Over the last several months we have beat
podiatric education, the schools, students,
degrees, admissions. APMA, CPME and AACPM to
death. We have neglected to discuss the faculty,
teaching and the question of who makes up the
schools, students or faculty.
I have heard the pseudo-podiatry professors boast
of their classroom acumen based on the fact they
have given a lecture on hammertoes to their local
podiatry academy and wrongfully belittle podiatry
school faculty with the age-old adage that those
who can do and those who can’t teach. Teaching at
a podiatry school is not seeking refuge and a ride
on the gravy train. When invited to the colleges
to guest lecture they politely refuse, but some
come and a few experience their first panic attack
in front of a classroom of students better read
than they are. Others have the gift and do a great
job. Good undergraduate students now have their
choice of schools and visit the different
campuses. They inquire as to the quality of
teachers.
By this time in their educational careers these
students are able to categorize teachers into one
of four categories. Neal Whitman called them the
“old goat,” who is not novel and the data not
useful, the “charlatan,” who keeps the class in
laughs but offers little useful information, the
“pedantic bore,” who does deliver useful material
if the students can stay awake. Lastly and best of
all is the” creative teacher,” who is novel,
somewhat funny and delivers the pertinent subject
matter. The last category is indeed a teacher who
is a real find and is the reason schools ask a
prospective teacher to guest lecture which is also
known as an audition lecture to students and
faculty.
According to almost every podiatrist in private
practice, they are superb teachers, especially the
ones who are on the lecture circuit, sanctioned by
APMA, often addressing the audience concerning
their invention in commercial form for CME credit.
They mistakenly think this is all there is to
being a podiatry college faculty member. Oh, how
wrong they are but because they have had 20 years
of education not counting kindergarten, they are
educational authorities. They tend or pretend to
emulate a teacher they once had in school whom
they liked and learned from. There are pillars
that hold up the podiatry college. It does not
balance on a single point. Besides classroom
teaching, there is patient care and clinical
teaching, running a practice, academic and
practice administration, community service,
mentoring, research and writing, along with
curriculum development.
In order to be promoted through the ranks and
achieve the title of professor, a teacher must
excel at most of these pillars. Earning the title
Professor is akin to Rabi or Monsignor and can be
carried for life. The Rank and Promotion committee
can be one of the most brutal on campus and strict
criteria are in the faculty bylaws to ensure the
process does not become simply a middle school
popularity contest. Many clinicians who have
distinguished themselves by earning a
professorship prefer to be called professor over
doctor referring to a physician.
Podiatry faculty also see patients and have a
practice. In many medical schools, faculty receive
two checks every pay period. One check is for
academic responsibilities and the other reflects
earnings from the practice. Like many private
practices and managed practices outside the
academic sector, the podiatrist is responsible for
the practice overhead before they are paid. Since
they cannot see patients full time, neither check,
academic or clinical can support the podiatrist
and their family by itself. My Ohio State contract
stated I was to be on campus for a minimum of 50
hours per week. Seeing patients in an academic
arena takes longer because there is teaching,
hopefully exceptional teaching going on, and this
takes considerable time per patient. It requires
more time than if I saw a patient by myself in a
private setting.
Somebody is required to oversee this practice.
Amongst other duties they hire and dismiss staff.
Patients are often seen in numerous locals and
surgeries scheduled. Granted, the college often
administers many of these tasks because they are
responsible for the overhead and the costs that
run through them. Personal preferences for
equipment must be put aside and the will of the
majority reflected by voting. This accounts for
new power equipment when it can be afforded,
waiting room furniture, chairs, clinic supplies,
and hours.
Administration duties take a large chunk of time,
and often they are performed outside the regular
7:00 am to 5:00 pm. Guest lecturers need to be
picked up at the airport, taken to dinner and
dropped off at the hotel. This sounds like fun but
gets tedious. Interviewing student applicants took
considerable time in the past. Meetings often take
place at lunch time such as human use and animal
committees, and the IRB. Podiatry’s NBPME, AACPM
and CPME occur on weekends. Trying to secure
outside affiliations occur after hours. Site
visits to fourth year clinical sites are travels
away from the school sometimes necessitating being
gone a week at a time. They are unannounced to the
students. Once I found a student doing his
dermatology rotation on the beach in Miami. I
guess he was looking for melanomas. There are also
student group meetings that require a faculty
representative to ensure funding by the school is
appropriated and spent correctly.
Faculty are required to become involved in
community service. The American Cancer Society,
Red Cross, podiatry academy, state medical board
meetings, community building committees (I was on
the board to build a new ice arena in Des Moines),
community symphony and arts boards. If one was in
private practice it would be easier to say “No,”
but as a representative of the school, an
invitation to join the organization is almost a
mandate.
Mentoring students is a time-consuming activity
but an absolute necessity. For the student,
attending lectures and small group discussions do
not make one a clinician. To secure better
residencies, a research paper is often necessary,
Typically, this endeavor must begin during the
second year. Bench research is virtually
impossible, so a meaningful clinical project must
be created and appropriate research methods
developed. IRB approval must be requested, forms
completed and more meetings attended. A
statistician must be secured.
Initially, students are very excited to be
involved in the project but as time progresses and
interest wanes, the faculty member is required to
push the student. Writing is the most difficult
part for the student. Most students do not have a
background in writing a coherent paper, let alone
a research article suitable for publishing. If the
work is accepted for publication prior to
interviews, that is a boon for the student.
And then there is curriculum development. Every
syllabus for every course, which contains the
title of every lecture given in that course must
be approved every year for all three years of the
academic podiatry curriculum.
The syllabus includes the exam schedule, the
reading list, schedules for classes and small
group meetings and is a legal document, a contract
which cannot be changed once approved and
distributed to the student. Not included in the
syllabus but under the purview of the committee
are the student evaluations and exam scores
reviewed at a meeting last year after the course
concludes. The exams consist of two questions per
hour of instruction. This was an inflexible rule
when I was chairman of the DO and DPM committee in
Des Moines. Once I started the doctorate at Drake
University it became natural for me to serve as
chair of the curriculum committee. Do a good job
and get another job. There was a tendency prior to
my taking leadership for the course coordinator to
say, “The syllabus is exactly the same as last
year, nothing has changed.” A vote was taken and
the syllabus approved.
That stopped. “Do you mean to tell me not even one
new article germane to your course has been
published in the last year and should be added to
the reading list?” Textbooks are fine for basic
principles but are generally obsolete the day they
are printed. New knowledge appears in journal
articles and I feel the core of the course should
come from those articles.
There are the classics which need to be taught
every year, such as the Frost nail technique. Test
questions and student evaluations from the last
time the course was taught are re-visited and
problems that showed up a year ago had to be
addressed. Course coordinators were not always
happy, but the quality of instruction improved and
this was communicated to potential students.
Constructing goals and objectives for fourth year
clinical rotations is more difficult.
I can’t recall eating lunch in all the years I was
at the Des Moines school. But I don’t recall
eating lunch very often in the years I was in
private practice in Monroe or at Ohio State. Over
30 years at American schools before the Caribbean
and KSA schools, another 30 years. The difference
wasn’t in the lunches or meetings, but rather in
the freedom to say, “No,” to the extra time-
consuming projects. Like being the new guy at the
hospital and having to coach the women’s softball
team.
The big difference was when an interesting case
came in. You could toss up the X-rays and say,
“Wow, look at this great case.” And there was no
one there to share it with. But it was the
similarities between Des Moines University and
Ohio State University, except for the football
team that kept my daughters from podiatry school
or med school. They didn’t want the lifestyle. All
the missed JINGO game dates and Super Mario
Brother game dates. It was missing dinners or
rushing to an athletic event then going back to
the university. All the time I thought I was in
control but I was only kidding myself. One
daughter is a CRNA and the other an ARNP. They
are happy not teaching, but it was adrenalin to
me. The problem is, too much adrenalin and one
crashes and burns out.
I don’t know who makes up the podiatry schools.
Who contributes more, the students or faculty. The
irony is like the short story by O Henry, The Gift
of the Magi. We know there may not be as many
students this year as previously, but schools
cannot lower standards or curve exams to keep
students in school. We would be lowering our own
standards. Faculty must hold their ground and
hopefully administration will not pressure them to
do the unthinkable. If that happens there will be
no students and no faculty. The Gift of the Magi
will have come to fruition. All those pseudo-
professors will now become teachers as we shift to
the apprenticeship model for podiatry school.
Rod Tomczak, DPM, MD, EdD, Columbus, OH
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