02/17/2016    Daniel Wu, BS, MS

New Podiatric Medical School to Offer DPM-MD/DPM-PA Degrees (Joseph Borreggine, DPM)

In response to Joseph Borreggine’s thoughts:

To give a voice for current students in podiatry
school, the long debate of parity has been
brought up to students by the APMA, APMSA,
podiatric state representatives, and current
practicing DPMs. The current problem I believe is
that students who are concerned about this issue
are compelled to help but are not given the tools
or platforms to contribute effectively at this
point in time. I agree with Dr. Borreggine that
some podiatrists who have responded to this
thread regarding parity have been in the
profession for years and at this point in their
career, may not see the urgency to change or push
for laws that may not necessarily affect them.

I agree that for the advancement of the podiatric
profession, we must strive to obtain an
unrestricted plenary license that current MDs and
DOs have under the law. An unrestricted plenary
license would not only give us the same legal
practicing license of an MD and DO, but moreover,
would help solve the issue of varying scopes of
podiatric practice by state. Some examples of
current state specific restrictions include
restricted ankle or leg privileges, amputations,
and anesthesia administration. With an
unrestricted plenary license, podiatrists across
the nation should be able to give the same
treatments without restrictions regardless of the
state they practice in.

To my knowledge, the 3 current ways that future
and current DPMs may obtain an unrestricted
plenary license are 1) change the law at the
federal level, 2) obtain an MD/DO degree, or 3)
pass the USMLE Step Boards. From my
understanding, it will be hard to change the law
at the federal level unless it is included in a
big omnibus bill that has a higher success rate
of passing. I think that is why podiatrists over
the years have rather pushed to obtain an MD/DO
degree or addition of it, seeing it to be a
potentially more feasible or obtainable option.
The third approach not talked about much is that
there is also a current push for podiatry
students to take the USMLE. Next year in 2017,
the class of 2019 podiatry students from the 2
current California podiatry schools, CSPM and
Western, will take an equivalent of the USMLE
Step 1, called the Comprehensive Basic Sciences
Exam (CBSE) on top of their APMLE Boards I Exam.

Results will be confidential and will help
determine if current podiatric medical education
is on par with current MD/DO medical education.
If results are poor, it will show where podiatric
medical education is weak and can be improved to
be on par to that of MD/DO medical education. If
results are good, there will be a push to then
take the USMLE. In my opinion, the prospects are
favorable given that current podiatry students at
Western take all the same basic science courses
as their DO counterparts, while CPSM offers a
basic sciences curriculum comparable to that of
current medical schools.

All in all, I believe that if current students or
younger podiatric physicians are given the tools
and platforms to help in this parity issue, more
would get involved given that it would directly
affect where and how they practice at this point
in time. Echoing Dr. Borreggine, unity is key to
establishing our identity as a profession.

Daniel L WU, BS, MS

PPMA Student Representative, 2nd Year student at TUSPM

Other messages in this thread:

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02/17/2016    Ira Baum, DPM

New Podiatric Medical School to Offer DPM-MD/DPM-PA Degrees (Joseph Borreggine, DPM)

Dr. Borreggine has suggested a solution of dual
degree that may mitigate podiatry's place in the
healthcare environment. Because we are a regional
specialty, it makes change complex. All aspects
of our profession are critical to the health of
the foot and ankle, vascular, trauma, surgical,
dermatological and biomechanics, but how do you
maintain all these specialties under one umbrella
called podiatry?

Independent (although in conjunction with the
APMA) specialty groups and boards have moved
podiatry in an evolution of improved education
and training that's undeniable. But podiatry does
not exist in a vacuum. So the improved education
in training has been focused on surgery,
impacting the profession in two profound
directions. A dichotomy in the profession to
surgical and non-surgical podiatrists (although
I'm sure the hybrid podiatrists still exists) and
a subset of podiatrists seeking employment in
orthopedic groups, or multi specialty groups.

But even in these environments there persists an
air of financial inequality. The financial
inequality has been mitigated by the "groups"
billing for the podiatrists, not the value of
podiatry in comprehensive health care. This is an
indirect and unsatisfying solution for the
profession.

Inertia requires energy and disruption of the
status quo. The specialty boards have made there
move and basically the APMA rationally
capitulated to the change. But the podiatric
institutions have not acted responsibly for the
profession. Efforts of the podiatric institutions
should be directed at a strategy to integrate the
profession into mainstream medicine.

A spirit of altruism is required by all the
podiatric institutions including the schools of
podiatric medicine may be the only foundation
that will enable physicians to benefit the
public's foot and ankle health and the
practitioners that chose that career.

Negotiations with respected medical schools will
require accommodations that may be met with
resistance, but from my perspective, if that
window of opportunity exists, it is the one that
should be explored. The end result may not be
recognizable to most of us, but to the future
foot and ankle specialists, it may mean a
satisfying career. A career not froth with issues
of identity and inequality.

Ira Baum, DPM, Miami, FL