The American Association of Colleges of Podiatric Medicine. 50 Years of Professional, Political, and Public Health Influence

As we celebrate the 50th anniversary of the American Association of Colleges of Podiatric Medicine (AACPM), it is appropriate to recognize the contributions that this organization has made to the professional growth, the political influence, and the promotion of podiatric public health. This started with the continuous quality improvement efforts of the educational system to ensure that the profession of podiatric medicine, through its education process, continued to develop, sophisticate, and progress in search of establishing and then maintaining the highest-quality education continuum. This included the doctoral programs (colleges of podiatric medicine), the postdoctoral programs (residencies and fellowships), and the continuing medical education programs. In June of 2018 the Mission Act of 2018 was signed into law. Section 502 of that law now defines podiatrists as physicians and surgeons in the Department of Veterans Affairs. This had been a 12-year journey beginning with initiatives from Jeffrey M. Robbins, DPM, Director Podiatry Services VACO, the Federal Services Podiatric Medical Association, and ultimately the American Podiatric Medical Association who did the heavy lifting on the legislative side. Introduced by Congressman Brad Wenstrup (R-Oh) and shepparded by Ben Wallner, Director of Legislative Affairs of APMA, the bill took 2 years to get through congress once it was introduced. As with all major efforts, no one does this alone and is another example of how the rank and file podiatrists, the education community, and the American Podiatric Medical Association work together to improve the lives of the public, specifically veterans and their families. This allows the Department of Veterans Affairs to recruit and retain our most experienced providers and provide America's veterans with the best in podiatric medical and surgical care.

History of the Podiatric Medical Curriculum

In 1960, in recognition of the growth of podiatric medicine, the then American Podiatry Association (APA) established a Special Commission on the Status of Podiatry Education to study podiatric medical education in the United States. Chaired by William K. Selden, LLD, who was the Director of the National Commission on Accrediting, it included representatives of higher education from colleges, universities, and the Association of American Medical Colleges.[1] Referred to as the Selden Report, it was considered by many to be podiatric medicine's sequel to the 1910 Flexner Report that led to revolutionary changes in medical education.[2] The report was a major catalyst that, together with the availability of federal funds in 1965, led to qualitative and quantitative changes in podiatric medical education. Major fuel for these changes included federal grants awarded between 1966 and 1973 to the then five podiatric medical schools. These were called basic improvement and capitation grants as well as special project grants provided directly to the colleges and for construction of new and expanded college facilities. Shortly after, a major follow-up to the Selden Report was an exhaustive 3-year study of the podiatric medical curriculum by the APA, the newly formed AACPM, and the then five colleges. It included 150 members of the college faculties, consultants, and other health professions analyzing the curriculum as it was in the 1960s, leading to the AACPM publication of The Podiatry Curriculum in 1970, authored by L.E. Blauch.[3] In the late 1960s and early 1970s, the APA and AACPM developed guidelines leading to board certification in podiatric surgery and, ultimately, the formation of the American Board of Podiatric Surgery. The three main events that led to the major metamorphosis of podiatric medical education were, therefore, the 1961 Selden Report, the 3-year Blauch Curriculum Study, and the availability of federal funds from the then Bureau of Health Resources Development for construction, capitation, special projects, and the Health Professions Loan and Scholarship Programs. As recommended by the Selden Commission that colleges of podiatric medicine adopt a uniform testing program to be administered on a nationwide basis, in 1968 the AACPM entered into a contract with Educational Testing Service of Princeton, New Jersey, to develop an admissions test. Called the Colleges of Podiatry Admission Test, it ultimately was succeeded by the Medical Colleges Admissions Test.

In 1973, after approximately 6 months of discussion, the AACPM, led by its Council of Deans and college presidents, defined the profession and its interrelationships with other professions, its scope of practice, and the colleges and education, which produced new members of the profession. All of the colleges of podiatric medicine and the APA leadership were also given the opportunity to provide suggested changes to achieve a general consensus.

In the 1980s, the Committee on Entry Level Expectations was established by the AACPM to once again further define and articulate the knowledge, skills, and attitudes necessary to enter into the practice of podiatric medicine to establish a guideline for the doctoral and postdoctoral education and training process. This was an arduous task that involved faculty from the colleges of podiatric medicine, residency directors, other practicing podiatrists, and members of the public. It resulted in the publication of a document that was used as a blueprint for the further development of curriculum and training.

In the mid-1990s, the then Liaison Committee on Podiatric Medical Education and Practice of the American Podiatric Medical Association (APMA), in collaboration with the AACPM, embarked on another enhancement program with the specific task of establishing a comprehensive plan to organize and enhance the podiatric medical educational experience from entrance into podiatric medical school through continuing medical education. Project 2000 involved representatives from the AACPM, the American Board of Podiatric Orthopedics and Primary Podiatric Medicine (now the American Board of Podiatric Medicine), the American Board of Podiatric Surgery (now the American Board of Foot and Ankle Surgery), the American College of Foot and Ankle Orthopedics and Medicine, the American College of Foot and Ankle Surgeons, and the APMA.

In the early 2000s, APMA launched Vision 2015 (renamed Vision 21st Century) to ensure universal acceptance of podiatrists, and to ensure that they are recognized as physicians, consistent with their educational training and experience. While progress toward achieving this vision has been made, there remains work to be done.

Podiatric Public Health

The development of podiatric medicine's role in the American Public Health Association (APHA) began with the efforts of Drs. Abe Rubin, Marvin Shapiro, Seward Nyman, Arthur Helfand, Martin Mussman, and Leonard Levy and Mr. John Carson back in 1963. In 1967 Dr. Leonard Levy was the first podiatric physician to earn the Master of Public Health degree, and the activities of the newly formed Podiatric Health Section increased significantly. He also was appointed as the dean of the then California College of Podiatric Medicine and joined the 1-year-old AACPM. Through his early influence, the podiatric medical educational community and the public health community began. Lead by Arthur Helfand who, with the help of a few others lobbied the profession and, simultaneously, the APHA to realize the potentially important role of podiatric medicine in public health to grant it section status. A strong ally of this effort at the time was the AACPM, as was the APMA. After several years, it was finally realized by the APHA that, indeed, podiatric physicians play an important role in the field of public health, and in 1972 the APHA established the Podiatric Health Section. The Podiatric Health Section formulated an official statement of the roles and responsibilities of podiatric physicians in the public health field entitled, Functions and Educational Qualifications of Podiatrists in Public Health, published in September 1975 in the American Journal of Public Health. For more than two decades, it remained the primary document defining and delineating the activities of the specialist in podiatric public health. It was recognized that in a time of evolving change in health-care delivery, this revision was needed.

The increasing interest in podiatric public health by the AACPM and the APMA was also a major catalyst that helped give birth to the American Board of Podiatric Public Health on April 14, 1980, the incorporators being Arthur E. Helfand, Leonard A. Levy, and Richard H. Baerg. This board no longer exists as a separate entity except that those who achieved diplomat status in this specialty are still recognized and the records are maintained by the American Board of Podiatric Medicine.

A mini-grant from the APHA in 1996–1997 supported the formation of a special commission to update the formal position of the APHA and its Podiatric Health Section with respect to podiatric public health, providing direction for the future of podiatric public health. This position was a shortened version of the report issued by the special commission of the APHA.[4-6] Headed by Arthur Helfand, it was published in JAPMA in 1998.[7]

Financial Disclosure: None reported.

Conflict of Interest: None reported.