A Doctor of Podiatric Medicine (DPM) is a specialist devoted to the health of the foot, ankle, and related structures of the leg, often referred to as the lower extremity. The DPM degree signifies a physician who has completed medical training on the diagnosis, treatment, and prevention of disorders in this area. Podiatrists manage a broad spectrum of conditions, ranging from common skin and nail issues to complex biomechanical problems and injuries. There is often public confusion about the exact scope of their medical and surgical authority compared to other medical professionals.
Defining the Podiatric Surgeon
A podiatrist with the appropriate postgraduate training holds the title “Podiatric Surgeon,” which is widely recognized within the medical community. The profession encompasses both medical and surgical treatment methods. The DPM is licensed to prescribe medications, set fractures, and perform surgical procedures on the lower extremity. The scope of their surgical practice is concentrated on the foot, ankle, and often the lower leg, though precise boundaries are defined by state licensing boards and hospital credentialing.
Podiatric surgeons commonly perform a variety of procedures, treating structural deformities, trauma, and joint conditions. This includes elective procedures such as bunion correction, hammertoe repair, and flatfoot reconstruction. They also manage acute injuries like tendon and ligament tears and complex fractures within the foot and ankle. Many podiatrists choose to focus primarily on non-surgical treatments like orthotics, physical therapy, and wound care.
Their practice involves addressing local manifestations of systemic diseases, such as diabetic foot wounds, which often require debridement or reconstructive surgery. They are trained in the musculoskeletal, neurological, and vascular systems of the lower extremity.
Education, Residency, and Certification
The pathway to becoming a Podiatric Surgeon begins with four years of undergraduate education, followed by four years of study at an accredited podiatric medical school to earn the Doctor of Podiatric Medicine (DPM) degree. The DPM curriculum covers foundational sciences like anatomy, physiology, and pharmacology, structured similarly to that of allopathic and osteopathic medical schools.
Upon graduation, the physician must complete a three-year hospital-based residency known as the Podiatric Medicine and Surgery Residency (PMSR). This training program provides competency-based experience in both medical and surgical patient management. Residency rotations often include exposure to internal medicine, general surgery, anesthesiology, infectious disease, and emergency medicine, providing a broad medical foundation.
Many residencies offer advanced training that includes reconstructive rear foot and ankle surgery. The final step for many surgical podiatrists is to achieve board certification through an organization like the American Board of Foot and Ankle Surgery (ABFAS). This process involves a review of surgical case logs to validate expertise, which is often required for obtaining hospital surgical privileges.
Distinguishing Podiatric Surgeons from Orthopedic Surgeons
The primary distinction between a Podiatric Surgeon (DPM) and an Orthopedic Surgeon (MD or DO) who specializes in foot and ankle lies in the focus of their initial medical training. Orthopedic surgeons complete a general medical school education followed by a five- to six-year residency that covers the entire musculoskeletal system. They then typically pursue a one-year fellowship for sub-specialization in foot and ankle surgery.
A Podiatric Surgeon, conversely, enters a medical school program that is exclusively focused on the foot, ankle, and related structures. Their subsequent three-year residency is also dedicated entirely to the lower extremity. Both professionals treat many of the same conditions, such as fractures, bunions, and arthritis of the foot and ankle.
While the scope of a DPM is concentrated on the foot and ankle, an orthopedic surgeon’s training provides a whole-body perspective on musculoskeletal issues. This perspective can be beneficial when a foot problem is linked to conditions in the knee, hip, or back. For routine foot conditions, the Podiatric Surgeon is the specialist, while severe trauma or advanced procedures like total ankle replacement may involve the orthopedic foot and ankle specialist.