Why We Are Training The Next Generation The Right Way

My partner and I recently had the pleasure of having a fourth-year podiatry student assist with surgery for a displaced ankle fracture. This was a young man who accompanied his grandmother to our office about four years ago. He let us know that he was finished with his bachelor’s degree in biology and was applying to several medical schools. He seemed interested in our work so I invited him to spend a day with us in the clinic.

Four years ago, he spent several days observing us in our daily office work and a few days in surgery. Now he is on the verge of completing podiatry school and is applying for residency programs.

I was impressed with his knowledge and skills as he assisted us with a complicated trimalleolar fracture. He knew the steps for reduction and fixation of the injury. It was obvious he had totally embraced our profession. His podiatry college is connected with an osteopathic program. He commented that many of the osteopathic medical students wish they had applied to the podiatry school. Hardly any of his classmates expressed a desire to be in the osteopathic program.

It occurred to me that podiatry is doing it right. Our students come out of four years of professional college with a sophisticated and well-developed knowledge base of our specialty. They begin their residency training with the essentials to hit the ground running.
Students in allopathic and osteopathic programs graduate with a broad knowledge base of every aspect of medicine but are true novices when they start residency training for a specialty.

It would be interesting to see what would happen if allopathic and osteopathic schools adopted the protocol that has worked so well for podiatry for so many years. A pediatrician would start with a focus on childhood diseases and conditions during the third year of medical school and continue that emphasis until graduation. Imagine how much better prepared that student would be for residency training.

There has been much discussion among podiatrists about our colleges adopting the allopathic and osteopathic protocol. The upside to some would be that our students would emerge with an MD or DO degree. The reality is that we would water down our college training programs until they would cease to be recognizable as podiatry schools. Our students would emerge as jacks of all trades and masters of none. Podiatry residencies would have to add a year or two so our medical/podiatry graduates could learn the basics of podiatry.

Most of my colleagues who are in medicine and osteopathy envy me. I entered my profession at a younger age than most of them. My degree, DPM, defines my expertise. The letters MD or DO after your name really do not tell people what you do.
I have had a handful of patients over the past 32 years let me know they would prefer to have surgery or complex work done by an MD. To them, I say, “Great idea! Those fellows need all the practice they can get. You will be doing them a great service and I think you are very brave.” Oddly, they tend to return to my care for the operation or to handle the complications when the team orthopedist for the NFL franchise attempts a bunion surgery. I never say “I told you so,” but I am thinking it as I dictate the description of the disaster with a copy to the football orthopod.

I will be participating in a debate on the topic of so-called dual degrees at the Florida Podiatric Medical Association conference in January. I would not trade my podiatric diploma in for a freshly printed medical degree nor will I spend a year or two in an offshore diploma mill to earn an MD diploma with an asterisk.

If there is a place in the sun for a physician with a dual degree, it should be an MD or DO who changes to podiatry. Our colleges would do well to develop fast-track programs for our generic colleagues who discover the great profession we enjoy. My guess is that these physicians would quickly drop the MD from their names.

There will always be those podiatrists who feel inadequate because they did not live up to their mother’s desire for them to be “real doctors.” I offer my deepest sympathy to these guys.

My mother always hoped I would have an honest job and stay out of jail. She also thought college was a waste of time. God rest her soul. I really appreciate her when I am in the company of a podiatrist who wishes he could be a “real doctor.”