02/18/2025 Jack Reingold, DPM
Why Podiatry School Applicants Remain Low
I have been involved in podiatry, both politically
and educationally since I graduated 45 years ago.
I have personally mentored about a dozen
undergraduate students in my office and virtually
all of them are now podiatrists. I have been
involved with podiatry schools and residency
programs for most of my career. I have brought up
the issue of declining applicants for over 20
years. At first thought, this makes no sense! When
I graduated in 1979, there were 225 million
Americans and about 10,000 podiatrists. Now there
are 325 million Americans and about 15,000
podiatrists. I believe the average age of a
practicing podiatrist is now over 50 (like our
MDs). We are an aging profession.
Please forgive me if my numbers are off, but I
think the point is that it is a great time to be a
podiatrist. A 3-year residency program has been
the standard for many years and there are many
opportunities for practice. It is not unreasonable
for our new graduates to receive salaries of 225K
and up, plus benefits. Kaiser San Diego had no
podiatrists when I started and now has 20. Several
orthopedic groups, that had opposed us getting
full surgical privileges, now have hired
podiatrists. The hospitalists at the hospitalists
beg us for podiatry consults.
Everybody has their theories as to why applicant
numbers are so low and here is mine. The problem
is that nobody knows what DPM stands for! This is
true for 99% of my patients and most physicians in
my area. All the hospitals in my area give full
staff and surgical privileges to qualified
candidates, irrelevant of their degrees. Young
physicians express the same respect for us as they
do for any other physicians and many seek our
treatment. Many of them have worked side-by-side
with podiatrists during their training and respect
our skill set. Undergraduate students and
councilors do not realize that our medical
education is not at allopathic or osteopathic
schools. They do not realize that podiatry
training programs are not chosen after graduation
from medical school but before. I am not
advocating for a degree or name change.
There are around 60,000 applicants for 20,000
allopathic seats. In podiatry,y there are about
6-700 applicants for about 600 seats. Average GPA
among allopathic applicants is around 3.55 and
podiatry is about 3.30. I do not believe that
selecting applicants solely by their GPA and
MCATs. However, there are a lot of undergraduates
that would make fine podiatrists but could not get
into allopathic schools. Many large universities
have 100's of applicants to medical schools. In
2024 UCLA, for example had 1,200 undergrads apply
to medicals schools. UT 966 and FSU 900. In fact,
over 133 universities had over 100 applicants to
allopathic schools. his does not include
applicants to osteopathic schools. These numbers
are from published statistics. There are
potentially tens of thousands more applicants for
podiatry schools out there.
I have been advocating for years to both podiatry
schools and our professional societies that we
need to reach out to these students. I know it is
not easy, but we have to do this. I know that all
of us are very busy between family and practice
obligations. Over the years I have brought this up
to our societies and many times they have said it
is the responsibility of the schools. Only in
recent years have they realized that their future
is tied to the number of practicing podiatrists.
Our professional societies have to take lead on
this.
Our schools do not have the staff or money to do
this. There are many possible avenues to do this.
For a couple of years at UC San Diego we had a
"pre-podiatry society." I was their podiatry
liaison and arranged student visits to podiatrists
and an occasional speaker. Recent graduates, who
are a little seasoned, can go back to their
undergraduate schools. We need to visit and
educate pre-med advisors. We don't have to target
every school, just a few of the large ones would
do it.
Sure, there are unhappy pods. There are underpaid
pods, But this is true of every profession. I
think it has never been a better time to be a
podiatrist!
Jack Reingold, DPM, San Diego, CA
02/10/2025 Lee C. Rogers, DPM
Why Podiatry School Applicants Remain Low (Rod Tomczak, DPM, MD, EdD)
I have read the comments from my colleagues with
interest. I would point out that this is a topic
that has received much attention from the
profession's leadership and deliberative bodies.
It has been addressed at the APMA House of
Delegates in the past several years and it is
discussed at almost every BOT meeting. The APMA
has been taking action to increase the number of
applicants. While it is not the APMA's "job" to
boost school enrollment, the APMA (and its
components) fully understands the connection
between reduced qualified applicants and reduced
membership and the imminent threat to the
profession.
The APMA has raised money to help better the brand
of podiatry as a career choice through a separate
foundation. Certainly, the entity primarily tasked
with increasing applicants and enrollment is the
AACPM. They have also taken this threat seriously
and started the "Feet on the Street" campaign,
funded by many interested parties in the
profession. These efforts have shown some success.
But we can't expect an immediate reversal. APMA
and AACPM are engaged in multi-year strategies.
While we can't positively identify the real cause
of the disinterest in the profession, and we can
all speculate about the effect of factors such as
the Student Doctor Network, economic changes that
impact the ROI of podiatry, uncertainty of success
in practice, or lack of professional identity.
It's worth noting that we're focused on the US,
but there is also a global enrollment crisis
occurring. Almost every country is experiencing a
similar downturn in podiatry enrollment. And this
is true even of countries where the education is
fully subsidized by the government, such as
Belgium, which has seen a '50% reduction in
enrollment. The UK's enrollment issues could be
attributed to the change in government funding for
podiatry education and services.
I applaud the few individuals that have sounded
the alarm over this issue and taken action, often
against headwinds in our own profession. I would
encourage those who have good ideas to help both
of the APMA and AACPM efforts. Volunteer your time
on a committee, offer to host an interested
student, or make a donation. The only way out of
this slump is through it, and to do it united.
Lee C. Rogers, DPM, San Antonio, TX
02/10/2025 Lawrence Oloff, DPM
Why Podiatry School Applicants Remain Low (Allen M. Jacobs, DPM)
Why are applications down? Everyone who has
weighed in on this is correct: too many schools,
lack of identity, competition, costs, etc..
Everyone who has suggested solutions is also
correct: profession, schools, practitioners all
need to reach out more for effective recruitment.
The problems and solutions are multifactorial. How
do you fix this. I don’t think you can close
schools, however economics will eventually solve
this problem. I do not think that all the schools
will survive economic down turns forever.
I was talking to a businessman recently about
this. His perspective was not what i expected. He
began to cite the supply and demand curve. He
thought if the supply of podiatrists went down and
the demand was the same or greater, then the
salaries of podiatrists would likely go up. I am
still thinking about what he said.
Is the demand there? I would say yes. I enjoyed
reading Barry Blocks publication over the years
and hearing viewpoints of colleagues. However it
does sometimes reads like a Yelp review. Negative
reviews predominate in Yelp because happy people
post less than unhappy people. The way of the
world. Negative after negative comment about the
profession. Do outsiders and prospective students
read this?
So is podiatry a worthwhile fulfilling profession?
Yes. This is not the same profession I entered
almost 50 years ago. The knowledge base and
competencies have incredibly advanced since then.
Some have argued three years residency is too
much? “There needs to be more medicine
training”.“There is too much emphasis on surgery”.
I do not agree. Podiatry needs to function in an
allopathic medical world not a podiatric medical
world. If you want to be accepted in the world of
medicine you better walk the walk and talk the
talk. People who do so are now becoming partners
in orthopedic practices, wound care centers, and a
variety of areas of mainstream medicine. So let’s
not keep talking down the profession. Our
residents get a lot of medicine training. It is
required by CPME. The only area in our training
that I feel is lacking is biomechanics and that is
a shame. It is one thing that distinguishes us
from the pack.
How about financials? Can you make a living?
Absolutely. But the prime objective of joining
health care is to help people, is it not? Teachers
enter their field not for the money. That being
said, there is tremendous financial opportunities
for those who are motivated as Allen Jacobs
stated. Private practice has drawn the short straw
- declining insurance reimbursement, coupled with
increasing staff salaries, and all other costs of
practice. The era of private practice is slowly
disappearing for these reasons. This is not just
podiatry but all of medicine. Hence the exodus to
multidisciplinary practices and institutional
medicine.
I would like to see a breakdown of salaries based
on type of practice. I am sure it was published
somewhere comparing salaries of each practice
type. I say that because when I look at the
starting salaries of new practitioners in my area,
the new doctors joining institutional medicine are
starting at almost twice that of private
practices.
I was in a previous life the managing partner of a
large sports medicine orthopedic group. The
advantage we had was ancillary income: surgery
center and MRI. One Orthopedist in our group had
90 percent overhead. The only thing that allowed
him a reasonable living was the ancillary income.
Our problems are not podiatry problems. They apply
to all practices of medicine.
Last remarks. I agree with Dr. Tomczak. We all
need to recruit. In another past life I was
Academic Dean at the California school. We use to
hold an over the top event at a Ritz Carlton hotel
in southern California for college health career
advisors. Very fancy. The money was worth it. We
got the message out. We received many applications
as a result. One student recruited from this venue
more than made up for the expense. The profession
and the colleges need to go big in this area.
Lawrence Oloff, DPM, Burlingame, CA
02/06/2025 Allen M. Jacobs, DPM
Why Podiatry School Applicants Remain Low (Aaron Solomon, DPM)
Recruitment? It is indeed a sad day that our
colleges have been compelled to develop strategies
to enhance student recruitment efforts. It is
depressing to hear a call for practitioners to
make efforts to recruit students. PM News readers
have expressed an eclectic universe of
explanations proposing the etiology for the lack
of interest in our profession. Many if not most of
these explanations are reasonable, and perhaps the
sum total of all of these propositions explains
the current disinterest in podiatry among college
undergraduates. Facts are what they are. There is
a demonstratable lack of interest in pursuing a
DPM degree. The numbers speak for themselves
There is no issue that the services provided by a
podiatrist are needed. The issue is whether a
podiatrist is needed to provide those services. As
other PM contributors have noted, services
provided by a podiatrist may be provided by
orthopedic surgeons, general surgeons, plastic
surgeons, vascular surgeons, physician assistants,
nurse, practitioners, general practitioners,
physical therapists, pedorthists, and others.
I am not suggesting that other healthcare
providers can provide services typically
administered by the podiatrist with the same
degree of expertise or skill. I am suggesting,
however, that there is not a uniqueness to the
disorders that we evaluate and treat. This is a
reality that needs to be confronted.
There are for example, many more podiatrists than
foot and ankle orthopedic surgeons. Yet, 70–80% of
bone joint surgeries performed on the foot and
ankle are performed by orthopedics and not by
podiatry. Corporations know this.
We have a mandatory three year residency program,
which is supposedly preparing individuals for
medical and surgical management of the foot and
ankle. From my observation, the majority of
emphasis is clearly in the surgical arena and many
of our graduates are ill prepared to provide
primary care podiatry services.
Furthermore, it appears that it will be
increasingly difficult to make a living, providing
primary care podiatry services.
I know many many young podiatrists who are doing
extremely well financially. These were generally
individuals who were motivated to learn and excel
at what they do. These individuals are working as
hospital employees, working within an orthopedic
group, or working for a general medical
organization. I know many podiatrists in private
practice who are similarly are doing very well
financially. The potential is certainly there for
individuals who are enterprising, competent,
caring, and maintain an up-to-date status with
reference to the services which they provide.
There is also the opportunity in podiatry to
supplement patient care income by dispensing
various product products which are needed for
patient management. Furthermore, as has been noted
by contributors to PM news, there there is the
potential to make a nice living with a cash basis
practice. An individual can make a reasonable
living as a podiatrist in the federal system. All
is not doom and gloom.
None of these observations change the fact that we
are not attractive to college graduates. Perhaps
they look at the frequency of services such as
nail care and feel that this is not something they
wish to spend their lives doing. I frankly think
this is understandable. A three year residency and
significant debt is not required to perform so-
called “routine care“ essentially dealing with
mycosis or toenail dystrophy.
I have made my particular position clear.
Individuals in this world are seldom familiar with
the term podiatry or podiatric . Our profession
has largely dissociated itself from the term
podiatrist and prefer the term foot and ankle
whatever. Others can provide similar services.
Orthopedics has the exclusive on broken bones and
joint replacements. We do not have the exclusive
on wound care. Gastroenterologists have the
exclusive on alimentary track disease. We do not
have the exclusive on skin disorders of the foot
and ankle. Gynecologists have the exclusive on
female reproductive health, and do not walk around
calling themselves ovary and uterus doctors.
Podiatrists do not have the exclusive on elective
foot surgical procedures. We can go on and on, I’m
sure you understand. We may want to sing this song
“nobody does it better “but the question is
whether patients or alternative medical providers
actually care. We are in the world of cost
containment and not quality care.
I certainly hope that the future podiatry is not
exemplified by the following from Macbeth; Out,
out brief candle! Life is but a walking shadow, a
poor player, that struts and frets his hour upon
the stage, and then is heard no more. It is a tale
told by an idiot, full of sound, and fury,
signifying nothing.
Allen M. Jacobs, DPM, St. Louis, MO
02/06/2025 Rod Tomczak, DPM, MD, EdD
Why Podiatry School Applicants Remain Low (Aaron Solomon, DPM)
Since late 2022, I have been submitting letters to
PM News and Dr. Barry Block has graciously been
publishing them for the profession to read. There
have been two main topics my submissions have
fallen into; 1. The issue of board certification
and the ramifications between the haves and have
nots and; 2. The severe decrease in the number of
students in the podiatry classes at the eleven
schools.
An honorable source who has nothing to gain by
lying has informed me that as of last week there
were approximately 300 applicants to all the
podiatry schools. This may not include the Texas
school in El Paso which has its own application
service outside of AACPM. The number 300 refers to
applicants going through AACPM. Schools offer
acceptance and seats. We have been trying to tell
the profession that there won’t be a need to
address the first topic of conversation, board
certification soon. There won’t be anyone to
certify nor will there be anyone around to do the
certifying.
This is analogous to two ship stewards arguing
over which one should be in charge of deck chairs
and which one should be in charge of the
shuffleboard tournament on the Titanic. The graph
of podiatry student enrollments has shown a steady
decline in recent years. It would be hard to
believe at this point that all 300 applicants will
matriculate giving the schools 30 students, on
average, per class. In 2023, 560 students started
podiatry school. In 2024, 338 students
matriculated as first year students. Should this
trend continue, the total number of all students
in every podiatry school graduating will be less
than our 1977 graduating class of OCPM or very
close to it.
Podiatrists currently in the field might want to
become aware of an economic reality approaching.
They won’t be able to count on selling their
lucrative practices. There won’t be any buyers.
Even a walk down the “K Mart Blue Light Special”
on aisle three memory lane will result in no
takers. There won’t be enough podiatrists ready to
incur more debt to buy your practice. There are
more left-handed, blond, heterochromic podiatrists
today than there will be podiatrists looking to
start practice in ten years. It will be a buyer’s
market and sellers can expect maybe three cents on
the dollar.
The three podiatrists at the local meetings will
sit there slack jawed with mouths open wondering
how this could have happened. They will be sitting
in the midst of the demise of a once proud and
flourishing profession and wonder how this all
happened. Some months ago, a podiatrist sent a
letter to this site relating a story about an
undergraduate student who visited another young
practicing podiatrist. The young podiatrist told
the undergrad student that if he had it to do all
over, he would choose something different for a
profession and advised the student to look
elsewhere in search of an occupation.
Granted, with all the DO schools opening, students
have more options. What we cannot allow is those
uncommitted students to neglect podiatry as an
option thinking for one reason or another that
podiatry is a less than profession based on a set
of letters behind the name of the practitioner. It
is, to say the least, an evolving profession,
maturing from the inside. This development can be
stymied by members of the profession who
continually debase and degrade what we do. Don’t
kid yourself, patients become aware these
podiatrists are ashamed of our profession.
We, the practitioners of the profession are the
only ones who can save what we now practice. If we
do nothing, the profession will die a slow and
painful death because those who are happy but do
nothing are outnumbered by the vocal complainers.
That often-misquoted line about the only thing
needed for evil to prevail is for good men to do
nothing is true. The miserable and the malcontents
in this profession are not going to step up and
save podiatry. In 2023 one of my late 1980s
students from Des Moines sent me a text agreeing
that this was a great profession, and he was
performing procedures we would have never dreamed
of. He said everything was great and I needed a
reality check. He said, “knowledge is king which
equals dollars and that’s where we are…My medical
knowledge is on par with other medical
professional (sic) out there…and if you ever wanna
(sic) know the real truth about our profession
just ask me.”
He has missed seeing what the profession has in
store, but he is exactly the type of person who
can save it. He is exuberant about podiatry. In
his text to me he said he is very sociable, and he
is. It’s time for him to use his great gifts to
show undergraduate students what a fantastic
profession this is before it reaches a vanishing
point, like the 1971 movie. We all remember Bishop
Berkely’s quote about a tree falling in a forest
and if no one is there to hear it, does it make
any noise? There are so many people who, if they
knew about this person’s practice and the joy he
experiences from it, the eleven schools would be
turning away students.
If every podiatrist who is not a malcontent, talks
to just one undergrad or high school student about
the satisfaction gleaned from helping patients
with foot pain, we would be a growing profession
rather than a shrinking occupation. It was one
podiatrist, Jerry Cashen, DPM who convinced me
this was a great profession, and I should consider
it for my future. Not a hard sell, just his
attitude and pride in what he did. He was a model
for the profession, and I don’t know if he knew
it.
Rod Tomczak, DPM, MD, EdD, Columbus, OH
02/05/2025 Chuck Langman, DPM
Why Podiatry School Applicants Remain Low (Aaron Solomon, DPM)
My take as someone who is closer to retirement
than just starting out is a little nuanced as we
can only see life through our own eyes. I did a
one-year surgical residency in the 1980s. I came
out being comfortable and proficient with forefoot
surgery. As I did more surgery, I realized I
wasn’t in love with it (and you need to be in love
with it to be great at it). I kept only to the
procedures I was comfortable with and never
ventured out of my comfort zone. I enjoyed far
more the people I was able to keep out of the OR
and the athletes I treated conservatively. Fast
forward to when I was about 50 years old and was
lucky enough to join a very large orthopedic group
that allowed me to be non-surgical and do
orthopedics and sports medicine all day.
I truly love what I do! I have a team of surgical
podiatrists and fellowship trained foot and ankle
surgeons to refer to for the cases that need
surgery. I also note that we have a large team of
nonoperative sports medicine docs to do the
nonoperative care that the sports medicine, joint,
hand, elbow and shoulder, and spine surgeons
don’t. I appreciate the comments of Dr Clark
about docs who promise associates the world and
create roadblocks keeping them from achieving
their potential. That said, I don’t think that is
the reason college students don’t apply to
podiatry schools. My son’s girlfriend is a 2nd
year medical student at an allopathic medical
school in Philadelphia. Approaching the end of her
second year and about to start rotations she still
does not know what specialty she wants to pursue.
How could she be expected to know that coming out
of college?
My son is pre-med and finishing his junior year of
college. He just returned from three weeks in
Portugal shadowing docs in a hospital that
included both surgical and non-surgical
specialties. He’s still not sure what direction he
wants to head in. The need for podiatrists that
don’t perform surgery is real. Perhaps a year of
internship followed by a surgical or non-surgical
residency would give PGY1 docs the ability to
choose a career path to their liking.
My thoughts are:
PGY-1 - combination of intro surgical skills and
medicine with the ability to scrub into high level
surgical cases. Really no different than what
first year ortho residents do.
PGY 2-3 (or 4?) surgical - everything that is
currently taught in residency
PGY 2 (or 3?) non-surgical - medicine, ultrasound
training including PRP, TENEX or Tenjet, sports
medicine, etc.
.
Chuck Langman, DPM, King of Prussia, PA
02/04/2025 Kathleen Neuhoff, DPM
Why Podiatry School Applicants Remain Low (Walter Clark, DPM)
I was so saddened to read Dr. Clark‘s letter. I
wonder if some of his opinions about his
inadequate pay resulted from lack of knowledge
about the cost of running a practice. Quite a few
years ago, I had an associate doctor. I paid her
40% of the gross that she generated and allowed
her to set her own hours and determine how many
patients she would see. She chose to work less
than 30 hours a week and still generated an income
above average for a full-time practitioner at that
time. My own income was approximately 32% of my
gross because I saw more than twice as many
patients and was carrying her. However, I liked
her. She was a good doctor and my patient liked
her so it was perfectly content with that.
After about five years, she came to me and told me
that she thought she should be receiving 90% of
the gross that she generated because it hardly
took me any extra cost to keep her on. I sent her
to my accountant for a day and had them go over
all the cost of the practice and the profit and
all of those things but it did not make any
difference. She was certain that I was taking
advantage of her.
So I released her from a covenant not to compete
so she could set up a practice about a mile and a
half from me, allowed her to take copies of the
records of all the patient she had seen in my
practice, helped her through the process of
developing a business plan to borrow money, and
allow her to work for me for about six months
until she was able to get her own practice up and
going.
During this time, she told multiple doctors that
she was leaving me because I did not pay her
enough. However, after she had left and been in
practice for a few years, she told me that she
wished she had never left because she was working
far more hours and making far less money that she
had with me.
I know there are doctors who take advantage of
young doctors. We have one of those in my
community. However, most of us really try to help
and to be fair. Want the next generation of
podiatrist to succeed. That is why we work with
the residency programs.
If Dr. Clark goes from doctor to doctor without
ever starting his own practice, it could be that
he will believe those doctors are all taking
advantage of him. In fact, they may be treating
him more fairly than he understands.
Most of us realize that the young podiatrist
coming behind us are the future of our profession.
I’m sorry if Dr. Clark has encountered those do
not understand this. I hope he has better luck in
the future.
Kathleen Neuhoff, DPM, South Bend, IN
02/03/2025 Brent D. Haverstock, DPM
Why Podiatry School Applicants Remain Low (Allen M. Jacobs, DPM)
As usual Dr. Jacobs nailed it on the head. We as a
profession don't have a clue what we are or want
to be, so how do we expect the public to know? Dr.
Jacobs has talked and written about comparisons of
podiatry to dentistry. It would appear to be a
good time to revisit this comparison. I feel all
graduating DPMs should complete a two-year
residency that focuses on podiatric medicine,
biomechanics, wound care and minor procedures.
This would lead to board certification in
podiatric medicine and those entering practice
would be called "podiatrists". Then there would be
a select number of podiatric surgical programs in
the country and those who are selected would
complete another two years of training in foot &
ankle surgery. This would lead to board
certification in podiatric surgery and those
entering practice would be called "podiatric
surgeons."
There would still be fellowships in disciplines
such as biomechanics, sports medicine, limb
deformity correction, wound care, diabetic limb
preservation and research. Fellowships would be
open to both podiatrists and podiatric surgeons
depending on the type of program and its
requirements.
This level of training would put podiatric
surgeons on par with all other surgeons that
complete four to five years of training. Is foot
and ankle care less complicated than that care
provided by oral max surgeons, ENTs and
ophthalmologists who complete training and
fellowships of similar length?
Dr. William Clark also made several excellent
points! He said what many think and I am sure he
will receive a lot of push back. I believe there
was a recent advertisement on this forum for a
surgical faculty position at the New York College
of Podiatric Medicine requiring board
certification in rearfoot and ankle surgery,
offering a salary of $120,000 a year! I think this
makes Dr. Clark's point for him.
Brent D. Haverstock, DPM, Birmingham, AL
01/31/2025 Rod Tomczak, DPM, MD, EdD
Why Podiatry School Applicants Remain Low (Elliot Udell, DPM)
I agree with everyone who claims that podiatry is
not well known to the public or to
premed students. All the letter writers are
correct in suggesting that podiatrists need to
expose themselves! There are no state laws thar
forbid any podiatrist from exposing himself or
herself to the public. Conway McLean, DPM posts
the multiple talks he gives in PM News as do
podiatrists almost every day. They should be
praised. You may say these aren’t directed toward
premed students, but I might suggest that exposure
to potential patients may ultimately
result in Aunt Hortense telling her nephew or
niece Lindsey, “there was this nicest foot
doctor who gave a talk about heel spurs to our
senior citizens’ lunch group.” Trickle
down exposure of the profession. Any podiatrist
can make arrangements to show up for
a meeting with a thumb drive and give a talk. APMA
is not going to pay for one of their
executives to fly out to present to 20 people, but
we can all give that presentation.
APMA has canned lectures you can use.
It’s tough to talk an organic chemistry professor
at Penn State to give up an hour of his
200 student class time to someone he doesn’t know
to talk about something he never
heard of. But when I was in Des Moines we were
able to schedule time at the community college to
talk to students with no trouble. We even had to
carry a big slide tray back then, but we did it.
No podiatrist needs any special training. Pretend
you’re talking to a patient. Bring some
business cards, tell the audience you will let
them come to the office to see what you do
as a podiatrist. Just tell them to dress like you
are dressed when you are giving your
talk. If you’re worried about the future
enrollment, take an hour and give a presentation.
Remember, 95% of life is showing up. Get involved,
be positive. If talking to a group
makes you nervous, pretend you’re talking to
patients. Make it a whole family who
brought in a six-year-old that trips over his feet
and you have to talk to the mother,
father, grandmother, sister and the kid who
doesn’t want something in his shoes the
other kids will laugh at.
Young people in private practice can look at the
hour as a practice builder and a future
profession builder. You do have the time, now
muster the commitment.
Rod Tomczak, DPM, MD, EdD, Columbus, OH
01/28/2025 Aaron Solomon, DPM
Why Podiatry School Applicants Remain low (Joel Feder, DPM)
Do pre-medical students know that podiatric
medical school is an option? This is an important
question to ask when addressing the low enrollment
to Podiatric medical schools. There was little
information given to our pre-med guidance
counselors about podiatry school. I was able to
get more information from the schools by
contacting them directly.
We had faculty from medical and dental schools,
talk to our pre-medical majors. I wonder if there
is any similar outreach on a national level either
from APMA or ACFAS to have the opportunity to
visit with premedical majors and speak to them
about the opportunities in the podiatric
profession.
I would also look at the schools of podiatric
medicine to see if they are continuing to provide
an education and curriculum that is commensurate
to an allopathic medical school. This certainly
was the case when I was a student. Granted when I
started school at PCPM, we had the benefit of have
having visiting professors from many of the local
medical schools to come teach us. This obviously
changed when we merged with Temple University in
1998. I hope that for courses such as pharmacology
and pathology that the school is taking advantage
of being part of Temple University and having
professors from the medical school help teach
these courses. I would hope the same for other
institutions that are now part of major
universities.
Ultimately if enrollment is low, it is because
pre-medical students either do not know that we
are an option, or they are not confident in the
ability to have a fruitful career as a podiatric
physician or surgeon. As I stated earlier, we need
to go to the students and convince them that this
is a good current option. This could be done at
the high school level as many schools have medical
clubs for students who are interested in a pre-
medical major.
Put on a PowerPoint presentation with numerous
pictures from limb salvage, traumas, or
interesting cases in the office. Show them the
melanoma you biopsied that saved a person's life.
Show them the ulcer you healed that made it
possible for somebody to keep their foot, or the
orthotic that allowed a person to finally run that
marathon. Show an ingrown toenail procedure. A
procedure that in 5 minutes can give somebody
relief from an extremely painful problem that they
had for weeks or months.
Of course, we also need to tell the students that
we are not broke and destitute. That we make good
livings, and we enjoy the fruits of our labor. The
economics of medicine are constantly changing.
This goes for us and all other professions. We
also cannot ignore that we as a profession do face
challenges such as lower reimbursement for
services that are reimbursed higher for other
professions. I think her struggle for parity
encompasses our ability to recruit new people into
the profession. Therefore, it is incumbent upon us
to continue to be politically active through our
various organizations to achieve this goal. I feel
that this would be a major boost for recruiting
students.
Aaron Solomon, DPM, Fort Oglethorpe, GA
01/27/2025 Evan Meltzer, DPM
Why Podiatry School Applicants Remain Low (Robert Kornfeld, DPM)
I’ve read with interest most of the letters
regarding the low number of applicants to podiatry
schools and the current state of podiatric
education. I graduated from PCPM in 1977 along
with just over 100 of my classmates. Two others
and I went into the Army. At that time, there were
only 3 states that required a one-year residency
for licensure. I remember only 2 other locations
where additional training was available beyond the
one year: Dalton McGlamry’s program in Atlanta and
Earl Kaplan’s in Detroit.
I believe that podiatric training should be both
medical and surgical. While I don’t intend to
write this letter as a promotion for my recent
memoir, I do discuss the frustration that I
experienced when my surgical privileges were
temporarily unavailable. I also described the
risks to patients who were treated for
conservative podiatric conditions by an improperly
trained nurse.
Those pre-medical students who don’t feel that
they do not want to be surgically trained should
consider the many non-surgical professions offered
in the DO and MD fields. As mentioned by
Dr. Kornfeld in his letter, a podiatrist can
choose to give up surgery if they want to and
continue to practice as Dr. Kornfeld described.
Should non-surgically interested podiatrists refer
their surgical patients to fellowship trained
orthopedists?
By the same reasoning, I agree that podiatrists
should have more medical training as well. I
practiced in New York State and proudly served on
the NYS Board of Podiatry until 2001. At
that time, ankle privileges were still not
available in NY. I can recall a patient I saw
whose chief complaint was a “sprained ankle.” The
subsequent x-rays showed a fully aligned oblique
fracture of his fibula. I knew how to treat this
condition but I had to refer him to one of my
orthopedic colleagues for treatment because of the
current NYS law at that time. (Another orthopedist
in my practice town of Ithaca, NY who specialized
in total joint replacement surgery asked me how
much time I used to apply phenol when doing a
permanent toenail matricectomy. I said, “come
on Chuck, can’t you even refer us ingrown
toenails?”). I didn’t answer his question.
Evan Meltzer, DPM, (retired), Rio Rancho, NM
01/22/2025 Steven Spinner, DPM
Why Podiatry School Applicants Remain Low (Kathleen Neuhoff, DPM)
Kudos to Dr. Neuhoff’s post. When I had the
opportunity to address the APMA House of Delegates
as president of ABPS, I argued against the
homologation of our residency training model. We
are not a surgical specialty…we are a diverse
profession which has foot and ankle surgery as one
of our sub-specialties. When I was done with my
presentation, I was approached privately by who if
I remember correctly was the executive director at
that time. He confided that I presented a strong
argument but the APMA had to protect the “grass
roots “podiatrists, and the profession believed
that all podiatrists, regardless of training, had
a right to do foot surgery. I remember asking him
if he had a daughter, and if he did, would he
rather a doctor from my training model or his do
her surgery. He leaned in closely and said, “well,
yours of course, but I can’t tell anyone that.”
So there are 2 issues. The first is that, as Dr.
Neuhoff said, that not all of our graduates either
want to be “surgeons” or have other talents which
do not translate to the operating room. The second
issue is that program directors are being forced
to share a diminishing pool of resources and
divide them “equitably” among all residents in
their program. This only serves to diminish the
training for those residents who truly have the
desire to take their training forward and deliver
a quality result for their patients, and force
other residents to meet minimal activity volumes
or they can’t graduate.
So, in my humble opinion, everyone loses. The
resident who could have benefited from additional
cases, the resident who had no desire to do
reconstructive foot/ankle surgery and was forced
to do those cases, and most importantly the
patient, who is being denied the DPM with a more
intensive training experience. I do, however,
disagree with Dr. Neuhoff on one point. I do
believe that a minimum of 3 years of residency
training should continue to be mandatory. But it
should be up to the discretion of the program
director and the desire of the resident to dictate
the allocation of the program’s resources.
Steven Spinner, DPM, Plantation, FL
