03/18/2024    Rod Tomczak, DPM, MD, EdD

Two Critical Documents at this Time in our History

As podiatry prepares to take steps in a yet to be
defined direction, it is imperative that all
members of the profession familiarize themselves
with two salient documents that generate strides
that advance our common cause and make headway
toward a collective goal. We must be certain we
are not taking the proverbial two steps forward
and one step backward.

The first is a White Paper authored by a joint
task force of orthopaedic surgeons and podiatric
surgeons titled “Improving the Standardization
Process for Assessment of Podiatric Medical
Students and Residents by Enabling Them to Take
the USMLE” This paper was endorsed in 2020 by: The
American Academy of Orthopaedic Surgeons, The
American College of Foot and Ankle Surgeons, the
American Orthopaedic Foot & Ankle Society and the
American Podiatric Medical Association.

They agreed to the following in order for DPMs to
be recognized as physicians within their scope of
practice by all four organization:

1. DPMs must pass all three parts of the USMLE.
2. Accreditation of colleges of podiatric medicine
should meet comparable standards to the Liaison
Committee on Medical Education (LCME). Podiatry
will accept the NBME’s determination on whether
the CPME accreditation standards are comparable to
LCME and sufficient to meet requirements which
would allow DPMs to take all parts of the USMLE.
3. CPME approval of podiatric residency programs
should meet comparable standards to the
Accreditation Council for Graduate Medical
Education (ACGME).
4. Board certification for DPMs should meet
comparable standards as set forth by the American
Board of Medical Specialties (ABMS).

The second paper is a draft introduced by the
American Orthopaedic Foot and Ankle Society and
the American Academy of Orthopaedic Surgeons to
the American Medical Association House of
Delegates. The Subject of the document is
“Improving the Standardization Process for
Assessment of Podiatric Students and Residents by
Initiating a Process Enabling Them to Take the
USMLE. This document can be found at:
American Medical Association House of Delegates
Resolution 303 (JUN-21)

This four-page document prioritizes whether or not
the education, training, residency education and
board certification of DPMs is equivalent to MDs
and DOs so that they can use the title of
physician.

The AOFAS and AAOS have agreed with the two
national podiatric organizations on a process by
which only podiatrists who meet the MD/DO
standards for undergraduate and residency
accreditation, board certification and examination
requirements would be considered physicians within
their scope of practice.

However only the AMA, an organization representing
all physicians, has the expertise and resources to
evaluate and initiate this new process. Near-term
action supporting this important policy of non-
physicians being considered physicians by meeting
physician standards, instead of lobbying
legislators and regulators, will have a positive
impact and improve patient care.

The APMA agrees to these conditions and to these
documents.

The above does not contain any personal opinion.
It is a summary of two documents, which if enacted
will have a dramatic effect on the podiatric
profession, at least as important as the 1961
Selden Commission Report which led to advances in
faculty development and improvement in podiatric
education. On the surface the Resolution may
contain a loophole allowing those podiatrists who
choose not to take USMLE or to complete a
residency not equivalent to an MD or DO program
and remain a “non-physician podiatrist” creating
two levels of podiatrists. I cannot imagine a
greater cause of dissension in the profession
making the board certification problem seem
miniscule.

Physicians as opposed to non-physician
podiatrists.

The Draft of the Resolution by the AOFAS and AAOS
finally suggest that we be allowed a seat at the
physicians’ table if we are able to demonstrate
that our education, from day one through the
complete gamut of training and evaluations
including residency and board certification is
comparable to physician standards. We will no
longer be “wink-wink physicians” but proud bearers
of the title physician. We will be recognized by
other physicians as members of an elite fraternity
to which we have always wished to be members. Of
course, to some colleagues this title confirmation
may not be of much importance but to the
profession it could be what generations have
struggled for.

If we are not careful, we stand the chance of
diluting residency training and board
certification to below MD standards. Let’s find
parity inter-professionally by meeting physician
standards rather than seeking parity intra-
professionally through legislation.

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

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