Podiatry or podiatric medicine is a branch of medicine devoted to the study of diagnosis, medical and surgical treatment of disorders of the foot, ankle, and lower extremity. The term podiatry came into use in the early 20th century in the United States and is now used worldwide with countries such as the United Kingdom and Australia.
A Doctor of Podiatric Medicine (DPM), is a medical specialist who diagnoses and treats conditions affecting the foot, ankle, and structures of the leg. The training of podiatric physicians includes human anatomy, physiology, pathophysiology, sociological and psychological perspectives, general medicine, surgery and pharmacology; this is similar to the training of a Doctor of Medicine (M.D.) or Doctor of Osteopathic Medicine (D.O.) Specialist podiatric physicians are podiatrists with additional postgraduate training or fellowship training and experience in the specialized field.
Within the field of podiatry, US trained podiatric physicians rotate through major areas of medicine gaining exposure and practice to areas including but not limited to: surgery, sports medicine, biomechanics, geriatrics, internal medicine, diabetes, vascular, neurological, pediatrics, dermatological, orthopedics, or primary care.
Podiatrists are uniquely qualified among medical professionals to treat only diseases of the foot and ankle. Whether it’s sports medicine, pediatrics, dermatology or diabetes, today’s podiatrist can tackle the many diverse facets of foot care. Podiatrists can be the first to identify systemic diseases in patients, such as diabetes and vascular disease.
Today’s podiatrists:
- perform surgery on Foot & Ankle
- perform complete medical histories and physical examinations
- prescribe medications
- set fractures and treat sports-related injuries
- prescribe and fit orthotics, insoles, and custom-made shoes
- order and perform physical therapy
- take and interpret X-rays and other imaging studies
- work as valued members of a community’s health care team
Doctors of podiatric medicine receive medical education and training in podiatric medical colleges including four years of undergraduate education, four years of graduate education at one of nine podiatric medical colleges and three years of hospital-based residency training. All podiatrists receive a DPM degree.
Medical School Training
The first year of podiatric medical school is similar to training that M.D. and D.O. students receive, but with an emphasized scope on foot, ankle, and lower extremity. Being classified as a second entry degree, in order to be considered for admission an applicant must first complete a minimum of 90 semester hours at the university level or more commonly, complete a bachelor’s degree with emphasis on general/organic chemistry, biochemistry, biology, etc. In addition, potential students are required to take the Medical College Admission Test (MCAT). The DPM degree itself takes a minimum of four years to complete.
Residency Training
The four-year podiatric medical school is followed by a surgical based residency, which is hands-on post-doctoral training. There are two standard residencies: Podiatric Medicine & Surgery 24 and Podiatric Medicine & Surgery 36 (PM&S 24 or PM&S 36). These represent the two- or three-year residency training. By July 2013, all residency programs in podiatry will be required to transition to a minimum three-years of post-doctoral training.[33] Podiatric residents rotate through core areas of medicine and surgery. They work alongside their MD and DO counterparts in such rotations as emergency medicine, internal medicine, infectious disease, behavioral medicine, physical medicine & rehabilitation, vascular surgery, general surgery, orthopedic surgery, plastic surgery, dermatology and of course podiatric surgery and medicine. Fellowship training is available after residency in such fields such as geriatrics, foot and ankle traumatology, infectious disease etc. In reality though, the residency training of most podiatry residencies today are already highly inclusive of these medical areas.
Podiatric Surgical Training
Upon completion of their residency, podiatrists can decide to become board certified by a number of specialty boards including the more common American Board of Podiatric Medicine and/or the American Board of Podiatric Surgery. The ABPMS or The American Board of Podiatric Medical Specialties has been certifying podiatrists since 1998.[34] Within the American Board of Podiatric Surgery, PSR 24 graduates can sit for Board Certification in Foot Surgery and those that complete PSR 36 can sit for Board Certification in Foot Surgery and Board Certification in Reconstructive Rearfoot & Ankle Surgery. Both boards in ABPS are examined as separate tracks.
Podiatrists certified by the ABPS have successfully completed an intense board certification process comparable to that undertaken by individual MD and DO specialties. There are two surgical certifications under ABPS. They are Foot Surgery and Reconstructive Rearfoot/Ankle (RRA) Surgery. In order to be Board Certified in RRA, the sitting candidate has to have already achieved board certification in Foot Surgery. Certification by ABPS requires initial successful passing of the written examination. Then the candidate is required to submit surgical logs indicating experience and variety. Once accepted, the candidate has to successfully pass oral examination and computer questions of clinical simulation.