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The Emergence and Acceptance of Podiatric Surgery.

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The Emergence and Acceptance of Podiatric Surgery. This essay will examine the role of the podiatrist as a podiatric surgeon; it will look at how this role has evolved, consider the controversy, surrounding the developing role of the podiatric surgeon, how it can be solved and discuss the training necessary to reach this high level in podiatry. It will finish by assessing how this evolving role will affect the podiatrist working as an independent health care professional. The podiatric surgeon practices surgical treatment of the foot and its related structures. It is usually carried out as a day case procedure and often under local anaesthetic. These types of treatment are available in many NHS trusts as well as in private hospitals and clinics. A podiatric surgeon manages bone; joint and soft tissue disorders. These include operations such as a bunionectomy, following the painful enlargement of the joint of the big toe (Hallux Valgus), the removal of plantar corns, which cannot be resolved via conservative podiatry, the correction of hammer, mallet and claw toes, a deformity in the lesser toes usually caused by tendon or joint imbalance and many other treatments. Podiatric surgery is a new and growing speciality, it has developed following the document 'Feet First' which examined the results of the Department of Health/National Health Service Executive task force on foot care that recognised the need for more effective services (DoH/ NHSE, 1994). ...read more.


To become a podiatric surgeon it is in fact necessary to become a fellow of the Surgical Faculty of the College of Podiatrists. This includes an entry examination, written examinations in surgery, case presentations and a final practical examination in basic surgical techniques (including soft tissue surgery and bone fixation). The training is rigorous and consists of a minimum of six years post-graduate training. The training includes a two to three year surgical residency within an approved centre. The podiatric surgeon, during this training period acquires complete knowledge of many subjects including, pharmacology, regional anaesthetic techniques, general pathology and radiographic interpretation, as well as an in depth knowledge of foot surgery. The modules are designed to provide the podiatrist with the medical science theory essential to the safe and effective practice of Podiatry in either the surgical or medical arena. The first part of the course can only be taken after 2 years clinical work and lasts one-year part time. This then enables the podiatrist to have the knowledge to pass part 'A' of the fellowship exams. The main criticism of podiatric surgery appear to be coming from the voices of the orthopaedic surgeons disputing the appropriateness of podiatric surgeons operating. Mr Smith from the The Edinburgh College of Orthopaedic Surgeons commented that he found it hard, to take a different stance on the question of non medically qualified individuals being able to perform operations on patients. ...read more.


However for podiatric surgeons to become accepted and respected it may be necessary to evolve as a multi disciplinary to begin with under the governance of orthopaedics as suggested by The Edinburgh College of Orthopaedic Surgeons. Like all changes it takes time for people to accept. However, some orthopaedic surgeons already view podiatric surgeons as experts in fore foot surgery and working as part of a multi disciplinary team. Published audits and a widely publicised curriculum will give more professionals knowledge of the level of expertise the podiatric surgeon has. This can only enhance the attitudes of orthopaedic surgeons towards the podiatric surgeon. Hopefully this will lead to a complete trust of the podiatry service to work independently self audit and maintain the standard expected by the general public. The emergence of podiatric surgery will have no immediate impact on the podiatrist in general. However, as podiatric surgery becomes extensively accessible and the podiatric surgeon becoming a viable alternative to having an operation performed by an orthopaedic surgeon, this should create a greater understanding of the role of the podiatrist. This in turn should lead to the layperson and medics alike beginning to see that there is a wider scope to the career and a far-reaching depth of knowledge held by the podiatrist than what they may at present imagine, this consecutively will lead to the profession being held in even greater esteem than it is today. ...read more.

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