10/13/2022    Rod Tomczak, MD, DPM, EdD

AACPM Statement on Board Certification (Joan Oloff, DPM)

I haven't noticed anyone complaining about
completing a podiatric surgical residency and not
being able to achieve board certification in
podiatric medicine. It's only podiatrists who
don't match in a surgical residencies who want to
qualify somehow as board certified podiatric
surgeons. Since 1986 I have been involved with
institutions granting osteopathic or allopathic
degrees to students who go through a match process
similar but not identical to ours. I went through
the first podiatric residency match in 1977 and
this process was supposed to end the early signing
of students into the most desirable programs and
give everyone the opportunity to apply and perhaps
interview for the more attractive surgical
programs if that's what the student wanted.

If a fourth year MD or DO student wants to
eventually become an orthopedic surgeon, he or she
must apply to interview at the programs the
student would like to train with. There is a
screening process based on data all students
submit. There is no guarantee the program will
want to interview that student, so students
usually apply to numerous programs. Students then
interview at programs that think he or she might
make a good resident and both the student and
program subsequently rank each other. There is no
guarantee that any program will match the student
and suddenly the student may not be able to enter
a program leading to board certification in
orthopaedic surgery. Some people consider a
physical medicine and rehabilitation (PM+R)
physician to be a non-operative orthopedist,
similar to a neurologist being a non-operative
neurosurgeon.

The point is that there is no guarantee that every
medical student who wishes to become a board
certified orthopaedic surgeon achieves it and not
every student who wishes to become a PM+R
specialist becomes one. What is certain is that
no PM+R physician can be granted a piece of paper
making them a board certified orthopedic surgeon
nor can an orthopaedic surgeon suddenly become a
PM+R physician. Attend any reputable orthopedic
seminar and you will see PM+R physicians there or
attend a good PM+R program and you will see
orthopedic surgeons in attendance. However, 25
hours of CME credit does not make one a cross
trained board certified anything else. To change
certification, an MD or DO must complete another
residency.

I was lucky enough to match into a PSR 24+ in 1977
taught by the best trainers on the East Coast. I'm
not sure what I would have done had that not been
the case, but I doubt my path in podiatry would
have been what it became. Are there current
graduates who are not able to fulfill their
potential because they have been limited by where
they matched? Some of us remember when ABPS
members were assessed to fight a lawsuit by
minimal incision surgeons over board
certification.

When ABPS board certified podiatrists applied to
hospitals in the early 1980s, we were met with the
response by surgeons that we had "a weak board."
Not that any of them took our board, but I think
they feared economic consequences of competing.
When I got to Ohio State University, I was handed
a single page listing surgical procedures that
included every surgical specialty. I checked one
line. It simply read, "Foot and Ankle." No
neuroma, no tarsal tunnel, no bunion, no internal
or external fixation, no specific ankle fractures.
I was told do what you were trained in and
comfortable with, ask for help if you need it.
There was no economic competition.

Rod Tomczak, MD, DPM, EdD, Columbus, OH

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