Podiatric medicine and surgery is a doctoral level medical profession defined by the American Podiatric Medical Association as “that profession of the health sciences concerned with the diagnosis and treatment of conditions affecting the human foot, ankle, and their governing and related structures, including local manifestations of systemic conditions, by all appropriate methods and means.” A Doctor of Podiatric Medicine (DPM) is a physician and surgeon who treats the foot, ankle, and related structures of the leg.
Feet are complex anatomical structures, all-in-one stabilizers, shock absorbers, and propulsion engines that are instrumental to overall health and well-being. They require expert care. Be sure you’re seeing the most qualified health-care professional to treat your feet by looking for the letters “DPM” after his or her name. The DPM means a physician has completed years of rigorous foot and ankle training in podiatric medical school and hospital-based residency training, making him or her uniquely qualified to care for this part of the body.
Podiatric physicians and surgeons, also known as podiatrists or foot and ankle surgeons, work with all organ systems of the foot and ankle, including the vascular, neurological, dermatological and musculoskeletal systems. Treatment can be medical, surgical, or biomechanical. (Biomechanics is the study of how the foot and leg function when the foot contacts the ground.) The podiatrists’ extensive knowledge of biomechanics allows them to alleviate many conditions with conservative therapy rather than surgery, and improve surgical outcomes. When necessary, surgically-trained podiatrists have the capability to fix the most complex foot and ankle conditions.
The non-surgical care provided by podiatrists in terms of medicine and biomechanics comprises 80% of most podiatric practices. According to the American Podiatric Medical Association (APMA), more foot and ankle surgeries are performed by podiatrists than any other medical specialist. According to the American College of Foot and Ankle Surgeons, 45% of its members’ patient base is treated for surgical care.
Doctors of Podiatric Medicine have undergone extensive education, training and board certification focused on the foot and ankle. They undergo more education and training specific to the foot and ankle than any healthcare provider and are the experts for a wide range of complex foot and ankle care.
In the United States, podiatric physicians and surgeons complete four years of post-baccalaureate medical school, followed by several years of residency. Their training is similar to that of other physicians.
Candidates for admission to Podiatric Medical Schools are expected to complete baccalaureate degrees before admission. As with institutions granting MD (medical doctor) and DO (doctor of osteopathy) degrees, the colleges will consider candidates who show unusual promise and have completed a minimum of 90 semester hours at accredited undergraduate colleges or universities. About 95 percent of all first-year students entering the colleges of podiatric medicine possess baccalaureate degrees, and about 10 percent have master’s degrees. Applicants for admission are required to complete the Medical College Admission Test (MCAT) as a prerequisite.
The course of instruction leading to the DPM degree is four years in length. The first two years are devoted largely to classroom instruction and laboratory work in the basic medical sciences, such as lower extremity anatomy, general human anatomy, neurobiology, genetics and embryology, histology, physiology, microbiology, biochemistry, pharmacology, and pathology.
During the third and fourth years, students concentrate on courses in the clinical sciences, gaining experience in the college clinics, community clinics, and accredited hospitals. Clinical courses include general diagnosis (history taking, physical examination, clinical laboratory procedures, gait analysis, biomechanics, and diagnostic radiology), and therapeutics (pharmacology, sports medicine, physical medicine and rehabilitation, orthotics, shoes, and prosthetics, surgery and anesthesia). Other courses include general medicine, pediatrics, women’s health, research, ethics and jurisprudence.
After completing the four-year course and receiving the DPM degree, the graduate is required to complete postdoctoral work before state licensure.
As they near graduation, prospective podiatric physicians seek postdoctoral residency programs. These programs, designed to strengthen and refine the practitioner’s medical, surgical, biomechanical skills, are based in hospitals accredited by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) and the American Osteopathic Association (AOA). These programs are now usually three years in length.
US-trained podiatrists have complete rotations through hospital departments and full exposure to all pathologies in the major areas of medicine during residency, including emergency medicine, orthopedic surgery, general surgery, anesthesia, radiology, pathology, infectious disease, endocrinology, sports medicine, physical therapy, biomechanics, geriatrics, internal medicine, critical care, cardiology, vascular surgery, psychiatric and behavioral health, neurology, pediatrics, dermatology, pain management, wound care and primary care.
Following residency, the podiatric physician may enter practice or continue their education through Fellowships in specialized areas of study.
Licensure, Practice and Continuing Education
Licensure testing occurs after the second and fourth years of school. The doctors are licensed by the State in which they practice. Podiatric Physicians are licensed in all 50 states, the District of Columbia, and Puerto Rico to treat the foot and its related or governing structures by medical, surgical, mechanical, or other means. Podiatrists can focus on many fields, including surgery, sports medicine, wound care, pediatrics, and diabetic care.
In addition to private practices, many podiatrists today are also part of group medical practices. They also serve in hundreds of prestigious medical centers, on the staffs of hospitals and long-term care facilities, the faculties of schools of medicine and nursing, as commissioned officers in the Armed Forces and US Public Health Service, in the Department of Veterans Affairs, and in municipal health departments. Read about our practice.
As licensed physicians and surgeons with independent authority to make clinical diagnoses, perform treatment and prescribe controlled substances, podiatric physicians and surgeons are required to complete 100 hours of continuing education every two years for licensure in the State of Washington. There is heavy attendance at many educational programs and seminars developed and presented each year by the colleges and podiatric medical associations.
Podiatrists can earn board certification with advanced training, clinical experience, and by ultimately taking an exam. In its continuing efforts to protect and improve public health and welfare, APMA has recognized and approved two specialty boards that certify in three areas: primary podiatric medicine, podiatric orthopedics, and podiatric surgery. These boards confer certification on a podiatric practitioner who has satisfactorily passed written and oral examinations and has demonstrated knowledge and experience in his or her chosen specialty. These boards are the American Board of Podiatric Medicine (ABPM), which certifies medical and orthopedic care, and the American Board of Foot and Ankle Surgery (ABFAS), which certifies surgical care. Dr. Hoy is certified by both boards.
The American Board of Foot and Ankle Surgery, the only certifying board for foot and ankle surgeons, utilizes a demanding, comprehensive certification process encompasses passing written examinations, submitting simple and complex surgical cases and completing simulations of cases. This ensures diplomates perform a diverse and extensive range of foot and ankle surgeries and that they have demonstrated the highest level of proficiency to earn board certification. To demonstrate continued proficiency, foot and ankle surgeons must be re-certified every 10 years.
Podiatry is the definitive, comprehensive medical and surgical specialty that deals exclusively with the foot and ankle.
“He was welcoming and listened well to the concerns I presented. I especially liked that I was able to write down my problem before I came in and he addressed them efficiently. I was diagnosed with a much different problem than I had been given before, and Dr. Hoy explained his simple, methodical method for his diagnosis as we went. I felt extremely cared for and like I will be able to make progress on my problem before I see him again. Definitely see Dr. Hoy if you’ve had problems seeing a general practitioner or orthopedist with no luck. It may be that you need a more specialized opinion.” -Samuel S.