06/22/2026    Rod Tomczak, DPM, MD, EdD

A Potential Solution to the Student Recruitment Crisis

“Some places will never let progress interfere
with 100 years of tradition.” So said Dr.
Battinelli of Northwell/Hofstra School of
Medicine. I have been advocating change in
podiatry schools since 1986. Faculty and
administration, including CPME wanted to see
Problem-based Learning fail at Des Moines so I
would cease to be a threat and would go away. It
didn’t and I didn’t.

Personally, I have a certain disdain for any most
podiatric school curricula. I don’t think they are
structured correctly, taught efficiently or
learned favorably, but I am but one voice crying
out in the wilderness of the medical school
experience. It took six years to earn a doctorate
in education from Drake and I never missed a
class, nights after a full day at DMU or all day
Saturday and Sunday. I cannot say the same for my
attendance at OCPM.

A six-year curriculum sounds appealing. I’m going
to tell you some of the obstacles I’ve heard or
personally run into when suggesting a modification
of a medical or podiatric school curriculum which
would correlate to a change similar to six years.
I am not making these up. They are too bizarre in
some cases and in others somewhat practical. It’s
easier to move a graveyard than it is to change a
medical school curriculum.

If we want to accept a student after two years of
college, what criteria do we use? One of our deans
recently mentioned in this column how accurate
organic chemistry is as a predictor of success in
medical school. I disagree and I have enough
support in the literature to back me up. Organic
chemistry is valuable if we expect our students to
make everything in the world out of a bag of
charcoal briquets and a bottle of benzene. The
grades are just as absurd when the class curve for
organic starts at 21% and juxtaposes negative
numbers. The high grade might be 33%. Remember?
That is unquestionably a reliable evaluation of
learning, but a good laugh for the professor who
wants to keep everyone out of medical school.

But state licensing organizations require biology
with a lab, general chemistry with a lab, organic
chemistry with a lab, physics with a lab, and
maybe calculus. These courses have been required
for admission so they would have to be taken
during the first year of undergraduate college, so
the podiatry schools have the pre-requisites to
judge the would-be podiatrists on. After all, the
admission cycle would take place during the second
year when all pre-requisite grades are already
submitted.

To make matters worse, the student opting for this
program would have to make the decision to have a
nervous breakdown during their senior year of high
school. Young ladies should be thinking about what
dress to wear to the prom, and young men should be
thinking about how to pin a corsage on it and
asking their grandmother how to perform a proper
box step. When is the decision made to enter this
six-year program and lose their childhood. Eighth
grade?

Should the future six-year student take special
classes during the high school years, like AP
courses in the sciences or will a shop class and
bookkeeping suffice to allow our future student to
a college that has everything he or she needs
including psycho- therapy and proper psychotropic
medications. The college cannot prohibit the
students from leaving school after two years, but
they will leave without a degree and someone is
going to be held accountable financially and
ethically for piling all this work on an 18-year-
old kid.

Since this schedule is ludicrous, how do we
measure which 20-year-olds are qualified to enter
a six-year podiatry program. I really do like the
European model where every student who passes
their national high school graduation test can go
to medical school and remain matriculated until
they fail out. Get through everything and you’re
an MD, write a dissertation and you become an MD,
PhD.

Okay, so we navigate the class obstacles. We must
look at the money borrowed. Money talks. As of
July 1. 2026 a dependent can borrow $31,000 total
for undergraduate work. That’s total. For
professional schools the maximum is $200,000. Do
we have a six-year professional school or a four-
year school with the first two years counting as
undergraduate? Money is a real problem no matter
how we structure the curriculum, even leave it
like it is. How terrible would it be for a student
to have to leave a six-year program podiatry
school after four years with nothing in their hand
except a handshake?

So, we clear that hurdle without scraping our
shins. Now we get to face the faculty, some of
whom can be real curmudgeons. First, we must come
up with a new curriculum that everyone gets a say
about and a vote to approve. Do we have two first
year classes or do we go all in on the gamble and
this six-year program is the only first year
class? This means there will be two years in the
future when there will be no graduating class.
Again, there are more residencies than students to
fill them and we are betting everyone stays in
school.

If we have two first year classes, the traditional
four-year curriculum class and the new six-year
class, what do we do for faculty? There are
literally two class at the same time for four
years if we switch to the six-year plan
immediately. What do we teach, for that matter? Is
it undergraduate courses that students didn’t get
in their two years in hopes of granting a
bachelor’s degree. Podiatry schools can’t really
grant a bachelor’s degree unless they are
chartered to do so any more than they can grant an
MD degree just because they want to.

Some faculty will see a move to a six-year program
as an actual boon. This is a chance to hire more
teachers and to strengthen their department by
giving that department more power. They don’t
understand the new program either. The coordinator
for neurology/special senses is adamant about
adding three hours in neuro-ophthalmology to the
curriculum because there are no hours on that
tantalizing topic. To accomplish this properly, we
need additional equipment and a PhD who
specializes in the special senses and will be
bringing a federal grant with them. And do we have
the physical space to accommodate another class?
Who pays for this new faculty?

Accountants are as conservative as can be. Liberal
accountants have offices at the state
penitentiary. No one wants a remake of Shawshank
and none of the accountants wants to lose a job.
Things are difficult right now for the schools.
Stretching a dollar is tough work. More change
equals more sleepless nights, and sometimes it
seems like the accountants run the schools.

When making a drastic change like this, there will
need to be approval by CPME and initial
correspondence between CPME and the school,
probably between the new liaison between CPME and
the schools, Tim Yoho, DPM. Usually, these
experimental new curricula are limited to a
smaller class the first few years until the
benefit or success can be proven. Full
accreditation isn’t granted until there is a first
graduation class which has proved its muster by
matching to residencies well and there are
positive reviews by the students.

Remember, this plan does not shorten the time it
takes to get a degree, it just makes it more
pleasant. Howard Barrows, MD the architect of
problem-based learning initially proposed the
first two years of medical school be spent in the
hospital and clinics and years three and four
devoted to the basic sciences. He thought the
basic sciences would be more meaningful after
years in the clinic. It makes sense, but just
because it’s better, doesn’t mean we should adopt
it. After all, look at how brilliant and learned
we all are and we were subject to the same
curriculum for the last 60 years with little
change. Why change now and risk a screw up? We
could lose everything we’ve gained, like a
$400,000 salary. That’s what counts, right? Make
it difficult on the students then criticize them
when they start work for us.

Rod Tomczak, DPM, MD, EdD

Other messages in this thread:

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06/22/2026    Rod Tomczak, DPM, MD, EdD

A Potential Solution to the Student Recruitment Crisis

“Some places will never let progress interfere
with 100 years of tradition.” So said Dr.
Battinelli of Northwell/Hofstra School of
Medicine. I have been advocating change in
podiatry schools since 1986. Faculty and
administration, including CPME wanted to see
Problem-based Learning fail at Des Moines so I
would cease to be a threat and would go away. It
didn’t and I didn’t.

Personally, I have a certain disdain for any most
podiatric school curricula. I don’t think they are
structured correctly, taught efficiently or
learned favorably, but I am but one voice crying
out in the wilderness of the medical school
experience. It took six years to earn a doctorate
in education from Drake and I never missed a
class, nights after a full day at DMU or all day
Saturday and Sunday. I cannot say the same for my
attendance at OCPM.

A six-year curriculum sounds appealing. I’m going
to tell you some of the obstacles I’ve heard or
personally run into when suggesting a modification
of a medical or podiatric school curriculum which
would correlate to a change similar to six years.
I am not making these up. They are too bizarre in
some cases and in others somewhat practical. It’s
easier to move a graveyard than it is to change a
medical school curriculum.

If we want to accept a student after two years of
college, what criteria do we use? One of our deans
recently mentioned in this column how accurate
organic chemistry is as a predictor of success in
medical school. I disagree and I have enough
support in the literature to back me up. Organic
chemistry is valuable if we expect our students to
make everything in the world out of a bag of
charcoal briquets and a bottle of benzene. The
grades are just as absurd when the class curve for
organic starts at 21% and juxtaposes negative
numbers. The high grade might be 33%. Remember?
That is unquestionably a reliable evaluation of
learning, but a good laugh for the professor who
wants to keep everyone out of medical school.

But state licensing organizations require biology
with a lab, general chemistry with a lab, organic
chemistry with a lab, physics with a lab, and
maybe calculus. These courses have been required
for admission so they would have to be taken
during the first year of undergraduate college, so
the podiatry schools have the pre-requisites to
judge the would-be podiatrists on. After all, the
admission cycle would take place during the second
year when all pre-requisite grades are already
submitted.

To make matters worse, the student opting for this
program would have to make the decision to have a
nervous breakdown during their senior year of high
school. Young ladies should be thinking about what
dress to wear to the prom, and young men should be
thinking about how to pin a corsage on it and
asking their grandmother how to perform a proper
box step. When is the decision made to enter this
six-year program and lose their childhood. Eighth
grade?

Should the future six-year student take special
classes during the high school years, like AP
courses in the sciences or will a shop class and
bookkeeping suffice to allow our future student to
a college that has everything he or she needs
including psycho- therapy and proper psychotropic
medications. The college cannot prohibit the
students from leaving school after two years, but
they will leave without a degree and someone is
going to be held accountable financially and
ethically for piling all this work on an 18-year-
old kid.

Since this schedule is ludicrous, how do we
measure which 20-year-olds are qualified to enter
a six-year podiatry program. I really do like the
European model where every student who passes
their national high school graduation test can go
to medical school and remain matriculated until
they fail out. Get through everything and you’re
an MD, write a dissertation and you become an MD,
PhD.

Okay, so we navigate the class obstacles. We must
look at the money borrowed. Money talks. As of
July 1. 2026 a dependent can borrow $31,000 total
for undergraduate work. That’s total. For
professional schools the maximum is $200,000. Do
we have a six-year professional school or a four-
year school with the first two years counting as
undergraduate? Money is a real problem no matter
how we structure the curriculum, even leave it
like it is. How terrible would it be for a student
to have to leave a six-year program podiatry
school after four years with nothing in their hand
except a handshake?

So, we clear that hurdle without scraping our
shins. Now we get to face the faculty, some of
whom can be real curmudgeons. First, we must come
up with a new curriculum that everyone gets a say
about and a vote to approve. Do we have two first
year classes or do we go all in on the gamble and
this six-year program is the only first year
class? This means there will be two years in the
future when there will be no graduating class.
Again, there are more residencies than students to
fill them and we are betting everyone stays in
school.

If we have two first year classes, the traditional
four-year curriculum class and the new six-year
class, what do we do for faculty? There are
literally two class at the same time for four
years if we switch to the six-year plan
immediately. What do we teach, for that matter? Is
it undergraduate courses that students didn’t get
in their two years in hopes of granting a
bachelor’s degree. Podiatry schools can’t really
grant a bachelor’s degree unless they are
chartered to do so any more than they can grant an
MD degree just because they want to.

Some faculty will see a move to a six-year program
as an actual boon. This is a chance to hire more
teachers and to strengthen their department by
giving that department more power. They don’t
understand the new program either. The coordinator
for neurology/special senses is adamant about
adding three hours in neuro-ophthalmology to the
curriculum because there are no hours on that
tantalizing topic. To accomplish this properly, we
need additional equipment and a PhD who
specializes in the special senses and will be
bringing a federal grant with them. And do we have
the physical space to accommodate another class?
Who pays for this new faculty?

Accountants are as conservative as can be. Liberal
accountants have offices at the state
penitentiary. No one wants a remake of Shawshank
and none of the accountants wants to lose a job.
Things are difficult right now for the schools.
Stretching a dollar is tough work. More change
equals more sleepless nights, and sometimes it
seems like the accountants run the schools.

When making a drastic change like this, there will
need to be approval by CPME and initial
correspondence between CPME and the school,
probably between the new liaison between CPME and
the schools, Tim Yoho, DPM. Usually, these
experimental new curricula are limited to a
smaller class the first few years until the
benefit or success can be proven. Full
accreditation isn’t granted until there is a first
graduation class which has proved its muster by
matching to residencies well and there are
positive reviews by the students.

Remember, this plan does not shorten the time it
takes to get a degree, it just makes it more
pleasant. Howard Barrows, MD the architect of
problem-based learning initially proposed the
first two years of medical school be spent in the
hospital and clinics and years three and four
devoted to the basic sciences. He thought the
basic sciences would be more meaningful after
years in the clinic. It makes sense, but just
because it’s better, doesn’t mean we should adopt
it. After all, look at how brilliant and learned
we all are and we were subject to the same
curriculum for the last 60 years with little
change. Why change now and risk a screw up? We
could lose everything we’ve gained, like a
$400,000 salary. That’s what counts, right? Make
it difficult on the students then criticize them
when they start work for us.

Rod Tomczak, DPM, MD, EdD

---

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