Rethinking The Notion Of Dual Degrees

By John H. McCord, DPM

   I consider myself a general podiatrist. I took a PSR-12 residency, which was the gold standard for post-graduate podiatric training in the 1970s. Now a PSR-12 will hardly get you a license. Podiatry has evolved during the past 30 years and hopefully I have evolved with the profession.    I am a Diplomate of the American Board of Podiatric Surgery but don’t consider myself a surgical specialist in podiatry. In a small town, you do everything.    This morning, we had a lady with a fractured ankle, a 10-year-old with a Salter I fracture of the fifth metatarsal head, an elderly man with metatarsal stress fracture, a woman with a calcaneal fracture and a guy with a compound fracture of his first toe. That all happened before noon. Lunch was followed by a complex surgical debridement for a 42-year-old man with diabetes, hepatitis-C, MRSA and some drug issues.    It was my light day. Most of my days are like this. I rejoice when I am presented with a plain, straightforward podiatric patient. This is what I had trained for.    I have opposed having dual degrees for podiatrists. Many advocate combined MD/DPM or DO/DPM training programs. I have always feared these would water down our profession. I still don’t like the idea of a short addendum to podiatry school via a degree from an offshore “medical” college.    Contemplating the nature of our work and having a few opportunities recently to visit with podiatry students has led me to ask: Why not have a dual degree for podiatrists?    I visited the California School of Podiatric Medicine at Samuel Merritt College and the Arizona Podiatric Medicine Program at Midwestern University recently and spoke with first- and second-year podiatry students. I spoke about part one of the National Board of Podiatric Medical Examiners license exam. I expected to be as welcome as a hemorrhoid in a bicycle race.    To my surprise, the students were great. They were gracious hosts and tended to ask more questions about practice than about the test. These students were very intelligent and eager to embrace the medical profession. Podiatry school was the pathway they had chosen to enter the calling of medicine.    Much of the podiatry school curriculum during the first two years parallels the medical and osteopathic programs. It seems logical to me that if the podiatry programs merged with medical or osteopathic programs, podiatry students could go into the clinical years with combined podiatric and medical training, and emerge after five or six years with combined degrees.    It also seems logical that the podiatry colleges affiliated with medical and osteopathic colleges would be in the best position to create these programs. These would include the Temple University College of Podiatric Medicine, the William M. Scholl College of Podiatric Medicine at Rosalind Franklin University of Medicine and Science, Des Moines University College of Podiatric Medicine and Surgery, and the new Arizona Podiatric Medicine Program.    Podiatry students will invest six or seven years in training and should have access to the rights and privileges of becoming fully licensed physicians. It will mean a few additional years of training but the payoff will be great for these students and our profession.    Our students sit for licensing exams that are as challenging as those taken by medical and osteopathic students. Our specialty board exams are also as tough as those taken by our medical osteopathic colleagues. When young podiatrists have passed those exams, it doesn’t seem right that they enter the medical profession with a limited license.    It is time for our profession to put some serious effort into offering our students and young DPMs the opportunity to use their training fully. I have met the deans of our podiatry colleges and know they have the educational ability and negotiating skills to make this happen.    My Forum column last year contained the opposite opinion (see “Should We Add ‘MD’ To Our Credentials?” page 74, September issue). It drew much criticism from podiatric physicians whom I respect and admire. I hate like hell to admit I was wrong and Barry Block, DPM, was right. Sorry, Dr. Block. Your subsequent letter to Podiatry Today, critical of my editorial, led me to rethink this matter.    Dr. Block stated I would not be a suitable candidate for a dual degree. I agree with him on that. I have a few years left to practice and I just want to be a plain old general podiatrist. Dr. McCord is a Diplomate with the American Board of Podiatric Surgery. He practices at the Centralia Medical Center in Centralia, Wash.

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