08/18/2022    Timothy Ford, DPM

ABFAS vs. ABPM (Allen Jacobs, DPM)

My colleague and friend Dr. Jacobs is spot-on
regarding podiatric medicine and surgery residency
(PMSR) training. Having the opportunity to evaluate
many programs in the past 20 years, I can tell you
there is a vast difference between programs.
Although CPME 320/330 provides common requirement
institutionally and program wise there is a clear
difference in residency training across the
country. This is a particularly true when it comes
to academic medical centers and community
hospitals, not just in training but in overall
institutional monitoring of residency programs.

Academic institutions often have 100+ residency and
fellowship programs they oversee, whereas community
hospitals may have only a PMSR at their facility. A
critical component of medical education involves
interaction with other residents and fellows in
various specialties which enables valuable
interdisciplinary learning to be achieved. This is
particularly true with complex patients where
various services discuss treatment plans to best
treat a patient. Academic and large medical centers
can afford this opportunity to our residents and a
push to develop more programs at these centers are
long overdue.

Like Dr. Jacobs, I also believe we place too much
emphasis on surgery and not enough in medicine. The
residency model we chose is podiatric medicine and
surgery, so shouldn’t we be more active in medicine
and its subspecialties like rheumatology,
endocrinology, wound care, and cardiology to just
name a few! We graduate residents who believe they
are “foot and ankle surgeons” and “fellowship
trained foot and ankle surgeons” but not podiatric
physicians and surgeons. We may be the only
profession where instead of your degree by your
name the statement of “fellowship training foot and
ankle surgeon” is a new title under your name. Why
are we always trying to split our profession—-guess
what we all have the same degree! My orthopedics
foot and ankle surgeons (I have 10 in Louisville
alone) say nothing about their fellowship(s) other
than in their resumes—some have 3 or more
fellowships so listing them all under their name
would be time consuming to say the least.

ABPM CAQ in podiatric surgery - I find it
fascinating that there is this much concern about a
CAQ. The ABPM has made it very clear that it is not
certifying anyone in podiatric surgery only the
ABFAS can do this. However since podiatric surgery
is absolutely a part of podiatric medicine the ABPM
has every right to provide a certificate of added
qualification (CAQ) to their board certified
members.

Interestingly, I have heard not one complaint about
our growing number of non-CPME fellowships by the
ACFAS or others. These fellowships are not Approved
by CPME or accredited by any governing body. The
ACFAS is not an accrediting body for our
profession, CPME is!

WE talk about protecting the public and confusion
with various verbiage like a CAQ in podiatric
surgery yet no one has once criticized the ACFAS
for its “recognized” fellowships. Since these are
not CPME approved fellowships who exactly is
protecting the public and monitoring these
fellowships— in short no one. Why isn’t the ABFAS
(and the APMA and ABPM) concerned about the
training and granting of “certificates” to these
non-CPME fellowships who now tout themselves as
“Fellowship trained foot and ankle surgeons” .

Finally, a comment on board certification—we as a
profession need to have one single board that
certifies us. As a double boarded Podiatric
physician (and a fellow of the ACFAS and ACPM) I
can tell you this division of podiatric medicine
and Surgery is unsustainable! As a person who is
the chief of the medical staff at a university and
a member of the credentialing committee for almost
17 years, I can say board certification is only one
component in credentialing your surgical skills,
surgical numbers, infection rate, OR time per
procedure and patient time to D/C days are even
more important!

The reality is that podiatric physicians and
Surgeons play a critical role in our healthcare
system we just need to be UNIFIED and embrace our
chosen profession. Stakeholders from CPME, APMA,
ABPM, and ABFAS need to find common ground and
understand that division within our profession
imparts a poor perception to not only the public
but to the overall medical community.

Timothy Ford, DPM, St. Matthews, KY

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08/15/2022    Lawrence Oloff, DPM

ABFAS vs. ABPM (Allen Jacobs, DPM)

The last published statement concerning the CAQ by
the board ABPM is incredulous. To put in writing
that a test that is designed to measure competency
is too difficult for its constituency, so they are
going to create a test that accepts a lower level
of competency is pretty disturbing. And to use
gender reasons, as one of the reasons to popularize
that stance is beyond disturbing. I believe one of
the purposes of board credentialing is to protect
the public, yet this seems to have been discarded.

The gripe here seems to be that a lot of the
members seem to be concerned that the bar to pass
the surgery boards is too high. I can appreciate
that stance, but not one that takes to lower
standards by another board whose members want a
less intense examination. Tackle the problem of the
pass rate. Is the test too hard, or is the
education between residencies too disparate. Don’t
try and find a walk around solution that lowers
Podiatry. It not only lowers a standard but also
creates another rift in a small profession.

The statements by Dr. Jacobs are right on.
Residencies are not all created equally. Perhaps
the failure rate is related to these discrepancies.
Look at those issues. No one, neither the
profession nor the public is served by lowering
standards. As a residency director, I have always
fully endorsed membership in both boards. It is
going to be very difficult to support APBM with
their recent position statements. I think the ABPM
Board members should feel embarrassed by the
statements they have put in writing. I was
embarrassed for podiatry just by reading them.

Lawrence Oloff, DPM, Burlingame, CA