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Podiatrists needing post grad education/training?

Discussion in 'Australia' started by matthewkeating, Oct 26, 2006.

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    hi all,
    I wanted to throw this one out there... currently doing a masters paper arguing the necessity for podiatrist to undertake post grad training and education. The point to argue is whether the profession has changed greatly in the last 30 years or so in relation to health care in Australia. What are the thoughts out there?
    Any ideas on literature/research to substantiate any arguements?
    cheers,
    Matthew Keating
     
  2. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Matthew,

    The profession is moving towards graduating podiatrists form undergraduate degrees with prescribing priveleges restrcited and/or controlled drugs; this is likely to be immenent in Victoria, and there are rumblings from Western Australia that it will be on the cards before long. This is an important issue that will affect all the currently registered podiatrists, as they will need postgraduate upskilling and education.

    Surgery is another issue, that you may want to liase with the Australasian College of Podiatric Surgeons about, as they require specific units within an approved Masters degree for training in this area.

    I'm not sure about the Sports Podiatry community, and any of their requirements for postgraduate education for Fellowship.

    Hope these help,

    LL
     
  3. Tuckersm

    Tuckersm Well-Known Member

    Matthew,
    The profession has changed over the last 30 years but so has the UG course. It has moved from a 2-3 years associate diploma to a 4 year degree (Newcastle excepted). The vast majority of pods don't have higher degrees, hence why there are not podiatry specific post grad courses widely available, the podiatrists don't see the need for them. Apart from in the Victorian Public sector (they pay a HQ allowance of about $80 per week) or for Pod surgeons (who need a masters to become fellows) their is no economic insentive to gain a higher degree. That may change if podiatric specialty areas are established and recognised.

    Re; Research articles: There is little published on the activity of podiatrists in Australia, or elsewhere in the world, (I looked at Acute OP Podiatry Activity for my Masters) so it is difficult to track a change in practice, but it may be worth reviewing Australian published case studies (in AJPM or its predicesssor Australian podiatrist) over the last 30-40 years, which may provide some information on new techniques, otherwise their are a number of health policy texts which track the change in the delivery of health services over time, eg: The Politics of Health by Helen Gardiner,

    Good Luck
     
  4. Post graduate training for podiatrists

    I did post a thread on this topic but not sure if it made it through; and I am wondering what the general consensus is out there on post graduate training and education? Has the profession changed enough to warrant post graduate training? I feel working in the public sector as opposed to the private sector has a great impact on this thought.... does anyone have any research they know of to support the need for post grad training?
     
  5. pgcarter

    pgcarter Well-Known Member

    How about considering the angle of What sphere of practice do you want to spend your time in....primary care? wounds? functional gait stuff? and can you actually learn more about these things in a formal learning situation or can you read and think and develope your skills without paying $20k for a masters. The health education world is about to be tipped on its head in Aus with common 1 or 2 year starts to lots of degrees and all specialty stuff done in fewer years (1 or 2) at the end....less will fit so the width of training for undergrads will decrease....so if there is not a need now there soon will be.
    There is not much being offered around Aus in terms of post grad tickets....and what do they do for you anyway?....after all you can do a weekend course in manipulation of the foot and this apparently gives you access to huge magnitudes of secret knowledge and expertise that you can then use to take $2k off patients while telling them that "isn't it great, you don't need orthoses any more". Amazing wall of fame using patient testamonials at one local practice...in specific contravention of advertising advice from rego board.
    If any one knows of a good post grad course offering value for money I'd be keen to know about it....
    regards Phill
     
  6. Tuckersm

    Tuckersm Well-Known Member

    Phill,
    If you have evidence of a podiatrist in breach of the Podiatrists Registration Act you should inform the Board so that it can be investigated and if warranted action taken.
     
  7. pgcarter

    pgcarter Well-Known Member

    Hi Steve
    Is it still true that advertising by patient testamonial contravenes the rules?...it used to be.....I'll have to take my camera and visit the place for myself....at this stage it is only a report from a person who went to the all singing all dancing revue evening in order to hear the new gospel prior to writing out the big fat cheque....and then decided to seek further advice.
     
  8. Atlas

    Atlas Well-Known Member



    You speak a lot of sense Phill.

    I should be completing my masters degree in physio by next year, and while I have benefitted, I am not sure that I got $15,000+ worth of knowledge. I think if you are lucky enough to have good employers (first job) and mentors etc., you can get much more than $20,000 worth, for nothing.

    Formal learning these days is extensive exploration of quality research. Much of it is giving critical analysis of various studies. IMO, if a profession wants better clinicians, short intensive clinically-based courses in a chosen sphere is the way to go. IMO, this may be more potent than adding an extra year to a diploma/degree, and/or going the post-graduate masters route.
     
  9. Cameron

    Cameron Well-Known Member

    Matthew

    > arguing the necessity for podiatrist to undertake post grad training and education.

    Parrity with other professional groups - respectable professions do it and the standard is set for others to follow. You can link this to the big QA initiatives such as Access to Primary Health Care and global acceptance developed countries have the infrastructure (public health systems) to make this possible. Part of which was the development of professional competences associated with professional registration. This focus came as we approached the MIllenium change

    Acceptance of a written culture (based on scientific method) and reliance on evidence based practice both necessitate the need for professionals to continue to update. This was not the case thirty years ago.

    Profesional automomy and need to ensure all members complete CPD. The introduction of managed care and preferred providers all enforced the need to have a work forced suitably trained and throughly conversant with contemporary issues. Again these are new initiatives.

    >The point to argue is whether the profession has changed greatly in the last 30 years or so in relation to health care in Australia.

    Ironically podiatry has not changed that much in the last thirty years (take a look at the podiatry textbooks over this period) but what has changed is the health industry which podiatry is on the fringe of. Major changes here and many windows of opportunity have presented themsleves necesitating retraining. Charting changes to bureaucratic organisation like the public health service would provide evidence to supoort this.

    Sterling works aside, the vast majority of podiatry in the world is directed towards pedicure and podicare (hence the difficulty that sometimes exists when trying to delienate the difference between podiatrists and pedicurists). Plenty evidence from legislation in Australia and the UK where due to the importance of anticompetitiveness has meant less prescriptive defintions appear. This means it is now essential for all modern practitioners to be seen to keep up to date.

    Scope of practice has remained remarkably stable over the last thirty years with the largest majority of podiatrists chosing to do the work they do (largely a narrow spectrum of skills) determined by personal preference and or their client demography. A very small minority of practitioner specialise (less than 10% of the total profession see Apod C stats) but in doing so this proactive group have set post basic education programs for others. These exist but pardoxically are not that popular, generally speaking. This is likely to reflect course flexibility, accessability and deliver, and costs.

    Finally people on average will change their job at least three times in a lifetime, hence the need to undertake post gradaute studies may facilitate job mobility. People coming back into the profession again would require on going training.


    All the best with the essay

    Cameron
     
  10. Tuckersm

    Tuckersm Well-Known Member

  11. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    I concur wholeheartedly.

    I have recently completed a Master of Podiatry degree.

    Whilst it is useful to have this piece of paper for various reasons, nothing in the entire degree has allowed me to go out and practice with an increased scope, or with newer skills.

    To contrast, my wife (a podiatrist) and our associate at the practice, attended a 'fantastic' acupunture/dry needling course a couple of weekends ago. Intensive, hands-on, practical skills acquisition. Monday morning they were able to put these new skills into practice, and have been thrilled at the additional treatment options they can provided to patients. As well, there is the professional stimulation of being able to offer more than general podiatry care and pieces of plastic.

    After half a dozen years of study and countless hours of practical surgical training, I am still yet to be able to offer any new service to my patients...

    Why not change the postgraduate paradigm to short intensive programs to upskill registrants in a new procedure/technique, that they can gradually phase into their practice.

    LL
     
    Last edited: Nov 16, 2006
  12. Cameron

    Cameron Well-Known Member

    LL

    This is a frustration which is shared by many people. I undertook a research project in WA in 1994/5 to measure attitudes in relation to post basic education. The WA pod population had a remarkable number of practitioners who undertook post basic training/education either as CPD or academic endveour. At the time there was no specific driver to encourage this amazing uptake from a profession which is nore normally inspired by mandates.

    I presented the findings at a conference some time back but from memory the survey results strongly came out in favour that podiatrists preferred craft over thought and were disapointed to discover the academic qualification did not extend their scope of practice (and could not charge more for their services), and were frustrated that CPD was not equated with academic equivolence (after all the money they had spent). These sentements are much in line with your posting.

    Several years later I undertook a national survey of podiatrists and found more or less the same findings. As a result our department put together a post graduate career which linked directly to CPD. As authors we worked on the assumption the vast majority of registrants would not complete their academic pathway but would benefit more practically from their acquisition of the individual units. The other thing we discovered from the survey was exisiting academic programs at university were too inflexibile in delivery mode and were severely constrained by time. Both aspects were less favourable to female students but the academic model preferred male students.

    What say you?

    Cameron
     
  13. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    Cameron,

    Being familiar with the PG coursework that you developed, I still see several upcoming issues in Australia.

    Legislative:

    Depending on how, and when national registration occurs for podiatry, this may test the spread of differing academic and CPD proficiencies across Australia. Consider drug prescribing.

    If Victoria is bringing in a system that enables new graduates to prescribe (and older registrants with postgrad qualifications - Steven, step in if this is incorrect), then how will this transfer to a nationwide system, or even with mutual recognition between states. I see prescribing as the new bandwagon that everyone (in the UK also) will be getting on board for in the next 5 years. Do we need older registrants to have a Grad Cert, a PG Dip, or a Masters? Could it be just a series of CPD activities and an exam?

    How will Boards, the professional association, and Universities split the responsibilities (or profits :rolleyes: ) of training and upskilling?

    I remember the words of a DPM who taught me. He would tell me stories of his early career in the States where he would attend weekend courses in a new surgical procedure (eg hammertoe), then put it into practice on Monday. His base degree, and the legislative framework, allowed him to acquire new skills, without formal additional qualifications form a university - as the profession was the provider of the new knowledge base.

    Apathy

    Unless, as you say, there is a mandate from Boards to compel people into additional studies, then 95%+ of the profession is content in their own sphere of practice. If a postgraduate qualification really allowed the practitioner gain competentcy in advanced scope of practice, then these courses would be flooded with applicants.

    Health Workforce Reform

    The Federal Government want more health providers, coming out faster, with broader generic skills (eg BP measurement, diabetes assessment skills etc). A new class of generic health worker is on its way, and specialised activities will be postgraduate persuits. How does podiatry fit into this? Where is the debate at senior levels of the profession on these issues?

    There are winds of change brewing, which will affect the UG and PG education sector, and the profession needs to be debating this points, and others we perhaps haven't even considered yet.

    What say Cameron?

    LL
     
  14. Cameron

    Cameron Well-Known Member

    LL

    In total accord. I have been a voice in the wilderness for donkey's years. Was around when the Croydon Post Graduate group (England) ran CPD courses which eventuated in the Podiatry Association (UK). My comments then were as of now and that is the major developments come from practitioners and not the educational centres.

    Keeping abreast of professional development is less pro-active than a radical like me would want but this conservative approach may be for the best of reason and the greater good. However as the rules change outside podiatry, then a head in the sand conservative approach may be seen to be out of step and inapproriate for whgat lies ahead. Plenty examples of this have been discussed on the Arena and Mark (Russell) has eruditely outlined these in his postings

    Restricting our conversation to the Commonwealth countries as North America is slightly different what has happened in the UK is likely to be mirrored elsewhere. The impact of HPC and national educational policies which prefer equity and equal opportunity (I have no problem with that) is likely to change the face of professional education as we know it and pu many sacred cows to the sword. Evolution or revolution?

    Rather like the super tanker effect, keeping a nice tidy ship without looking where you are going will only ensure when you hit the bottom of the sea after bumping into the iceberg, all things are shipshape and Bristol fashion. :)

    Cheers
    Cameron
     
  15. LCG

    LCG Active Member

    From my point of view, in the present scope of legislation, I consider the post graduate program quite useless for many of the reasons mentioned above. However, with current health reform this hopefully (fingers crossed ) should change. On the topic of post vocational education, what do others think about the accredited podiatrist program. I remember when the program was first released there were rumblings that podiatrists would need to be "acredited" to provide third party care, ie. DVA patients, TAC and workcover. Can anyone realisticly ever see this happening? Could this encompass medicare funded patients as well? I think it would be great for the professional recognition of podiatry if such a push was forthcoming, but I hardly see it on the horizon. The only real benefit I get from being accredited is a small discount in my association fees. Any thoughts?
     
  16. LuckyLisfranc

    LuckyLisfranc Well-Known Member

    LCG

    In terms of 'accreditation' models, there is certainly a precedent in General Practice, with the accredited GP program, which allows practices to receive additional payments from HIC for having met a certain 'standard' (eg facilities, procedures, staffing etc).

    I see this more as using/wasting additional taxpayer money to 'prop up' the cottage industry of GP practices, when it would make much more sense to consider alternative models for delievering primary health care..but that is a different argument for another day.

    Rewarding practitioners who endeavour to push their professional skillset beyond basic competence would be a reasonable 'carrot' though, and should be worthy of debate. Typically the people who do not participate in professional forums such as Podiatry Arena (read: apathetic?) are the ones most difficult to convince. Maybe if there are any State DVA Podiatry Advisors out there they might pick up on this?

    Being over in the UK recently, I observed the potential career benefits of the "Agenda For Change" career ladder in the NHS. I was impressed at how this rewarded podiatrists, who had advanced training, by providing them with a mechanism to strive for prestige Consultant posts, with similar professional kudos and income to equivalent medical practitioners. How this could ever transpose into the mainly 'private practice' based podiatry industry of Australia would be a very difficult challenge.

    Once more I lament the tiny political influence of our meagre profession in this country, when the UK and US seem light years ahead in terms of 'real' career opportunities. If only the weather was as good up there... :rolleyes:

    LL
     
  17. Podiatry777

    Podiatry777 Active Member

    I found it very interesting how certain threads attract a huge audience yet few members respond. That can be a clue in what the audience wants from the profession podiatrists or otherwise. Do the moderators watch and study this?

    Perhaps the focus needs to be on "Lower LImb Specialist?" Then run fast to practically bridge all gaps in expertise and training to answer such a statement. When I consider this slogan I think, what do I need to know to consider myself such. Else we all get lost in Pedicure, specialise in a single area of Podiatry, have fantastic and expensive Post Grad Qualifications-talking angles and joints but do little help the public, and allow the FEW to do all the work for the profession. And perhaps somewhat ashamedly I have.

    I see some obsticles that need to be rammed down.

    1./ OP scores need to be uniformally high to attract thinkers with a dual hands on talent.
    2./ There needs to be a clear call and reward for practitioners to share their discoveries through their own experience and exposure. Not expensive Masters that most find impractical on daily clinical level.
    3/. Up skilling for anything less than bachelor level practitioners is a must (I think its happening?)

    In short-UNIFY the profession as a TOP Priority so more numbers join, job satisfaction remains and intelectual level stays high for select few interested in research. Research that translates to clinical expertise also, please. This should lead to increasing power to persuade the beaurocrats for any changes needed eg. medicare, X-Rays subsidy, etc...

    A window of opportunity is here as the health profession is restructuring, but it will shut again with little, slow changes to follow once again. Let's hope Forums like this inspire the 'drowsy' out there sitting on their skills and gained knowledge, and students wondering what is Podiatry really all about.



    Nurses and teachers are high in number- they get what they ask for from the government. They can even strike regularily -I'm not an advocate of this but their influential ability is obvious.

    Drugs prescription is a start and needs to run hard and fast in all states. Physical therapies like ultrasound-clear in decades of therapaudic usage and increased patient satisfaction and monetary rewards should alert us to let's go that way and study, implement, and enjoy being a Podiatrist treating our area of the body with all safe modalities available!

    Untill we stop demanding top dollar for association fees and P.G. courses in a profession that doesn't offer same standard rewards as others, who would want to invest their own time and money? Bridge knowledge gaps in hands on will increase Podiatry usage to the public. Our improved statistics will do the rest for us. Immediate financial and clinical gain for Podiatrists will increase the enthusiasm that almost died for me since graduating over a decade.

    I started Masters-waste time and money-Quit early(poor investment). Enrolled in Different Professional course for carear change.-Quit as felt lacked a natural talent.

    So I'm stil here looking at any changes a decade on. Intellectually and hands on talent for me is stil a match.
     
  18. admin

    admin Administrator Staff Member

    yes...
     
  19. Podiatry777

    Podiatry777 Active Member

    Sorry, dumb question, the forum is well structured, hence I'd expect you must be. :eek:

    It is clear with all the Diplomas and rare Bachelors shown by admin in another thread why the profession is slow to change in Australia-self preservation. How are we going to motivate Podiatrists who shot low to shoot high?

    Perhaps clinical systems linking closest to theories emphasis. I think I'll post pone my grandoise surgery ideas for yet another decade or 10. I hoped when kids grow up I'll reconsider. That UNIFORMITY of educational standards is going to be a BATTLE!
     
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