Podiatry crisis point in Australia

Al Kline said:

"Call it what you may, but PODIATRY in the rest of the World is not PODIATRY at all, but CHIROPODY. I just don't see that level of expertise in the rest of the World, sorry. Facts are facts, the educational requirements to call ones self Podiatrist doesn't compare to our system in the US"​

I guess it's nice to see someone being so patriotic about their profession's educational system. Good for you. However, I suggest that you refrain from further criticising the system in other countries until you have at least a basic understanding of the differences in both the historical development and current status of educational and healthcare structures.

Regards,

Hylton

 

Yes...facts are facts....and then there is this other thing....called opinion.
I don't "put anything over my windows" when I think about other peoples opinions....they are entitled to them.
Regards Phill Carter

 

A rose by any name...

Hey Al,

We are fortunate in Australia to have a system of Tertiary education which offers outstanding education at an undergraduate level leading to fully qualified and competent professionals in a range of areas, including Architecture, Engineering, Teaching, Podiatry, and gosh, hang on, even Medicine. Yup, our Doctors graduate after only 6 years at Uni (and a few more in supervised practice). It is simply a different system. (Perhaps we work the buggers harder - ain't much partying going on down here, the kids I teach are sweatin'.)

Although there are some courses which are completed at a Post-graduate level (that is, after the first degree), most of these lead to specialisation rather than preliminary qualification. The emphasis of most postgraduate education in Australia is on research and development, which contributes significantly to the body of knowledge and practice in our profession.

We do indeed have a goodly number of Podiatry folk around these parts who call themselves Doctor. These are people who have either completely long, arduous residencies, as well as Masters degrees, to become surgeons; or are those exceptional few who have earned the extraordinary distinction of gaining a PhD.

The rest of us are not called Doctor, because we don't need to be. Sometimes skill speaks for itself.

I too believe that the education system in the USA has produced brilliant Podiatrists, has led the world in so many areas of understanding and practice, and has been an inspiration to many of us. But, my friend, it is not the only way.

In friendship

Felicity Prentice

 

Felicity,
I'm glad somebody else notices the words.....my windows remain uncovered.
Regards Phill

 

well done

 

Podiatry crisis, Australia!

Hi Al.,

Felicity has pointed out the use of the word "Shutter." I was happy to let shuttering something up with the "trembles" pass me by??? I'm good at mixing my there's with my their's you know, too!

However, the thing that grates with me and gets right under the skin is your use of 'ignorance/ignorant' with something else in your postings. As a Northern Englishman the use of those two words are usually taboo, breaking the norm/rule in the use of good English. I excused you many times before because no one is immune from the misuse of English, especially, (The Americans), no I really mean me!

Quote, "No ignorance intended, [Post no. 41 above?]." If I were to go down to my cities main street on a Saturday night and used that phrase or something like it with ignorance in my voice, I would be pleased and relieved to wake up in the local hospital on Sunday morning with all my spare parts still attached!!!

Do you mean what you say, 'No ignorance intended!' That to me means that you are insulting yourself, and I don't believe you mean that surely? Could it be 'No offence intended,' possibly? (Or something similar!). You see it's bad enough changing the English amongst the English but to do it amongst the Aussie's, that can be a Little Risky! As bad as my trying to spell Aussie whilst using my US. ieSpell Check here can be???

This is not to try to put you down I assure you, using versions of the word 'ignorant' tends to raise heat automatically amongst the English, and that bunch down under, using it could be very risky as posts are showing, (Felicity/Virginia above!) Try to think of a more neutral word when tempted to use, IGNORANCE please! You see it grates on the ears. Further more when in extreme pain on this Forum "It brings Tears to the Ears!!!

Now can we let the Australians get on with their own little problems! I don't know what Admins going to make of this, it could be nasty!

Yours sincerely and with regards,

Colin. (No insult intended, I'm sure you are mixing Americanisms with English!).

P.s.: I wonder whether if I had used 'Ignorance is Bliss' in Australia I might have been 'Crocodiled Dundee-ed???'

P.P.s.: My Spell check got it right on the Second time, Only joking fella's!!!

 

Aussie Podiatric Surgeons

Hi all

Just wanted to suggest to Al to visit the Australasian College of Podiatric Surgeons website.
Our surgeons undergo an intensive and extensive training programme that includes spending time in training in the UK as well as in the USA (Atlanta). The level of training and competencies achieved by registrars at various levels are continuously evaluated and culminates after upto 10 years for training with a final exam which involves evaluation of performing a surgical procedure in theatre.A partnership has been established with the Podiatry institute in Atlanta and will be further strengthened in due course. If you have any doubts as to the competency of Australian trained Podiatric surgeons I suggest you contact Craig Camaster in Atlanta. In summary Podiatric surgeons in Australia are as competent to their colleagues in the mighty USA.

Yusuf

 

> Sorry if I set off a few nerves, no need to change the English language. However, there is a huge difference between Chiropody and Podiatry as seen here in the United States. Firstly, we don't even use the term in the US and any inference to Chiropody brings us back to the 1940's. Call it what you may, but PODIATRY in the rest of the World is not PODIATRY at all, but CHIROPODY.

The work of the foot physician in both its narrowest and broadest scope covered within both terms i.e. the study of foot care by the hand (chiropody) and someone who treats the foot (podiatry). The latter is more acceptable from a language point of view because it involves only a Latin prefix and not the Greco-latin prefixes-Chiro and Pod, in chiropody. So podiatry is a more accurate term and one more accepted by 21st century foot practitioners. As to what is practised within the title varies within nations as well as across the globe. Professional bodies keen to promote their membership and safeguard their best interests have promulgated protectionism and restricted practice combined with custom and practice. Subsequently there is a degree of artificiality in delineating differences between the two terms. This does not stop people from doing it, however. All perfectly understandable and as witness by the good-humoured sensitivities caught within the postings rather too close to call.

Be assured Al, if Felicity says it is true, then it is true.


The US is in its position of acceptance, largely in the medical and lay community, because of our political prowess and advances in Podiatry as a well-established discipline. Much has been made in the advancements of foot surgery and the understanding of foot biomechanics published here in the US. Most of the World regards Podiatrists to be experts in the foot and ankle including its biomechanics and surgical reconstruction there of. This is mainly, in part, to the acceptance gained here in the United States.

Can I ask have you been outside the US? The reason I ask is the feeling you clearly articulate may not be as well accepted outwith as within.

The move towards the public university system in the US has been the best move the US profession could make and by doing so is beginning to establish an intellectual basis for what has been good clinical practice. I would think all that you hope for in podiatry would come via this route and in combination with the global experience.

I just don't see that level of expertise in the rest of the World, sorry. Facts are facts, the educational requirements to call ones self Podiatrist doesn't compare to our system in the US.

Agree but would add respectfully North America is not (yet) the be all and end all of civilisation. A matter of time, no doubt.

I shutter to think of someone doing surgery on my foot without any formal training.

You are certainly not alone there.

Maybe the rest of the World is riding off the coat-tails of our hard work and political strife and just calling them Podiatrists, but are rather Chiropodists?

I suppose we have to thank the French for all of it anyway and the UK and the US only plagiarised it.

I wish you luck in gaining the political strife and acceptance that we have so long and arduously worked for here in the states. I would like to see the day when our World is more uniform in its requirements for such a great profession.

Outside the States the impact on the foot care profession has been driven from above and is despite the sterling works of countless individuals across the globe to better the chiropody/podiatry standing. Sweeping government changes in the UK have recently impacted on the job role of thousands of practitioners working in the public sector. It is yet to be seen whether this will benefit the profession overall or not. But it will change it.

The same external stimulus was witnessed in the US with the introduction of Managed Care and to a lesser extent when they recently removed podiatry from public funded health insurance. Practitioners no longer able to print money needed to diversify into chiropody and cosmetic surgery. I refer you to the 60 Minutes program (ABC) with the articulated concerns relating to malpractice and the diverse practice sometimes unlicensed within North America. US professional bodies were very concerned about this anomaly within their ranks.

In the end the foot world is evolving and more likely to grow into a homogenous species. Welcome to the global village.

Cheers
Cameron
Hey, what do I know?

 

OK, did some research, and it seems I owe everyone a huge apology. It seems that I did not understand the differences in educational requirements for podiatry, let alone, other areas of medicine overseas. I recently spoke to an orthopedic surgeon from Canada, who went to school for 6 years (for a fraction of the cost here in the US). Got his masters and MD degree, came to the US, was exempt from taking the flex examination and underwent residency here in the US. I guess I'm a little jealous, after spending over $100,000 to get my degree. It's opened my eyes to the capitalistic differences in education here in the US.

It seems the US still has differences in the way we view other areas of the world when it comes to education. This is probably a 'deep rooted' attitude based in our society. i.e. "We have the best education in the World, blah blah blah"

With all that said, I would still like to see a uniform program for Podiatrists to undergo surgical training. I'm sure your boards are working toward those goals. Good luck!

 

...and a lot more besides. However if some of your fellow countrymen, including your near neighbour in Crawford, had just a little of your humility, what a different place the world might be.

Graduate debt is a real bugger and unfortunately we seem to be following suit, without, I'm afraid to say, the same earning potential as yourselves. I rather liked the anarchic advice offered by one of our more colourful parliamentarians recently on the question of student loans. Immediately upon graduation, make yourself bankrupt. The system would soon change.

Best wishes

Mark Russell

 

Well, our little buddy down the road in Crawford has just tried to pass sweeping legislation to close the bankruptcy loop-holes! lol

 

devils advocate

Following the earlier thread of pod shortages and government marginalisation...

Well if the government doesn't want to run the course, and if they do the students will be full (or close enough) fee paying - why don't the pod's of NSW (aust) provide a private course with govt grants.

(that ought to get people thinking!).

Virginia.

 

Foot Care Nurses

" As an Endicrinologist is to a Diabetes Educator, perhaps we can be to those nurses who wish to performBASIC foot care. " Now you're cooking Andrea, how refreshing to hear a positive way of incorporating your health professional team! Clinical nurses must incorporate reviews from ALL the Allied Health Services when compiling care plans to ensure thorough Primary nursing care standards are met, especially in residential care to promote mobility - sadly, the shortage of podiatrists in Oz often leads to omissions. Therefore, dare I suggest, the foot care course for Nurses would fill the HUGE gap?
Would appreciate any comments - Anita

Just my thoughts . I'd love to hear other people's thoughts.
A[/QUOTE]

 

BSc vs DPM

I don't mean to be a downer in this forum, but can you really support the notion that a Podiatrist deserves the distinction of "doctor of Podiatric Medicine or DPM" after only having trained after 3 or 4 years of High School Education?

the answer to Al Kline DPM is we are not classified as Dr s after our three or four years, not do we expect to be. This time period is perfectly adequate for the role of Podiatrist as far as Australia see s it (not going into the arguement of the flexibilty of our Podiatry Acts), in which the only surgery they perform is generally nail phenolisation and VP curettes.

Our service is to provide all possible conservative treaments before resorting to surgery. As for saying the world podiatry community should follow the US standards, the rest of us are Podiatrists, not podiatric surgeons. We have terrific podiatric surgeons and we do not need to all be surgeons.
Would a US Podiatrist (ie a Podiatric Surgeon) exhaust conservative options before resorting to surgery? Obviously proceeding straight to surgery is necessary and advantageous is certain cases, but not all.

Proudly, Tully, BSc

 

just wanting to say I didnt realise there was the whole 2nd page of this discussion- apologies from the new girl for most of above already being written!

I will say I work in the VIC public system, 4hrs from Melbourne, and although the starting salary for a new grad here is in the $50G bracket, it is a sad state of affairs when we cannot recruit Australian new grads, indeed and Australian Pods to work here, often there is only one podiatrist when we are funded for 3FTE (three full time podiatrists).

We are now advertising overseas. Our town here is 10 000 with a catchment area of 26 000 and we are funded for three podiatrists, and I know in another state there is a town of 18 000 (also four hours from the state capital Perth), with a catchment area of at least 30 000, who is funded for around (please correct me if I m wrong) 3 days per week, for one podiatrist. (Please keep in mind this is all public, not including private). So it is obviously different to compare state to state in Australia.

Quite simply, there are so many vacancies around, no one wants to work public and rurally, and who can blame them?

 

Andrew Kingsford

Al Kline,

Podiatric surgeons in Australia typically undertake a four year Bachelor degree at a public university, followed by a Masters degree at a public university, and a 5-6 year residency program culminating in national examinations (similar to your ABPS certification). We perform the full complement of foot and ankle surgery in hospitals under neurolept and general anaesthesia and admit in-patients. We are registered in each state of Australia and by the federal government. Podiatric surgeons have been practicing in Australia since 1975.

Podiatrists in Australia are well trained through a comprehensive four year degree program but restrict their surgery practice to skin and toenail procedures. They are very skilled in biomechanics, sports medicine, pedal management of diabetes, palliative treatment, and wound management. Podiatrists are registered by state governments and are given provider numbers by the federal government. The model of training is different to the USA but our practitioners are competent, safe, regulated and well trained.

Dr Andrew Kingsford FAAPSM, FACPS.

 

I am in my final year of podiatry - ie i have just completed a four year undergratuate degree. I don't profess to be a doctor - and will never be - but i will be calling myself a podiatrist and consider myself to be qualified to specialise in foot care. To think that four years is not enough to learn podiatry is somewhat naive. We don't do complex surgical procedures, and would never presume to know everything (hence continuing education).

ps - less than 10% of my graduating year are straight from school - most have done at least part of another degree

lise

 

dear Mr Payne
Im am currently studying podiatry at QUT heading into my fourth and final year. I have always had doubts about the viability of our profession that centre around the issues discussed in this forum. For example, what can we provide that other professions cant, the cascade of pod school closures, the fact that many of the major sporting teams in this country utilize the services of phsiotherapy rather than a podiatrist to treat and rehab ankle sprains etc... and a general lack of awareness amongst people outside the profession (family, friends and co-workers) that I talk to as to what we do and why we need to study for so long (questioning our relevance). When I have raised these issues with my peers, staff and podiatrists I have generally been treated as a "party pooper" and with contempt. I have never meant to personally offend any of the pods/staff I have directed these questions to, however upon graduation I will be lumpt with a significant HECS debt and I will have spent four years of my life studying to become a podiatrist. Is it possible that many prospective students are turned away from studying podiatry becuase of a combination of the above factors?. The fact that I am unable to get answers and the semingly gloomy outlook for the proffession that seems to be the main theme of this forum represents a significant source of anxiety for me and some of my peers. So Im curious to know if you or any of the other pods that frequent this forum can see a shift in the scope and perhaps more significantly, the focus of practise for podiatrists. Previously in this forum you wrote, "I find the prospects of what we can do with what is happening to be exciting.... "a new dawn" - to be embraced .... either we take the lead or we get led (talk about use cliches )(sorry to be a bit cryptic, but the final policy document is not yet finished). I understand that you may not be able to elaborate to much on this statement but any insight to exactly what about this policy document excites you would be greatly appreciated.

Thankyou

 

Where are you getting your information from? --- there is an acute shortage of podiatrists in Australia at the moment; the demand is increasing! --- everyone I talk to is doing well in practice - how is that unviable?

The same applie to physio etc - we are not unique.

What closures? There has only been one!! Another has suspended intake for a couple of years, but 2 new schools have opened!! --- that looks healthy to me.

Why wouldn't they? I do not see that as our role.Things are happeneing behind the scenes re podiatry involvement in AIS

. I think you talking to the wrong people and reading the wrong messages.

Hell yes. Did you not read what happened here last week in Victoria - its soon to happen in Queensland (ie extended prescribing rights legislation was passed)

Look what has happened with prescribing rights (thats exciting); look what has happened with the expanded role for Podiatry Assistants (thats what I was refering to above) - the first course has just about completed and will be evaluated before a national roll out (thats exciting); look at the huge advances in our understanding of foot orthoses, many of which have been reported and discussed here (thats exciting); the podiatric surgeons recently got canberra to change the law for giving them professional attention (thats exciting); look at the national conference in Christchurch (that was exciting); I was in Brisbane at the weekend speaking at the Musculoskeletal Physiotherapy Association conference (that was exciting);..etc etc

 

Mr Payne
Thankyou very much for taking the time to respond to my post. I apologise for any misguided or inaccurate statements I may have made (especially re; school closures) and appreciate you setting me straight on those issues.

Thanx
trophikas