Guest Editorial: This week I am pleased to continue our series of 'Future of Podiatric Medicine' editorials with a provactive piece by Jeffery M. Robbins. Robbins is the Director of the Veterans Health Administration Headquarters Podiatry Services and Chief of the Podiatry Section at the Louis Stokes Cleveland VA Medical Center. He is a graduate of the Ohio College of Podiatric Medicine, Cleveland Ohio where he also holds the faculty stature of Professor of Podiatric Medicine. He is board certified by the American Board of Podiatric Orthopedics and Primary Podiatric Medicine and the American Board of Podiatric Public Health, and is a fellow of the American College of Foot and Ankle Orthopedics and Medicine.

     —John Steinberg, DPM, PRESENT Editor

Jeffrey M. Robbins, DPM Clinical Assistant Professor Director Podiatry Service VACO Podiatry Section Louis Stokes VA Medical Center School of Medicine Case Western Reserve University

Future of Podiatric Medicine:
Its up to Us!

It is not difficult to predict the needs of the future, if you are paying attention to the present.  In the case of the future of the profession, we have a convergence of conditions that suggest a path that will most likely be taken.  The only question is, how soon will we take it?

After many years of educational strategic planning and progress (Committee on Entry Level Expectations -CELE, Project 2000, Educational Enhancement Project-EES, Vision 2015) we have finally defined our graduate program leading to the DPM degree.  We are training our students, much like medical students, to be competent in the history and physical examination process, with an emphasis on the lower extremity.  In other words, we are preparing them for postgraduate training.  I do not disagree with Professors Boulton’s assertion that we need to be doing it more consistently, and in health science centers, alongside our colleagues in allopathic and/or osteopathic medicine, but we are doing it.  Next we have finally defined our profession in terms of our postgraduate education by creating a single residency program standard, the Podiatric Medical and Surgical Residency Program, that allows us to focus on what makes a podiatrist a podiatrist, e.g. medicine, biomechanics and surgery.  You could argue that all programs should offer rearfoot and ankle reconstruction and again I would not disagree, however we are not there…yet. We will get there, as that is what the public health need is, especially as it relates to the diabetic foot and the aging population. 

The final piece to this puzzle is our board certification process, which is, in its current form, standing in the way of defining podiatry as a single profession and therefore standing in the way of progress.  This too will change, as the two-board system no longer makes sense, since our residency graduates are all trained the same way and the demands of podiatric practice require significantly more knowledge and skill than in the past in medicine, biomechanics and surgery.  This change will be difficult, but it is necessary and we can only hope the current leadership on both boards musters the courage to get it done -not in haste, but in thoughtful discourse to ensure that we address the needs of the present and the needs of the future for both patients and practitioners.

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