What is podiatric medicine?

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A stickied thread for discussion and explanation of the profession.

As there seems to be a lot of confusion about a podiatric physician's current education, I have asked that this thread be posted at the top of our forum. I am hoping that this post will save us the trouble of endlessly explaining our education, as well as educate those that are unaware of our training. Thanks to ItsGavinC!

A Podiatric Physician's education consists of:
-4 years college (med school pre-reqs)
-4 years podiatric medical school
-3 years podiatric surgical residency

The most erroneous statement made is that podiatrists only know/need to know about the foot and ankle. While this is our specialty, we are also taught a great deal about general medicine. This is because we must medically manage our ER patients/surgical patients/inpatients. When called into the ER or managing our inpatients, we must have the ability to order a plethra of tests, read those tests, consult if necessary, and treat the patient accordingly.

So where do we get this medical education? Besides our first two years consisting of basic science and systems (as an MD/DO curriculum, some podiatry programs being fully integrated with MD/DO programs), and various general medical rotations 3-4 year (depending on the program), our residency allows us to rotate through many different medical specialties (ER, general surgery, path, IM, etc). And along with medically managing our own patients during residency, we are well educated by the time we finish residency.

Podiatric medicine is an extremely challenging and rewarding area of medicine. As stated before, make SURE this is what you want to do because, unlike MD/DO, you can't just change your mind on specialties!

Below is an example of a podiatric medical school curriculum (which vary slightly from school to school) and an example of a 3-year surgical residency (PM&S-36).

Podiatric Medical School Curriculum

-First-Year Academic Program

Introduction to Podiatric Medicine
Basic Life Support
Biochemistry
Honors Problem-Based Learning Biochemistry (elective)
Anatomy
Histology
Immunology
Physiology
Microbiology
Honors Problem-Based Learning Microbiology (elective)
Physical Diagnosis
Pathology
Neuroanatomy
Pharmacology I

-Second-Year Academic Program

Pharmacology
Endocrinology
Cardiovascular/Respiratory
Hematology
Lower Extremity Biomechanics
Neurology
Gastrointestinal/Nutrition
Renal
Lower Limb Anatomy
Behavioral Medicine
Clinical Podiatric Medicine & Diagnostics (includes Radiology)
Clinical Podiatric Biomechanics & Surgery
Medical Research and Writing
During the summer at the end of the second year, you are introduced to the University ambulatory care clinics, where you begin acquiring clinical skills.

-Third-Year Academic Program

Basic Life Support Re-certification
Operating Room Protocol
Dermatology
Trauma/Emergency Medicine
Public Health Issues
Advanced Cardiac Life Support
Clinical Rotations
Principles & Practices of Evidence-Based Podiatric Medicine (Problem-Based Learning)

-Fourth-Year Academic Program

Senior Independent Readings
Clinical Rotations

PM&S-36 Residency Curriculum (varies between programs)

-PGY 1

Podiatric Medicine and Surgery* - 2 month
Medical Imaging - 1 month
Pathology - 1 month
Medicine - 1 month
Emergency Medicine - 1 month
Infectious Diseases - 1 month
Anesthesia - 1 month
General Surgery - 1 month
Orthopaedic Surgery - 1 month
Psychiatry - 2 weeks
Electives (3)** - 1 month each

*Concurrent with other rotations
**Vascular surgery, family medicine, neurology, rheumatology, rehabilitative medicine, geriatrics, other rotations available

-PGY 2&3

Podiatric Surgery - 3 months
Orthopaedic Surgery - 3 months
Orthopaedic Trauma - 3 months
Orthopaedic Foot & Ankle - 3 months
Sports Medicine - 3 months
Pediatric Orthopaedics- 3 months

Originally Posted by jonwill

As there seems to be a lot of confusion about a podiatric physician's current education, I have asked that this thread be posted at the top of our forum. I am hoping that this post will save us the trouble of endlessly explaining our education, as well as educate those that are unaware of our training. Thanks to ItsGavinC!

A Podiatric Physician's education consists of:
-4 years college (med school pre-reqs)
-4 years podiatric medical school
-3 years podiatric surgical residency

The most erroneous statement made is that podiatrists only know/need to know about the foot and ankle. While this is our specialty, we are also taught a great deal about general medicine. This is because we must medically manage our ER patients/surgical patients/inpatients. When called into the ER or managing our inpatients, we must have the ability to order a plethra of tests, read those tests, consult if necessary, and treat the patient accordingly.

So where do we get this medical education? Besides our first two years consisting of basic science and systems (as an MD/DO curriculum, some podiatry programs being fully integrated with MD/DO programs), and various general medical rotations 3-4 year (depending on the program), our residency allows us to rotate through many different medical specialties (ER, general surgery, path, IM, etc). And along with medically managing our own patients during residency, we are well educated by the time we finish residency.

Podiatric medicine is an extremely challenging and rewarding area of medicine. As stated before, make SURE this is what you want to do because, unlike MD/DO, you can't just change your mind on specialties!

Below is an example of a podiatric medical school curriculum (which vary slightly from school to school) and an example of a 3-year surgical residency (PM&S-36).

Podiatric Medical School Curriculum

-First-Year Academic Program

Introduction to Podiatric Medicine
Basic Life Support
Biochemistry
Honors Problem-Based Learning Biochemistry (elective)
Anatomy
Histology
Immunology
Physiology
Microbiology
Honors Problem-Based Learning Microbiology (elective)
Physical Diagnosis
Pathology
Neuroanatomy
Pharmacology I

-Second-Year Academic Program

Pharmacology
Endocrinology
Cardiovascular/Respiratory
Hematology
Lower Extremity Biomechanics
Neurology
Gastrointestinal/Nutrition
Renal
Lower Limb Anatomy
Behavioral Medicine
Clinical Podiatric Medicine & Diagnostics (includes Radiology)
Clinical Podiatric Biomechanics & Surgery
Medical Research and Writing
During the summer at the end of the second year, you are introduced to the University ambulatory care clinics, where you begin acquiring clinical skills.

-Third-Year Academic Program

Basic Life Support Re-certification
Operating Room Protocol
Dermatology
Trauma/Emergency Medicine
Public Health Issues
Advanced Cardiac Life Support
Clinical Rotations
Principles & Practices of Evidence-Based Podiatric Medicine (Problem-Based Learning)

-Fourth-Year Academic Program

Senior Independent Readings
Clinical Rotations

PM&S-36 Residency Curriculum (varies between programs)

-PGY 1

Podiatric Medicine and Surgery* - 2 month
Medical Imaging - 1 month
Pathology - 1 month
Medicine - 1 month
Emergency Medicine - 1 month
Infectious Diseases - 1 month
Anesthesia - 1 month
General Surgery - 1 month
Orthopaedic Surgery - 1 month
Psychiatry - 2 weeks
Electives (3)** - 1 month each

*Concurrent with other rotations
**Vascular surgery, family medicine, neurology, rheumatology, rehabilitative medicine, geriatrics, other rotations available

-PGY 2&3

Podiatric Surgery - 3 months
Orthopaedic Surgery - 3 months
Orthopaedic Trauma - 3 months
Orthopaedic Foot & Ankle - 3 months
Sports Medicine - 3 months
Pediatric Orthopaedics- 3 months

Thanks a lot for the info Jonwill

Is it common for a DPM in a hospital to fully manage the patients? For example, if you suspect that a hemoglobin is low because of a increased BPM and decrease blood pressure after a surgery, or a traumatic ER patient, do the DPM's usually order the CBC or HB, cross match? What if the HB<10.0, can the DPM order so many units of blood? Same with glucose, insulin? Coagulation tests (PT, APTT, FIB) and Heparin? Cardiopanel or BNP in the ER with a patient suspected with heart problems?

Just Curious. I am sure that in surgery the anes doc will do most of the lab ordering and reasoning.

Thanks for the feedback.

Originally Posted by doclm

Thanks a lot for the info Jonwill

Is it common for a DPM in a hospital to fully manage the patients? For example, if you suspect that a hemoglobin is low because of a increased BPM and decrease blood pressure after a surgery, or a traumatic ER patient, do the DPM's usually order the CBC or HB, cross match? What if the HB<10.0, can the DPM order so many units of blood? Same with glucose, insulin? Coagulation tests (PT, APTT, FIB) and Heparin? Cardiopanel or BNP in the ER with a patient suspected with heart problems?

Just Curious. I am sure that in surgery the anes doc will do most of the lab ordering and reasoning.

Thanks for the feedback.

Most of the DPM usually manage the patient issues as they relate to the Podiatric issue or Podiatric Surgery. For example, if you did a major reconstructive rearfoot surgery on a patient and you admitted the patient for pain management, you may order CBC to monitor the Hgb/Hct. If the Hgb is less than 8, you will probably would then transfuse the patient. Podiatric Surgeon may also order preoperative labs such as CBC, Chem 7, Coagulation studies (PT/INR/PTT). The Podiatric Surgeon may also put the patient on Heparin / Lovenox / Fragmin postoperatively for patient at risk of DVT.

Even though many of the Podiatric Surgeons are exposed to medical management of patient during residency, most Podiatric Surgeons do not medically manage their patient. If the Podiatric Surgeon was to admit a patient with significant amount of medical issues, he/she would usually consult medicine service to medically manage the patient.

Originally Posted by dpmgrad

Most of the DPM usually manage the patient issues as they relate to the Podiatric issue or Podiatric Surgery. For example, if you did a major reconstructive rearfoot surgery on a patient and you admitted the patient for pain management, you may order CBC to monitor the Hgb/Hct. If the Hgb is less than 8, you will probably would then transfuse the patient. Podiatric Surgeon may also order preoperative labs such as CBC, Chem 7, Coagulation studies (PT/INR/PTT). The Podiatric Surgeon may also put the patient on Heparin / Lovenox / Fragmin postoperatively for patient at risk of DVT.

Even though many of the Podiatric Surgeons are exposed to medical management of patient during residency, most Podiatric Surgeons do not medically manage their patient. If the Podiatric Surgeon was to admit a patient with significant amount of medical issues, he/she would usually consult medicine service to medically manage the patient.

Thanks for the help dpmgrad. Most of the medical managing I've done with my attendings has been with diabetic wound infections. It usually always starts out with being called into the ER where they work the patient up, admit, and begin treatment accordingly. If complications arise or systemic involvement is feared, the proper consults are made. In my experience, IM becomes your best friend in those situations. Those guys are AMAZING when it comes to medicine.

The following article was written by Dr. Vincent Mandracchia (editor of Clinics in Podiatric Medicine and Surgery) and discusses podiatric medicine in this day and age. Thanks to Krabmas for bringing it to our attention!

http://download.journals.elsevierhea...inics&mis=.pdf

Originally Posted by jonwill

The following article was written by Dr. Vincent Mandracchia (editor of Clinics in Podiatric Medicine and Surgery) and discusses podiatric medicine in this day and age. Thanks to Krabmas for bringing it to our attention!

http://download.journals.elsevierhea...inics&mis=.pdf

^This is a very good article... and quite a good thread as a whole.

It seems this sticky might be most useful in the pre-pod forum, though.
Most of us students already know what we're getting ourselves into (I hope).

This thread is extremely helpful. There are many who will definitely benefit from the information encountered within this thread (Including me..).