A Doctor of Podiatric Medicine (DPM) is a physician and surgeon who specializes in the prevention, diagnosis, and treatment of conditions affecting the foot, ankle, and related structures of the leg. The training DPMs receive includes extensive medical and surgical education, qualifying them to treat a wide range of lower extremity disorders. Podiatrists are licensed to perform surgery, often functioning as specialized foot and ankle surgeons within the broader healthcare system. This surgical capability allows them to correct deformities, repair injuries, and alleviate chronic pain that has not responded to conservative treatments.
Professional Scope of Podiatric Surgery
The surgical practice of a podiatrist focuses on the lower extremity. Podiatric surgeons treat complex conditions involving the musculoskeletal, neurological, vascular, and dermatological systems within this anatomical region. While the exact limits of practice vary by state, nearly all states permit comprehensive treatment of the foot, with the majority also allowing procedures at or above the ankle.
To perform surgery in a hospital or surgical center, a podiatric surgeon must maintain a valid, unrestricted state license. They must also obtain specific hospital privileges, which are granted by the institution based on a review of their training, board certification status, and surgical competence. The scope of privileges reflects their specialized education and focuses on reconstructive, trauma, and elective procedures of the lower limb.
Training and Certification Requirements
Becoming a surgical podiatrist requires four years of undergraduate education, followed by four years at a college of podiatric medicine, resulting in the Doctor of Podiatric Medicine (DPM) degree. This medical school curriculum is comparable in length and intensity to allopathic and osteopathic medical schools, covering basic sciences and general medicine. There is a strong emphasis on lower extremity specialty education starting early in the program.
After medical school, prospective surgical podiatrists must complete a hospital-based residency program. These post-graduate programs, known as Podiatric Medicine and Surgery Residencies (PMSR), provide substantial training in general surgery, internal medicine, and emergency medicine. They also include a high volume of foot and ankle specific surgical cases. The final step in formal credentialing is board certification, most commonly sought through the American Board of Foot and Ankle Surgery (ABFAS).
The ABFAS offers two distinct certifications: one in Foot Surgery and another in Reconstructive Rearfoot and Ankle (RRA) Surgery. Achieving board certification involves passing comprehensive didactic examinations and a demanding case review process. This process verifies the surgeon’s experience and competency across a diverse range of surgical procedures.
Common Surgical Procedures Performed
Podiatric surgeons routinely perform a variety of procedures to address both common deformities and complex traumatic injuries of the foot and ankle. Among the most frequent elective surgeries is the bunionectomy, which involves removing the bony bump and realigning the joint at the base of the big toe to correct the deformity known as hallux valgus. Hammertoe correction is also common, which straightens the contracted joints of the lesser toes by releasing tendons or removing a small segment of bone.
Podiatrists perform procedures like plantar fascia release to alleviate chronic heel pain from plantar fasciitis that has not responded to non-surgical care. They also perform neurectomies to remove benign enlargements of nerves, such as a painful Morton’s neuroma. These procedures aim to restore function and relieve pain caused by nerve entrapment or inflammation.
Podiatric surgeons are trained to manage complex reconstructive and trauma cases. This includes the open reduction and internal fixation of fractures in the foot and ankle, often using plates, screws, or pins to stabilize the bones for proper healing. They also perform advanced procedures such as ankle arthrodesis (fusion) for severe arthritis or reconstructive surgeries to correct acquired flatfoot deformities, which may involve tendon transfers and osteotomies (bone cuts).