Should Podiatrists Obtain a Dual Degree?

A while back, one of our readers asked my opinion as to whether or not podiatric medical schools should offer a dual degree program.  I’m certain this is a controversial issue, so I’m going to lay some parameters before I state my own opinion.  First, although I am a full-time assistant professor at the College of Podiatric Medicine at Western University of Health Sciences, I am by no means an expert on educational policy.  Second, my opinions are just that — my opinions.  What I say here does not reflect the opinion of anyone at Western University, nor is there a university policy in this regard.  Third, I’ve deliberately avoided discussing this topic in the past because it’s a polarizing hot potato in the podiatry arena, and frankly, I’ve been somewhat of two minds on the topic. 

Let’s start our discussion this week by asking a few questions to frame the issue. At the conclusion of the eZine, I'll ask you to take a brief opinion poll and see where our readers stand. Following this five questions survey, feel free to join in the dialogue on eTalk.  In next week's eZine, we’ll complete our discussion — if that’s at all possible — with some analysis of our poll results and perhaps some recommendations to rationally approach the dual degree controversy.

Let’s break down exactly what we’re talking about.  The dual degree is a combination of two separate degrees, whether MD/DPM, DPM/MPH, DPM/PhD, DPM/MBA, etc.  There are many combinations of degrees that one could obtain for any variety of reasons.  Dual degree programs exist in many academic venues, whether it’s medicine, law, dentistry, or any of a number of other professions.  It’s fair to say the “dual degree” controversy is not over the addition of MBA, MS, cPed, or PhD, but rather those sticky letters MD and DO.  I’ve never heard anyone argue over whether or not podiatrists should get PhDs.

Historically in medicine, the purpose of a dual degree, especially the MD/PhD, was for the creation of the “physician scientist.”  This was a doctor who underwent the standard clinical training, but spent extra time to study scientific methods so he or she could pursue an academic career as a clinician and researcher. In modern times, the purpose behind obtaining a dual degree has broadened somewhat.  For example, a physician obtaining an MBA provides that doctor the means to better understand business and entrepreneurship, useful skills in the world of private practices and managed care.  A podiatrist obtaining a Master’s degree or PhD will have a mastery of research methods, epidemiology, and biostatistics, opening the doors to research.  The other purpose is more controversial: parity.  Podiatrists rightly want to be treated equally with our MD and DO colleagues, and having the same degree is one method to obtain this parity.  Essentially, if you can’t beat ‘em, join ‘em.

Is there a precedent?

Have any other specialties attempted to obtain a dual XYZ/MD degree?  The answer is yes: dentists. Dentists created a dual DMD-MD degree which provides Oral and Maxillofacial surgeons (OMS) an MD degree.  Here’s a description of the dual degree residency training program at the University of California Los Angeles (128.97.112.24:8000/Dentistry/admissions/programs-for-dentists/program-descriptions/oral-and-maxillofacial-surgery):

“The Section of Oral and Maxillofacial Surgery, in conjunction with the David Geffen School of Medicine at UCLA and the Ronald Reagan UCLA Medical Center, offers a six-year training program leading to the MD degree and a certificate of specialization in oral and maxillofacial surgery. The program includes three years as a resident on the Oral and Maxillofacial Surgery Service, two years as a full-time student at the David Geffen School of Medicine at UCLA, and one year as an intern/resident on the General Surgery Service of the Ronald Reagan UCLA Medical Center.”

As it turns out, UCLA is not unique.  As of 2001, approximately 38% of OMS training programs offer an integrated degree program.¹  A significant amount of controversy seems to have surrounded this dual degree in the past, though the fact that the majority of these programs arise from American dental schools that are associated with American medical schools should tell us something about the level of acceptance these programs enjoy.

What are the arguments for a dual degree for podiatrists?

• Elimination of the History and Physical limitations placed on podiatrists at many healthcare facilities.
• Greater respect by the rest of the medical community.
• Greater education as required by the material required to complete the MD degree.²
• The addition of the DPM/MD degree is part of the natural evolution of podiatry.⁵
• Dual degree programs in dentistry have not hurt their profession⁵ (the assumption being that it would also be beneficial for podiatry).

What are the arguments against a dual degree for podiatrists?

• Podiatrists will no longer desire to practice podiatry in lieu of their MD training.³
• Existing DPMs will not be able to compete with the new breed of DPM-MD3.
• Insurance plans will eliminate the DPMs in favor of the DPM-MDs.³
• Confusing the public by advertising a mixed podiatric appearance.³
• Patients still want to see a specialist for their foot and ankle complaints rather than a general MD.⁴
• Respect by the medical community and patients comes from hard work rather than a new degree.⁶
• A new degree will not make us better podiatrists. We learn what we need in podiatric medical school⁶

With these questions in mind to frame the issue, let’s have a productive discussion about this very important and very controversial topic that has the potential for great impact on our profession. Please take a moment to take our five question survey, at the conclusion of which you will be directed to the etalk on dual degrees. Your participation is welcomed and encouraged.

Keep writing in with your thoughts and comments. Better yet, post them in our eTalk forum. Best wishes.

Jarrod Shapiro, DPM
PRESENT Practice Perfect Editor
[email protected]

REFERENCES:

1. Herford A, et al. Integration of the Medical Degree in Oral and Maxillofacial Surgery:
   A 10-Year Follow-Up. Journal of Oral and Maxillofacial Surgery, 2001; 59: 1471-1476.
2. Block B. Revisiting the DPM/MD Debate. Podiatry Today, Nov 2004; 17(11): 16.
3. Dumm D. Dual Degrees May Not Benefit DPMs. Podiatry Today, March 2005; 18(3): 14.
4. McCord J. Response to ‘Dual Degrees May Not Benefit DPMs.’ Podiatry Today, March 2005;
   18 (3): 14.
5. Levy L. Exploring Another View on the DPM/MD Debate. Podiatry Today, May 2005; 18 (5), 12.
6. McCord J. Should We Add ‘MD’ to Our Credentials? Podiatry Today, Sep 2004; 17(9): 74.

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