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05/18/2023
RESPONSES/COMMENTS
RE: Unequal Treatment of Ex-Patriot DPMs by ABPM
From: Jeff Carnett, DPM
There are many of us American trained DPMs working overseas who are not eligible to be board certified by either board as we did one or two-year residencies, but not three-year programs. So, how shocking to see that ABPM will certify those with bachelor degrees in podiatry from the UK, SA, Australia, Malta, and New Zealand who did not take the MCAT, have no basic medical sciences in their courses, and no residencies. These degrees are right from high school.
Doesn't that discredit anyone with the ABPM certification in the U.S.? So, we expatriate DPMs need to take a bachelor podiatry degree so we can get certified, but we can't get certified with a CPME-approved DPM degree and residency? I’m trying to understand how that helps the profession. While overseas, our work is often highly surgical, but alas that doesn't count.
Jeff Carnett, DPM. Auckland, New Zealand
Other messages in this thread:
07/01/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1B
From: Joel A Feder, DPM, Pete Harvey, DPM
Kudos to Dr. Kiel. He has hit the nail on the head. Wake up podiatric medical colleges.
Joel A Feder, DPM, (Retired) Sarasota, FL
Kudos to Dr. Kiel. He is precisely correct. I too have performed thousands upon thousands of bone and soft tissue surgeries. However, I never forgot the practice guidelines taught to me by my father who graduated in 1929, my brother who graduated in 1954, and dozens of other hero podiatrists in Texas and around the country.
Pete Harvey, DPM, Wichita Falls, TX
07/01/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Ivar Roth, DPM, MPH
Dr. Keil is so on point with his observations. I see way too many operations being done for problems that can be eliminated or helped with good old podiatric non-surgical treatments.
Today's students and residents are being taught that surgery is the answer and not conservative care. We are losing our way and becoming like the orthopods, with every problem a surgical one. It is not too late, but the skill set of our predecessors will be lost soon if we do not teach podiatric medicine and diagnostics to our current students soon.
Ivar Roth, DPM, MPH, Newport Beach, CA
07/01/2026
RESPONSES/COMMENTS (STUDENT ENROLLMENT) - PART 1B
From: Elliot Udell, DPM
The writer espousing that the real underlying problem why some of our podiatry schools are not filling their classes need not hide his name.
He is correct that college seniors do their economic analysis of which medical specialty pays the best. It's not just podiatry; in many communities getting a primary care physician is becoming problematic because general practitioners do not make as much as ophthalmologists, GI specialists, and plastic surgeons, and hence, MDs and DOs are not choosing to become family doctors. This is not just affecting our own profession but is affecting our nation's entire healthcare system.
Elliot Udell, DPM, Hicksville, NY
07/01/2026
RESPONSES/COMMENTS (STUDENT ENROLLMENT) - PART 1A
From: Bret Ribotsky, DPM
Two Roads, and the Cost of Walking Down Neither
For more than thirty years — from podiums across this country, in the pages of this publication, and in every room where this profession’s future was being discussed — I have argued a simple, unfashionable truth: unless you can keep the doors open to your practice, you cannot help anybody. Economics is not a peripheral concern for the practicing physician. It is the pre-condition for everything else. So when the anonymous correspondent frames our enrollment crisis as a pure economics problem, I do not disagree with the diagnosis. I have been making a version of that argument since before many of our current applicants were born.
The debt-to-income calculus is brutal. The downstream comparisons to NPs and CRNAs are damning. The profession’s identity confusion between “surgeon” and “specialist” has left a generation of graduates holding credentials that the credentialing world does not know quite what to do with. These are facts, not provocations — and they are thirty years overdue for a direct response from...
Editor's note: Dr. Ribotsky's extended-length letter appears here.
06/30/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1B
From: Allen M. Jacobs, DPM
In response to Dr. Tomczak, "The truth you speak doth lack some gentleness/And time to speak it in; you rub the sore/When you should bring the plaster" (Shakespeare, The Tempest)
Allen M. Jacobs, DPM, St. Louis, MO
06/30/2026
RESPONSES/COMMENTS (STUDENT ENROLLMENT)
RE: Solving the Student Enrollment Crisis
From: Name Withheld
With respect to all the commentators here, none of them have set foot near an admissions committee or a basic science curriculum in years, if ever. Everyone is writing from the residency end of the pipeline, mistaking proximity to graduate medical education for actual insight into what's happening at the undergraduate and graduate college level. They are not educators in the sense this crisis requires. They are downstream observers diagnosing a problem they've never had to recruit, admit, or retain a class for.
So let's set the record straight. The driver isn't curriculum structure. It's economics, full stop. Nurse practitioners, non-surgical, autonomous in most states, two to three years of training post-bachelor's, out-earn the median podiatrist. CRNAs clear $300K+ with a fraction of the debt-to-income ratio our graduates carry. Any college senior with a calculator and five minutes on Reddit can run...
Editor's note: Name Withheld's extended-length letter can be read here.
06/30/2026
RESPONSES/COMMENTS (PODIATRIC PRODUCTS IN THE NEWS)
RE: Treace Medical Completes First Surgery with New HyperPlate XM Implant (Vince Marino, DPM)
From: Allen M. Jacobs, DPM
With reference to the "newest and latest", be it surgical instrumentation, a pharmaceutical, whatever, the best question I have heard was from Jack Schuberth DPM. He will listen and ask, "Well Doctor, what is the problem that you are solving?" It is a basic and brilliant question that I ask every time I read about a new wound care product, fixation device, pharmaceutical, anything. Industry informs us of a "problem" they have solved.
As Dr. Marino correctly notes, many of these solutions are expensive and may not provide significant if any benefit to the patients we treat. And yes, sometimes the oldies are goodies. For example, plate fixation vs. two-screw fixation for 1st MPJ arthrodesis. Digital implants vs. simple K-wire fixation. Complex Lapidus...
Editor's note: Dr. Jacobs' extended-length letter appears here.
06/30/2026
RESPONSES/COMMENTS (PM NEWS QUICK POLLS)
From: Rich Hofacker, DPM
I am scratching my head today, wondering why almost 50% of my colleagues who took the recent PM News poll, are opposed to an accelerated six-year undergraduate/podiatric degree. I truly believe that one and maybe two of my children would have gone into podiatry had this change been in effect ten years ago.
What discourages many potential podiatry students is not only the cost, but the number of years it takes to finish the process. So, with enrollment in podiatry schools at an all-time low, our profession continues to keep its head in the sand. Change is inevitable in every facet of life. Why are we so determined to stay on a course that is killing our future?
Rich Hofacker, DPM, Akron, OH
06/30/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY) - PART 1A
From: Brian Kiel, DPM
Dr. Tomczak’s letter was very thoughtful and a great deal of his opinions are valid, however, I think the major issue concerning our profession is that there is very little podiatry being taught or practiced any longer. The so-called leadership has decided that we are surgeons of the foot, not podiatrists. Too many find it demeaning to debride nails and lesions. Too many have no idea about how to treat patients with orthotics. Everything is surgery, surgery, and more extensive surgery.
I have practiced for over 50 years. I have done lots and lots of surgery, but patient satisfaction is also when an 8-year-old comes in with calcaneal apophysitis that no one else has helped and they come back to you in 3 weeks asymptomatic. It is when an MD allergist that you treat for an ingrown toenail says it must be so satisfying to be able to relieve pain immediately. We have lost ourselves. We need to re-institute basic podiatry and find a way for graduates to practice without a 3-year surgical residency. Don’t eliminate 3-year residencies, just keep them for the few who want and are capable of performing that type of surgery. Allow 1- and 2-year programs that teach what most of us see daily. This allows practitioners to be able to make a good living and also, by the way, reduce the pressure to cheat.
Brian Kiel, DPM, Memphis, TN
06/29/2026
RESPONSES/COMMENTS (THE FUTURE OF PODIATRY)
RE: Podiatry: A Shakespearian Tragedy in the Making
From: Rod Tomczak, DPM, MD, EdD
In an email last week, Allen Jacobs, DPM sent me several quotes that he felt depicted today’s podiatry status. He felt the opening sentence of A Tale of Two Cities, “It was the best of times, it was the worst of time of times” by Charles Dickens depicted the “where we are today” condition of podiatry. He also sent a few quotes from Shakespeare. The most accurate and poignant from Macbeth, “….so foul and fair a day I have not seen.”
I started thinking about the elements of a tragedy and if we personify and vivify podiatry, and use a little imagination, we have the makings of a true Shakespearian tragedy happening right before our eyes. And if you remember, Hamlet, Macbeth, Othello, Romeo and Juliet, Anthony and Cleopatra, and Julius Caesar, they do not end well for the tragic hero. The three witches in Macbeth make three predictions for Banquo, a companion of...
Editor's note: Dr. Tomczak's extended-length letter appears here.
06/29/2026
RESPONSES/COMMENTS (PODIATRIC PRODUCTS IN THE NEWS)
From: Vince Marino, DPM
I constantly read about the latest and greatest hardware developments to assist the podiatric surgeon in performing procedures that have been done for decades. While these inventions appear to be innovative, the problem with them is that the companies developing these charge facilities an exorbitant amount of money, making it impossible for a surgeon to use these devices in a surgery center or even hospital. While the actual implant itself is sometimes reimbursed by the insurance companies, the instrumentation used to perform the procedure with these implants is separately billed by these companies and never reimbursed by the insurance companies. Therefore, surgery center administratiion and hospital administration tell us that we cannot utilize those particular devices because they actually lose money on a surgical case.
Perhaps, these companies could make it so that the instrumentation utilized to implant the devices could be recycled, and therefore they would not have to charge the facility an amount that cannot be reimbursed. Sometimes they tried and true way of doing something the way it has been done for decades is still the most economical for for the facility and works just as well.
Vince Marino, DPM ( retired), Novato, CA
06/26/2026
RESPONSES/COMMENTS (PODIATRIC MEDICAL EDUCATION)- PART 1B
From: Sev Hrywnak, DPM, MD
College seniors increasingly rely on online resources to compare healthcare paths, focusing on cost, time-to-licensure, and scope of practice. When evaluating whether a profession provides a full license after education, the four common tracks are physician assistant (PA), nurse practitioner (NP), medical doctor (MD) and doctor of osteopathy (DO). NPs and PAs practice autonomously in many states and under supervision in other states.
Cost considerations are critical. MD/DO programs typically require the longest training (pre-med, four years of medical school, residency), with high tuition, but potential lifetime earnings can be substantial. PA and NP programs are shorter and less expensive upfront, often resulting in lower debt and earlier entry into..
Editor's note: Dr. Hrywnak's extended-length letter appears here.
06/26/2026
RESPONSES/COMMENTS (PODIATRIC MEDICAL EDUCATION)- PART 1A
From: Rod Tomczak, DPM, MD, EdD
There is a third alternative. At Ohio State, we offer an independence study program for the first two years. Students are given assigned readings and at the end of that assignment, which is usually one of the subjects that is being taught in the classroom, students come in and take an exam on the computer. They do have to show up for anatomy and any other clinical lab required class. They can complete the first two years at whatever speed they need. They can take step one of the national boards when they feel ready.
It might be possible to get a student to graduate with an independent study in basic science and then clinical work in three years or less. No one says we have to start residency programs July 1; students can be placed in residency programs outside of the match. We can call it early match just like MDs do for urology.
Rod Tomczak, DPM, MD, EdD, Columbus, OH
06/26/2026
RESPONSES/COMMENTS (PODIATRIC MEDICAL EDUCATION) - PART 1C
From: Donald R Blum, DPM, JD
When I applied to podiatry college in 1973, the California College offered a 3- year program, 36 months; rather than a 4-year (4 nine-month school years).
Donald R Blum, DPM, JD, Dallas, TX
06/25/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1C
From: Jack Reingold, DPM
50 years ago this June, I started my accelerated 3-year program at CCPM in San Francisco. Yes, we were well prepared for a residency, but it was brutal! The answer has always been in understanding the uniqueness of our degree. We are 1 of 3 physician groups under federal regulations. However, we are the only specialty that you have to pick before starting your medical schooling. Our young undergrads and their pre-med advisors just don't know this. They did not 50 years ago and they do not now!
I have had more than a dozen undergrad students come through my office and every one of them became a podiatrist. Residencies for MDs or DOs are very competitive. Many who hope to become surgeons end up as primary caregivers. Nothing wrong with that, but it was not their first choice. What an opportunity podiatry is for undergraduates. Employment for life with great income. Guaranteed 3-year residency. Many sub-specialties, including surgery to pick from. We have failed for at least the past 50 years to educate pre-med advisors and students about what a great opportunity podiatry is. Better late than never to start now.
Jack Reingold, DPM, Encinitas, CA
06/25/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1B
From: Tim Vogler, DPM, BS-Mgmt
I did part of my training in the early nineties at the University of Missouri Kansas City School of Medicine. 75% of their medical students at that time were on a six-year track for their MD that started out of high school. They were exceptional students. When they started their internship residency, they were very well equipped, having had years of clinical experience which began in their first year.
The rising costs of undergraduate and professional education makes this pathway very attractive to young students; obviously by shaving off two years of tuition but with the added benefit of “earning” two years earlier which decreases the compound interest effect on their student loans significantly. Of course, the DPM curriculum would have to expand to include the preliminary sciences and courses to ensure communication skills, etc.
Podiatry education has been “streamlined” for decades for our specialty. Dr. Leonard Levy used to famously quote a study on the efficiency of our curriculum in preparing students for our profession (conducted outside of our profession). Podiatry should now capitalize on its background and use this to its advantage as a recruitment tool.
Tim Vogler, DPM, BS-Mgmt, Winston-Salem, NC
06/25/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1A
From: Amol Saxena, DPM, MPH,
The discussions about shortening podiatry school interest me. I had a colleague who went to University of California-Berkeley in the ‘70s who was in a 7-year program, three years of undergrad and 4 years at CCPM. His degree came from CCPM. That program was ended for unknown reasons to me, though UC Berkeley still has an optometry school there.
My MPH thesis was on shortening medical school to incentivize primary care enrollment. In my research, I found about 1/3 of US MD/DO schools have some form of a shortened pathway. Some had 2-3 years of undergrad while others had 3-4 years of medical school - in general, a 7-year track. I received kudos from my program (even being invited to be commencement speaker) but was told even Dartmouth Medical School would not entertain an accelerated track, despite being in a primary care shortage area. (My thesis defense is on my webpage.) Interestingly, my research revealed three medical schools had accelerated pathways to orthopedics.
During this time period (2021 onward), the AMA started their process to designate only MDs and DOs as physicians and surgeons. This was in part due to NPs and PTs using the designation "Doctor". I believe the longer training period at least for MD and DOs, is what they use to distinguish themselves from those professions. I believe they will use the same argument to differentiate themselves from the DPM degree.
Amol Saxena, DPM, MPH, Palo Alto, CA
06/25/2026
RESPONSES/COMMENTS (PODIATRIC MEDICAL EDUCATION)
RE: A 3-Year DPM Degree
From: Allen M. Jacobs, DPM
I would like to offer a second alternative for your consideration with reference to addressing the "student recruitment crisis". That is to consider an accelerated podiatry school education program condensing the traditional 4-year DPM curriculum into 3 years.
Over 35 medical schools in the United States and Canada offer an accelerated MD pathway under the umbrella of the Consortium of Accelerated Medical Pathway Programs (CAMPP). Medical colleges such as Wayne State University school of medicine, University of Arizona College of medicine, NYU Grossman school of medicine, Penn State University school of medicine, the Ohio State University College of medicine all offer these programs. They do so for individuals who have determined the specialty into which they wish to...
Editor's note: Dr. Jacobs' extended-length letter appears here.
06/25/2026
RESPONSES/COMMENTS (CODING & BILLING Q&As FROM CODINGHELPLINE.COM)
From: Kristin Happel
If you did enter the claim with a POS 12, there could be other factors at play. A few years ago, we realized that the ASCs we were doing surgery at were not supplying CAM boots anymore, because they weren't getting paid for them by most major insurances. So we started dispensing them before surgery, or having the doctor bring them to the ASC and dispense them the day of surgery, and we would put it out as a separate billing from the surgery.
Kristin Happel, Podiatry Biller, Chicago, IL
06/24/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1D
From: Mark A. Jones, DPM
I would advise direct admit to a podiatry college in a two-tiered approach. First would be to recruit and train podiatry nurse practitioners (NPs) who ultimately will be performing the bulk of non-operative footcare (see podiatry job boards). Some of those NPs will be exceptional and then could be offered the advanced DPM degree with the intent of becoming surgeons.
The surgical podiatrist would eventually oversee the clinical nurse practitioner (NP) and work collaboratively. Based on my search, the average salary for a NP in podiatry is around $135K while a surgical DPM estimate is between $230-300K or higher.
Mark A. Jones, DPM, Portage, IN
06/24/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1C
From: Gwen S. Greenberg, DPM
I have no particular objection to the academics of this proposal, and the logistics would be the subject of much discussion. An undergraduate student currently considering podiatric medicine is making a very specific life choice. However, they do have a number of years of college education and lived experience to help guide that choice.
An undergraduate student considering allopathic medicine is making a similar choice, but a lot less specific. They have several years of medical school and medical experiences prior to selecting among the wide variety of medical specialties. A medicine resident (as an example) has several more years prior to committing to a possible sub-specialty as vastly different as gastroenterology vs. cardiology.
My concern is about the level of sophistication of a high school student making such a lasting commitment to podiatry. Therefore, the proposal warrants careful consideration of whether high school is the right decision point for such a specialized path.
Gwen S. Greenberg, DPM, (retired) Allentown, PA
06/24/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1B
From: Chuck Langman, DPM
This link is a simple ChatGPT search. The premise that Americans are not ready to accept this is not at all backed up. I’m 64 years old and there have been accelerated programs here since I was in high school. A couple of prominent examples of their success are Michael Acker, MD, who was chief of cardiothoracic surgery and head of the cardiac transplant team at the University of Pennsylvania. He did a 6-year accelerated program at Brown University.
Another is Michael Kane, MD who completed the Pennsylvania State University/Thomas Jefferson Medical College program that was a 5-year combined program. He is a plastic surgeon on Park Ave in NYC and was the largest Botox user in the U.S. at one time. He lectures worldwide on the medical use of toxins. Some of his ideas opened the door for Botox use for migraines. My point is that this type of program is not only doable, but historically well-respected and produces extremely well-trained physicians.
Chuck Langman, DPM, King of Prussia, PA
06/24/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART 1A
From: Richard Graves, DPM
I am always interested and usually in alignment with Dr. Steinberg's responses. One thing I think must be clarified here: "...we need more WELL QUALIFIED AND PODIATRY-MOTIVATED students..." (not just more students).
Richard Graves, DPM, Long Beach, CA
06/24/2026
RESPONSES/COMMENTS (PODIATRIC MEDICAL EDUCATION)
RE: The Cons and Pros of a Six-Year BS/DPM Program
Fro.m: Rod Tomczak, DPM, MD, EdD
Yes, a podiatry school can grant a DPM degree after a six-year post high school program. The problem is getting it recognized and accredited. If we’re not careful in fulfilling all the legal and bureaucratic requisites, the degree is a useless piece of paper. John Kennedy wanted a man on the moon before the '60s were over according to his May 25, 1961 speech to Congress. To successfully implement a six-year recognized high school to DPM degree will regrettably take some time, but maybe we could speed it up. I cut my own toenails in high school without a lot of schooling on how to do it.
I think we have to do something quickly to save what we have, but it will take chutzpah and time by the hoi polloi, not the politicians. Here are the impediments those of us who want to see the podiatric philosophy flourish will have to navigate. All of them lead to obstructionists who...
Editor's note: Dr. Tomczak's extended-length letter appears here
06/23/2026
RESPONSES/COMMENTS (STUDENT RECRUITMENT) - PART C
From: Richard Rettig, DPM, Robert Scott Steinberg, DPM
Dr. Jacobs and PM News readers may be interested in knowing that “back in my day” in the early ‘70s there was a very prestigious 5-year BS/MD program. This was before Penn State had a medical school, and they partnered with Jefferson Medical College for a 5-year (12 month continuous) program that was extremely competitive. I think they only took a small number of students each year and merged them in with the regular Jefferson class.
Richard Rettig, DPM (retired), Philadelphia, PA
I am sickened by the naysayers. First and foremost, we need more students. Nothing should get in the way of accomplishing that. The first podiatry school to offer such a track will likely receive the most applicants.
Robert Scott Steinberg, DPM, Schaumburg, IL
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