A Doctor of Podiatric Medicine (DPM) is a physician and surgeon specializing in treating the foot, ankle, and related structures of the leg. This field focuses entirely on the lower extremity, addressing conditions from common skin ailments to complex musculoskeletal deformities. Podiatrists utilize a comprehensive approach, including medical, biomechanical, and surgical methods, to diagnose and manage patient issues. Many DPMs are highly trained surgical specialists qualified to perform surgery within their scope of practice, which is the foot and ankle.
Defining Podiatric Surgery
Podiatrists who pursue surgical specialization perform a broad spectrum of procedures on the foot and ankle. Their surgical scope ranges from minor, in-office interventions to extensive, hospital-based reconstructive operations. This specialized focus provides in-depth expertise on the 26 bones, 33 joints, and numerous ligaments and tendons that compose the lower extremity.
Common surgical procedures include bunion correction, which involves realigning bone and soft tissue, and hammer toe repair, often requiring bone fusion to straighten contracted toes. Podiatric surgeons also manage trauma, such as complex fractures of the foot and ankle, using plates, screws, or pins to stabilize bones and restore function. For chronic conditions, procedures like plantar fascia release may be performed when non-surgical treatments fail.
Podiatric surgeons also treat complications of diabetes, performing reconstructive surgery or wound care for diabetic foot ulcers to prevent limb loss. The specific extent of surgery is determined by the individual DPM’s training and state licensing laws.
Education, Residency, and Board Certification
The training pathway for a DPM who performs surgery is intensive and mirrors the length and rigor of other medical specialties. Candidates first complete four years of specialized medical education at a College of Podiatric Medicine, focusing intensively on the foot and ankle alongside general sciences. This is followed by a mandatory, minimum three-year post-graduate residency program, known as the Podiatric Medicine and Surgery Residency (PMSR).
The hospital-based residency provides comprehensive training in medicine and surgery, including rotations in general surgery, internal medicine, and anesthesiology. A primary element of this residency is the substantial volume of dedicated time spent in foot and ankle specific training, ensuring proficiency in both non-operative care and complex surgical techniques.
Following residency, a podiatric surgeon can pursue board certification through the American Board of Foot and Ankle Surgery (ABFAS). This process requires a demanding examination and the submission of surgical case logs, confirming competence in foot surgery or reconstructive rearfoot and ankle surgery. Achieving this certification is typically required for a DPM to gain full surgical privileges in hospitals and ambulatory surgery centers.
Podiatric Surgeons vs. Orthopedic Surgeons
The distinction between a podiatric surgeon and an orthopedic surgeon often causes confusion, as both treat foot and ankle problems. The core difference lies in the scope of their initial training. Orthopedic surgeons (MDs or DOs) complete a five-year residency covering the entire musculoskeletal system, including the spine, hips, and knees.
Orthopedic specialists may then complete an additional year-long fellowship to subspecialize in foot and ankle surgery. In contrast, DPMs have a singular, focused training path dedicated exclusively to the foot, ankle, and associated structures of the lower leg from the start of their medical education. This provides the podiatric surgeon with deep, specialized knowledge of the lower extremity, while the orthopedic surgeon maintains a broader, whole-body perspective.
In practice, both are recognized surgical providers for the lower extremities and often work together in hospital environments. For routine foot conditions or diabetic foot care, a podiatrist is an excellent choice. For severe injuries, complex ankle fractures, or conditions affecting the entire leg, an orthopedic surgeon with a foot and ankle subspecialty might be consulted.