05/03/2021    Leonard A. Levy, DPM, MPH

Treatment for Ungual Melanoma In Situ (Bryan C. Markinson, DPM)

Bryan Markinson, DPM, says, “The simple truth is
that no podiatrist is denied the opportunity to
perform Mohs surgery, he or she just has to go to
medical school, get trained in
dermatology/dermatological surgery, fellowship in
dermatopathology, then fellowship in Mohs
surgery. Simply put, Mohs surgery on the foot is
not podiatric medicine and surgery.” A few
decades ago, DPMs would not, for example, dare to
perform rear foot bone surgery, and rightly so,
nor would they even put bone screws into a
metatarsal. As our pre-doctoral education changed
and residency training became a requirement
rather than just an experience that an occasional
podiatrist would complete for 6 months or a year,
reconstructive foot surgery became a standard for
DPMs who completed a 3-year podiatric surgical
residency.

I am very aware of the training a dermatologist
receives, having been invited years ago by the
chair of the Department of Dermatology at
Stanford University School of Medicine to join
the faculty as associate professor and later
invited to be a member of the American Academy of
Dermatology (I am currently a Life Member of the
Academy). I helped train medical students who
took electives in dermatology, dermatology
residents, and was even invited to speak to
members of the Dermatology Section of the
California Medical Association. Yes, DPMs are not
CURRENTLY qualified to do Mohs surgery only
because they have not received the necessary
training in residency or in a fellowship
experience.

Mohs surgeons are dermatologists that typically
have an onsite technician who takes the specimen
removed from the patient and then cuts it in
sections so that they can be examined
microscopically to determine if the entire lesion
has been removed and if additional sectioning is
necessary. It is time (and long overdue) for DPMs
to have a license that is the same as MDs and
DOs. This could be accomplished with about six
additional months of additional training for
current podiatric medical students. In addition
to my podiatric medical education and service as
dean of three podiatric medical schools and
president of one, for the last 20 years, I have
been a full-time medical educator including in an
osteopathic medical school (i.e., associate dean)
and more recently as a member of the Curriculum
Committee of a new allopathic medical school at
the same university.

Leonard A. Levy, DPM, MPH, Ft. Lauderdale, FL

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