03/13/2026    Rod Tomczak, DPM, MD, EdD

What We Should Think About

Don’t think for a moment the healthcare community
hasn’t noticed the down trend in the number of podiatry students in this country. This down trend has caused an
upswing in other lower extremity care givers.
Nurses now treat what chiropodists treated in the
1950s in the United States. Nurse practitioners
and physician assistants have expanded their
practices, especially considering the fact that
these disciplines did not exist until the early
1960’s when they originated and it was not until
the late 1970s that they became universally
licensed. Podiatry has a history of looking to the
horizon while these other care givers looked
beyond the horizon after we get our heads out of
the sand.

Don’t think for a moment the government isn’t
aware that for the first time in years podiatric
residencies have gone unfilled because there
aren’t enough graduates to fill them. Actuaries
predicted what podiatry would need in the future
to assure adequate foot care to an increased
diabetic population. They also forecast what it
would really cost to start amputating limbs
because there wouldn’t be adequate care.

Don’t think for a moment we haven’t had
opportunities to join university medical centers
in the past. In researching my doctorate in
education, I interviewed an anesthesiologist and
pharmacologist from Case Western Reserve
University. He taught our class pharmacology.
After WWII Case Western offered to assimilate OCPM
into its university system but the Cleveland based
school declined the offer. Never look beyond the
horizon, there are no guarantees of a paycheck
there. While we stand around gazing at stars and
reveling at how far we have come, others are
looking at where podiatry could go as a
profession.

Don’t think for a moment that ACGME doesn’t know
what they are doing. And because they have extra
time on their hands, have offered to look at our
residencies to see why we are successful at that
level but can’t seem to fill the slots with DPM
graduates.

Don’t think for a moment that it would take more
than a heartbeat to offer new residency programs
to would be foot and ankle care givers who aren’t
DPM degree holders. If needed, medical education
would do this without input from DPMs. If you
think about it, a DO graduate could spend a year
in a transition internship, earn a plenary license
and seeing how attractive the DPM residents view
the horizon and view the practice of podiatry as
fulfilling. This could happen, with a little
jiggling of the medical pinball machine in a year.
A new residency for DOs or even PAs and NPs could
be created without podiatry’s contribution or
philosophical input while we look at college
premed majors years away from a podiatry
residency.

Don’t think we can’t influence podiatry for years
to come even if it is a DO or even an MD degree.
We are, hands down the best foot and ankle care
givers who can train the next generation which is
just over the horizon. The government would rather
spend money to prevent the cost of amputations
than throw money at the back end in amputations
and prosthetics. And the government will strive to
prevent serial amputations and prosthetics
regardless of the degree. Our profession wants a
plenary degree, even if the tasks we perform don’t
require one. But if we don’t push students to a DO
degree, we may cease to exist as an ideology. We
have lived with degree changes in the past, let’s
look over the horizon. DSC to DPM to DO, all
preserved podiatry. That is the way to think about
the future today.

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

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