07/01/2026    

RESPONSES/COMMENTS (STUDENT ENROLLMENT) - PART 1A

RE: Solving the Student Enrollment Crisis (Name Withheld) 

From: Bret Ribotsky, DPM

 

Two Roads, and the Cost of Walking Down Neither

 

For more than thirty years — from podiums across this country, in the pages of this publication, and in every room where this profession’s future was being discussed — I have argued a simple, unfashionable truth: unless you can keep the doors open to your practice, you cannot help anybody. Economics is not a peripheral concern for the practicing physician. It is the pre-condition for everything else. So when the anonymous correspondent frames our enrollment crisis as a pure economics problem, I do not disagree with the diagnosis. I have been making a version of that argument since before many of our current applicants were born.

 

The debt-to-income calculus is brutal. The downstream comparisons to NPs and CRNAs are damning. The profession’s identity confusion between “surgeon” and “specialist” has left a generation of graduates holding credentials that the credentialing world does not know quite what to do with. These are facts, not provocations — and they are thirty years overdue for a direct response from...

 

Editor's note: Dr. Ribotsky's extended-length letter appears here.

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07/02/2026    

RESPONSES/COMMENTS (STUDENT ENROLLMENT) - PART 1A

RE: Solving the Student Enrollment Crisis (Bret Ribotsky, DPM)

From: Carl Solomon, DPM

 

I’m now retired. Looking back, I think the enrollment crisis goes beyond simply looking at the economics. I attribute a large portion of it to the over-the-top and worsening hassle factor associated with practice.

 

When I entered podiatry, I was motivated by the satisfaction of helping people, the intellectual challenge of making diagnoses and solving problems, being able to administer treatment and see positive responses, forming long-lasting relationships with my patients and those with whom I worked. I enjoyed a successful private practice, did my share of surgery, established a very good reputation in my medical community, was chief of the podiatry service at a major hospital, never really set the world on fire but made a living that I was happy with.

 

Then one day it happened. The door to my reception room... 

 

Editor's note: Dr. Solomon's extended-length letter appears here.