care patients that are lined up at your door, but those nail care patients eventually may have a fracture, eventually may have a daughter who wants her bunion fixed. You just never know where that can lead, so I think opening your door in private practice to any and all and not going into a private practice route trying to make it very niche from the beginning is important.

I think that’s one of the reasons that, for our private practice, we’ve seen so much success early on is because we were willing to just do it all and take it all on and take whatever came in the door. I think that there’s so much reward in that. When it’s a private practice, it’s yours. Those are your patients. You’re dictating how your day goes. You’re dictating how much you’re doing. There’s just so much inherent reward that comes with that.

You have to be okay with some financial instability, especially in the beginning. Insurance can change up on you all the time, and it does, and when you’re in private practice, you are always at the mercy of whatever insurance companies are doing, are accepting or denying or paying you for or not paying you for, and that’s hard, versus when you’re in a hospital, you’re typically salaried.

You may be salaried with base pay plus then an incentive bonus, and that incentive bonus usually comes after you’ve earned the hospital a certain revenue or you’ve done a certain volume of cases for them, and then, you may start getting small percentages of everything that you do thereafter, which is nice because you automatically start with financial stability. You don’t have to worry about marketing. You don’t have to be a good marketer. You don’t have to be a person with an MBA background and know anything about business because someone else is doing that for you. Sometimes, in a hospital setting, you even have people doing billing and coding for you, which is, I will tell you, I think the worst part of medicine, in general, is billing and coding.

With the hospital job, there are pluses and minuses there too because then you trade off freedom. You are at the mercy of when they want you there, when they want you to leave, how much volume they want you to see, maybe even, unfortunately, how they want you to practice, when they want you to do something, when they want you to refer something out, what your vacation time looks like.

I have some good friends in California who work for large health systems and who put their vacation time in one year in advance. That one-week vacation gets put in the calendar a year ahead of time, and you have to know that those are the only days that you’re going to have off, versus in private practice, I can decide. Something else came up, I need to add on this emergency add-on case, I need to cancel patients for this afternoon, or I need to make an appointment this day so I’m going to go ahead and block my schedule. There are definitely pluses and minuses to both. I don’t know if I gave you a fantastic answer to that but bouncing back and forth, those are some pros and cons that I’ve definitely noticed.

Laura Turner: I think it was a pretty detailed answer. I feel like you gave a really good explanation of what the different aspects of a hospital versus a private practice would be like. We have another question here about Kent State. Somebody asked about how does Kent State view low MCAT scores but a relatively high GPA?

Dr. Christina Pratt: Just like with patients, every case is different. N equals 1, right? It’s the same way with applicants. It’s the same way with students. I had been on the admissions committee for a few years and do some work on the admissions committee now as well, and we really, really try to look at all of those applications as an individual application. I hesitate, always, when we’re– I don’t like to see students say, “I’m not going to apply,” or, “My score didn’t hit this mark,” or, “My GPA didn’t hit this mark,” because there are so many other things that can make an application great.

I would say, as far as a low MCAT score but a high GPA, if you are proving to us somewhere that you have the academic ability, we’re still going to look at that application. Of course, at any school, at any university, there are minimums across the board that they hold students accountable to, but then, there are always variables that come into place where this may make up for that or this makes up for that a little bit. I would still say, with a high GPA, that that’s still probably what can be considered a potentially competitive application.

Laura Turner: Good. We have another application question here from Paulina, and she’s asking when should primary applications be submitted considering rolling applications.

Dr. Christina Pratt: Oh dear, you guys, I just do foot and ankle surgery. I don’t know all of this information-

Dr. Christina Pratt: -about application cycles and things like that. Oh gosh.

Laura Turner: We can always tell them that they should go ask questions on the Student Doctor Network forums. Maybe that’s-

Dr. Christina Pratt: I guarantee that we probably got some of our staff that is in the department of academic enrollment that can absolutely give great answers to all of these questions. I just don’t want to give the wrong ones because I don’t know.

Laura Turner: Great. Let’s switch over here. We have another question from Aidan who’s asking what made you look at the DPM route as opposed to the MD or DO route, and is there anything, particularly, that stood out for you in podiatry that MD/DO didn’t offer?

Dr. Christina Pratt: Yes, I mentioned this a little bit in the beginning when I was first probably given a long-winded chat about why I got into podiatry. For me, this was something that, as I started again learning more about myself and realizing how much I thrived on details and specifics, much to the annoyance of a lot of people close to me in my life, I realized that I wanted that in a profession because I knew I was good at that.

I think that there’s obviously a lot of that in podiatry because we’re focused on one specific area and the surgeries that we do as foot and ankle surgeons are very, very detailed. They’re obviously orthopedic in nature so I’m putting in plates and screws and things like that all day long, but it’s very detailed in the sense of fixing or improving one area. I think that what stands out with podiatry is just we’re this surgical subspecialty of medicine, but at the same time, we have so much freedom in how we set up or create our careers and what we’re doing on a daily basis.

I have a unique perspective because my sister- she and I went through school at the same time. She was going to an allopathic school in Toledo while I was going through school out in the Bay Area. She ended up going to a residency for general surgery. She’s a general surgeon, did a fellowship in bariatric medicine. She’s actually the first female bariatric surgeon hired by her health system in Toledo.

I watched her go through her training, her residency, her fellowship, and I saw just this complete lack of flexibility in what she was doing and even the job opportunities that she had. There’s not a lot of variability in the career choice that she chose. It’s not like she can just go decide, one day, to open up this private practice and change what her clinical surgical situation is.

I can decide, one day, I want to get out of academics and go into a hospital-based route. I can move into a private practice route. I have so many sub-specialties within podiatry. I can decide tomorrow I want to be a specialist in wound care and go work in a wound center and do wounds and hyperbarics and all of that. I can decide that I only want to do sports medicine, or I only want to treat routine care patients, and maybe one day, I just drop surgery because I’ve decided that I just want to become nonsurgical. My younger sister doesn’t have that option. Her career is what it is. She also doesn’t have that flexibility. I think podiatry offered so much of that, and it’s made me really happy in my young career so far.

Laura Turner: That’s a very detailed answer. I appreciate you going into such detail, and as you said, you have a unique perspective because your sister, you were able to see her go through that allopathic route. We have another question here in that same area. What are your thoughts on the push for podiatry students to take the USMLE?

Dr. Christina Pratt: Sure. I think it’s great. I think that it’s important to continue as I said, a little bit earlier if we want this parity in working alongside our allopathic and osteopathic colleagues to show that not only is our residency training on par but our education is on par. I don’t see a problem with podiatry students going through and taking USMLE exams. Likewise, I would invite our osteopathic and allopathic colleagues to really take a look at our residency training. Obviously, that’s where our surgical-specific training comes into play, and I think that’s really where you have to start to measure where are we at on par surgically or otherwise with our allopathic colleagues.

Laura Turner: I’m going to circle back to– We got a response from Carla, from Kent state here, who said that-

Dr. Christina Pratt: Perfect. Thank you, Carla.

Lauran Turner: -the VF priority deadline is April 1st, 2021. That was an answer to the question that Paulina had about when was the best time to apply with rolling admissions. I wanted to circle back to that one in case other folks had some questions on that. I’m going to jump over to this. Here’s another question– This is a question about competitiveness for matching into residencies. I don’t know if this is one that you feel comfortable answering. How hard is it to match into residencies as a DPM as a student who’s coming out of school?

Dr. Christina Pratt: That fluctuates I think depending on what application cycles look like for a few years, how many students are currently in podiatry school, thus, how many are matriculating and graduating, thus, how many are then applying for residency positions. Back when I was graduating from school and applying to residency, which, gosh, is almost going to be 10 years pretty soon, there was a significant shortage of available residency programs, so the advantage was on the side of basically these residency programs because they had their pick of top students.

It was very, very competitive because there were close to 20% of students the year that I graduated that went unmatched, that just didn’t have an available spot to take, and they then had to matriculate into cycles thereafter. Now, that tide has shifted a little bit, and we have now more residency positions open and available, for the most part, year to year than we do necessarily having students matriculate and graduate.

It is not something necessarily that needs to be competitive to get a program but maybe to get the program that you want, and what I would really say is that more so than KSU, more so than any other school, the onus is really on the student at that point. When you’re a fourth-year and you are outperforming on externships, you’re basically putting yourself in front of people for a month-long interview. The onus is really on you to be competitive and to make a good impression.

It was on Kent to give you that background and that education and that clinical training, but it’s also up to you to take advantage of all of that to make sure that you’ve got it and to put that in front of other people. I think, in general, our students are pretty competitive as far as matching into the programs that they want. I don’t think it’s something where you would have to worry at this point about matching into a program.

When you’re a fourth-year and you are outperforming on externships, you’re basically putting yourself in front of people for a month-long interview. The onus is really on you to be competitive and to make a good impression.

Laura Turner: Thank you. We have just a little bit more time to ask a few more. We have a number of additional questions here. We’ve just a little more time. I’m going to skip to this question here from Mason about, what is one patient or story that has stuck with you throughout your time as a podiatrist?

Dr. Christina Pratt: Oh my gosh, so many patients and stories. I think one of the really cool things about our profession is that your patients stick with you. Literally, they stick in your mind as far as the stories that you go through with them but because you go through so much with them clinically and then maybe surgically, these are patients who are with you sometimes a career-long.

I’ve talked a little bit before about gaining rapport with patients and how difficult and how challenging that can sometimes be as a young physician or as a female physician, in general. I saw a patient through our school clinic as a favor for another physician who was on vacation who had asked, “Can you just go in? All I need you to do is take a measurement of this ulcer. She has an ulcer, a wound on the tip of her toe. We just need to clean it up, put a fresh dressing on it, take a measurement for me. I’ll see her again next week.” “Okay, no problem.”

The student comes out, presents the patient, and says, “I think it looks a little bit concerning. I think it might be infected.” I go in and I see the patient and that’s just one of those things where you lay eyes on it for two seconds you know immediately that this is what gangrene is. This is something where the patient has gas in their soft tissues. This is an OR situation so the patient needs to go right to the hospital. This is also my first introduction ever, walking into the room saying, “Hello, nice to meet you. I’m Dr. Pratt. I’m a foot and ankle surgeon, and we need to go to the hospital now because we need to amputate this toe.”

I mean, you think about how scary that for a patient, meeting a stranger for the first time. I am not your regular doctor. I don’t look anything like your regular doctor, I don’t sound like your regular doctor, and I’m now telling you probably the most serious news that you’ve ever had in the sense that we’re going to need to cut this toe off today and this is going to be a long journey to get this to heal.

That’s one of these patient cases where she and I had this odd start, this difficult start as far as I didn’t even know if she was going to trust me enough to meet me at the hospital to get up to the operating room, and now, she is my favorite patient in the world. I love to see her and I hope she loves to see me. I still follow up with her every couple of weeks for routine care visits.

She and I were on this two-year surgical journey of getting her wound healed, doing that amputation, complication after complication, and to see her now, that whole situation has manifested into a complete lifestyle shift. This is someone who now has their diabetes under control, who no longer smokes, who has a totally different diet, who has never had a single foot or ankle issue since so that just is the biggest success story in my mind, not because we got her to heal and she’s okay but because her whole lifestyle is different. If I even had a little role to play in that, that’s just awesome. I’m never going to forget her.

Laura Turner: Thank you. We’re pretty much out of time here. I’m going to pull that one. We already talked about that one. I just wanted to say thank you again to Dr. Pratt for taking the time. I know she’s got other things I’m sure she wants to get done with her evening here as the night is falling. We’re going to go ahead and wrap up here. Again, I’d like to say thank you to Dr. Pratt. We appreciate her coming on. I just want to also give a shout-out about the Student Doctor Network at studentdoctor.net.

We have a lot of resources available. They’re including a large community where you can talk to other folks about what it’s like to go through the whole process of getting into and getting through health professional school. We cover a range of different areas both from allopathic and osteopathic medicine as well as podiatry, optometry, dentistry, a number of different areas. We have a lot of resources. We are a non-profit so all of our resources are available to you through the generous support of our donors and available to you for free. We invite you to come to visit our site and check out our resources. Again, Dr. Pratt, thank you very much for taking the time. We really appreciate it.

Dr. Christina Pratt: Absolutely. Thanks.

Laura Turner: Thank you, everybody. Hope everyone is doing well, has a good evening, and we’ll talk to you at our next webinar. Thanks, and good night.

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