A Doctor of Podiatric Medicine (DPM) is a healthcare specialist dedicated to the diagnosis, treatment, and prevention of conditions affecting the foot, ankle, and related structures of the leg. The answer to whether all podiatrists are surgeons is no. Podiatry is a diverse medical field, and while all DPMs receive training in both medicine and surgery, the extent to which they perform surgery varies widely based on their postgraduate training and practice focus. Some DPMs primarily manage medical conditions, while others are specialized foot and ankle surgeons who perform complex reconstructive procedures. The distinction lies in the residency track completed and the subsequent board certifications they achieve.
The Broad Scope of Podiatric Medicine
DPM education involves four years of medical training with an intense focus on the lower extremity. All DPMs are licensed to treat the foot and ankle, including related tendons, using medical, mechanical, and surgical means, though the specific scope varies by state. This foundational knowledge allows many podiatrists to concentrate on non-surgical care, which forms a significant part of the profession.
These medical-focused podiatrists provide comprehensive care for common conditions like plantar fasciitis, ingrown toenails, and bunions, often using conservative treatments. They are experts in biomechanical analysis, prescribing custom orthotics and braces to correct gait abnormalities and redistribute pressure. A considerable portion of their work involves the long-term management of systemic diseases, such as providing diabetic foot care, wound management, and limb salvage efforts to prevent complications like ulcers and amputations.
This general medical approach also includes diagnosing and treating dermatological issues, infections, and sports injuries affecting the lower limb. Podiatrists focusing on these areas manage chronic conditions and provide preventive care. Their ability to treat local manifestations of systemic diseases makes them an integral part of a patient’s overall healthcare team.
Specialized Training for Podiatric Surgery
A podiatrist who intends to practice surgery extensively must complete a rigorous postgraduate program known as a Podiatric Medicine and Surgery Residency (PMSR). This comprehensive residency is the standard, mandatory three-year pathway for all new DPM graduates, providing structured training in both medical and surgical management of the lower extremity. The curriculum includes rotations in internal medicine, emergency medicine, general surgery, and orthopedic surgery, ensuring a broad foundation in patient care.
The critical difference that determines surgical capability is the additional credential in Reconstructive Rearfoot and Ankle surgery, resulting in a PMSR/RRA designation. Programs with the RRA credential provide a sufficient volume and diversity of complex procedures, training the resident to perform not only common forefoot surgeries, such as bunion and hammertoe corrections, but also more intricate operations. These advanced procedures include ankle fusions, complex rearfoot reconstructions for flatfoot deformities, and the surgical management of severe foot and ankle trauma.
Completion of a PMSR/RRA residency signifies that a DPM has met the highest standards of surgical training. This training is essential for obtaining hospital privileges to perform complex surgical procedures above the level of the foot. This experience differentiates a podiatric surgeon from a general podiatric physician.
Navigating Podiatric Board Certifications
After completing residency training, a DPM can seek board certification, which is often required for hospital privileges and professional recognition. The profession has two primary certifying bodies reflecting the two main areas of practice: medicine and surgery. The American Board of Podiatric Medicine (ABPM) certifies competency in the medical, biomechanical, and orthopedic management of the lower extremity, focusing on non-surgical expertise.
For patients seeking a confirmed surgeon, the American Board of Foot and Ankle Surgery (ABFAS) is the recognized indicator of surgical competency. ABFAS offers certification in both Foot Surgery and Reconstructive Rearfoot and Ankle Surgery, correlating directly to the complexity of the procedures they are qualified to perform. Certification involves written examinations and a rigorous case review of the surgeon’s actual experience, validating their practical skills.
The ABFAS certification in Reconstructive Rearfoot and Ankle Surgery confirms specialized training in the most complex procedures involving the entire ankle joint and the back portion of the foot. When seeking a surgeon for a complex issue, verifying certification with ABFAS is the most reliable way to confirm a podiatrist’s surgical expertise.