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For many of those who came from the former Soviet Union, the
word 'podiatry' is unfamiliar at best. This is, however, a roughly
century-old profession which used to be called 'chiropody' in
the old days. It is not unique to the United States, nor it
is only found in the Western hemisphere. Instead, this profession
does exist in Canada, New Zealand, Australia, Belgium, and some
others.
Podiatrists treat ailments of the foot, ankle, lower leg, and
on a rare occasion, knee. The scope of practice is determined
by the licensure of the particular State, ones own training,
as well as the hospital privileges granted to an individual
practitioner. Such variation in the scope of practice has been
due to long-standing heterogeneity in training throughout the
past several decades.
To become a podiatrist, one should have a pretty good idea about
the profession itself and its place in the medical community.
College education is a pre-requisite for admission to the podiatry
school. The school is a four-year graduate education institution
which may or may not be affiliated with major universities in
the area. With basic science classes somewhat similar to the
ones in the allopathic medical school, some of the specialty
subjects are introduced early on. Students star their clinicals
sometimes during their second year in school. There is a mostly
centralized match system for residency applicant nationwide.
Presently, there are seven or eight schools which graduate doctors
of podiatric medicine.
The post-graduate training in the form of a residency is required
by the vast majority of hospitals, professional associations,
in order for privileges to be available to a podiatrist. The
residency training may consist of one to four years, plus an
option of additional fellowships. The years spent in post-graduate
training may be all surgical, include some or all primary medical
training, or any combination of the above. Recently, however,
a more uniform system of residency training has been introduced
by which every podiatric medical school graduate receives a
total of three years of residency training.
Board certification process is established for both surgical
and non-surgical podiatrists (ABPS, ABPOPPM). Podiatrists deal
with the complications of diabetes, ulcers, wounds, bone and
joint deformities, soft tissue inflammatory processes, infections,
skin and nail problems, vascular problems, gait disturbances,
developmental anomalies, and many others.
Podiatrists do not treat systemic conditions such as diabetes,
venous insufficiency, osteoporosis, SLE, or others. They are,
however, trained to recognize those conditions and to provide
proper referrals for their patients. Just like other specialty
doctors.
Podiatrists employ a variety of methods, tools in treating their
patients. Those include Minimal Incision Surgery, External Fixation
techniques for bone procedures (i.e. Ilizarov's devices), partial
and total implants of the foot and ankle joints. We also utilize
Endoscopy and Arthroscopy, Laser and Cryo surgery, extra-corporeal
shock wave therapy, Physical therapy modalities used on-site
or by referral. We systematically take X-rays in the office
and are trained to read them, as well as the CT and MRI.
Aside from technology, we are to provide appropriate patient
care by coordinating it with the patient's primary care provider.
Some recent law changes in certain States allow for independent
hospital admission by a podiatrist. Of course, if the medical
management is needed, as it often is in case of a hospital admission,
an MD is supposed to be consulted for that purpose.
Practicing podiatry is very rewarding for it allows for developing
a very personable relationship with the patients, satisfaction
drawn from being able to help many patients in a short time
frame, practicing both the conservative and aggressive surgical
medicine.
More about podiatry can be found on the American
Podiatric Medical Association's website.
Vadim Glukh, DPM |
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