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Podiatrists See a Great Future in Feet

Want to jump feet first into a good profession? Why not consider podiatry?

Consider these facts: the average person will walk over 80,000 miles in their life. In each mile, the feet will hit the ground 1,800 times.

The foot has 26 bones, 33 joints, 107 ligaments, and over 20 muscles. So it's no wonder that three in four Americans will experience foot problems at some time in their life!

Some of these problems will be minor, like ingrown toenails and athlete's foot, or deformities like calluses and bunions. Some people will have problems that are more serious that can eventually cause problems in their knees, hips and backs.

A podiatrist is a doctor who specializes in the foot. A podiatrist focuses on the prevention, diagnosis and treatment of foot disorders that arise from injury or disease. Podiatrists know how to treat all kinds of problems, like corns, calluses, ingrown toenails, bunions, heel spurs and arch problems.

Podiatrists were known as "chiropodists" until the title was changed in the early 1960s. Some jurisdictions may still use the term.

Look to the Foot

"Injuries sustained by an increasing number of men and women engaging in exercise has created a great demand for doctors of podiatric medicine [DPMs]," says the American Association of Colleges of Podiatric Medicine.

Meanwhile, the number of older North Americans is increasing. That adds to the demand for podiatrists.

Plus, the 10,000-member strong American Podiatric Medical Association (APMA) reports that 75 percent of Americans will have problems with foot health in their lifetime. They urge the public to have periodic checkups with a podiatrist.

But it seems podiatry isn't attracting large numbers of people. In recent years, fewer people have applied to podiatry schools in North America.

Admission standards remain high. But there are no waiting lists, says John Andrews. He is dean of student affairs at the Ohio College of Podiatric Medicine.

"The applicant pool has dropped. Because of managed care, some doctors are having difficulty getting paid. Some of them are asking, 'If I had the chance, would I do it all over again?'"

Podiatry students enjoy a great selection of residencies because of their relative small numbers. "There are currently enough [residency] slots for students who are graduating from schools of podiatric medicine," says Glenn B. Gastwirth. He is the executive director of the APMA.

"There are fewer applicants to the colleges, which may be reflected later on. Surpluses in residency positions may exist in the future as fewer students attend the colleges."

There are various reasons why students are not choosing podiatry. One may well be the cost of schooling. Usually, podiatry students already have a bachelor's degree in science.

Considering it takes four years to get a doctorate in podiatric medicine, you're looking at a pretty big debt load. It's something that's of great concern to students.

"Like most of the people I know, I am looking at a $100,000 debt load upon completion of school," says Mikel Daniels. He is a student at Temple University School of Podiatric Medicine in Philadelphia.

"I have also wondered how to pay these back....I understand why people are beside themselves with debt repayment, and I am beginning to understand why some people get really down on podiatry, really fast."

Another factor is the politics of health care. In the U.S., managed care is a real issue of concern.

Finally, it might be the reputation of the field. "Too many people still don't appreciate what it takes to become a podiatrist," says Gastwirth.

"Too many people don't realize that we are physicians, or they don't know what DPM [doctor of podiatric medicine] stands for. And too many think that DPMs treat only minor, uncomplicated foot problems."

Walking Into the Future

Sources differ in their projections of future demand. Andrews says there will be little or no growth in the demand for podiatrists in the U.S.

Thomas Melillo is a podiatry professor at the Ohio College of Podiatric Medicine. He says there's no easy answer to the demand question. "The number of podiatrists per 100,000 patients hasn't increased over the past 10 years, while the population is aging and demanding more foot care," he says.

"It's difficult to state how long this potential shortfall will last."

Specialized Schools

Science should be the focus for anyone who wants to become a podiatrist. You'll also need a good score on the MCATs (medical school admissions tests).

About 80 out of every 100 applicants are accepted into podiatry school. That doesn't mean it's a cinch to get in.

The AACPM reports that among entering students, about 98 percent of applicants already hold a bachelor's degree, almost half of which are in biology.

Andrews recommends students try job shadowing a podiatrist.

"Find out if you have a comfort zone for the work," says Andrews.

Once you're set on podiatry, you'll have to pick a school. You won't have a long list to pick from -- there are seven colleges of podiatry in the U.S.

Basic podiatry school takes four years. Then, most podiatrists are required to complete at least one year of postgraduate residency training in an approved health-care institution.

"The training program consists of a number of rotations, such as anesthesiology, internal medicine, radiology, infectious disease, surgery orthopedics, emergency room and pediatrics which provide an interdisciplinary experience," notes the AACPM.

Podiatrists may also become certified in one of three specialty areas: orthopedics, primary medicine or surgery.

Also on the horizon are changes to the education system for podiatrists. "I think graduates of the podiatric colleges will be completing far more comprehensive training programs that will all lead to some kind of board certification or qualification," says Gastwirth.

Working podiatrists have already experienced large changes in the field. "Solo practice is a thing of the past. Group practices, especially in multi-specialty groups, is the way medicine seems to be going," says Gastwirth.

Those in the field say the working conditions, financial rewards and benefits of being a foot specialist are good. The average workweek of podiatric physicians varies from less than 40 hours to as many as 50 hours.

The practice of podiatric medicine lends itself to flexible hours and is comfortable for those who want to make to make time for a balanced life.

While this may be encouraging to students contemplating the career, experts point out that the evolution of managed care is the single most important factor affecting the income and demand for future podiatrists.

"Obviously, managed care is changing and there is more direct referral to specialists evolving. But it does have an impact and influence on where a new graduate should consider practicing," Melillo says.

Still, it's not something that should stop an aspiring podiatrist. Gastwirth believes these doctors can thrive during these times of change.

"There is no substitute for knowledge. You must possess the podiatric medical knowledge and skills to market yourself. You also must be prepared to get out there and work hard."

He is optimistic about the future. "I truly believe that the best days are in front of us."


American College of Foot and Ankle Orthopedics and Medicine
An affiliated organization of the American Podiatric Medical Association

American Podiatric Medical Association
Gives details on foot health

Foot and Ankle Institute
Has medical and general foot care information, along with a discussion forum

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