09/30/2025    Rod Tomczak, DPM, MD, EdD

APMA Rejects ACGME Task Force (Brook Bisbee, DPM}

Dr. Bisbee, there are a few individuals one should
never try to mislead. First is your lawyer about
your actions, second is your clergyman about the
state of your soul, and the third is Rod Tomczak
about medical educational matters, especially
podiatric medical education.

In 2020, five years ago, AAOS, ACFAS, AOFAS and
the APMA endorsed a four point plan in a White
Paper titled “Improving the Standardization
Process for Assessment of Podiatric Medical
Students and Residents by Enabling Them to Take
the USMLE.”

Point three of the four reads, CPME approval of
podiatric residency programs should meet
comparable standards to Accreditation Council for
Graduate Medical Education (ACGME). APMA agreed to
this. I call renege. ACGME cannot testify to the
equality of podiatry residencies to say,
ophthalmology residencies without taking a hard
look at our programs. We, podiatry wanted and
agreed to tis in 2020, like 20-20 vision.

In your September 16 letter to PM News you stated,
“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.” Podiatric residency
evaluation by ACGME was already agreed on. Who do
you think you’re kidding? This is a blatant cover
up and I see through it. Those folks against a
residency evaluation visit by ACGME are afraid of
what they will find. I know it, you know it and
now we know it together with the entire
profession.

This whole process to earn a seat at the adult
table started in 2013 with the introduction of
three year residencies. That did not happen in a
vacuum. In 2020 APMA and the other alphabet
organizations I mentioned agreed that ACGME should
concur that our residency programs are comparable
to ACGME standards. Now, ACGME is reaching out as
the accreditation organization for MD and DO
programs and offering to startr discussing the
process on how to perform the function you (APMA)
agreed on. Now a few people from the September
meeting have thrown a wrench into the process.
They just want to talk about it but podiatry
doesn’t want to do that, it’s too close to getting
a foot in our door.

This process to gain parity with MDs and DOs and
perhaps save podiatry is going to be your and Dr.
De Heer’s legacy. Why in God’s name would you
reach this decision to put a halt to the course
agreed on five years ago and tell ACGME we are not
interested in you (ACGME) looking at our
residencies? Their approval is a vital sine quo
non to something the entire profession, your real
stakeholders, a word you throw around quite
casually has been working for since 2013. We have
some residency programs where graduates are more
adept at drinking coffee than performing hammertoe
corrections.

Perhaps you are trying to protect the entire
profession for unfulfillable promises made in 2018
that can’t possibly be kept today. If we aired our
dirty laundry in the form of inadequate residency
programs we would be victims of the podiatry three
step; one step forward and two steps back.

That reason for the out of the clear blue reply to
ACGME is perhaps the worst kept podiatry secret
since the invention of the nail dust vacuum. Is
the profession to believe that this day of
reckoning would never come? Diabetic wound care
has become an important part of podiatry filling a
niche no other specialty was good at or wanted to
accept, but that is not our sole raison d’etre.
If that is the only thing we do, we are not doing
a very good job in the prevention column. We have
residencies programs that would not cut the
mustard of inspection by an outside agency because
the logbook would be ludicrous in comparison to
other specialties.

In the White Paper the example of ophthalmology is
used. No ophthalmology resident has a 90% cataract
surgery concentration and still be proficient at
being a general ophthalmologist. I think there are
other podiatrists who feel the same way. Dr. De
Heer is in the on-deck circle to follow your
performance at the plate. Dr. DeHeer told me in a
PM News reply that it is easy to criticize the
Dead Heads, or something like that, without
offering a solution. Here’s the solution. Why
don’t we get rid of these inferior programs?

I know, there’s too much money lining residency
directors’ pockets and hospitals. Now figure out
how as a profession we can get out of this corner
the profession painted ourselves into. Surely
people in the podiatry alphabet organizations knew
this day would be coming. Altruism in podiatry got
lost somewhere and some podiatry residency
directors got blinded by the Benjamins.

Are we at the point where we have to scuttle our
own ship because in a moment of false magnanimity,
bravado, and pride, we boasted a future prediction
we could not possibly fulfill? Did our MD
counterparts know our egos would outrun our
potential and open the door and then our cash
cravings would slam the door on our foot? Let’s
admit where we went wrong and as a profession fix
it. Let’s at least show some good will by
confessing to ACGME that we erred on the side of
vanity like we suddenly became 8 foot tall and
bullet proof instead of having this massive
Achilles to repair that we have now. We can ignore
fixing the present condition forever and limp
through podiatry’s future endlessly.

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

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