Yes, a podiatry schools can grant a DPM degree
after a six-year post high school program. The
problem is getting it recognized and accredited.
If we’re not careful in fulfilling all the legal
and bureaucratic requisites, the degree is a
useless piece of paper. John Kennedy wanted a man
on the moon before the 60’s were over according to
his May 25, 1961 speech to Congress. To
successfully implement a six-year recognized high
school to DPM degree will regrettably take some
time, but maybe we could speed it up. I cut my own
toenails in high school without a lot of schooling
on how to do it.
I think we have to do something quickly to save
what we have, but it will take chutzpah and time
by the hoi polloi not the politicians. Here are
the impediments those of us who want to see the
podiatric philosophy flourish will have to
navigate. All of them lead to obstructionists who
want to be sure there will be some naïve 11-year
product ready to buy their million dollar practice
because there will never have enough money.
Our state foot and ankle or podiatric medical
society do not unilaterally grant a podiatry
license anymore than they can revoke one.
The state legislatures in conjunction with the
medical or podiatric board issue a license. One of
the biggest mistakes podiatry ever made was to
merge with the MD/DO medical board. If podiatry
had its own board in every state, this would be a
lot easier to accomplish. But no, we wanted to be
under the same restrictions and over watch as the
MDs. “Please, Sir, may I have another!”
These are the people that must be convinced a new
model for podiatric medical education is better
than the existing model of a four year podiatry
program and a three-year residency that supposedly
keeps us on par with the MDs. How do we justify
less training for a podiatrist when we’ve been
preaching the necessity of longer is better?
Perhaps if the whole of podiatry voted on this
proposal, we could convince legislature that this
program as it is now was a mistake to implement.
It seems like several people writing into PMNews
favor a change. ABFAS, CPME, and AACPM see a
change as a mistake. According to them, we need to
furnish new DPMs with all the training MDs have,
even though our politicos don’t want ACGME to look
at our residencies.
Some state legislatures have mandated certain
academic requirements on medical professions if
they wish to earn licenses. These include
undergraduate courses in physics, calculus,
organic chemistry, etc. When was the last time you
really used these premed courses? Most states
require a three-year CPME accredited residency
before a license is granted. I think podiatry
lobbied that into place so we would be just like
our MD siblings. Suddenly we want to cut podiatric
education almost in half. There is going to be a
large portion of the DPM community that is not
going to want another change. It’s ironic that
primary care MDs need to know the most medicine
but they have the shortest path to residency
completion and board certification.
As I’ve said, someone has to come up with a
curriculum that makes sense and fills every hour
of the six years in podiatry school. Then someone
must come up with a new residency format and plan
for board certification. My future son-in-law is a
dentist. He told me at dinner tonight there are 12
recognized dental specialties with residencies
that range from two to six years.
Another certifying podiatric board has been
working on this specialty issue and now recognizes
eight specialties. It appears they are the future
thinkers of what the profession wants and not CPME
or ABFAS. In reality there are more specialties
than medicine and surgery. Some younger
podiatrists must bite the bullet and take a seat
on CPME if they want change also.
Without CPME and AACPM approval the best laid
plans for this program are going to go nowhere.
How do we convince these two organizations that we
absolutely need something to happen before the DPM
degree goes the way of elevator operators. After
getting state laws changed and the state societies
to accommodate a change in the DPM product, CPME
can simply say, “NO.” There is no immediate
recourse because podiatry has produced eminent
callous scholars. They are now members of the CPME
board. They whisper to themselves, “We will not
risk losing our elevated perch on the medical
hierarchy ladder, or the value of our practices.”
CPME and AACPM forged a niche for the few rearfoot
and ankle surgeons but have forgotten the majority
of the profession and the future of the profession
itself. It seems that at the mention of ABFAS,
every knee shall bend and every head shall bow. At
least according to them.
Not everyone wants to perform Rubik’s Cube or
erector set procedures and leave the complication
to a PA or NP. Some podiatrists would be happy to
build a geriatric practice or a sports medicine
practice, but before that could happen, CPME would
want a residency curriculum for such a residency.
That program would be administered by a non-
certified geriatric podiatrist. ABMSP has solved
that conundrum by offering that board. They are a
board of inclusion, not exclusion.
June 30th is the last day to accept applications
for Fall admission to podiatry school. Unless
there is a fourth quarter surge in applications or
planned overtime, AACPM ought to have a pretty
good idea of how many students have enrolled; not
been accepted or reserved a seat but sent real
tuition money to the schools. AACPM has not shared
information with the podiatric community. When
anything good happens in podiatry, even a
podiatrist correcting an ingrown toenail on an
Oscar winning actor, finds a way to get it in the
local newspaper. A lot of medical schools start
MED I in late July or early August. Podiatry will
still be relying on Dr. DeHeer’s “Feet on the
Street.” Since we haven’t heard much about the
program, well, I guess this is not conjuring an
increase in admissions, but the lip service is
outstanding.
We all agree podiatry can be satisfactorily
learned in less time than is being devoted to the
process right now. We can limit much of the fluff
and “one in a million cases” without jeopardizing
the curriculum or endangering the patients we
treat, but garnering the assistance of CPME and
AACPM to assisting in accomplishing the changes of
hearts and minds is, in my opinion, almost
impossible. The big problem is that runaway train
barreling down the tunnel without any students.
Why does the profession see the impending
disaster, but the bureaucrats are not informing us
with what they are doing at the school level and
prior to it to prevent extinction? Is it just
crisis podiatry or something else? Changing
anything devalues the politicos’ practice value
when it comes time to sell and ride off into the
sunset. Plain and simple.
Let’s face it, the majority of podiatrists cut toe
nails and trim callouses. The minority tell us
they are so busy with rearfoot and ankle
reconstruction they have no time for the
occasional paronychia. Ironically, dates are never
on the X-rays they show at seminars year after
year. I’ve been on that circus (sic) where you
often heard in the ready room, “Can you send me a
copy of the slide?”
Maybe right now we need to start a two-track
system maintaining the current 11-year track but
also initiating a six-year track after high
school. We need to implement it before podiatry
goes away. We have plenty of time to borrow for
the start up from the established and still work
on the future curriculum.
Rod Tomczak, DPM, MD, EdD, Columbus, OH
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