10/14/2025 Rod Tomczak, DPM, MD, EdD
Obituary for the DPM Degree
The obituary can now be completed and a necrology
constructed. It’s time to sit Shiva,
recite the Kaddish and assemble the musicians for
Mozart’s Requiem. The mourning is
not for podiatry, it is too strong, stronger than
the 70 or 80 years of Psalm 90. The
mourning is for the DPM degree. Podiatry is a
philosophy much stronger than three
initials and will continue to be with us for a
long time.
But what we have learned in the last months is
that the youth opting for our profession
want a plenary license, not the parochial one we
have possessed and have thrived under. They want a
seat at the adult medical table. How do we know
this? Eighty-seven percent (87%) of the
podiatrists who answered the survey in PM News
stated concerning a professional degree they
wanted the option of having a DO degree to
practice podiatry or at least have the option of
choosing podiatry as physicians with a DO degree.
Only 13% of the responding podiatrists said they
were happy with a DPM degree and a limited
license. Thirty percent (30%) of the respondents
wanted to complete a one-year DO internship then a
two year residency in podiatry and practice
podiatry as a profession.
Implicit in this plan would be passing all
sections of USMLE and having a new residency
program approved by ACGME, the accreditation
organization for the rest of the MD/DO residencies
in this country. CPME would cease to exist unless
there were enough students who still wanted a DPM
degree to have a DPM school or two remain open and
the residency programs we have now continue.
Those folks obtaining a DO degree would have
nothing to do with CPME which also accredits DPM
schools, creating a possible conflict of interest
which we have now.
And how do we know this? Dr. Bisbee recently
stated that certain important stakeholders did not
want to respond to the invitation from ACGME to
become involved with podiatry residencies even
though this plan to accredit podiatry residencies
was set in motion more than 10 years ago. Part of
any plan to parity with the MD/DO community
would involve approval of our residency programs
by an outside agency, not like CPME which now
accredits all DPM residencies. Dr. Bisbee uses the
term “stakeholders,” making it sound like a huge
part of the profession doesn’t want ACGME looking
at our post-graduate programs, like they are going
to steal some of our training ideas and methods.
The real stakeholders have just responded to
another survey posted by PM News. Eighty-eight
percent (88%) of the over 600 respondents wanted
ACGME to discuss accreditation of podiatric
residencies by ACGME. Only 7% of the over 600
respondents or about 43 podiatrists did not want
ACGME to review the DPM residency programs.
This is an extremely important finding. First, why
would any residency directors not want to show off
what they have built? When I started the three-
year residency program at the Ohio State
University over 25 years ago I wanted everyone to
see what we had done, how our three years
consisted of a first year medicine/surgery
internship to fill in any gaps that might have
existed after podiatry school. If our residents
had to speak allopathic or osteopathic medicine,
they knew the language.
Secondly, residency directors and chairs of the
departments our podiatry residents rotated through
were impressed with the knowledge and work ethic
of our podiatry graduates. We had absolutely
nothing to hide but rather these chairs and other
department residency directors and the chief of
graduate medical education told me they were
pleasantly surprised at the quality of the
podiatry residents. For many years they had heard
spurious rumors about podiatrists knowing little
else except feet. Our residents now educate the
MD/DO community about their capabilities.
If podiatry moves to a DO degree and a one-year
general internship followed by two years of
podiatry it will happen slowly. There will still
be a need for the podiatry residencies we have now
before a complete transition takes place. During
this period, it will be an absolute necessity for
the podiatry residencies to have dual approval. We
can not let the 7% who do not want the ACGME to
see their programs ruin the post-graduate
education for the entire profession as it moves to
a plenary license and the residency that is part
of the process.
Two documents, one from AACPM and the other from
CPME add credence to what should inevitably happen
if the profession is to continue to exist, not as
DPM physicians, but as DO physicians. We now have
11 DPM granting colleges. Chicago and New York
have the largest incoming freshman classes with 86
and 85 students respectively. The other nine DPM
freshman classes have a total of 348 students.
This year’s freshman class has more students than
any since 2022. This data along with the percent
of students who graduate in four years has been
published in PM News.
What has not been widely publicized is the cap on
federal loans for all medical students. The total
amount that can be borrowed for medical schools is
$250,000, Many students surpass this amount when
cost of living is added to the tuition. The total
that can be borrowed for undergraduate school is
$31,000 which would be subtracted from the total
of $250,000 lowering the maximum that can be
borrowed for medical schools to $219,000. Of
course, who can be sure of these figures tomorrow?
Many of the 37 DO schools have a large war chest
to help subsidize student education. This is not
the case with private DPM colleges which have a
more difficult time subsidizing students because
of lower endowments.
Many of you remember that first day of school when
the dean or president addressed the class and
said, “Look to your left, look to your right. All
three of you will be here graduation day.” That’s
not the case anymore. CPME releases graduation
rates. New York, which admits the most students,
85, has the lowest graduation rate, 68%. Ohio
has the second lowest graduation rate at 70%.
Philadelphia has the highest graduation rate at
94%. The overall graduation rate for all the
schools is 80%. What we don’t know is when during
the four years does someone fail out or decide to
leave on their own. What we do know, is there is
no money back guarantee for tuition already paid
through loans. Mom and dad’s second mortgage has
come due.
More importantly is the answer to the question,”
Why aren’t graduation rates close to 100%?” What
happens to students from the time of acceptance to
graduation day? If students are failing out, it
can only be because the students are not
academically or intellectually equipped to
withstand the rigors of medical school or the
delivery is lacking in methodology or student
expectations. Regardless of whatever pumped up and
inspiring verbiage is used, the one universal
mission of every podiatry school is to prepare
students for the next level of training. Preparing
students for practice is no longer a requirement
for graduation.
In Dr. Bisbee’s comments about declining the offer
of ACGME to begin conversations with APMA to
review residencies, was something that was
initially brought up years ago. To suddenly
require the HOD to vet the process seems like a
stalling technique. To squelch this step forward
can do nothing but force ACGME to wonder if we are
hiding something. What are the real concerns? Are
we afraid of giving a bad impression and if so,
it's time to do something about these
programs?
Admissions since 2022 have been low, ranging from
a total of 465 to this year’s 519. If only 80% of
matriculating students are graduating, 415 not 465
students will be filling residency positions and
some resident positions will remain empty meaning
a loss of federal funding. It’s time to trim the
chicken fat and make sure the residencies that
survive are the quality that will endure as
podiatry transitions to a DO podiatry program.
Jejune podiatry residencies must be closed to gain
and maintain credibility with ACGME.
If podiatry does not respond to this invitation by
ACGME, we will eventually fall victim to the
soothsayer’s prophecy, “Beware the Ides of March.”
We will become exactly like Caesar did in the
Shakespeare play Julius Caesar. Caesar shunned the
advice in a fit of hubris. Caesar felt
untouchable, above the fate that awaited him. We
can proceed feeling we don’t need ACGME but we
would be proceeding, perilously, without the
protection of the real certifying organization,
ACGME. We place ourselves outside their protection
and at risk and could lose government recognition
and funding.
Towards the end of the same play, Marc Antony
delivers another famous quote, “I come to bury
Caesar, not to praise him.” The “bury” Shakespeare
refers to here shouldn’t be confused with the
colloquial meaning of bury, which is to get rid
of, usually under the cloud of disgrace. I think
Shakespeare wants the infinitive “to bury” to
assume a different meaning. Antony wants to put
Caesar to rest, to grant him peace and to move
on from the onus of “dictator for life.”
As we sit here, we have to wonder if some
organizations in podiatry are making a push
to become “dictators for life” at the expense of
the hoi polloi of the entire profession, the
dues paying individuals who make up the
profession. Ultimately we are proud to be members
of; the folks who are just as good as, the
practitioners who are just as qualified as, and
doctors who are just as capable as, but can’t get
a seat at our own certification table,
podiatrists.
The next generation of the profession has spoken,
not as soothsayers, but as the authentic future.
We can listen to what they are saying or we can
dismiss them as prideful, arrogant upstarts who
just won’t listen to our infallible wisdom.
Remember when we were in their shoes; when we
never trusted anyone over 30? We had a solution
for then, now we need to Beware the Ides of March!
Rod Tomczak, DPM, MD, EdD, Columbus, OH
