The nine podiatry schools in the United States received a total of 883 applications in 2018, a 1.7 percent increase over the 868 applicants from 2017, according to the American Association of Colleges of Podiatric Medicine (AACPM).
The AACPM will release specific applicant data for individual schools this fall, according to the AACPM Executive Director Moraith North. Citing AACPM statistics, a January 2018 Podiatry Today cover story noted that total applications to podiatry colleges numbered 1,194 in 2015 but had declined to 892 in 2016.
In the last two years, since learning of the downward trend in podiatry school applications, the American Podiatric Medical Association (APMA) has worked to boost the numbers through social media and advertising campaigns geared toward increasing awareness about careers in podiatry, notes APMA President Dennis R. Frisch, DPM. Dr. Frisch says the APMA has worked closely with the AACPM and its Office of Career Development to magnify the impact of each association’s efforts. He also notes the APMA has also worked to enlist its members as mentors to encourage prospective students to apply to podiatric medical schools.
“Our efforts are beginning to pay off but we still have much work to do,” says Dr. Frisch. “We are moving in the right direction on student recruitment, proving once again that when we come together to tackle a goal, we get results.”
Podiatrists “continue to have low professional visibility,” says John S. Steinberg, DPM, FACFAS, the President of the American College of Foot and Ankle Surgeons. He supports an innovative, active campaign to put the profession in front of the right audiences. Dr. Steinberg notes that when applicants know about podiatric medicine and surgery, they have a very high rate of application to podiatry colleges but the initial visibility is “still our greatest barrier.”
Dr. Frisch says the APMA’s House of Delegates passed Resolution 9-18 in March 2018, directing the APMA to devote staff time and resources to leading the way on student recruitment. He adds that Resolution 9-18 calls for financial support from stakeholders within the podiatry profession and that stakeholders be included in recruitment efforts directed by the APMA when appropriate. Dr. Frisch says the American Board of Foot and Ankle Surgery and the American Board of Podiatric Medicine have committed funding to support the APMA’s student recruitment efforts.
However, Doug Richie Jr., DPM, FACFAS, says that the “insignificant increase” in the applicant pool illustrates that the strategy of the APMA and the podiatry schools is not working to attract more students. Relying on currently practicing DPMs to recruit and mentor college students has been encouraged for years, but he says that strategy “clearly has not been effective.” Dr. Richie says using social media to communicate with college students is the most effective method of recruitment and is what all successful companies use to reach this audience, but he cautions that one must carefully craft the message to catch the eye of this target population.
“Today’s millennials are interested in quality of life,” says Dr. Richie, an Adjunct Associate Professor within the Department of Applied Biomechanics at the California School of Podiatric Medicine at Samuel Merritt University in Oakland, Calif. “Less work and more free time. This is exactly what the podiatry profession offers.”
Rami Basatneh, a fourth-year-student at the Temple University School of Podiatric Medicine, says an appeal to prospective students should focus on three areas. Two such areas of focus are the balanced lifestyle of podiatrists, who work an average of 40 hours a week, and that podiatry schools cost less in general than other medical schools, says Basatneh, a National Delegate for the APMA Students Association. He adds that one focus should be that podiatric medical school offers a “guaranteed path to a surgical specialty,” which allopathic and osteopathic medical schools only offer to the top students. However, Dr. Richie is skeptical.
“I believe that the emphasis on portraying our profession as ‘surgeons’ has failed,” says Dr. Richie. “We need to emphasize the superior lifestyle of the podiatric physician.”
Every year, Dr. Steinberg speaks to pre-med student groups on several undergraduate campuses in his area. Each of those visits will yield a few visits to his practice by prospective students who had never heard of the podiatry profession before.
“The vast majority of students who visit my office will end up applying to one of our colleges and joining the profession,” says Dr. Steinberg. “These efforts are time consuming and very grassroots, but they provide consistent results.”
What can the profession do better to attract more students? Dr. Steinberg says the profession has left the recruitment process up to the schools of podiatric medicine but he calls for a well-funded national campaign. Dr. Frisch says the APMA has committed $50,000 to invest in market research with the hiring of an independent research firm. According to Dr. Frisch, there is ongoing market research, which will collect data from current podiatry students, prospective students, college admissions staff and other health professions. He notes that while there are a number of theories on the best recruitment efforts, the research findings, due this fall, will delineate effective and efficient tactics to utilize for student recruitment.
Dr. Frisch says the AACPM has a DPM Mentors Network that will permit students to shadow DPMs in their practices and enable DPMs to visit schools or return to their own undergraduate institution to talk about podiatry. Many students have told the APMA that meeting with a current podiatry student or practicing podiatrist was the experience that prompted them to apply to podiatry college, says Dr. Frisch.
“That firsthand experience of our great profession and the enthusiasm our members have for it is a powerful recruitment tool,” emphasizes Dr. Frisch.
Dr. Steinberg praises the DPM Mentors Network but says it needs to be publicized more and streamlined to be more user-friendly for mentors and mentees. He also praises the colleges’ student recruitment offices but advocates a more organized effort at the national level.
“The uptick in applications in 2018 suggests to me that the profession’s widespread commitment and collaborative action on this issue are having the desired effect,” says Dr. Frisch.
For further reading, see “Are There Too Many Podiatry Colleges?” in the January 2018 issue of Podiatry Today.
Study Of Triplane Bunion Correction System Shows Strong Results After One Year
By Brian McCurdy, Managing Editor
A recent retrospective, multicenter study shows a system that corrects bunions in three planes is effective in the long term.
The study of Lapiplasty 3D Bunion Correction (Treace Medical Concepts) focused on 61 feet with hallux valgus in 72 patients. The mean time for patients to start weightbearing was 10.5 days. At an average 13.5-month follow-up, 96.7 percent of patients maintained three-plane correction in the intermetatarsal angle, hallux valgus angle and tibial sesamoid position, according to the study, which was presented at the American Orthopaedic Foot and Ankle Society (AOFAS) annual meeting.
Study coauthor Paul Dayton, DPM, FACFAS notes the Lapiplasty can help the surgeon correct the bunion deformity at the anatomic apex, resulting in more complete correction. He says the system provides simultaneous triplane correction and offers “very consistent and reproducible” results.
The Lapiplasty allows surgeons to make precise bone cuts that can correct a deformity with reproducible results, notes William Fishco, a faculty member of the Podiatry Institute who is in private practice in Phoenix. He feels the technique encourages surgeons to spend more pre-op time assessing the deformity and planning the surgical procedure.
The Lapiplasty’s biplane plating maintains “excellent stability” in all three planes and has been designed and tested to be compatible with early protected weightbearing, according to Dr. Dayton.
“This type of biologic fixation achieves bone strength faster than compression/primary healing, which one would see when using interfragmentary screws,” says Dr. Dayton, who is a consultant for Treace Medical Concepts.
Dr. Fishco notes the Lapidus procedure is the most effective way to correct bunion deformities in all three planes as it enables surgeons to wedge the medial cuneiform bone to correct transverse plane deformity, plantar displace the first metatarsal bone for sagittal plane deformity and rotate the first metatarsal to address frontal plane deformity. Although surgeons can achieve these effects in other ways through an osteotomy, he says it can be challenging for fixation whereas the Lapidus procedure is amenable to easy fixation.
Dr. Fishco believes the most important criterion for bone union rates is the stability of the bone segments.
“I think as a profession, we are all infatuated by compression,” adds Dr. Fishco. “Nobody knows how much compression is necessary and if there is too much compression.”
A construct that is too rigid can undermine union rates, according to Dr. Fishco. He notes micromotion at the fusion site is necessary for healing. Furthermore, Dr. Fishco says as long as there is good bone to bone apposition and the fixation construct affords maximum stability, one should attain union (barring other complicating factors such as metabolic disease, smoking or non-adherence).