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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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