is Podiatric Medicine?
Medicine is the health care specialty that provides comprehensive medical treatment
of the foot.
is a Podiatrist?
the United States and Puerto Rico, most people know that a
"Podiatrist" is the term for an
individual with a Doctor of Podiatric Medicine (D.P.M.) degree.
The podiatric physician is a health professional specialist who is involved with
examination, prevention, diagnosis and treatment of foot and ankle disorders by
the use of physical, medical and surgical means.
term "podiatrist" means the same thing in most of Canada, too,
although there is a little less familiarity with the profession since there are
no schools that teach podiatric medicine in Canada, and there are currently only
a few post-graduate residency training positions here.
But the term "podiatrist" can be a little confusing to some because in
countries, and even in some parts of Canada, the term may be misused. More
What kind of
foot and ankle conditions do podiatrists treat?
treat virtually any medical abnormality of the foot--including
arch pain, heel pain, flat feet, shin splints, sports medicine, bunions,
hammertoes, neuromas, nail problems, skin problems, infections, fractures,
trauma, corns, calluses, warts, diabetes and
podiatrists have areas of specialization, depending upon their individual
interests, specialized training, and expertise.
Most of North America's 16,000 podiatrists work in private practice, though some have group
practices with other podiatrists and/or other medical specialties.
podiatrists have some sort of affiliation with one or more hospitals, and
according to a 1998 survey of U.S. hospitals, most hospitals (over 80%) have a
podiatrist as part of their medical staff. This is more true in the U.S.
where there are a lot more podiatrists than in Canada.
kind of training do Podiatrists (D.P.M.'s) have?
In order to
become a Doctor of Podiatric Medicine, one must attend a university to obtain
basic undergraduate science training. This typically takes four years of
study, and most graduate with a
Science (B.S. or B.Sc.) degree.
undergraduate studies, a prospective podiatrist enters into an additional
four-year course of study in podiatric medicine. Like with general
medicine, podiatrists study basic medical science, then receive practical training
in hospitals all over the country. This training encompasses all areas of medicine,
including family practice, surgery, emergency room,
and so forth, albeit with additional classes and a stronger emphasis on the
lower extremity (the foot and leg) than medical doctors receive.
degree is granted at one of eight specialized schools in the United States--in
New York City, Philadelphia, Cleveland, Chicago, Des Moines, Miami, Phoenix and San
Francisco. Some podiatric medical schools offer a dual D.P.M.-Ph.D.
degree program, in conjunction with studies at affiliated major
Additionally, a program has recently opened up at the University of
Trois-Rivières campus (in the city of Trois-Rivières, Quebec). This
program, affiliated with the New York College of Podiatric Medicine, is the
first and only school offering the D.P.M. (Doctor of Podiatric Medicine) degree
in Canada, and it is the only program offering the D.P.M. degree program in
obtaining the D.P.M. degree, a podiatrist
then does a broad-ranging residency program, with an emphasis in various
fields of specialization. Specialties within podiatric residency programs
include fields as disparate as: foot and ankle surgery,
medicine, geriatrics (the elderly), pediatrics
(children), sports medicine, the diabetic foot, trauma, and
biomechanics (the study of the mechanical function of the body).
residency programs are found all over the United States, in some of the finest
medical institutions in the world, including Harvard University's Cambridge
and Deaconness Hospitals, Columbia University's New York-Presbyterian
Hospital System, Yale University's DVAMC West Haven Hospital, the
University of Chicago hospital system, Western Pennsylvania Hospital, the University
of Texas Health Science Center in San Antonio, and our own facility, Vancouver
Hospital and Health Sciences Centre Hospital / University of British Columbia.
residency process typically takes two to three more years after graduating
school with a doctorate (D.P.M.), depending upon the area of specialty.
many podiatrists pursue fellowship training in a sub-specialty
So, in total, the typical podiatrist being licensed today has between
10 and 12
years of education after high school.
undergraduate education, graduate education, and residency, fellowship
training in a variety of specialized fields (the diabetic foot, biomechanics,
specialized surgery) is also available to podiatric physicians.
many podiatrists choose to pursue board certification. There
are two boards recognized by the American Podiatric Medical Association:
Board of Podiatric Orthopedics and Primary Podiatric Medicine and
Board of Podiatric Surgery .
In order to become board certified by one of these organizations, specific areas
of training are required, and the podiatrist must pass a strenuous
written and oral examinations. For more information about board
certification and what it means, please visit our web page on
training mean that a Podiatrist is the same as an Orthopedic Surgeon?
orthopedic surgeon would have taken the same basic undergraduate classes in
a university that a podiatrist would have taken. For the most
part, these courses are the basic sciences.
orthopedic surgeon would have taken the same test to get admitted to medical
school that a podiatrist would have taken. This test is
the MCAT, the Medical College Aptitude Test. (This is true in the
U.S.. In other nations other tests may be used.)
medical training an orthopedic surgeon would have received would be the same
length (4 years) that a podiatrist would have received.
content of each groups training would be similar, though podiatrists take
some additional courses specifically relating to the podiatric
profession. For example, while both groups take gross anatomy,
(anatomy of the whole body), podiatrists take an additional anatomy course
specifically devoted to the anatomy of the lower extremity.
cases, the orthopedist and the podiatrist graduate from their respective
medical training with a post-graduate medical degree.
residency program for orthopedists and podiatrist both include rotations in
most major departments in the hospital--emergency medicine, family medicine,
general surgery, anesthesiology, and so forth.
surgeons and podiatrists may both pursue specialized fellowship programs
beyond residency training. Some of these orthopedic programs, (and all
podiatric programs), are devoted to the foot.
receive a general Medical Doctor degree. This is the same degree your
family physician receives. Podiatrists receive a degree more specific to the
foot---the Doctor of Podiatric Medicine, or D.P.M., degree.
many rotations through the hospital are the same for both groups, orthopedic
residencies usually have differences with podiatric residencies. For
example, most orthopedic residency programs run 5 years and encompass
training in orthopedic conditions throughout the body. For example,
orthopedists would receive more training in knee surgery, hip surgery, back
surgery, shoulder surgery, elbow surgery, hand surgery, and so forth.
This means relatively less time--usually 3 or 4 months during those 5
years--devoted to the foot. In contrast, podiatric programs usually
run 2-4 years, with less time devoted to surgery for other parts of the
body, and with the majority of the residency time spent specifically to the
foot and ankle.
orthopedists choose to specialize in the foot, and they may (or may not)
receive additional training through a fellowship program in this area.
These foot fellowship programs typically last 1 year, though some are 6
months in length. However, there is no orthopedic board certification
program specifically devoted to the foot. The only board certification
available to orthopedists is in general orthopedics. In contrast,
podiatric physicians may also pursue additional fellowship training, but
because the podiatric profession is already dedicated to the foot, these
podiatric fellowship programs are usually in sub-specialties in the foot--in
fields such as the diabetic foot, the pediatric foot, biomechanics,
foot and ankle surgery, and so forth. Podiatric medicine has
board certification in the sub-specialties of foot and ankle surgery, foot
and ankle orthopedics and primary podiatric medicine. Podiatric
radiology, podiatric dermatology, pediatrics, podiatric sports medicine
and other sub-specialties offer other types of professional specialty
groups may offer the patient similar treatment options, there may
be differences in both the philosophies and treatment plans between orthopedists
Podiatrist the same as a Chiropodist?
U.S.-trained podiatrist is not a chiropodist, no.
But in some parts of Canada, the use of these words is a little more
confusing than that, and requires some explanation to fully understand it.
term "chiropodist" and the profession of chiropody is British in
origin. It has been traditionally used to describe an individual who
treats feet in various ways, and up until the 1950's and earlier, there were
chiropodists in both the U.S. (where Abraham Lincoln had a chiropodist) and Canada based on that British
the advancements in medicine, however, it gradually became evident in the U.S.
that the level of education received by chiropodists was inadequate to allow
practitioners to practice in a comprehensive way. Hence, in the
1950's, the profession of chiropody was abandoned in the U.S., and podiatric
medicine, with its much lengthier training, developed. This is known
as the "Doctor of Podiatric Medicine" standard.
of these changes, the term "chiropody" or "chiropodist" has not existed in the United States
for about 50 years now. So there is little confusion between
the terms "chiropodist" and "podiatrist" in the
situation in parts of Canada is not so clear-cut.
with "Doctors of Podiatric Medicine"
chiropody was being abandoned and podiatric medicine was being born in the
United States, Canada
was caught somewhat between the influence of its British heritage and the
influence of the United States' changing standard. As all the
schools of podiatric medicine were (and still are) located in the United States, however,
provinces like Ontario,
the U.S.-based podiatric standard. Quebec
adopted the U.S. standard sometime later.
these locations, the term "podiatrist" has the same meaning as in the
those provinces where chiropodists of one sort or another continue to practice
makes things much more confusing.
While Ontario also accepted the U.S. standard, and there are quite a few
podiatrists practicing in that province, Ontario has also added a new level of
chiropody training into the mix. While it had been a 2-year program,
current licensing requirements for this group in Ontario involves a 3-year
course after high school, leading to a "Diploma of Chiropody".
The "Diploma of Chiropody" or "DCh" designation is accepted
in Ontario, but is not recognized in other locations. Those with a DCh
following their name are known as "chiropodists". They are not
called "podiatrists" because that would confuse them with the
"Doctors of Podiatric Medicine" who already practice in
in New Brunswick
also practice in New Brunswick. Because there is no podiatric (meaning
"Doctor of Podiatric Medicine") organization in the province, these
practitioners use the title "podiatrist" even though they have no
degree in the field.
fact, some chiropodists who practice there may have as little as a 2-year
educational program after high school, yet have begun calling themselves "D.P.",
or Doctor of Podiatry. This despite the fact that they have earned no
doctorate in podiatric medicine. And this despite the fact that there is no
"D.P." degree offered anywhere in the world.
practitioners in Saskatchewan and Manitoba
While U.S.-trained podiatrists are licensed in Saskatchewan and Manitoba, too,
these provinces are unique in Canada in that they continuing to follow the
British standard as the minimum requirement to practice there.
Influenced by the success of podiatric medicine in the United
States, British educational institutions have, over the years, expanded the curriculum of the
foot-care education offered.
years the program offered a 3-year chiropody training program after high
school. And to emulate U.S. program, the educational institutions began
offering what they termed a "D.Pod.M.",
a "diploma in podiatric medicine".
isn't so confusing in places like Britain where there are no DPMs, (Doctors of
diploma in podiatric medicine that those trained in Britain have following their
name is not the same as a doctorate-level degree
that Doctors of Podiatric Medicine have. So in a place like Canada,
where Doctors of Podiatric Medicine already existed, the issue of two groups
with very different levels of training, yet with very similar sets of letters
following their names ("D.Pod.M." versus "D.P.M."), was
clearly unnecessarily confusing.
the British have updated the educational system since that time. They now
offer a degree called a "B.Sc. (Podiatry). This is also true in
British Commonwealth countries such as Australia, New Zealand, and South
Africa. The overly-confusing "D.Pod.M." diploma is no longer
granted, though there are still quite a few practitioners in Britain,
Saskatchewan and Manitoba with the the "D.Pod.M." diploma.
B.Sc. (Podiatry) program now offered in Britain, (and in British Commonwealth
countries like Australia, New Zealand, and South Africa), is similar to the
chiropody program in Ontario in that it involves at least a 3-year program
following high school.
the B.Sc. (Podiatry) program differs from the Ontario program in that there is
an actual degree offered in lieu of the diploma offered in Ontario. The
British system also differs from the Ontario system in that some individuals may
choose to pursue additional training programs on top of the basic program.
This is unavailable to those who follow the DCh path in Ontario. For
example, some British-trained individuals may pursue a Masters or Ph.D. in the
field. This is certainly an advance in the education of British-trained
individuals, and it's certainly a benefit to patients. However, additional
training is not required for licensure in Saskatchewan and Manitoba, and remains
the exception more than the rule in those provinces.
has become confusing is that as the British practitioners adopted the U.S.
terminology of using the word "podiatry" in their diploma / bachelor
degree name, they also began calling themselves "podiatrists", despite
the difference in training with their U.S. counterparts. The practice has
carried over to some the provinces where British-trained individuals
practice. So while the term "chiropodist" is still used in
Britain and Saskatchewan and Manitoba, so, too, is the term
"podiatrist", despite the fact that throughout the U.S. and in several
provinces the term refers to a doctorate-level of training.
the chiropodists of New Brunswick, some British-trained individuals even affix
the title "Dr." to their names, despite most not having achieved any
sort of doctorate in any field whatsoever.
provinces remain unregulated with regards to the minimum standard of education
to practice and the titles those individuals may use. This is true in
provinces like Prince Edward Island, Nova Scotia, and Newfoundland and Labrador
and in the territories. In theory, someone in those provinces or
territories can practice as he wishes and call himself anything he likes.
With These Groups Compared to "Doctors of Podiatric Medicine"
As described in more detail at the top of this web page, the D.P.M.
or "Doctor of Podiatric Medicine"
found in the U.S. and in provinces like British Columbia, requires 10-12 years
of education. This includes 4 years of undergraduate university education just
to get accepted in the podiatric medical school.
other words, the prerequisites to even get into the program is longer than the
entire chiropody program offered in other locations.)
there the podiatrist undertakes 4 years of doctorate-level, professional,
graduate-school education, and a minimum of 2 and up to 4 years of hospital residency
training. Fellowship programs and Board Certification may be pursued
Ontario-trained practitioners who now have as much as a 3-year diploma, and
unlike the British-trained practitioners, the vast majority of whom either have
a 3-year diploma (previous requirement) or at least a 3-year bachelor's degree
(today's requirement), Doctors of Podiatric Medicine do, in fact, receive a
doctorate degree. This is achieved at the end of their first 8 years of
training, after which time they are properly called
licensing standards in British Columbia require 2 years of post-graduate
residency training after the 8 years of undergraduate and graduate-level
schooling, making the minimum training required for licensure here at least 10
in podiatric medical specialties is an additional step. For more
information on Board Certification, please follow our
to that web page. There is no such thing as board certification for either
Ontario-trained or British-trained practitioners.
such a difference in training between podiatrists and chiropodists, why are
these groups sometimes confused?
most places in Canada, it doesn't happen so much these days, but there are a few reasons the two groups
are still sometimes confused.
professions may be confused among people who come from British
Commonwealth countries and some Canadian provinces where chiropody still exists. And as both
groups treat the foot, people may, somewhat naturally perhaps, confuse the two
people in those areas where
chiropody has disappeared (like in the U.S. and here in British Columbia) are
still old enough to remember their parents or grandparents going to a
what's particularly confusing, is that some provinces allow those with lesser
levels of training sometimes go by the term "podiatrist" just as those
with the U.S.-level of training do, and that some provinces allow those without
even a college degree--but as little as a 2- or 3-year technical diploma--to use
the title "Doctor", just as those have an actual doctorate. This
can obviously be very confusing to the public,
where the term 'podiatrist' and the term "doctor" already have an
the sake of clarity, throughout this website, the term "podiatrist" is
used in the sense that has been traditional for 50 years now, and in
the sense it is used in the entirety of the United States and in the majority of
describe a Doctor of Podiatric Medicine, or D.P.M..
I seek help from a Doctor of Podiatric Medicine?
ankle discomfort is abnormal, and warrants professional attention from
a podiatric physician. One may also seek professional attention from a
podiatrist for concerns which are visible,
even if they are not