03/03/2025    Rod Tomczak, DPM, MD, EdD

If you were a pre-med student, which path would you prefer?

The results of the recently completed survey of
students committed to a DPM degree or already have
a DPM degree and limited license piqued 688
professionals enough to respond to four questions.
The most surprising outcome to me was the overall
tenor of our colleagues who responded. Over at
least the last 20 years there has been a clamoring
of DPMs for a degree change so that our profession
could be granted an unrestricted license.

I was certain the pathway described leading to an
unrestricted license and parity with the
osteopathic and allopathic communities based on
passing USMLE would generate thousands of
participants. With the increase in DO granting
institutions and the decrease in students applying
to our DPM colleges, it appears we are quickly
approaching an unbelievably important crossroads.

It is so significant that the future of DPM
podiatrists versus DO foot specialists hangs in
the balance abd the direction we take.
Perhaps we were looking for an equal split of
choices among the four categories meaning 172
podiatrists would choose each category. Each
category is not equal in the real world. These
choices are not equivocal or ambivalent.

One day, I feel like a sesame bagel but tomorrow I
might want a poppy seed bagel; not so with the
future of podiatry. Our choices about which way we
are looking for the profession to move is strong
and consistent. It is unlikely that today I am
happy with a DPM degree and a three year residency
but tomorrow I would prefer a DO degree and a
different specialty all together before my fourth
year of medical school.

The major hypothesis for the survey is what the
profession thought about becoming a DO, completing
a one year general internship leading to an
unrestricted medical license then completing a two
year residency in podiatric medicine and surgery.
Thirty percent (30%) or 206 respondents of the 688
total respondents thought this was a path they
would pursue if given the opportunity when
starting professional school. Fifteen percent
(15%) or 103 respondents preferred a four year
residency in some other undecided discipline but
without any podiatry training. Forty-two percent
(42%) or 289 of the respondents would have chosen
to become a DO then decide on a residency before
year four, perhaps including podiatry, perhaps
not. Only thirteen percent (13%) or 91 respondents
would prefer a DPM degree and a three year DPM
residency maintaining the status quo.

When the categories are grouped together for
further examination, 86% or 591 of those who
participated in the survey wanted a DO degree but
were not sure until they rotated through other
specialties if they would choose a foot care route
to unlimited licensure and a lifetime choice of
what specialty to choose.

Only 91 respondents would choose a podiatry
specialty which would require a DPM degree from
one of the current podiatry colleges. DO colleges
cannot grant a podiatry degree. I had no intention
of this survey ever having any predictive value
but just a cursory look at the results has
staggering implications for our podiatry colleges.
There are some ethical questions we need to
answer. If we know that after a three year
residency a DPM will become quickly disenchanted
with their future lives’ work, should we use what
we have long suspected and now know be hidden
merely to fill DPM seats and keep the podiatry
colleges open knowing DPM graduates with a three
year residency will probably not be happy with a
restricted license?

Allen Jacobs, DPM sent me a one-word email not
long ago. He simply asked “Recruitment?” Should
CPME call the schools together and institute a
full court press for first year students? It’s
important to remember the DO schools also need to
fill their seats to stay viable. Both schools will
look at applications and at least subconsciously
label potential students as 5-star, 4-star, 3-star
potential success. Suddenly admission to medical
school will become the same as finding a 5-star
left tackle who is 6 foot 6 inches tall, agile,
and runs a 4.7 second 40 yard dash and tests clean
for illegal performance enhancing drugs. When we
compare what each DPM schools has to offer as if
it’s a future in a football career, in light of
what the 688 respondents to the survey think, it’s
like Slippery Rock football competing against the
national champions for this student.

Eighty-five percent (86%) or 591 of the
respondents do not want a DPM with a license
restricted to foot and ankle. But 203 respondents
to the survey do want an unrestricted license foot
care specialist. This implies they would be happy
as a podiatrist, but with a DO license, a virtual
impossibility again, two hundred-three respondents
want to become DOs and practice podiatry with an
unrestricted license.

These numbers are not statistics, they are data.
They do not result in a p < .05 value, and they do
not demonstrate a correlation or predict the
future. We are not interested in hearing Mark
Twain’s quote about lies and statistics. The
survey merely tells a story about our restricted
license and in what direction the respondents want
to see the profession move. Because we are dealing
with fractions, rounding up results in different
totals than are initially obvious. Remember, we
are only reporting data. One or two units do not
make a big difference when interpreting the
summary data.

We have relative certitude that recruiting a
student into a status quo college of podiatric
medicine will result in an unhappy graduate, and
remember, unhappy alumni do not donate. Do
potential students understand they will have a
limited medical license if they graduate from a
podiatry school and is it ethical to sugarcoat
that restriction with some podiatric assurance
they don’t need one or in fact don’t really want
one? Will we go to any length to fill seats in
podiatry colleges rationalizing with confidence
this silly trend about wanting an unrestricted
license will soon pass? Is there any potential
student who does not know at least one current
student in one of the DPM colleges who will pass
on what the survey shows?

Deception and sophistry by the colleges are
possible. Obfuscation is always imaginable in this
high stakes game. Potential students don’t
recognize when they are being subtly persuaded
because this is their first time being subjected
to high pressure recruiting and quasi-promises
that may not be 100% accurate. Are they aware of
what a restricted license means? When I
interviewed at OCPM no one mentioned a limited
license or restricted prescribing privileges. For
the last 48 years it hasn’t mattered.

The promise of a scholarship is indeed enticing,
but the fact that it only amounts to $300 is
misleading at best. Telling the potential student
that the student to faculty ratio is the best of
all the schools may mean there are not many
students to generate monies for good faculty,
ancillary personnel, or extra perks. Remember, the
recruitment process is another term for
advertising and as consumers we know how we feel
about truth in advertising and hyping the product,
even if it is only by the weatherman on the
11:00pm news.

Podiatry school faculty need to fill the seats at
the college, but hopefully it is not at the cost
of their souls. If the trend in osteopathic
medical education continues there will obviously
be a greater decrease in podiatry students to the
point that there will not be enough tuition
generated to keep all 11 schools open meaning,
there will be faculty without appointments. One
thing I am sure of is deception involving
potential students is not the answer, but once the
student has a year or two of DPM school under his
or her belt and sees the reality, it is too late
to escape the web and transfer.

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

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