Considerable Decrease in Podiatric Medical School Enrollment

With the beginning of the 2022-2023 academic year, a significant number of available first-year positions at the colleges of podiatric medicine are not filled due to a drastic reduction of qualified applicants.(1)  Conversely,  applications to allopathic medical schools substantially increased by 18% compared to last year. (2)

I wrote Part 1 of this blog 8 years ago in 2014. (3) At that time, I was alarmed by the relatively small number of people applying for admission to the nine colleges of podiatric medicine in the country.  That year, there were 1004 applicants which grew to 1194 applicants in 2015 and then there was a steep decline in subsequent years.(4) This year in 2022, there were 716 applicants for 697 positions at the nine podiatric medical schools (excluding the newest school in Texas). This represents a 21% decrease compared to the previous year. See Table 1

TABLE 1

Source: Reference 4:   https://aacpm.org/wp-content/uploads/Historical-TRENDS-of-apps-2012-2021-10-2021-for-health-professions-update.pdf

While it might be easy to blame the drop in numbers of applicants to podiatric medical school to an overall decreased appeal of any medical career to a current undergraduate student, a look at applications to allopathic medical schools and osteopathic medical schools dispels this notion.

From Table 2 we see dramatic increases in the numbers of applicants at both of those institutions, while podiatry has remained flat over the past 8 years.

TABLE 2

Sources:

Reference 4:  https://aacpm.org/wp-content/uploads/Historical-TRENDS-of-apps-2012-2021-10-2021-for-health-professions-update.pdf

Reference 7:  https://www.aamc.org/media/57761/download?attachment

Reference 8: https://www.aacom.org/docs/default-source/data-and-trends/2021-aacomas-applicant-matriculant-profile-summary-report.pdf?sfvrsn=c0220197_4

Possible Causes for Decrease in Podiatric Medical School Enrollment

The sudden decrease in 2022 with the number of applications to podiatric medical schools appears peculiar to podiatry and was not experienced by other institutions of training for various medical occupations. What event or trends began in 2021 which dramatically affected the appeal of podiatry to undergraduate students?

Several notable administrators at podiatry colleges have cited the growing number of posts on social media from practicing podiatrists who regret choosing this career.(1)  While these might be damaging, I also see many similar posts in social media from practicing MD’s who are unhappy with all the changes that have occurred in their own profession which have affected their income and quality of life. I am not sure how many undergraduate students read social media posted by older, practicing podiatrists. To the contrary, undergraduate students value the opinions of their own peers and most likely search social media frequented by other students.  In this regard, I was curious to learn which websites might be most commonly accessed by undergraduate students seeking insight into the current attitudes among students at various podiatric medical colleges.

I found a website called The Student Doctor Network (SDN) which has over 700,000 members with broad membership including high school students, medical students, podiatry students and practicing physicians. (9) The SDN Forums contain over 20 million posts covering all areas of the health education process.  Of interest is the section labeled “Podiatry Community” which is co-hosted by the American Podiatric Medical Students Association (APMSA) and contains many discussions between podiatry students and residents concerning podiatry education and career options. (10)

Clearly, the SDN is a popular forum for podiatric medical students and would likely be accessed by undergraduate students seeking more knowledge about the current situation of podiatric medical education. Indeed, within the Podiatry Community forum on the SDN site, the Pre-Podiatry section has the most threads and messages.(10)

The most popular thread on the podiatry student forum at the SDN website focuses on an important event which occurred early in the year 2021.(11)  This thread, with over 9K reads was posted in May, 2021 and focuses on the recent publication of a white paper titled “Improving the Standardization Process for Assessment of Podiatric Medical Students and Residents by Enabling Them to Take the USMLE,” written by the Joint Task Force of Orthopaedic Surgeons and Podiatric Surgeons. (12)  This white paper was developed and agreed upon by the American Academy of Orthopaedic Surgery (AAOS) and the American Orthopaedic Foot and Ankle Society (AOFAS) as well as the American College of Foot and Ankle Surgeons (ACFAS) and the American Podiatric Medical Association (APMA).   I have previously written a blog about the ramifications of this white paper, specifically on the changes it would mandate for podiatric medical education. (13)

In short, there was general dismay voiced in the majority of posts from podiatric medical students on the SDN site regarding the conclusions and recommendations made by the Joint Task Force of Orthopaedic Surgeons and Podiatric Surgeons regarding the education and status of current podiatrists practicing in the United States.(11)  Specifically, many posts reflected frustration and anger with the statement in the white paper that “There is a lack of consensus among the four organizations as to whether DPMs should currently be considered to be physicians.” Furthermore, the majority of the podiatric medical students posting on this thread questioned whether any of the pre-conditions set forth  by the Joint Task Force in order for podiatrists to “gain the public trust” and become “recognized as physicians” could ever occur. They specifically cited concerns about the National Board of Medical Examiners (NBME) accreditation process based on the standards of the Liaison Committee on Medical Education (LCME).  Basically, many students voiced skepticism that the NBME would have an open mind about accrediting podiatric medical schools.

Even if this were to happen, most students agreed that, given their current training, they could not pass all three steps of the United States Medical Licensing Examination (USMLE) which is another requirement proposed by the joint task force in order for podiatrists to be considered physicians.  Finally, many podiatry students questioned what additional benefit podiatrists would ultimately enjoy if they took and passed the USMLE but still held a DPM degree.

This particular thread focusing on the requirement of podiatric medical students to take and pass the USMLE spawned many posts voicing disappointment regarding their quality of current education, future residency training as well as general concerns about job placement and competitive salary upon completing their education.(11) Reading this thread as well as several others posted in the podiatry forum of the Students Doctor Network (11,14,15) would, in my opinion, dissuade many who are considering a career in podiatry.    How the publication of the white paper in 2021 from the Joint Task Force of Orthopaedic Surgeons and Podiatric Surgeons and subsequent debate on social media platforms may have influenced the serious decline in potential applicants to podiatric medical schools in 2022 remains speculative, but the two events appear to be more than coincidental in my opinion.

Enhancing Awareness of Our Profession to Students

Notwithstanding, there is a crisis facing podiatric medicine which requires urgent focus at multiple levels.   Mentoring prospective applicants by practicing podiatrists has been and will continue to be a viable strategy, but thus far this effort alone has not produced significant change.  Educating and recruiting middle school and high school students does not address the immediate need and has questionable long-term value in my opinion.

The low hanging fruit for recruitment to podiatry colleges is the pool of 80,000 applicants to allopathic medical schools and osteopathic medical schools.  I am told by several sources that some effort is made to reach out to these people by the podiatry schools which are already affiliated with these medical schools such as Temple,  DesMoines, Midwestern and Western.   Some other schools have access to the mailing list of all people who take the MCAT every year and some effort has been made to educate and recruit them to consider a career in podiatry.

I find it hard to believe that not even a small percentage of people applying to and many who fail to be accepted to medical school or osteopathic school would not consider applying to podiatry school.  Perhaps the message is not crafted or delivered properly?

My message to anybody who has considered a career as a doctor is that podiatry offers the best opportunity compared to all other options when considering  lifestyle, potential income and ability to consistently and positively affect patient lives . If you agree with me, please get this message out on social media platforms and dispel some of the recent myths which have negatively affected perceptions of our profession.

See other blogs related to this topic written by Dr. Richie:

Applications To Podiatry Colleges Up 1.7 Percent In 2018

What A New Study Reveals About The Knowledge Of Musculoskeletal Medicine Among Podiatric Surgical Residents

What Courses Should Be Eliminated From Podiatric Medical Education?

REFERENCES

1. Linne A. Sending Out an SOS.  A decline in the applicant pool threatens podiatry.  Podiatry Management Magazine.  August, 2022; 65-70.

2. https://www.aamc.org/media/57761/download?attachment

3. https://www.hmpgloballearningnetwork.com/site/podiatry/blogged/why-arent-more-people-choosing-career-podiatric-medicine

4. https://aacpm.org/wp-content/uploads/Historical-TRENDS-of-apps-2012-2021-10-2021-for-health-professions-update.pdf

5. Bureau of Labor Statistics. Occupational outlook handbook: podiatrists. U.S. Department of Labor. https://www.bls.gov/healthcare/podiatrists.htm  Updated November 3, 2017. Accessed December 18, 2017.

6. https://www.bls.gov/ooh/Healthcare/Podiatrists.htm

7. https://www.aamc.org/media/57761/download?attachment

8. https://www.aacom.org/docs/default-source/data-and-trends/2021-aacomas-applicant-matriculant-profile-summary-report.pdf?sfvrsn=c0220197_4

9. https://www.studentdoctor.net/about-sdn/

10. https://forums.studentdoctor.net/categories/podiatry-communities-dpm.152/

11. https://forums.studentdoctor.net/threads/orthopaedic-podiatric-surgeons-joint-task-force-2021.1441625/

12. White Paper Joint Task Force of Orthopaedic Surgeons and Podiatric Surgeons – White Paper. Improving the Standardization Process for Assessment of Podiatric Medical Students and Residents by Enabling Them to Take the USMLE. Available at: https://www.aaos.org/globalassets/about/bylaws-library/ortho-podiatry-task-force-consensus/joint-task-force-of-orthopaedic-and-podiatric-surgeons—white-paper.pdf

13. https://www.hmpgloballearningnetwork.com/site/podiatry/blogged/what-courses-should-be-eliminated-podiatric-medical-education

14. https://forums.studentdoctor.net/threads/leaving-podiatry-for-md-do.1457891/

15. https://forums.studentdoctor.net/threads/leaving-podiatry-school.705503/