Getting into a podiatry career is not something most medical practitioners delve into, making it a sleeper but still an interesting field. To learn more about this particular specialization, Richard Marn, MD sits down with podiatrist Ernest Isaacson. In the first part of his interview, Ernest shares why he decided to take podiatry and the experiences he had when still training as a medical practitioner. He explains how podiatry training has evolved in twenty years, as well as the possible challenges a married practitioner in training could face in taking care of family relationships, which Ernest personally experienced and was able to overcome.
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Balancing A Podiatry Career And Family Life With Ernest Isaacson
Go into the worst parts of medicine. Don’t start in the operating room. If you’re thinking of being a surgeon, don’t spend your first day in the operating room. Whenever students come to shadow me and they want to go into the operating room with me, I have that as the last thing that they’re allowed to do. I have them watching me in the office for at least a few days before they can go into the operating room. Because once you go into the operating room, that’s it. You’re hooked. It’s done. There’s nothing sexier than the act of walking into a room in green scrubs with your hands dripping wet.
What you read was a snippet of our next guest. We have a great interview with him. In this episode, we’re going to talk with Dr. Ernest Isaacson, otherwise known as Ernie. I consider him a friend and also been fortunate to have him take care of me for some of my foot issues because we are dealing with a podiatrist. Ernie is a podiatrist. From the previous episode, we went from ENT with Dr. Guy Lin and we’re going to the other end. We are not stopping in the middle. To give you some background information on Dr. Isaacson, he went to college at Brown University, then got his Doctor of Podiatric Medicine or Podiatry degree at the Scholl College of Podiatric Medicine in Chicago.
He then completed his podiatric residency at both Wyckoff Heights Medical Center in Brooklyn and Our Lady of Mercy Medical Center in the Bronx. I consider Dr. Isaacson an excellent clinician, hilarious, funny and light-hearted, and knows the topic of his specialty well. This is another great guest to have on this show. I did not want to cut out much of his interview. I’m going to split this interview into two different episodes to make each episode tangible for the audience and easy to digest. Let’s get started.
How are you doing?
It’s great to be here. Thank you. It’s a pleasure. This is the closest I could get to a pediatric anesthesiologist.
You’re a podiatrist. When you were a kid, were you even thinking about medicine and podiatry as a career?
Yeah. It sounds a little cliché, but I was always thinking about medicine as a career even when I was a little child. I used to operate on my friends.
What do you mean as a child? You mean like when you were in grade school?
Yeah. I used to do little surgeries on my friends, like take things out. I did always have a keen interest in medicine as long as I can remember. It was always my thing.
How did that come about? Is it because you were coming from a family of doctors?
No. Everybody is in business in my family. I’m the only doctor in the family. I have a PhD doctor but no medical doctors in the family. Nobody else is interested. I always had a yearning for it. The science part of it always interested me and then medicine. When I was in high school, I volunteered in the emergency room on Sundays. I lived in a dorm for high school. I volunteered in an emergency room to get experience and I used to read all sorts of books about doctors and their careers and talk to a lot of different doctors. I always had a keen interest in it.
Even early on, you’re intrigued by the life and practice of people in medicine.Where you’re doing medical residency is oftentimes where you will end up living. Click To Tweet
I think it’s common among doctors, I would think. I don’t know if you found that also to have a calling toward it.
Did you watch a lot of doctor TV shows?
Yeah. St. Elsewhere was a favorite in high school. Kids won’t remember that one, but you can look it up on YouTube. That was when before Howie Mandel was doing whatever it is he’s doing, America’s Got Talent, and when he had hair. He was Dr. Wayne Fiscus. Denzel Washington, by the way, and many other famous actors. I like the doctor shows and I read books about doctors, doctor life, and different things. I was always interested. I imagined I would become a doctor.
Even when you were in high school, and even maybe in middle school, you were thinking, “I’m going to be a doctor.” How would you describe yourself as a student then knowing that that was where you want to go?
I think I was always bright, but I was a little bit aloof. I was an interesting student. I always had good knowledge, but I wasn’t a good test taker. I was a good student, and I had an interest in science. Even in high school, I was more interested in taking science classes. That appealed to me more. Math, not as much but science, yes. I was a good student though. I was interested in school. I was kind of an uber nerd.
You were part of the more geeky nerdy crowd.
I spent some time in the lockers. I don’t mean a locker room, but in the lockers. I had my share of wedgies before I learned to fight back. I lived in a dorm for high school so it was an interesting experience.
Why is that?
That was the school my parents picked for me. That’s a long boring saga but I went away for high school to a dorm. My parents were getting divorced and my father felt it would be best for me to be out of the house, which at the time was tough, but in retrospect, it was a good decision. It was a unique academic environment, but the school I was in was in Providence, Rhode Island. I ended up spending a significant amount of time there because I was there for high school, then I went back there for college.
Where did you grow up, though? Was it in New York?
I grew up outside of Boston, a place called Marblehead, which somebody has heard of. It’s a lovely place, idyllic and right on the ocean. I had a lovely childhood.
You spent school in Rhode Island then?
Correct, yes. I was there for four years of high school and then I went and went back for college. I got married and spent a year there after I was married and did research for a year in a hospital in Rhode Island.
How did you go about choosing your college?
College wasn’t a hard decision because I lived in Providence already. I went to Brown for undergrad. We knew Brown. You couldn’t not know it. Providence is not a big town. The football stadium was across the street from my high school. We used to have gym class in the Brown gym. On a Sunday, when we wanted to hang out, we would go down to their street. It was like the big hang out and pretend we were college kids. That was not a hard decision. It was just a matter of getting in. Once I got in, that was the thing.
When you were at Brown, you were there for years, then you’re thinking about medicine, but at some point, you were thinking of podiatry.
Somehow I found podiatry when I was in college and it seemed like a good field because there’s a lot of different stuff you can do. Podiatry is a diverse field and I think it’s a little bit of sleeper field. Not a lot of people know what podiatrists can do. The people who know both from doctors and patients and other doctors, podiatrists and patient perspectives know what podiatrists can do and what we’re capable of doing. People who are looking into medicine may not know what podiatrists do. Podiatry is a great field, because there are a lot of interesting things that you can do. There’s a lot more on the foot than you would think. It’s a lot more complex than people think.
I treat everything in everyone. There are a lot of different things that get incorporated into my practice. It’s also because you’re going to schooling that’s specialized from the beginning, the podiatry school is it’s four years of a separate type of school. Now it’s 3 to 4 years of residency. At the time when I was doing it, you could get away with one year of residency, but I did three years of residency. Podiatry became interesting to me sometime in college. That’s what I ended up choosing.
Where did that interest start for you for podiatry? For years, you’re thinking medicine. Podiatry is medicine-related, but it’s not the traditional medicine that we envision. Was there an a-ha moment? Was there someone that was a podiatrist that you were shadowing? What was the situation that made you think, “I need to make a course change here?”
It was somewhere in college. My pre-med advisor suggested it to me and I looked into it, and it seemed interesting.
It was because someone mentioned it and you did more research?
Yeah, pretty much. I spoke to some people and it seemed interesting to me.
Who did you talk to Ernie that gave you more information at the time? Other podiatrists?
I ended up shadowing a podiatrist. There’s literature and stuff like that and there were PR materials on what podiatrists do and what the school is like and all that. At some point, I decided to apply. Podiatry is an interesting field because it is a little bit of sleeper. Because of that, it’s a little bit easier to get into podiatry school than it is to get into medical school.If you’re going to pursue a medical career, you must understand that there will be some sacrifices. Click To Tweet
Would you say that’s the same thing now as well?
I think so. There’s even more podiatry school. There’s newer podiatry school. I think there are ten schools now nationwide, which doesn’t sound like a lot relative to those medical or dental schools that you have. Even the number of DO schools that you have is far more. There are not that many podiatrists so you think the demand would be tough to get in. There are not a lot of people deciding to go into it because there are some hurdles that you have to think about. When I looked into it, it seemed like an interesting field. It was also something that I could get into. When I interviewed for podiatry school, I only heard of two schools. One is Chicago and one in Philadelphia and the Philadelphia school I interviewed with a guy who I didn’t know at the time, but he happens to be a renowned expert on infectious diseases. He lectures all over the place. He’s one of the few podiatrists and a member of the Infectious Diseases Society of North America, which is like the premier infectious disease group.
Infectious disease for podiatry?
Yeah. His thing is infectious disease. He deals with a lot of bone infections, osteomyelitis, diabetic foot infections. He’s a renowned doctor and he lectures at national conferences. He’s well versed on infections that happen to affect the foot. When he interviewed me, I at the time happened to be applying to dental school as well because I wasn’t sure what direction I was going to take.
You applied to two different specialties, two different fields.
Your wife is a dentist so this may not bounce well off of you but he said, “Why would you want to be a dentist? You’re going to spend your whole career with your hands in people’s mouth. How are you going to have a conversation with them?” He told me a few other things which also were at the time, wise. He told me that he would accept me to podiatry school, but only if I would shadow a podiatrist and he wanted to make sure that I was committed to it.
Did you shadow a podiatrist before that?
I did. I had spoken to a podiatrist but I hadn’t shadowed anybody. I ended up shadowing somebody. I saw what they do and it looked good to me. I haven’t looked back. I think it’s a great field.
For myself, I thought I would be a surgeon, even when I was in grade school. When I didn’t become a surgeon because of a choice, it was like finding myself, if you will, professionally. Did you have that knowing that you were going to go into medicine, but then you were now only applying to dental school and podiatry school? Did you have that moment, the struggle, if you will?
Yeah. It’s like getting married. You never quite know if the decision is the right one. You go ahead and try not to think about the what-ifs, could haves, would haves, and should haves. I made the decision. It seemed like a good one at the time and you go with it, you live with it, and hopefully it’s not awful, and it hasn’t been. I like what I do. I do a lot of diverse things. To your point, this is a surgical field. It’s something that I can do. I can do anything pretty much at the foot and ankle. I do stuff that vascular surgeons do, and that orthopedic surgeons do. I have dermatology issues and infectious disease issues. I have little kids that come in, old ladies and everything in between, and sports medicine.
It’s a diverse field because there’s a lot of stuff that affects the foot. The ankle is the most commonly injured joint to the body. I deal with a lot of ankle sprains and I can deal with them from the minor ankle sprain to the severe ankle sprain to the chronic ankle sprain that needs to be fixed surgically. Whatever comes in, I’m able to fix. Working closely with other doctors also and the stuff that we do with the diabetics is unique and specialized. That’s a lot of what I like about this. That’s what makes the decision easier looking back on it because I like what I do on a day-to-day basis
I want to get to your career and what you’re doing but to give a fuller picture that led up to that, how did you decide to choose the Chicago residency training versus the one in Philadelphia? I would presume based on where you choose to work and train can affect your career. How did you come to that decision?
You find this is true also, somebody had told me a long time ago and I remember reading this in doctor books that where you’re doing residency is oftentimes where you end up living. I was cognizant of that. As far as the schooling goes, it was between Chicago and Philadelphia schools, either one would have been fine. The schooling themselves, I felt, were mostly equivalent. I started podiatry school in 1986. Now, a lot of the podiatry schools are incorporated into medical schools, like the school that I went to is part of what used to be Chicago Medical School and now it’s Rosalind Franklin University. The Philadelphia School is now part of Temple. The school in New York got bought up by Touro.
A lot of them have some affiliation with a medical school or they’ve been incorporated or bought out or whatever it is. That’s pooling resources, things like that. The schooling, I felt that Chicago and Philly schools academically were much equivalent, and I still feel that way. I knew people in Chicago, I had friends there. I was married at the time. Our oldest son was born right before I started school, so I knew that my wife is going to be home. It was a quality of life. It’s a place that we could live for four years. That was a lot of what made the decision. I had spent some time in Chicago and I knew people there, so I knew it would be a good life for us.
Ernie, you had a family when you were in training? How did you manage that?
It’s like anything else. It’s a matter of you have to set your priorities and you have to manage your time. You have to have an understanding spouse. It’s a lot. The first two years of school, I’m buried down with my head down to the book in the library the whole time or in a lab somewhere, and you’re working hard the first few years. You prioritize. It’s hard. We had our first child right before I started school. I had a second child during my second year of school, third child in my first-year residency, and my fourth child right after residency. You have to have a mandate from God to have that many kids to have them in rapid-fire succession like that. That was the case but we made that decision. My wife was home with the kids, and we were able to swing it. It was having a dedicated spouse.
I had a friend that I went to school with that had five children. He got divorced in the middle of school, like in his senior year. He went through a lot. He worked hard. He had a job while he was in school. I thought I was working hard, but he put it in. You have to go into it with the understanding that this is going to be the long-term. My schooling was four years and I did three years of residency. The minimum amount of time that you’re going to spend in school and residency, if you’re doing any medicine, is four years of school and three years of residency. If you’re doing some other subspecialty, if you’re doing a medical subspecialty, you’re talking about three years of residency plus three years of additional time of fellowship. That’s six years.
Surgical specialties, it’s six years of residency, and then you could have two years of fellowship. You could be talking about eight years of postgraduate training on top of four years of medical school. If you’re going to do it, you have to make that decision that there’s going to be some sacrifice, and it’s going to be hard on your spouse. Money is going to be tight. It can be tense. This is not a family therapy show, but you have to be able to dedicate some time to the spouse. You have to be able to figure out time for your kids. You have to realize that there’s not going to be a lot of free time at all, because any free time you have is going to be dedicated or should be dedicated to the family. You have to be able to dedicate that.
Understand what you’re getting yourself into and hopefully have supportive parents too, because you’ll need people to help out with time and money, and other things. It has to be a team effort in order to do, but it can be done. It’s also again, this is not family therapy, but you have to recognize when there are strains, and you have to be able to look into that. It’s like when in your residency working like a dog. You can be working twenty hours a week, barely at home, and when you’re at home, there’s no energy. You’re just passing out. You have to have a spouse that’s willing to go through that. When I’m doing that, I’m doing it for my career. It’s a selfish thing. Hopefully, it will benefit both of us in the long run, but I’m doing it to advance my career. You have to have a spouse that’s dedicated and willing to go through that and then you have to show them the love for that.
That’s great information because there are students who are managing several responsibilities like you did. Knowing that there are successful podiatrists out there that are able to do that and get through that is a great information. I’m glad you shared that.
The other thing that was helpful was at the time when I was in Chicago, the groups that had the largest families were the Orthodox Jews and the Mormons. We had what was called a family pod. We had a club in school, where we all used to get together. Everybody would get together and talk and everything. Everyone gets together with the kids and everything so everybody could commiserate and the wives could commiserate, or husbands. The spouses could talk to each other and talk about what it’s like on the other side. That was a good outlet. That was a good release. A club like that can be helpful.
There are schools, especially there are residency programs that will brag about their divorce rates. It’s like surgery residency programs, whether you’re routinely working 100 to 120 hours a week, they are not necessarily going to be sensitive to the needs of the family. I think now people, in general, are more sensitive to those kinds of things. Back in the day, Halsted was one of the original famous surgeons of Bellevue at the turn of the twentieth century. He used to brag that his residents should be on call 364 days a year. He was a speed junkie too, but that’s another story.
How did you end up in New York for your residency? Was that because you want to end up in New York?
It was serendipity. The way the residency works, in case any reader doesn’t know it, you do a lot of rotations. The third and fourth year go to different programs. You get to know them and they get to know you and the way it works is there’s a ranking system. You rank your top residency spots and the residency spots rank who they like for students, and then there’s a match system that matches up as close as possible. The two groups, I ranked a program that said they were going to rank me, which was Cook County in Chicago, which is the hospital that is loosely based off.Going into the medical field calls for an understanding that it needs long-term dedication. Click To Tweet
Yes, that was when TV was watched by people. I did Cook County and I had ranked it and they said they’re going to rank me. They ended up not liking me apparently because I didn’t get the program. I had to scramble, which means you just pick up whatever over. I ended up doing my first year at Wyckoff Heights Medical Center in Brooklyn because they had a ton of spots. They had 45 first-year spots, which is huge for both programs, especially for podiatry program.
It’s shocking to even think that they had such a large program. They had spots available. They had to scramble to fill spots. I ended up going there. For my 2nd and 3rd year, I did a program in the Bronx. At the time, podiatry residency was divided into either non-surgical or surgical categories. You can get a non-surgical residency now. The programs all have a surgical component and they all have surgical training. It’s not a problem to get surgical training but at the time, you could get a residency and not get any surgical training. I did thankfully manage to get a surgical program and I got surgical training.
There are podiatrists your age or even older that are not surgically trained in podiatry. That’s not their skillset that they picked up.
Some of them by choice or not necessarily by choice. They just didn’t do a residency. Maybe it’s good to put it out there, but it is a bit of an evolving field. When I first started school, I believe that most states didn’t have a residency requirement for podiatry. By the time I left, by the time I graduated, I think there was a one-year residency requirement and now I believe it’s a three-year residency requirement for all podiatrists graduating, so the training is much better than it was.
Training has evolved in about twenty years.
It’s much better. The guys who are around my age and even a little bit older got much better training because the people who are graduating before, the people graduated like prior to let’s say 1990, a lot of them weren’t able to get residency programs because it wasn’t a requirement and they didn’t have a lot of programs. They didn’t necessarily get the residency training. Some of them did what’s called a preceptorship, which is like shadowing somebody in the office and getting training that way. It’s not a formal residency program in a hospital. To be fair, my residency during my first year, I rotated through many different specialties. My second year I did four months of internal medicine, four months of general surgery. I’ve done two months in the ER and I did two months on trauma at Lincoln Hospital. I did orthopedics, vascular.
I did a month of neurosurgery. I’ve done a craniotomy, skin-to-skin. My last month at Wyckoff was general surgery. My first month at Our Lady of Mercy in the Bronx was general surgery. I went from a very intense month. At a busy Brooklyn hospital where I was the surgical intern on the service for a month, and then I started out in general surgery in the next program with all the other first-year general surgery interns. When I did my first month of general surgery, I was ready. I was ready to rock like I knew how to get things done. I knew how to get a CAT scan ordered. I knew when to push potassium. I knew the Ranson criteria. When they asked questions, I was ready to go.
You were pushing potassium?
Potassium, if given too quickly, can stop your heart.
I know that. I know you have to put it slowly. They didn’t know, so I was able to provide that critical information. I knew how to get things done. I was the superstar first-year resident in general surgery who was a podiatrist. That worked well for me. I started in August of 2001 and I think we all know what happened in September of 2001. I was on service during 9/11.
You and I were both in New York at that time.
The point is I have diverse training. I did a lot of different things. During four months of internal medicine, I was an internal medicine intern on the floor, so I had a list of patients that I had to take care of every day. It wasn’t like coming in and saying, “I’m the podiatrist. I’m going to take care of you.” It’s like, “I’m the medicine intern taking care of you.” I was managing people’s diabetes, hypertension, pancreatitis and whatever else they would come in for. I developed a fluency in medicine. I’m not going to admit patients to my service and manage their asthma, but if somebody comes in and tells me they have asthma, I know the difference between a mast cell stabilizer versus a beta agonist. You developed that.
What was that diverse experience for you to get you to where you are now? How was that experience helpful because you had such a diverse residency training?
If I have a diabetic that I’m managing their foot infection, I understand what it’s doing to the rest of the body, not to the point where I can manage it, but I understand the medicines they’re taking and how it interacts and how things work. The diverse surgical training was definitely a help. I did a month of plastic surgery. I learned a lot of plastic techniques, how skin heals, and how to prevent scarring from happening. Same with orthopedics and learning how bone heals in other parts of the body. My residency director was old school when I was in the Bronx.
He used to say, “Surgery is surgery. If you’re closing a wound, it doesn’t matter if it’s on the abdomen, arm, or foot. You need to learn how to make a plastic closure. You need to learn how to make things look good because that’s what patients will see.” I learned that and I learned from a plastic surgeon that you always want to pay attention to details and never take shortcuts. That’s stuff that I apply now. I know how to make a wound look good and how to heal things. It was helpful at the time when I was a resident. You learn how to work hard. It helps me on a day-to-day basis. It helps to have a diverse knowledge.
When you finished residency and you first started working out, did you have to work for a lot of different offices or you just start off working on your own? How did you get started?
I did a lot of different things when I came out. Just as an intro to that question, the job opportunities are not always the same as they are for medicine. If you’re doing orthopedics, surgery or other medical specialties, it depends on the specialty but with some things, if you’re having an independent specialty, you’re going to get a nice offer from some groups that will take you in and give a nice salary, benefits, this and that. In podiatry, it can be tough. The business of podiatry can be a little bit challenging. Some of these offices may offer part-time work and the salaries may not be what you think. I don’t want to discourage anybody because there are good opportunities and you can make a comfortable living. It’s a good field. It can be lucrative and it’s a good lifestyle and all that.
That being said, when I came out, I got a couple of different opportunities. I was working in a day and a half in the city for somebody. I was working a day and a half in the Bronx for a different group, and then I worked Sundays in Kings Plaza Mall at the dental foot care office. I did house calls. I said yes to a lot of different opportunities. Eventually, it consolidated down. The office that I worked at in the city, I worked there for four months and then at some point, he said, “You need to be the captain of your own ship. You’re just not good at working for other people.” I said, “I agree.” Long story short, I ended up opening an office a couple of blocks away. That evolved into the practice that I have now in Manhattan. The office that I worked at in the Bronx, I worked for a day and a half there in a satellite office.
I ended up going to their main practice when the satellite office closed. I worked there for about 12, 13 years. One day, the wife of the doctor that I was working for, and she was also the office manager, she came to me and said, “Do you want to buy the practice? He’s retiring.” I said yes and I ended up buying that practice. The two big opportunities that I had in residency and the reason I got these opportunities was because they were connected to attendings that I worked with in residency. I worked hard, I was a good resident, and they gave me opportunities. Those opportunities that I had have evolved into the practices that I own now.
That was Dr. Ernie Isaacson, a podiatrist. This is the first half, part one, of his guest interview. The next episode will be the second half of this episode, where we dive into more of the details of his career, what it’s like day-to-day, and what he enjoys and does not enjoy. There are a whole bunch of gems in that episode as well so I hope you’ll be able to read it.
About Ernest L. Isaacson
Ernest L. Isaacson, DPM PC, is an exceptionally well-qualified and experienced board-certified podiatrist providing services for men, women, and children of all ages living and working in the Murray Hill neighborhood of Manhattan in New York City.
Dr. Isaacson is a graduate of the Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science in North Chicago, Illinois, earning a Doctor of Podiatric Medicine. He completed two years of further training in general surgery, internal medicine, orthopedic surgery, plastic surgery, vascular surgery, and podiatric medicine as part of a comprehensive medical education before beginning his podiatric surgical residency.
Dr. Isaacson is an active researcher and author of several notable scientific papers. He is a diplomate of the American Board of Podiatric Surgery and a fellow of the American College of Foot and Ankle Surgeons and the American Society of Podiatric Surgeons. Dr. Isaacson is also a member of the New York State Podiatric Medical Association and the American Diabetes Association.
Dr. Isaacson welcomes new patients to his practice, where his priority is to both treat and enlighten his patients in a comfortable atmosphere.
Dr. Isaacson provides gentle, personalized care when diagnosing and treating foot conditions and injuries.
One of his many skills is his expertise in sports injuries affecting the feet and ankles, such as Achilles tendonitis, shin splints, sprains, and strains. He also excels in treating a wide variety of foot problems, including heel pain, toenail fungus, bunions, neuromas, and plantar warts, and has exceptional surgical skills.
When he’s not dedicating himself to the health of his patients’ feet and ankles, Dr. Isaacson enjoys running, reading, and above all else, spending time with his family.