I'm not one to judge. Let's debunk the public perceptions myths, and give it to you straight.

我不是一個喜歡評判的人。讓我們揭穿公眾認知的神話，並直接給你看。

This is the reality of podiatry. Dr. Jubbal, MedSchoolInsiders.com.

這就是足科的現實。Jubbal醫生，MedSchoolInsiders.com。

Welcome to our next installment in So You Want to Be. In this series, we highlight a

歡迎來到《你想成為什麼樣的人》的下一期節目。在這個系列中，我們將重點介紹一個

specific specialty or profession within medicine, such as podiatry, and help you decide if it's

醫學中的特定專業或職業，如足科，並幫助你決定它是否是

a good fit for you. You can find the other videos on our So You Want to Be playlist.

一個適合你的地方。你可以在我們的 "你想成為 "播放列表中找到其他視頻。

And make sure you're subscribed if you want to vote for future videos.

如果你想為未來的視頻投票，請確保你已經訂閱了。

Podiatry is the field specializing in the foot and ankle, and related structures of

足科是專門研究足部和踝部以及相關結構的領域。

the leg, both in medical and surgical management. They use principles from sports medicine,

在醫療和手術管理方面，他們使用了運動醫學的原則。他們使用運動醫學的原則。

biomechanics, wound healing, and various surgical techniques to treat anything from discomfort

生物力學、傷口癒合和各種手術技術，以治療各種不適症狀。

and pain to discoloration or odor. Some common conditions podiatrists manage

和疼痛到變色或異味。足科醫生管理的一些常見情況

include plantar fasciitis, which is inflammation of the connective tissue on the sole of the

包括足底筋膜炎，它是鞋底結締組織的發炎。

foot, in-grown toenails, achilles tendonitis, structural deformities such as crossover toes,

腳、內生趾甲、跟腱炎、結構畸形，如交叉腳趾。

nerve or vascular damage, ankle sprains, ulcers, infections such as athlete's foot, fractures,

神經或血管損傷，踝關節扭傷，潰瘍，感染，如香港腳，骨折。

and bunions. Many patients requiring podiatry care have

和拇指外翻。許多需要足科護理的病人有

comorbidities, meaning other chronic medical conditions, such as diabetes. Because of compromised

合併症，指其他慢性病，如糖尿病。由於受到損害

blood circulation in the foot and resulting nerve damage, diabetics are particularly prone

糖尿病患者的足部血液循環和由此產生的神經損傷，特別容易造成

to foot issues, such as neuropathic ulcers from losing protective sensation. On the other

到腳部問題，如失去保護性感覺的神經性潰瘍。在另一個方面

hand, some of your patients may be healthy athletes, and you'll be tasked with treating

另一方面，你的一些病人可能是健康的運動員，而你的任務是治療

their ankle fractures or other acute injuries with bracing, casting, orthotics, or surgery.

他們的踝關節骨折或其他急性損傷，要進行支撐、鑄造、矯形器或手術。

The conditions you treat within podiatry will be both acute and chronic in nature, sometimes

你在足科治療的病症既有急性的，也有慢性的，有時是

for the same injury. For example, an acute ankle sprain, meaning soon after it occured,

對同一種傷害的治療。例如，急性踝關節扭傷，意味著發生後不久。

is primarily focused on dealing with the immediate inflammatory process. If the patient continues

主要側重於處理直接的發炎過程。如果病人繼續

to have chronic ankle issues and repeated sprains, say one year later, the management

有慢性踝關節問題和反覆扭傷，比如一年後，管理

plan changes. If they have scar tissue and structural changes, for instance, surgical

計劃改變。如果他們有疤痕組織和結構變化，例如，手術

intervention may be warranted. Podiatrists will assess neurovascular, dermatological,

可能有必要進行干預。足科醫生將評估神經血管、皮膚病。

and musculoskeletal components in making treatment decisions. While most presentations are non-urgent,

在做出治療決定時，要考慮到肌肉和骨骼的成分。雖然大多數的介紹都是非緊急的。

urgent and emergent management may be necessary for open fractures, degloving injuries, compartment

對於開放性骨折、脫位性損傷、室間隔損傷，可能需要緊急處理。

syndrome, and some infections. Podiatry is a misunderstood field, and as

綜合症，以及一些感染。足病學是一個被誤解的領域，而作為

I joked about at the beginning of this video, many think podiatrists have foot fetishes.

我在這個視頻的開頭開玩笑說，許多人認為足科醫生有戀足癖。

Maybe some do, but they probably aren't getting their kicks through podiatry, as they're working

也許有些人是這樣做的，但他們可能不是通過足科得到他們的樂趣，因為他們正在工作。

with diseased feet with ulcers, fungus, calluses, and interesting smells.

有病的腳，有潰瘍、真菌、老繭，還有有趣的氣味。

Some believe podiatrists only cut toenails and give pedicures. While it's true that clinical

有些人認為足科醫生只剪腳趾甲和修腳。雖然這是事實，但臨床

care may involve trimming toenails and calluses for patients who are at elevated infection

護理可能包括為感染率高的病人修剪腳趾甲和老繭。

or bleeding risk, they do much more than that. Podiatrists run the whole gamut, from trimming

或出血的風險，他們做的遠不止這些。足科醫生負責整個領域，從修剪

toenails to surgical procedures. And last, many people confuse podiatry with

趾甲到手術的過程。最後，許多人把足科和外科混為一談。

pediatrics. We have a So You Want to Be a Pediatrician episode to clear up any confusion.

兒科。我們有一集《你想成為一名兒科醫生》來澄清任何困惑。

Podiatrists earn their DPM, standing for Doctor of Podiatric Medicine, after attending podiatry

足科醫生在參加完足科培訓後，可獲得代表足科醫學博士的DPM學位。

school, which is 4 years, just like medical school. You'll cover some similar foundational

學校，是4年，就像醫學院。你將涵蓋一些類似的基礎知識

training that MD and DO students cover in the first two years, but focus more heavily

醫學博士和醫學博士的學生在前兩年所涉及的培訓，但更注重於

on podiatry in years three and four. In the U.S., there are 9 podiatry schools,

在第三和第四年，關於足療的問題。在美國，有9所足科學校。

with roughly 1,000 students applying each year, and approximately 60% gaining admission.

每年大約有1,000名學生申請，大約60%獲得錄取。

If you thought that applying to podiatry school would spare you from the MCAT, think again.

如果你認為申請足科學校會讓你免於參加MCAT考試，那麼再想想吧。

Do note, however, that podiatry school admissions are substantially less competitive than either

然而，請注意，足科學校的錄取競爭大大低於以下兩種情況。

allopathic or osteopathic medical schools. In 2020, the average matriculant scored a

異體醫學或骨科醫學學校。在2020年，預科生的平均分數為

494.6 on the MCAT, which is around the 35th percentile, with a 3.4 overall GPA, more specifically

MCAT考試成績為494.6分，約為第35百分位，總體GPA為3.4分，更具體的是

a 3.2 science GPA and 3.5 non-science GPA. In comparison, allopathic medical school averages

理科GPA為3.2，非理科GPA為3.5。相比之下，對抗療法醫學院的平均成績為

were 511.5 on the MCAT, which is an 88th percentile, and an overall GPA of 3.73.

在MCAT考試中為511.5分，這是一個88分的成績，總體GPA為3.73。

After podiatry school, most states require a 3 year residency covering medical and surgical

在足科學校畢業後，大多數州要求有3年的實習期，包括內科和外科。

training, although the duration does vary by state. And just like with MD or DO residency,

培訓，儘管持續時間因州而異。就像醫學博士或醫學博士的住院醫師一樣。

podiatrists have various general and more specialized rotations.

足科醫生有各種普通和更專業的輪換。

As a first year resident in your postgraduate year 1, or PGY-1, you'll spend anywhere from

作為研究所學生第一年，即PGY-1的第一年住院醫生，你將在以下任何地方度過

2 to 6 months on podiatry, and the rest of the year on core rotations, including anesthesiology,

2至6個月在足科，其餘時間在核心輪轉，包括麻醉科。

orthopedics, and emergency medicine. As a PGY-2 and 3, you'll focus exclusively

矯形外科和急診醫學。作為PGY-2和3，你將專注於

on podiatry, both in the inpatient and outpatient settings, gaining additional autonomy as your

在住院病人和門診病人的環境中，獲得更多的自主權。

training progresses. Podiatry is more male dominated, with close

培訓的進展。足科更多的是由男性主導，有密切的聯繫。

to 60% of matriculants being men. However, the gap has been narrowing as more and more

到60%的預科生是男性。然而，隨著越來越多的人加入，這一差距已經在縮小。

women enter the field. After podiatry residency, you can subspecialize

女性進入這個領域。在足科住院醫師培訓結束後，你可以進行亞專業培訓

further with podiatry fellowship, which are usually each 1 year in duration.

更進一步的是，足科獎學金的期限通常為1年。

Sports medicine podiatrists deal with athletes and their associated injuries. It's the

運動醫學足科醫生處理運動員和他們的相關傷害。它是

highest compensated, as it includes a high volume of quick procedures. Conservative management

得到最高的補償，因為它包括大量的快速手術。保守性管理

is also common, including taping, padding, dressing, splinting, and casting. It includes

也很常見，包括包紮、填充、包紮、夾板和鑄造。它包括

a strong biomechanics component and incorporation of physical therapy modalities and rehabilitation

強有力的生物力學成分，並納入物理治療模式和康復。

techniques. Limb salvage and preservation podiatrists

技術。肢體搶救和保存足科醫生

work primarily with diabetic or vascularly compromised patients. You'll be preventing

主要為糖尿病患者或血管受損的患者工作。你將會預防

or conducting lower extremity amputations, and therefore there is a heavier operative

或進行下肢截肢，是以有較重的手術量。

component to this fellowship. The lifestyle may be more unpredictable, however, as you

這個獎學金的組成部分。然而，生活方式可能更加難以預料，因為你

may need to take call. Reconstructive podiatrists are the most heavily

可能需要接電話。修復性足科醫生是最大量的

surgical, dealing with complex reconstructions such as in addressing Charcot foot. Compared

手術，處理複雜的重建，如處理夏科足。與之相比

to other podiatry subspecialties, complication rates are higher and compensation is lower,

與其他足科亞專業相比，併發症的發生率更高，賠償也更低。

as cases take longer on average. Public health podiatrists place an emphasis

因為案件平均需要更長的時間。公共衛生足科醫生的工作重點是

on quality care and preventive medicine. This subspecialization is best suited for those

在優質護理和預防醫學方面。這個亞專業最適合於那些

who want to think bigger picture about healthcare policy, clinical care, and making a wider

希望對醫療政策、臨床護理有更大的思考，並能在更大範圍內做出貢獻的人。

impact on quality of care. Wound care podiatrists focus on complex wounds,

對護理品質的影響。傷口護理足科醫生專注於複雜的傷口。

managing infections, and limiting complications. It's highly interdisciplinary, incorporating

管理感染，並限制併發症。它是高度跨學科的，包含了

elements from infectious disease, dermatology, vascular surgery, and plastic surgery.

來自傳染病學、皮膚病學、血管外科和整形外科的元素。

There are other fellowships too, including trauma, pediatrics, and orthopedics.

也有其他的獎學金，包括創傷、兒科和骨科。

There's a lot to love about podiatry. It's a low acuity field with great work-life

足科有很多值得喜愛的地方。這是一個低敏度的領域，有很好的工作和生活。

balance, with podiatrists working generally 30 to 60 hours per week, depending on practice

平衡，足科醫生一般每週工作30至60小時，這取決於診所的情況。

type and setting. You aren't dealing with life or death situations, and outcomes are

類型和環境。你不是在處理生死攸關的情況，而結果是

generally favorable. It's less taxing when your patients aren't dying on you, but note

一般來說是有利的。當你的病人沒有死在你身上時，它的負擔就會減輕，但要注意

that depending on your clinical focus, some of your patients may have substantial complexity

根據你的臨床重點，你的一些病人可能有很大的複雜性。

or comorbidities. Depending on your interests, there is some

或合併症。根據你的興趣，有一些

flexibility in your clinical practice. For example, you could be more or less surgical

在你的臨床實踐中具有靈活性。例如，你可以多做或少做手術

depending on your preference, or subspecialize with one of the various fellowship offerings.

根據你的偏好，或在各種研究金中選擇一個專業。

One of the other benefits of already being comparatively narrow in scope compared to

相比之下，範圍已經相對狹窄的另一個好處是

something like medical school is that you already know your specialty from day one.

像醫學院一樣的東西是，你從第一天起就已經知道你的專業。

That means you won't face the stress or uncertainty with choosing a specialty, or having to work

這意味著你不會面臨選擇專業的壓力或不確定性，或不得不工作。

extra hard to match into a particularly competitive specialty.

額外難以匹配到一個特別有競爭力的專業。

Podiatry isn't for everyone. First, and most obviously, you'll need to be ok with forever

足科並不適合所有人。首先，也是最明顯的是，你需要能夠永遠接受

working on the foot and ankle for the rest of your career. Unlike medical school, where

在你餘下的職業生涯中從事足部和踝部的工作。與醫學院不同，在那裡

you can choose highly varied specialties, the level of differentiation within podiatry

你可以選擇高度多樣化的專業，足科內部的差異化水準

is comparatively limited. You won't get the same social recognition,

是相對有限的。你不會得到同樣的社會認可。

status, or compensation as going the physician route, despite spending 4 years in podiatry

儘管在足科花了4年的時間，但他的地位或報酬卻不如走醫生的路線。

school and 3 years in residency. The average podiatrist makes $148,000 per year, which

學校和3年的住院醫師培訓。足科醫生的平均年薪為148,000美元，其中

is substantially less than the average physician, yet podiatry school is roughly the same cost

大大低於普通醫生，但足科學校的費用卻大致相同。

as medical school – approximately $40,000 per year. With four years of medical school

作為醫學院--大約每年40,000美元。隨著四年的醫學院學習

and 3 years of internal medicine residency, you would make an average of $248,000. And

和3年的內科住院醫生，你將平均賺取248,000美元。而

yes, we know your cousin's toad's sister's twin makes a million dollars per year as a

是的，我們知道你表哥的蛤蟆妹妹的孿生兄弟每年都能賺到一百萬美元，作為一個普通人。

podiatrist, but we're speaking to the U.S. averages here. After all, you could say the

足科醫生，但我們這裡說的是美國的平均水平。畢竟，你可以說

same about high earning outliers in just about any specialty or field of medicine.

在任何專業或醫學領域，高收入的離群者也是如此。

There's debate between orthopedic surgeons and podiatrists. Given the 5+ years of surgically

骨科醫生和足科醫生之間有爭論。鑑於5年多來的手術

focused training orthopedic surgeons receive in addition to specialized foot and ankle

矯形外科醫生除了接受專門的足部和踝部訓練外，還接受重點訓練。

fellowship, my orthopedic surgeon colleagues believe they are better suited for surgical

我的骨科醫生同事認為，他們更適合做外科手術。

management of the lower extremity, and believe podiatrists are better suited for non-surgical

療，並認為足科醫生更適合於非手術治療。

management. However, podiatrists do receive a mix of medical and surgical training focused

管理。然而，足科醫生確實接受了內科和外科的混合培訓，其重點在於

on the foot and ankle in their 3 year residency, and most podiatrists would argue they are

在他們3年的實習中，大多數足科醫生都會說他們是 "腳和腳踝"。

plenty qualified. I cover this more in my So You Want to Be an Orthopedic Surgeon video.

有足夠的資格。我在《你想成為一名骨科醫生》視頻中更多地介紹了這一點。

This leads us to the next point, which is an ego battle. If you need the ego boost that

這就把我們引向了下一個問題，也就是一場自我的戰鬥。如果你需要自我提升，那麼

comes with being a physician, podiatry may leave you unfulfilled. On one hand, some podiatrists

作為一名醫生，足科可能會讓你感到不滿足。一方面，一些足科醫生

want recognition for their hard work, and want to be considered physicians and surgeons.

他們希望自己的努力工作得到認可，並希望被認為是醫生和外科醫生。

As one podiatry student writes, they have "the same education, training, and expertise

正如一位足科學生所寫的那樣，他們擁有 "相同的教育、培訓和專業知識"。

as MDs and DOs, yet lack the same recognition". On the other hand, many MDs and DOs find the

作為醫學博士和醫學博士，卻缺乏同樣的認可"。另一方面，許多醫學博士和醫學博士發現

obfuscation of the term "physician" or "surgeon" to be unnecessary and believe it simply further

對 "醫生 "或 "外科醫生 "一詞的混淆是不必要的，並認為這只是進一步的

confuses patients. They raise the question, what's wrong with saying you're a podiatrist

使病人感到困惑。他們提出了一個問題：說你是足科醫生有什麼問題？

that went to podiatry school, versus a podiatric physician that went to podiatric medical school.

與去足科學校學習的足科醫生相比，去足科醫學院學習的足科醫生。

How can you decide if podiatry is a good fit for you? If you want to build longitudinal

你如何決定足科是否適合你？如果你想建立縱向的

relationships with patients, work with feet, and want to improve quality of life without

與病人的關係，用腳工作，並希望改善生活品質而不

the pressure of life or death decisions, podiatry may be a good fit.

在生死抉擇的壓力下，足科可能是一個不錯的選擇。

If you are comfortable focusing on the foot, but are not sure how medical or surgical you

如果你對關注腳部感到舒服，但不確定你是如何進行醫療或手術的

want to be, podiatry offers that flexibility. If you want to work in healthcare but aren't

如果你想成為一名醫生，足科提供了這種靈活性。如果你想在醫療保健領域工作，但不是

thrilled about how cutthroat and competitive premed can be, podiatry offers a more attainable

激動於醫學預科的殘酷和競爭，足科提供了一個更容易實現的機會。

alternative. If you like the idea of working within a smaller

替代方案。如果你喜歡在一個較小範圍內工作的想法

community, podiatry has you covered, with only approximately 15,000 active podiatrists

社區，足科為您提供服務，只有大約15,000名活躍的足科醫生。

in the U.S. Thanks to The Podiatry Journey for helping

在美國，感謝 "足療之旅 "的幫助。

me with the creation of this video. Link to their channel in the description.

我與這個視頻的創作。在描述中鏈接到他們的頻道。

If you enjoyed this video, check out my video on So You Want to Be an Orthopedic Surgeon,

如果你喜歡這個視頻，請查看我的視頻《你想成為一名骨科醫生》。

or my episode on being a physician assistant. Much love, and I'll see you guys there.

或我關於成為醫生助理的那一集。非常感謝，我們會在那裡見到你們。