06/19/2026    Allen M. Jacobs, DPM

A Potential Solution to the Student Recruitment Crisis

I would like to offer a potential solution for the
current podiatry college “recruitment crisis“. The
solution requires out of the box thinking and a
dramatic change in the education of our future
podiatric physicians. Change is always difficult.

My proposal is that the podiatry colleges, at
least one or two as an initial program, institute
a direct admission program for the DPM degree.
That is to say, admitting students directly from
high school into the colleges of podiatry for a
five or six year combined DPM and bachelor of arts
or bachelor of science degree.

Before you react, keep in mind that with the
exception of the United States and Canada, the
rest of this world has direct admission of
students from high school into medical school.
This includes European countries, the United
Kingdom, Australia, Asia, South America, and so
on. There are very few countries beyond Canada and
the United States that require a bachelors degree
for admission to medical school.

The direct entry program offers many obvious
advantages. Clinical sciences are integrated with
basic sciences. In fact, I would suggest going one
step further and adopting the Northwell/Hofstra
model of medical education which has shown to be
successful. That is to say placing students
immediately into clinical rotations and exposure
to patient care from day one.

A direct entry program reduces cost to the
individual by eliminating two years of college
education. The majority of foreign trained
physicians with whom you work daily did not
graduate college,but went directly from high
school to medical school. Do you question their
qualifications? Do you really care if that
physician performing a cardiac stent can quote
Shakespeare's Macbeth? Are you concerned that
your gastroenterologist cannot recite details of
World War I?

Furthermore, another controversial suggestion;
eliminate the requirement for the MCAT
examination. Review the high school performance
and interview the individuals under consideration
for admission to the podiatric colleges. How many
exceptional pediatric physicians do you know,
providing advanced, non-operative and operative
care, who did not perform well enough on the MCAT
examination to be accepted into medical school.
Again, this would allow a distinct competitive
advantage for the recruitment of students to the
colleges of podiatric medicine. Therer are
medical schools which have done so.

The direct entry model of admission from high
school into an integrated program for five or six
years is consistent with the overwhelming majority
of the world. The requirement for a bachelors
degree is stressed only in the United States and
Canada, and in my opinion does not offer any real
advantage. When is the last time the Krebs cycle
plaedy a role in your decision making for the
correction of a bunion deformity? How much
calculus do you employ when prescribing medication
dosages?

There are now significant limitations to the money
available through federal assistance for medical
education. Reducing the pre-entry requirements
would be helpful in reducing debt, and in my
opinion would give priority to the selection of a
career in podiatry too many graduating high school
students.

Some of the colleges of podiatry are already
affiliated with universities and the program could
be instituted in a relatively convenient manner if
there were a will to do so.

I do not believe that a direct entry program
eliminating the requirement for a bachelors degree
for entry into a podiatry college would result in
a lowering of standards or esteem or prestige of
the DPM degree. That is the way the majority of
this world functions to award an MD degree. The
old phrase “what’s good for the goose is good for
the Gander“ is certainly applicable.

The construction of an integrated direct entry
curriculum can be obtained if the desire and
effort were there to do so. It represents a
radical departure only by Canadian and American
standards and is consistent with what the
remainder of this world does.

If an individual seeks care from a podiatric
physician we desire an individual who is best
trained in the evaluation and treatment of foot
and ankle disorders. Initiating clinical
experience from day one has been shown to be
effective if not superior to the traditional
models of classroom teaching for the first several
years leaving clinical experience to the final two
years of medical education. These are not
controversial points and are well established in
the rest of this world. Certainly the experience
of Northwell/Hofstra medical school supports this
concept.

I had worked my way through school as a scrub
nurse and retractor holder. I remember one
evening, taking a break during a long case. I was
sitting in the doctors lounge. An Indian born
physician for some reason, sat next to me on a
couch and assumed that I was a medical student
from Jefferson medical college. He asked “how is
my patient doing in the operating room“? I told
him that I was taking a break, but that it looked
as though the case was going well. For some reason
he then spontaneously said to me with no prompting
“I do not need a surgeon to think. I will do all
the thinking. I just need a surgeon to do a good
job with the surgery on my patient“.

I’m not suggesting that our profession align
itself only with the training of future surgeons,
although manual skills can be a major part of our
professional services whether it is so-called
routine foot care or treatment of an ankle
fracture or anything in between. The point is to
turn out a knowledgeable and well trained and
confident podiatric physician. I strongly believe
we can do this with a direct entry program. I
strongly believe that marketing this would attract
high school students to enter our field. It would
represent a dramatic change in our educational
system, but could be done.

Tradition should not trump progress.

I asked this question to Rod Tomczak and
experienced medical educator as you know. He has
been a frequent contributor to PM magazine. I
forwarded to him a summary of the textbook
describing the changes in medical education
available at the Northwell/Hofstra school of
medicine. His response was interesting and
consisted of one line. “Someone will be losing
money“.

I was making rounds at the hospital 6 AM this
morning with the chief Resident. He is
extraordinarily well trained, leaving to do a
fellowship, and I am certain we have a wonderful
and successful career as a podiatrist. I told him
I was about to send a controversial letter into PM
news to discuss this matter. Interestingly, his
response was exactly that of Dr. Tomczak. He said
to me. “Someone is going to lose money if we do
this”. Interesting insight for an individual that
does not have the credentials, experience, or
education of Dr. Tomczak, but was able to draw the
same conclusion immediately.

The recruitment problem must be addressed. I
believe this is a reasonable alternative approach
to the propositions forwarded thus far. It would
require a dramatic change in the current
educational system. I fully expect a plethora of
negative commentary as to why it cannot be done.
My response would be simple; why is it that the
rest of this world conducts medical education in
this manner?

Allen M. Jacobs, DPM, St. Louis, MO

There are no more messages in this thread.