12/02/2025    Rod Tomczak, DPM, MD, EdD

De-Extinction (H. David Gottlieb, DPM)

About 50 years ago, I was asked to speak to the
state medical board of Ohio. I think I was a
second year student at OCPM and the purpose of my
address was to help convince the medical board
that podiatry should be under the aegis of the
medical board and that the podiatry board
subsequently be disbanded. One of the members of
the medical board asked me why podiatry should be
under the medical board. I replied that our
education was not equal to an MDs education and
oversight by the medical board would help us
attain credibility in the eyes of the public. By
being under the guidance of the medical board, I
was saying we want to be held to the same
standards as MDs. I could have just as easily said
that podiatric education is different than an MD’s
education and the profession should remain under a
podiatric board because it would make more sense
to be judged by a peer who had navigated the same
education and training, but we knew we would never
be equal. Naturally, I had been coached up on what
to say and the podiatry board was disbanded and
podiatry was under the all seeing eye of the
medical board.

Twenty-five years later, I was asked to give my
opinion to the medical board on whether or not the
practice of podiatry should include ankle surgery.
This was easy, The practice guidelines of ACFAS ,
of which I had been appointed Chair of the new
Division 13, clearly stated that if the podiatrist
was trained in ankle surgery and could show logs
attesting to that fact, he or she should be
allowed to perform ankle surgery. Proof of
training did not include a weekend course on saw
bones or office exposure in arthroscopy. I was
asked one question. “Do you fixate fractured
ankles at Ohio State Medical Center?” I replied,
“Yes.”

A few days later, the council for ACFAS called and
asked me to resign as Chair of Division 13. If I
didn’t, he said there would be mass resignations
by members of the division because of my
testimony. I said sure, I’d resign but asked what
good the guidelines did if I quoted them then was
asked to resign. I learned that moral flexibility,
also called situation ethics, or ad hominem
choices are important in podiatry. This is still
true today. We want to be treated as equal to MDs
and DOs with all the rights and privileges but
without the responsibilities of ACGME residency
evaluations and USMLE exams.

If our education and training are equal to that of
an MD or DO we should be judged by them as our
peers, but if we are not on par then we should be
judged by our DPM peers. We can’t have both. The
previous survey concerning a DO degree has been
hashed over ad nauseam and it attests to the fact
that the stakeholders want the profession to move
toward a plenary license. Eighty-six percent (86%)
of almost 700 podiatrists in the earlier PM News
survey want the profession to earn a DO degree
rather than a DPM degree.

In the current PM News survey, 67% of the
responders favored ACGME’s involvement in
podiatric residency evaluation. That is a 4:1
ratio over those who want us to judge ourselves
and tell the MD/DO community we are equal. We
can’t have both. The stakeholders think we should
eventually have residencies accredited by ACGME,
and only 80 of the 500 podiatrists who responded
felt ACGME accreditation would not advance the
goal of parity with medicine for podiatry. It’s
quite clear where most podiatrists stand on the
topic. We are not all futurists, but we are all
smart enough to see where this road leads, rugged
terrain or not. The stakeholders have said they
want a DO degree in the future and are not afraid
to have our residencies, which lead to parity,
looked at by ACGME.

What’s really important for everyone with a DPM
degree to realize is that no one is disparaging
podiatry or a DPM degree. No one is a malcontent
casting aspersions on the profession. All the
positively responding stakeholders are saying is
that it is time to evolve without losing our
essence and that is completely possible.

Borrowing from Immanuel Kant’s The Critique of
Pure Reason, we can surely say, “Tigers exist.”
This is not the same as saying, “Tigers have
stripes,” which presupposes that tigers in fact
exist. But, can tigers exist without stripes?
There are clearly white tigers without stripes who
have the essence and DNA basics to classify them
as a species of tiger. The same can be said of
podiatrists. If a DPM degree evolves to a DO
degree, as the stakeholders clearly want, then the
training must be comparable to the DO, it will be
the specialty boards that will decide who is
qualified to call themselves a podiatrist while
the medical board will attest to the ability to
practice medicine. In the beginning all the
stakeholders will be the current striped tiger
variety of podiatrist but soon there will be a
minority of white tigers, then the majority of
tigers will be white tigers with DO degrees. Just
as there are retinal ophthalmologists, radial
keratotomy, and a cataract surgeon, all certified
by the American Board of Ophthalmology, there will
be board certified DO podiatrists who specialize
in rearfoot trauma, limb salvage or sports
medicine to name three.

There are also Siberian tigers who belong to the
species Panthers tigris. They have evolved
characteristics that enhance their ability to
survive in cold climates. And so it is with the DO
podiatrist who evolves into the subspecialty that
suits him or her the best. They will be the sports
medicine podiatrists, limb salvage podiatrists,
trauma podiatrists, all bound together by being
podiatrists but with different characteristics and
completing a recognized fellowship. This gives
podiatrists the freedom to choose, an existential
right. Podiatrists today have limited choices that
can be certified; either as a surgeon or not a
surgeon. To not make a choice is in fact making a
choice.

So, who then are the stakeholders? They are the
podiatrists who will ask the candidate running for
a podiatric office, “Do you think ACGME
accreditation of our residencies will advance the
goal of parity? and “Are you in favor of a DO
podiatrist?” If the answer is “No,” further
questions from the stakeholders are unnecessary.
The stakeholders are guardians of the profession
who spoke in the two PM News surveys. Chances are
they will never see the white tiger evolve, but in
this case, fear of evolution leads to extinction
of all tigers.

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

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12/02/2025    Rod Tomczak, DPM, MD, EdD

De-Extinction (H. David Gottlieb, DPM)

About 50 years ago, I was asked to speak to the
state medical board of Ohio. I think I was a
second year student at OCPM and the purpose of my
address was to help convince the medical board
that podiatry should be under the aegis of the
medical board and that the podiatry board
subsequently be disbanded. One of the members of
the medical board asked me why podiatry should be
under the medical board. I replied that our
education was not equal to an MDs education and
oversight by the medical board would help us
attain credibility in the eyes of the public. By
being under the guidance of the medical board, I
was saying we want to be held to the same
standards as MDs. I could have just as easily said
that podiatric education is different than an MD’s
education and the profession should remain under a
podiatric board because it would make more sense
to be judged by a peer who had navigated the same
education and training, but we knew we would never
be equal. Naturally, I had been coached up on what
to say and the podiatry board was disbanded and
podiatry was under the all seeing eye of the
medical board.

Twenty-five years later, I was asked to give my
opinion to the medical board on whether or not the
practice of podiatry should include ankle surgery.
This was easy, The practice guidelines of ACFAS ,
of which I had been appointed Chair of the new
Division 13, clearly stated that if the podiatrist
was trained in ankle surgery and could show logs
attesting to that fact, he or she should be
allowed to perform ankle surgery. Proof of
training did not include a weekend course on saw
bones or office exposure in arthroscopy. I was
asked one question. “Do you fixate fractured
ankles at Ohio State Medical Center?” I replied,
“Yes.”

A few days later, the council for ACFAS called and
asked me to resign as Chair of Division 13. If I
didn’t, he said there would be mass resignations
by members of the division because of my
testimony. I said sure, I’d resign but asked what
good the guidelines did if I quoted them then was
asked to resign. I learned that moral flexibility,
also called situation ethics, or ad hominem
choices are important in podiatry. This is still
true today. We want to be treated as equal to MDs
and DOs with all the rights and privileges but
without the responsibilities of ACGME residency
evaluations and USMLE exams.

If our education and training are equal to that of
an MD or DO we should be judged by them as our
peers, but if we are not on par then we should be
judged by our DPM peers. We can’t have both. The
previous survey concerning a DO degree has been
hashed over ad nauseam and it attests to the fact
that the stakeholders want the profession to move
toward a plenary license. Eighty-six percent (86%)
of almost 700 podiatrists in the earlier PM News
survey want the profession to earn a DO degree
rather than a DPM degree.

In the current PM News survey, 67% of the
responders favored ACGME’s involvement in
podiatric residency evaluation. That is a 4:1
ratio over those who want us to judge ourselves
and tell the MD/DO community we are equal. We
can’t have both. The stakeholders think we should
eventually have residencies accredited by ACGME,
and only 80 of the 500 podiatrists who responded
felt ACGME accreditation would not advance the
goal of parity with medicine for podiatry. It’s
quite clear where most podiatrists stand on the
topic. We are not all futurists, but we are all
smart enough to see where this road leads, rugged
terrain or not. The stakeholders have said they
want a DO degree in the future and are not afraid
to have our residencies, which lead to parity,
looked at by ACGME.

What’s really important for everyone with a DPM
degree to realize is that no one is disparaging
podiatry or a DPM degree. No one is a malcontent
casting aspersions on the profession. All the
positively responding stakeholders are saying is
that it is time to evolve without losing our
essence and that is completely possible.

Borrowing from Immanuel Kant’s The Critique of
Pure Reason, we can surely say, “Tigers exist.”
This is not the same as saying, “Tigers have
stripes,” which presupposes that tigers in fact
exist. But, can tigers exist without stripes?
There are clearly white tigers without stripes who
have the essence and DNA basics to classify them
as a species of tiger. The same can be said of
podiatrists. If a DPM degree evolves to a DO
degree, as the stakeholders clearly want, then the
training must be comparable to the DO, it will be
the specialty boards that will decide who is
qualified to call themselves a podiatrist while
the medical board will attest to the ability to
practice medicine. In the beginning all the
stakeholders will be the current striped tiger
variety of podiatrist but soon there will be a
minority of white tigers, then the majority of
tigers will be white tigers with DO degrees. Just
as there are retinal ophthalmologists, radial
keratotomy, and a cataract surgeon, all certified
by the American Board of Ophthalmology, there will
be board certified DO podiatrists who specialize
in rearfoot trauma, limb salvage or sports
medicine to name three.

There are also Siberian tigers who belong to the
species Panthers tigris. They have evolved
characteristics that enhance their ability to
survive in cold climates. And so it is with the DO
podiatrist who evolves into the subspecialty that
suits him or her the best. They will be the sports
medicine podiatrists, limb salvage podiatrists,
trauma podiatrists, all bound together by being
podiatrists but with different characteristics and
completing a recognized fellowship. This gives
podiatrists the freedom to choose, an existential
right. Podiatrists today have limited choices that
can be certified; either as a surgeon or not a
surgeon. To not make a choice is in fact making a
choice.

So, who then are the stakeholders? They are the
podiatrists who will ask the candidate running for
a podiatric office, “Do you think ACGME
accreditation of our residencies will advance the
goal of parity? and “Are you in favor of a DO
podiatrist?” If the answer is “No,” further
questions from the stakeholders are unnecessary.
The stakeholders are guardians of the profession
who spoke in the two PM News surveys. Chances are
they will never see the white tiger evolve, but in
this case, fear of evolution leads to extinction
of all tigers.

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