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07/29/2025 James DiResta, DPM, MPH
RE: DPM is NOT a Dead-End Degree; It Is Just a Starting Point (Paul Kessleman, DPM)
I normally enjoy comments from Dr. Kesselman on the blog, but I do believe he has missed the mark on his recent entry regarding the DPM degree. I can also speak to his comment on the fellowship program at Dartmouth which had been a positive initiative for the profession, but it is simply not true that this is just getting started in the world of allopathic medicine. I completed the program at Dartmouth from 2002 thru 2004 in the initial MPH class and was taught by several MD/MPH faculty. I chose Dartmouth because of their initiative to change the business of what we knew as healthcare delivery and for both good and bad they were influential in forming the Affordable Care Act (Obamacare) and the development of what we know today as an Accountable Care Organization (ACO). They continue to be a leader in healthcare delivery innovation.
What I don't think Paul realized is that with present financial constraints on APMA, they have chosen to place their priorities elsewhere and discontinued funding for this fellowship program. This program provided the opportunity for fellows like Dyane Tower, Rachel Albright, Brandon Brooks, Rebecca Sundling, JD Shin, and others. When some have asked me about the ROI of this program, I point to these fellows as results. Google anyone of these members of our profession and then ask yourself “what the heck happened?” Where is the fiduciary responsibility of your APMA leadership that they would close out this program?
I think many comments that readers have perceived as being negative are from DPM leaders that recognize the issue we will have going forward with our limited license. Our organizations from APMA and ACFAS on down recognize this problem and have so for years, and they have tried hard to make us as DPMs whole i.e. a plenary license. They took a calculated risk when the task force produced a white paper that labeled us non- physicians until we passed the USMLE exam and then the powers to be took the opportunity away from our students to take the exam and left us as a profession hanging. I'm not critical of the task force initiative as they worked hard for a long time to get this to fruition and had our best interests. I'm just terribly disappointed in the final results.
When I was on the MFAS (MPMS) board years back I was trying to find a way to get our ankle scope bill passed and I decided to approach Mass Medical Society (MMS) through their leadership and their lobbyist as I was friends with a former MMS president and AMA Trustee who was a fellow PHO and IPA board member with me for our local hospital and physician community. A prominent colleague of our profession who is retired now and who was a former president of APMA told me at that time whatever you do and whatever you might think they are telling you, don't ever place your trust in MMS. I believed he was naive and I ignored this advice. I went ahead and placed a task force together with members of our society leadership along with Mass Orthopedic Association (MOA) leadership and I have regretted it ever since.
I loved practicing podiatry for over 40 years and I was and still am proud of my DPM degree, but I have come to realize that as a profession we can no longer continue on our present educational path relying on a limited DPM degree and continue believing we can enroll qualified students to fill the seats at the present colleges of podiatric medicine. I ask you to survey the landscape. Look at the available pool of applicants and how they could possibly commit to podiatry when we are competing with such an influx of new medical schools particularly from the osteopathic profession and the increased number of seats available at all their schools! Then look at competing professions i.e. PA (physician associate/assistant) and other healthcare programs.
As a profession we need to take our heads out of the sand and have some foresight as to what the future of healthcare looks like. Put yourself in the shoes of these applicants. I have encouraged and mentored several students to become podiatrists and almost all of them have been successful and I don't regret what I have done BUT going forward I would be very cautious when speaking with future applicants.
I don't want our profession to lose the strides it has made and allow everything to slip away. As the old cliche goes, start thinking out of the box. As Dr. Tomczak has proposed, why don't we look to the osteopathic profession for help? They want to open more and more schools and campuses for future applicants. We have a pool in place and some of our students are already training side by side with osteopathic students. There are many potential models to make this work and get us a plenary degree DO. This is serious business but unlike Hyman Roth said to Al Pacino in The Godfather, it's not simply business, it's also personal.
James DiResta, DPM, MPH, Newburyport, MA
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