What are the qualifications of podiatric surgeons?
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 who have achieved scheduled medicine endorsement with the Podiatry Board of Australia 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 will be directly involved in over 2000 surgical procedures, rotations with other medical specialists, overseas and interstate clinical placements, and final examinations.
The Fellowship qualification of the Australasian College of Podiatric Surgeons is bestowed on individuals who have successfully completed all training and examination requirements set by the College. Once FACPS qualification is obtained, the practitioner may apply to the PBA for specialist registration as an 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 the Australian Health Practitioner Regulation Agency (AHPRA).
More information of the ACPS training requirements can be found here.
Who oversees and regulates the activities of podiatric surgeons?
The Podiatry Board of Australia (PBA) is the overarching authority overseeing the regulation of Podiatric Surgeons. Fellows of the ACPS are bound by PBA policies, standards and guidelines.
Public health and safety of foot and ankle surgery is of prime importance to the College. For this reason the College provides an accreditation system for its Fellows. To maintain College accreditation Fellows must abide by the College’s Code of Conduct participate in peer review of their surgical outcomes and meet other College continuing professional development requirements.
The ACPS training program is currently being assessed for accreditation by the Australia and New Zealand Podiatry Accreditation Council (ANZPAC). This was previously undertaken by the Australian Podiatry Council until July 2010.
How long has Podiatric Surgery been a profession in Australia and is it performed internationally?
Podiatric Surgery has been a recognized profession in Australia since 1976 and is performed in all States and Territories. With the introduction of national health regulation through AHPRA podiatric surgery was recognized a specialty surgical profession in 2010.
Internationally, podiatric surgery is performed within the United States, United Kingdom, New Zealand and within many European nations.
What facilities do Podiatric Surgeons operate from?
Most procedures performed by podiatric surgeons occur in accredited private hospitals or day surgery facilities. Typically, a specialist anaesthetist is present to provide safe and effective sedation or general anaesthesia. Some procedures can safely be performed under local anaesthetic, provided by your podiatric surgeon.
Other operating theatre nursing staff will be present during your surgery, providing care and support as part of the surgical team. 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‘ rooms.
Other medical specialists may be asked to participate in your care, particularly if you have a chronic medical condition such as heart disease.
Do I need a referral to see a podiatric surgeon?
No, but most patients are 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 are taking a range of medications a referral from your general practitioner will aid cooperative management of your medical needs. 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. (insert link to list of current fellows) You should check that your surgeons is:
A registered specialist
Holds FACPS qualification
Hold current certification of compliance with the ACPS accreditation program
What should I bring to my initial appointment?
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.
What will happen after my surgery?
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 elevated 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, or unless, 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
Your podiatric surgeon may also involve your GP, podiatrist, physiotherapist or medical specialist in the care of your foot or ankle condition during the post-operative period.
Are there alternatives to surgery for my foot or ankle problem?
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.
I am a podiatrist. How do I train to become a podiatric surgeon?
Podiatric surgeons from overseas will need to initially register with Podiatrists Board of Australia. 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.
I have a complaint about my podiatric surgeon, who can I speak to?
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 the Australian health practitioner regulation agency (www.ahpra.gov.au) who will be able to investigate and assess your complaint, and work towards resolving any issue that may have occurred.
I didn‘t realise podiatrists could perform invasive surgery. How long have podiatrists been practicing surgery in Australia?
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.
The Podiatrists Board of Australia hold the authority to oversee and regulate podiatric surgery activities across Australia, under specific podiatry regulations and legislation. 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.
What are the costs for podiatric surgery?
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.
How much experience does my podiatric surgeon have in the procedure I require?
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?
Podiatric surgeons during training also rotate through centres of excellence in foot and ankle surgery within both the United Kingdom and the USA. This reflects the high standards set by the College.
I am an international podiatric surgeon, how do I become accredited to practice podiatric surgery in Australia?
Podiatric surgeons from overseas will need to initially register with the Podiatrists Board of Australia. Assessment of overseas competencies is currently undertaken 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.