09/15/2025    Rod Tomczak, DPM, MD, EdD

APMA Rejects ACGME Task Force (Lee C. Rogers, DPM)

ACGME, the accreditation agency for MD and DO
residencies and fellowships has invited podiatry
into their fold and become the accreditors rather
than CPME. Accreditation by ACGME would mean
podiatry is officially a specialty of medicine,
just like orthopedics or internal medicine. APMA
has voted not to accept the ACGME invitation.

When I attended OCPM we had the opportunity to
enjoy a few high quality MD instructors from Case
Western Reserve University. One of them was an
anesthesiologist who taught pharmacology to the
medical students at Case. He constantly munched on
Sen-Sen breath mints and challenged anyone who
wanted to play racquetball for a dollar a point. I
took the dare and lost my weekly allowance. We had
a couple of beers after the game and he told me
that after WWII, Case offered to assimilate OCPM
into the University.

It would have been Case Western College of
Podiatric Medicine. OCPM voted against the merger.
Why?, You might ask. Let’s just say there would be
no need for an OCPM president, and the dean would
probably be different and many of the full-time
faculty would no longer be on the Carnegie Road
Gravy Train. The future of podiatry was stymied to
preserve the security of a few. The decision from
OCPM was supposedly based on a “difference in
educational philosophy,” which might alter the
essence of the profession. If you’re going to do
me, do me easy. The decision to remain independent
was purely economic and the chance to move
podiatry forward went the way of the last German
U-Boat.

Why bring this up now? What does make this day
different than every other day? Some of us have
gone out looking for the educational prophet who
will change the profession only to be continually
turned away. I have been behind the curtain and
chatted with the Great Oz. Ohio State University
has 79 medical and surgical ACGME residencies and
close to 90 accredited fellowships. I was on that
ACGME committee as an at-large member and as the
director of the three-year podiatric surgical
program starting in 1999. Here the operative word
is accountability. As a residency program have you
done what you told us and your specialty Residency
Review Committee (RRC) that you accomplished what
you said you were going to accomplish? There’s
nothing to be afraid of here, after all, we are
podiatrists and we always accomplish what we say
we are going to accomplish.

The goals and objectives are determined by what
the residency program has done previously. Nobody
pulls numbers out of the air to impress the RRC.
The program goes on probation quickly if it
declares it will perform 50 Total Ankle
Replacements (TAR) per year but you can only
produce 10 patient records. The ACGME programs are
run on honesty and integrity as their fuel.

The ACGME Residency Committee has other
obligations that are more administrative and they
are usually taken care of within the committee. If
they are not met, the rest of the institutional
residency programs are privy to your shortcomings.
If general surgery residents are taking call every
other night or working 100 hours per week these
grievances are aired at the meetings and some
explaining is required. Or the self-study for the
RRC visit must be completed with enough time to
spare that anyone who wants to review it has time
before it is submitted to ACGME. It’s essential
that honesty prevails. It would be unwise to
submit a work of fiction to the RRC only to have
them ask to see the call schedule or interview the
residents that look like Zombies and have atrial
fibrillation from lack of sleep.

Why in God’s name would APMA and CPME be against
ACGME offering us a chance to investigate a seat
at the big boys’ table of medical and surgical
residency education? I can’t wait to hear their
excuses and explanations which might be traced
back to the wallets of those in the influential
positions of APMA and CPME. Everything can be
traced back to the administrative hustle to add a
few more students to the freshman podiatry class
of 2025. A couple of fraternity rush scenes from
the movie Animal House come to mind. ACGME
realizes the DPM degree as we see it, may be going
the way of the bowling lane pin setter and
switchboard operator. If you choose to care for
feet, the PM News survey showed the profession
would rather provide the care as a DO.

Throwing money at inferior DPM residencies that go
unfilled or don’t meet minimal ACGME standards
would come to an end. The only podiatrists against
that are the podiatrists on the same gravy train
that halted the assimilation of OCPM into Case
Western. Purely economic. Patrick DeHeer, DPM the
chair of the Fund for Podiatric Education (FPE) a
life preserver to keep schools open and the
president-elect of the APMA tells us he has no
idea what the freshman class size for 2025 is.
What’s really sad is he expects us to believe it.
We also don’t know what the FPE has done, not
planned on doing, or what has been ethically
accomplished. Of course, there will be no
transparency on their part. Double Secret
Probation like the movie Animal House. Isn’t it a
shame our professional education has become a
mirror for one of the all-time educational
comedies?

So how do we prevent the few from allowing the
majority from moving to the next level? The APMA
gave lip service to taking USMLE, gaining parity
with MD and DO residencies but when ACGME called
APMA’s bluff and offered podiatry parity via
residency training, the hypocrites said, “NO!” It
seems some podiatrists feel such a move will be
the demise of podiatry as we know it. And we sit
here and believe they are out for the common and
better good of the profession. Here we go back to
Animal House again. “Thank you, Sir, May I have
another?” Every member of CPME and the APMA needs
to be impeached, or it has come time to form a
new government, a new Podiatric Medical
Association and a new accreditation agency for
Podiatric Medicine and Surgery. A homecoming
parade like in the movie. God love Dean Vernon
Wormer.

Perhaps I’m wrong and the APMA is just trying to
protect our students from the rigors of being held
to the same standards as MD and DO residents
rather than protecting their own self-interests,
but I doubt it. For a long time it was possible to
become a DPM with very little effort, to ride
through the colleges on a big wave, to enjoy the
same gravy train as pseudo-teachers who expected
the minimum so they got the minimum from students.
Those expectations prevailed until the baby
boomers refused to coast through school and were
insulted as professors when they heard that
ancient adage about those who couldn’t, teach.

Ask any of my students who heard me after the
first test when I threatened to write truthful
letters of recommendation rather than fluff. Or
ask any of my students about “the Look.” No words
were spoken, they just got “the Look.” As a
teacher, some students will give you what you
expect of them. They have become quite adept at
just getting by rather than learning all they can.
We started teaching just when video games became
popular, when teachers coddled students and wet-
nursed them. That changed, but maybe some members
of podiatry’s political elite want to save
students and the profession from intellectual
embarrassment by expecting them to meet the same
rigorous standards as USMLE students.

We have our foot in the door of prestigious
institutions, but our podiatrists have the
ultimate and final say about the podiatry
evaluations and we can couch them a bit when
needed. When I got to Philadelphia as a resident,
the PCPM faculty thought OCPM had a remedial
curriculum compared to theirs. Faculty told them
they were the elite of the profession. You can
start to believe it if you let yourself, but once
you see one of the elite auscultate the heart
without their ear buds plugged in, you know what
they’re selling is snake oil. I remember a
resident at New England Deaconess Hospital who
couldn’t believe I could perform a hammertoe
correction complete with hand-ties during the
residency interview. I’ll never forget his
condescending attitude.

For years ,I’ve been preaching that our podiatry
students and residents can go toe to toe and trade
blows with the MD students and residents. They can
intellectually arm wrestle the USMLE’ers to a
draw. I’m not talking a chief resident versus a
third year student, but the same weight class,
second year resident versus second year. One of
the criteria for starting a three year residency
at Ohio State was that the first year would be
identical to the MD orthopedic residency. Step for
step, no exceptions. There was no bell to ring to
get out of a tough situation, no tapping out.

Our residents were walking into services where
attendings had no idea what to expect from DPMs,
what kind of training they had or what to expect
of them. They asked if the time spent in internal
medicine was to be merely observational and they
would pass just by showing up. No, the same as the
first year MD residents with the same
expectations, assignments, presentations,
formative and substantive evaluations, and end of
rotation exams.

The feedback I received from rotation and
residency directors was overwhelming. They could
not get over the fund of knowledge the residents
and students brought to the experience and how
driven they were to be as good as if not better
than others in their same class. They managed
diabetics and patients with CHF, worked through
COVID with the same commitment as the MDs.
T
hey spent nights reading techniques to intubate
and start arterial lines, manage fluids and
ventilators. Attendings gave them the
responsibilities they thought the DPMs could
handle. They rose to the occasion never ha
ving had advanced medical and surgical rotations
and sub-internships as fourth year MD students
had. They served the profession well and cemented
the attitude of the orthopedic department chair, a
Rancho Los Amigos foot and ankle fellowship
trained orthopedic surgeon that podiatrists could
sit at the same table as orthopedic surgeons.
F
ifty years ago, podiatry charged some graduates
with a new term, PSR 24+ and the responsibility of
moving the profession forward so that all DPMs
could fulfill their potential and ensconce
podiatry in the niche it belonged in within the
health care milieu. Students are better and
brighter, the curriculum, both academically and
clinically is even par with the MDs and DOs. We
now have residencies and fellowships at some of
the most prestigious health care facilities in the
country. ACGME, the evaluation organization for
over 100 residencies and fellowships has extended
an invitation to our profession to accredit
podiatry as a specialty of medicine. T

he last seven words are what podiatry has been
working toward for more than the last 50 years.
Accredit podiatry as a specialty of medicine. The
chance to be recognized by the same organization
that says a neurosurgical program trains its
residents to the highest level, or that
ophthalmologists who can blind a patient with a
wrong diagnosis are properly trained. They would
be willing to tell society that we are capable
foot and ankle surgeons, the same organization
that says the same thing about orthopedic foot and
ankle surgeons. We know it’s true, now it’s time
to make sure society knows.

Except, NO! The APMA does not want ACGME involved.
It has responded NO on the RSVP invitation by
ACGME. Patrick DeHeer, the President-elect of the
APMA and founder of FPE is worried about the
number of students applying to our schools. APMA’s
NO vote is the final nail in the coffin for FPE.
How does it fly for the president to let potential
students know we don’t want an outside agency
confirming we train our students as well as the
MDs and DOs. Our leadership has flat out betrayed
us for 30 pieces of silver.

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

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09/16/2025    Brook Bisbee, DPM

APMA Rejects ACGME Task Force (Lee C. Rogers, DPM)

This summer, APMA became aware that the
Accreditation Council on Graduate Medical
Education (ACGME) has interest in exploring
accreditation of training programs outside
allopathic and osteopathic medicine. This interest
is part of ACGME’s business plan to
explore extending their accreditation programs to
a variety of other healthcare
professions.

After an initial discussion with ACGME, APMA
shared this information with the leadership
of its component organizations and with the
leadership of other large podiatric
organizations with a stake in residency training
including CPME, AACPM, COTH, ABPM,
ABFAS, and ACFAS. In recent weeks, we held
meetings with many key stakeholders within
the profession to discuss the pros and cons of
participating in an exploratory process with
ACGME. We also gathered written feedback from
stakeholders. The feedback was shared
with our Board of Trustees at their September
virtual meeting to determine whether and
how to move ahead.

The feedback gathered from the profession made
clear that while there is some
curiosity within the profession about pursuing
accreditation by ACGME, there also is
widespread uncertainty and apprehension about this
process. Stakeholders raised
concerns about autonomy, the impact for residency
programs and graduates, competing
strategic priorities, and more. Additionally,
there was no guarantee in the conversations to
date that ACGME was interested in creating parity
through accreditation.

Our board weighed these concerns and determined
that this question requires
significantly more input from the profession and
would ultimately need to be vetted by
our House of Delegates (HOD). Based on that
determination, the board voted at this time
not to participate further in the process with
ACGME. ACGME will continue to explore
accreditation beyond MDs and DOs through its
internal task force, but it does not intend to
engage or move forward with podiatry without
APMA’s cooperation on behalf of the field.

Matters of significant magnitude affecting the
profession, especially when there is no clear
consensus, should be debated in an open and
transparent process through the House of
Delegates. We recognize that there are many
opinions on this issue, and it’s essential that
all these voices are represented. To that end, we
encourage members to reach out to APMA
and those groups who represent you to provide
feedback. Additionally, APMA will review
our governance documents to address how issues of
magnitude come before the association in the
future.

Until the HOD provides direction on the issue of
ACGME accreditation, APMA will remain
laser-focused on the pressing strategic and
operational priorities our board and house have
approved, including student recruitment, advocacy
on behalf of the profession, continued
growth and development of the member value
proposition, support for our component
organizations, recognition of podiatry among the
public, our task force on the status of
podiatric education and training, the reimagining
of our educational offerings, and
operational effectiveness as an organization.
These initiatives require staff time, significant
member involvement, and resources to execute
effectively, and they have the
demonstrated support of our community of interest.

APMA gratefully acknowledges the many individuals
and organizations that answered
our call for input and took the time to provide
initial feedback on this matter in recent
weeks. It takes the entire podiatric community
coming together to effect change on
behalf of the profession. We look forward to
continued collaboration and support from
our partners, our components, and our individual
members as we tackle the most critical issues
facing podiatry.

Brook Bisbee, DPMM, President, APMA