Podiatric surgeons are podiatrists who have undertaken extensive postgraduate training and education in reconstructive foot and ankle surgery. Most podiatric surgeons will have had at least 10-12 years of training and experience in the medical and surgical care of foot and ankle conditions before they begin surgical practice.
Currently, all podiatrists are required to complete a 4 year (or equivalent) undergraduate degree in podiatry to become initially registered as a general podiatrist. All undergraduate podiatry degrees incorporate general medical and surgical studies, as well as specific content related to pathology and diseases affecting the foot and ankle. All graduate podiatrists may administer local anaesthesia and perform minor skin and nail surgery.
To become a podiatric surgeon, a podiatrist must practice as a general podiatrist for 2 years, then complete a Master‘s degree incorporating additional core studies in general medicine, surgery, pharmacology, pathology, radiology and podiatric medicine. Candidates may then apply to sit an entrance examination with the College, and if successful they may enter into an accredited training program as a Registrar. The length of time to complete training will typically range from 3-6 years, and incorporate exposure of up to 2000 surgical procedures, rotations with other medical specialists, overseas and interstate clinical placements, and final examinations.
The award of Fellow of the Australasian College of Podiatric Surgeons is bestowed on individuals who have successfully completed all training and examination requirements set by the College. Only then are they nominated to the Commonwealth government to be a recognised and accredited podiatric surgeon for the purposes of health insurance rebates.
Podiatric surgeons have ongoing obligations to maintain professional competencies as determined by the College and local registration boards.
More information of the ACPS training requirements can be found here.
All podiatric surgeons must be registered in the state or territory they practice, where the respective Podiatrists Registration Board oversees the conduct and activities of surgical practice by individual Fellows of the ACPS.
Fellows of the ACPS are bound by the Code of Conduct of the ACPS, and are subject to continuous peer review, CPD and accreditation requirements set by the College for ongoing surgical practice. Public health and safety in the field of foot and ankle surgery is of prime importance to the College.
The College (and its training program) is currently accredited by the Australasian Podiatry Council, who will be handing over this responsibility to the Australia and New Zealand Podiatry Accreditation Committee (ANZPAC) as part of the requirements for National Registration and Accreditation in July 2010. After this time, the Podiatrists Board of Australia will then be the overarching authority regulating the practice of podiatric surgery.
The ACPS was originally established in 1976 to formally address the needs for the training and supervision of podiatric surgeons in Australia. Prior to then, podiatrists wishing to gain additional qualifications in foot and ankle surgery had to travel to the USA, where podiatric surgeons have been practicing since the 1950‘s.
Individual state and territory Podiatrists Registration Boards hold the authority to oversee and regulate podiatric surgery activities across Australia, under specific podiatry regulations and legislation. All states and territories in Australia allow suitably qualified podiatric surgeons to operate on bone, joint, nerve and connective tissues of the foot and ankle.
Most western countries (such as the United Kingdom, USA, Spain, Canada and New Zealand) have podiatric surgeons working within their health care systems.
Typically, the fees for a podiatric procedure are a combination of the surgical facility fees, the surgeons‘ fees, and the anaesthetists‘ fees.
The costs of different procedures vary considerably according to the complexity, length of stay and need for additional items such as surgical implants.
Your podiatric surgeon is obliged to give you an accurate estimate of these fees upfront, and prior to your surgery. Currently, Medicare rebates are not able to be claimed on the fees charged by the podiatric surgeon or anaesthetist, though the fees for your hospital stay and any surgical implants (eg pins and screws) may be claimed under private health insurance.
Most procedures performed by podiatric surgeons occur in private hospitals or day surgery facilities. Typically, a specialist anaesthetist will be present to provide safe and effective sedation or general anaesthesia, if required. Some procedures can safely be performed just under local anaesthetic, provided by your podiatric surgeon.
Other operating theatre nursing staff will also be present when you have your surgery to ensure that your procedure goes smoothly. Your podiatric surgeon may also have a surgical assistant or Registrar (trainee podiatric surgeon) present to assist during the procedure.
Some minor procedures may be safely performed under local anaesthetic within the podiatric surgeons‘ office.
Other medical specialists may be asked to participate in your care, particularly if you have conditions such as diabetes or heart problems.
Yes. In most (though not all) states and territories of Australia, podiatrists and podiatric surgeons may prescribe a range of medications for clinical problems such as infections, pain relief, and preoperative sedation and anxiety. At this time, Pharmaceutical Benefits Scheme (PBS) cover does not apply to prescriptions written by podiatrists and podiatric surgeons. All podiatrists are licensed to administer various local anaesthetics according to state and territory regulations.
Podiatric surgeons participate in up to 2,000 foot and ankle procedures prior to obtaining Fellowship with the ACPS. The number of procedures that Australian podiatric surgeons take part in throughout their training is currently more substantial than any other international podiatric surgery training program.
The ACPS encourages prospective patients to discuss directly with their podiatric surgeon specific issues such as;
- How many times has he/she performed the proposed procedure?
- What are his/her individual complication rates?
- What alternative procedures might also be effective?
No. As podiatric surgery fees are not currently covered under Medicare a medical referral is not required. However, most patients will still often be referred by their local podiatrist, GP, physiotherapist, or other health professional following a period of non-surgical care. If you have a complex medical history or a taking a range of medications a referral from your general practitioner will aid cooperative management of your medical needs in the peri operative period.
In some situations, such as a WorkCover or TAC claim, a medical referral will be required.
If you would like to see a podiatric surgeon, a list of Fellows of the ACPS can be found here (link).
Please bring any relevant x-rays, scans and your current footwear and any foot orthoses you may have been prescribed for you initial appointment.
Please also bring the name and address of your regular GP, medical specialists and podiatrist so that your podiatric surgeon can liaise with them to ensure your safe and appropriate care.
You will typically be discharged from the surgical facility with verbal and written instructions on post-operative care.
These will include which medications to take, and when (especially for any pain relief), and a direct contact number if you have any concerns or problems.
General post operative instructions for any foot or ankle procedure will include;
- Keep the affected foot/ankle elevate well above the level of your heart as much as possible, particularly in the first few days after your surgery
- Take your pain medications regularly, as prescribed. Applying ice packs to the affected area will usually help control swelling and pain.
- Don‘t attempt to bear any weight through the foot until instructed that it is safe to do so
- Keep the foot dry until advised it is safe to do so
- Do not remove your dressings or bandages unless instructed to do so
Yes. Not every problem requires surgery and it is important to be aware that there are risks associated with any form or surgery. Many podiatric conditions can be easily resolved with conservative non-surgical methods; such as orthotics, footwear modifications, injections, physiotherapy and other techniques.
Your podiatric surgeon may recommend that you seek non-surgical care for your problem if this not has been attempted previously, or your condition is not amenable to surgical treatment. He or she will work closely with your podiatrist, GP and any other health professionals to ensure that this occurs.
Registered podiatrists in Australia who have graduated from recognised accredited podiatric educational programs may be eligible to undertake the entrance examination to become a Registrar with the ACPS. The entry requirements and selection process is competitive, and there are only a limited number of accredited training posts in Australia. Training with the ACPS is a rigorous program incorporating practical and theoretical competencies and examinations. Podiatrists interesting in applying for entry into the College training program may contact us for an information pack.
Podiatric surgeons from overseas will need to initially register with the relevant Podiatrists Registration Board in the state or territory they wish to practice. Assessment of overseas competencies is currently undertaken by the Australasian Podiatry Council (APODC) though this will soon be administered by the Australian and New Zealand Podiatry Accreditation Committee (ANZPAC).
Once general registration is achieved, overseas trained podiatric surgeons may apply to the ACPS for formal assessment of their log book, educational competencies and previous training. Following this assessment, the applicant will require formal assessment of their practical skills and theoretical knowledge via examinations, and be required to undertake additional mentoring or supervised practice. If additional academic qualifications and/or training are required, this must be completed prior to acceptance as a Fellow of the ACPS
The ACPS strongly advises internationally qualified podiatric surgeons to carefully research the Australian Health care system and the current position of podiatric surgeons in this system, prior to making a commitment to emigrate. In Australia, the health system provides no funding support for podiatric surgeons, irrespective of qualification and experience . This will provide a significant limit in ability to practice.
Many complaints regarding health care providers can often be a case of miscommunication or misunderstanding about issues surrounding the care you have been given. The College recommends in the first instance that you contact your podiatric surgeon directly to discuss any issues you may be concerned with, so that they may be resolved quickly.
If you still have a complaint about the care given by your podiatric surgeon, the College can assist you further with your problem. As the ACPS is committed to ensuring the highest levels of care to the public, it will assess any complaint about a podiatric surgeon and, where indicated, facilitate appropriate investigation and management in an open and transparent manner.
Alternatively, you may wish to contact your state or territory Podiatrists Registration Board, who will be able to investigate and assess your complaint, and work towards resolving any issue that may have occurred.
