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With the world of Podiarty changing, for the better.... I´m wondering what people thoughts are in attempting to help make the profession a world standard. At the moment Podiatry is finally expanding around europe with the new school on Stockholm about to have the 1st students finish their 3 year degree standard course. Intersting since Sweden has one of the highest rates of Diabetes, but I digress.
The School has looked to England, Belgium and little with Australia to help set the course.
I am involved in the course at only a 25% level on top of openning the 1st clinic in Stockholm.... Busy life. It has been a great thing for me as I have become intersted in the profession again, from a new theory point of view and even joined PA last week. Better late than never..
My question is if other teachers/pods beleive that a base international standard of teaching should be introduced to help spread the profession at the same time maintaining the standard. It would also allow more intercountry travel. Ie 2 of my students want to travel and work in oz next year but their degree is not recognised.
It would also help to protect the Podiatry name so that people do not begin to use the name when they have not reached a set standard.
It would also allow new ideas to be better communicated to teachers and therefore students...
What we really need is to defent podiatry in each country of the europeen union. Because there is still a lot of problems in the recognazing of podiatry in some country's
You ahve started off in a blaze of glory Michael. 3 posts, and pretty informative stuff from the 2 I have read. The best percentage on PA.
The discrepancy between DPMs and Australian Pods seems to great to me. Their training might be more in depth etc., and I perceive they get into cutting and sewing a bit more.
Also, I think Javier has banned me from practicing in Italy. So the globalisation of podiatry might be a generation away.
hi again,
I guess what Im looking at is not so much direct globilization but a level or guide lines of teaching for subjects. So in no way am I saying the DPM is the same as my BHsC (pod) but if the biomechanics course studied around the world had the same base and a international standard and the ability to be fluid the students and the profession would develop better. Degrees would be more readily accepted from country to country.
ie I completed my degree in 95, Root was king and Axis theory was the baby. We were not taught moments, tissue stress etc at any great level. So when I began to teach after just treating patients with very little CPD, moving into my own customised treatment plans designed from patient feedback, I looked at my old notes from school to begin with.
If their was an international guide this would not have happened.
This guide would not set anything in stone but would help the new schools, new countries and maybe give a kick to some old schools to change. This guide could also be a listing of current lit. , ideas for course plans etc
hi again,
I guess what Im looking at is not so much direct globilization but a level or guide lines of teaching for subjects. So in no way am I saying the DPM is the same as my BHsC (pod) but if the biomechanics course studied around the world had the same base and a international standard and the ability to be fluid the students and the profession would develop better. Degrees would be more readily accepted from country to country.
ie I completed my degree in 95, Root was king and Axis theory was the baby. We were not taught moments, tissue stress etc at any great level. So when I began to teach after just treating patients with very little CPD, moving into my own customised treatment plans designed from patient feedback, I looked at my old notes from school to begin with.
Michael Weber
They have never even come remotely close to standardizing podiatric education in any two colleges here in the US. And you want global standards? Good luck! Who are you going to lock in a room for ten years to even attempt it? And by the time they get out, it will have changed. I gave up on the crazy notion of standardization years ago! We are getting less standardized as time goes on, not more. Just look at this forum as an example. But that's just my opinion!
Jeff is right. Complete standardization among all schools is never going to happen. But you could certainly agree on basic course content among the schools of podiatry, giving each teaching institution some latitude for what content they wanted to emphasize over the other.
In the United States, all podiatry students must pass the "National Boards Part I" and "National Boards Part II" where professors from all the schools get together to write questions for the tests, thereby ensuring a basic standard of knowledge for all US podiatry school graduates. Maybe, if the worldwide, non-US podiatry schools all tried to get together to write similar styles of "International Podiatry Board Tests", then you could have made some progress. This may be very difficult to achieve, but I admire your goals and am just trying to brainstorm a little for you.
Good luck.
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
In the United States, all podiatry students must pass the "National Boards Part I" and "National Boards Part II" where professors from all the schools get together to write questions for the tests, thereby ensuring a basic standard of knowledge for all US podiatry school graduates. Maybe, if the worldwide, non-US podiatry schools all tried to get together to write similar styles of "International Podiatry Board Tests", then you could have made some progress. This may be very difficult to achieve, but I admire your goals and am just trying to brainstorm a little for you.
Good luck.
This problem is compounded by differences in scope of practice. Unless the scope of practice is the same, you can't expect to have standardized education or boards. Given the surgical scope of podiatry in the US and the amount of educational time dedicated to it, you will likely have less emphasis in biomechanics than in those countries where podiatry is less or non-surgically oriented.
I could be wrong, but in the years before my time ( I was in the first ever cohort of UK degree students- Sussex boy ) I recall that students in the UK all sat the same exams, set by the Society of Chimopodists, hence there was a norm in the UK at least. Like I said, I could be wrong as it was before my time, but I remember my mates in the years above me sitting Society papers. I can't believe that this is twenty years ago!
__________________ Science is the antidote to the poison of enthusiasm and superstition
This problem is compounded by differences in scope of practice. Unless the scope of practice is the same, you can't expect to have standardized education or boards. Given the surgical scope of podiatry in the US and the amount of educational time dedicated to it, you will likely have less emphasis in biomechanics than in those countries where podiatry is less or non-surgically oriented.
I agree. This is basically the main problem. Perhaps, Michael Weber is thinking to implement a Bologna Process for Podiatry worldwide. It could be achieved if all countries with university podiatry programs agree to establish a minimum core knowledge, but total standardization is impossible neither desirable. Lacking of discussion it would stop professional advance.
There is a move to globalise podiatry and as we speak attempts to compile profesional competencies are being undertaken through the offices of FIP. There was an educators conference at the last FIP International Conference in Copenhagen with the foci of bringing together member countries in an ttempt to formulate common curriulum. At that time Australia was not a member although I understand New Zealand has subsequently joined. To the best of my knowledge the FIP working party includes representatives from the US, UK and other European countries.
Up until a certain point in time in the UK, the Society of Chiropodists and Podiatrists were singularly responsible for the training syllabi which each recognised centre of podiatric education would comply with. Individual institutions such as public sector colleges of education of NHS schools of chiropody attempted to within their resources make available the minimum standards required and whilst these were not entirely the same from region to region, it was carefully monitored. The society would set a national paper and provide external examiners and inspectors to oversee the professional examinations. On the positive side this brought unity across the UK but on the negative side it was very costly. When individual institutions introduced podiatry degrees and eventually when colleges became universities the absolute control of the society was challenged. The autonomy of universities meant the presence of the Society was no longer required and greater reliance was given to work with the Registration Board. By the introduction of the HPC all had changed and the present system was established.
One major advantage which was lost with the change was the end of the Society' seminars and conferences for educators/inspectors training courses. Although (the affiliated) Assoc of Chiropody Teachers in the UK (ACTUK) continues the conferences in its hayday it was an excellent forum for interchange between teachers across the UK.
A word on scope of practice and competnecies. All things considered there is little discrepency between the countries which host podiatry and no major discrepency between the US and anywhere else. Some countires (and states within) have established means by which surgical practice is more easily accessed by the public, otherwise the profession is very much the same, worlwide.
All things considered there is little discrepency between the countries which host podiatry and no major discrepency between the US and anywhere else.
Cameron:
I'm not so sure about that, Cameron. Probably 90% of practicing podiatrists in the United States currently perform hammertoe, bunion and other types of osseous procedures. Surgical residencies in the US are now standardly three year post graduate programs which are completed after a four year Doctor of Podiatric Medicine (DPM) degree is earned. This makes a total of seven years of post-undergraduate college education necessary to practice podiatry within the US. Therefore the average age of most podiatrists in the US who are just beginning to practice podiatry with foot and ankle surgery privileges is at least 29 years old, assuming no breaks in education from kindergarten to their last year of surgical residency.
I believe this is very different from any other country in the world. Please correct me if I am wrong. As an aside in this regard, I remember lecturing in New Zealand for the first time in August 1991 with Drs. O.A. Mercado and Jeff Stone and being quite surprised to see that many newly graduated podiatrists were only 22 years old. This is at least the age when nearly all podiatry students in the US first start their freshman year of podiatry school. However, I will say that the seeing 22 year old podiatrists dancing in New Zealand at the evening conference party was certainly much more entertaining that seeing a bunch of 30 year old podiatrists dancing in the US.
__________________
Sincerely,
Kevin
**************************************************
Kevin A. Kirby, DPM
Adjunct Associate Professor
Department of Applied Biomechanics
California School of Podiatric Medicine at Samuel Merritt College
>Therefore the average age of most podiatrists in the US who are just beginning to practice podiatry with foot and ankle surgery privileges is at least 29 years old, assuming no breaks in education from kindergarten to their last year of surgical residency.
Up until now surgical training in the Uk and Australia and New Zealand has been post graduate and only on completion of three/four year undergraduate university education. Many universities will not allow students to register full time until they are 17/18. Surgical training would take on average about three to four years to complete. In Australia the surgical training has highlighted practical elements and students normally complete a Masters Degree at the same time. The vast majority would undertake this part-time so would complete their programes about mid to late twenties. I am sure the UK is not that different (but I stand to be corrected). However there is a new undergraduate degree at University of Western Australia which may now include surgical training and if so this is a new kid on the block.
> I will say that the seeing 22 year old podiatrists dancing in New Zealand at the evening conference party was certainly much more entertaining that seeing a bunch of 30 year old podiatrists dancing in the US.
None of these chums would have completed a recognised surgical training as that came after 1991. I was there the year after you and got the degree started. Can't say I did much dancing but they were a good crew. I can also share this secret I have taight on several post grad programs with surgical pods and have to say they work hard and party even harder ( I have the bruises to prove it !) :-)
There is a move to globalise podiatry and as we speak attempts to compile profesional competencies are being undertaken through the offices of FIP. There was an educators conference at the last FIP International Conference in Copenhagen with the foci of bringing together member countries in an ttempt to formulate common curriulum. At that time Australia was not a member although I understand New Zealand has subsequently joined. To the best of my knowledge the FIP working party includes representatives from the US, UK and other European countries.
As we say in Spain, it a "toast to the sun". It is a nice attempt but useless at the end. First of all, there are many differences among FIP members regarding podiatry education level (many of them have not a university degree in Podiatry) and scope of practice. Also, Spain is represented by 3 scientific association but not by the professional body that represents all Spanish podiatrists. This associations offer different post graduated courses but without universities recognition (like to Podiatry Institute in USA). Spanish podiatry schools have achieved a recognition for a new podiatry degree under Bologna Process rules that it will increase knowledge, undergraduate formation (from 3 years to 4 years), post graduated courses (2 years masters in surgery, biomechanics, or other specialities ) and research (PhD in Podiatry). I think Spain is the only European country to achieve this 4 years podiatry degree adapted to European Higher Education Area, for now.
As we say in Spain, it a "toast to the sun". It is a nice attempt but useless at the end. First of all, there are many differences among FIP members regarding podiatry education level (many of them have not a university degree in Podiatry) and scope of practice. Also, Spain is represented by 3 scientific association but not by the professional body that represents all Spanish podiatrists. This associations offer different post graduated courses but without universities recognition (like to Podiatry Institute in USA). Spanish podiatry schools have achieved a recognition for a new podiatry degree under Bologna Process rules that it will increase knowledge, undergraduate formation (from 3 years to 4 years), post graduated courses (2 years masters in surgery, biomechanics, or other specialities ) and research (PhD in Podiatry). I think Spain is the only European country to achieve this 4 years podiatry degree adapted to European Higher Education Area, for now.
javier
I understand and have no political axe to grind. However I think once there is a set of professional competences agreed through the offices of FIP (which represents the majority of interested parties) then this will benchmark podiatry internationally. From that will come a whole conglomerate of legislation and educational requirements and under these circumstances the concensus will determine podiatry across the globe.
With due respect to all on this forum, and all podiatrists everywhere, this really is an issue of scope of practice - and all that comes with it.
Unfortunately, though it is wonderful to talk about all the wonderful things we can do with pieces of plastic inside shoes, there is a massive difference between a podiatrist who practices surgery/prescribe drugs, and those who don't. This is not an issue of ego, intelligence or competency - it is a matter of training.
Whilst this massive divide separates podiatry in the US vs. (most of) the rest of the world - teaching, learning and training issues will always be in question. I have often heard comments from orthopaedic surgeons who will never accept the opinion of a podiatrist, unless they were trained in the US in a system that bears some resemblance to what they went through.
IMHO the only turning point for the future of podiatry education outside of the US is if those small number of people who are practicing a full scope of podiatric care (ie proper medicine and surgery of the foot and ankle) become the full time educators of the next generation. We have seen a glimmer of this at UWA. Its no different to those who first started teaching Root biomechanics all those years ago.
I believe strongly, and without prejudice, that having our research podiatrists being the clinical educators of each new generation of podiatrists has been the greatest impediment to the growth of podiatry outside of the US. WIth respect, my experience has been that university based podiatry academics are there primarily to research something of interest (commonly something esoteric in biomechanics), and have had limited postgraduate education (or interest) in such things as drug prescribing and surgical care. They teach things as they too were taught, and the mindset is very much of learning basic chiropody care and following this some time spent on orthotics and a smattering of diabetes and rheumatology etc. Full stop. Its been like that since the 1970's, and as we approach 2010, all of the Commonwealth curriculi look very similar, very primitive, and very out of date.
I am not trying to upset or irritate those with no interest outside of either orthotic therapy or general foot care, but this is the awful truth.
Its time to pull our heads out of the sand and look to the future. If we can teach people to be full scope medical doctors in 4 years, we should be able to educate a much better class of podiatrist in 4 years that we have done for the last 30 years or more.
Sharpen the swords..I'm ready for the backlash.
LL
__________________
***************************************** Remember, it's just a foot.
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Hi Michael,
Nice to see your name popping up in the Arena
Quote:
Originally Posted by m weber
With the world of Podiarty changing, for the better.... I´m wondering what people thoughts are in attempting to help make the profession a world standard...
It could be that i'm a bit biassed on this point, but the way our universities work together at this point, is probably already much further then others will come in the next decade or so. Everything has to do with the preset Standards of Proficiency and the Bolongna process.
The bigger structure set out by Bologna with the bachelor/master structure, is a European Fact, but how this is implemented locally in the diferent Universities, is an complete other ballgame. We have quite some students from up north comming in our Podiatry program because we have more time set out in our curriculum for biomechanics, clinical reasoning and orthotic therapy.
I think networking is going to become very important, and since podiatry in europe is still in it's "early days" (compared with US, Australia, NZ, ..., or even UK), we have the advantage of not having a fixed strucure (or should I say content)
Like Kevin and others said - a world standard will not happen, but after a chat with Kevin and Craig a couple of years ago during their "Flash Visit" to Ghent I remember them saying that they went through the same problems we are going through now... ONLY this was 20/25 years ago... And this time difference will never become any smaller, I think...
Quote:
Originally Posted by m weber
My question is if other teachers/pods beleive that a base international standard of teaching should be introduced to help spread the profession at the same time maintaining the standard. It would also allow more intercountry travel.
As we are doing this staff exchange now for almost 5 years on orthotic therapy in different countries, the international standard of content (to a certain level) only came by asking, talking, comparing and eventually deciding... an international standard for teaching in my opinion is way beyond this... you can be a perfect clinician, knowing what you should bring, but the ability of bringing this content, filled with enthusiasm, reaching a certain level with your "students" is something completely different...
Quote:
Originally Posted by m weber
It would also help to protect the Podiatry name so that people do not begin to use the name when they have not reached a set standard.
Again, this is something which is different in every country - and it all starts with the profession-name. To give you an example:
"podoloog" in Belgium is a higher degree compared with The Netherlands where this degree is called "Podotherapeut". However, "Podoloog" in The Netherlands is a general "toe nail clipping" person... (and we almost speak the same language, ...)
Interesting topic ...
__________________
Ken Van Alsenoy
Artevelde hogeschool
dept. Podiatry
Ghent - Belgium
With due respect to all on this forum, and all podiatrists everywhere, this really is an issue of scope of practice - and all that comes with it.
much cut:
I am not trying to upset or irritate those with no interest outside of either orthotic therapy or general foot care, but this is the awful truth.
Its time to pull our heads out of the sand and look to the future. If we can teach people to be full scope medical doctors in 4 years, we should be able to educate a much better class of podiatrist in 4 years that we have done for the last 30 years or more.
Sharpen the swords..I'm ready for the backlash.
LL
Here in the US at my orthotic lab, I don't see MD's treating patient's non-surgically like podiatrists do. Some want to see DPM's become MD's or MD/DPM's. Since MD's can essentially practice podiatry but podiatrists can't practice as MD's, would not this educational change be the kiss of death for podiatry as we know it? Podiatrists should have parity with MD's for those things in which they have a common scope of practice. If you overly broaden the scope of podiatry, I think you will likely kill it in the process.
This is very interesting.
I did not realize Podiatry practice had such variation internationally.
The MD/DPM idea is alive and well. The school where I attended, BUSPM (Miami) offers a dual-degree, with the DPM and a PA degree. I have colleagues who have moonlighted as Physician Assistants and done quite well.
It appears to me, from limited, intermittent exposure to this Forum, that podiatrists in the UK and Australia are studying a lot of biomechanics.
Have a great day-
-John
__________________
Dr. John G. Fasick
LSUHSC New Orleans
Clinical Insructor, LSU School of Medicine jfasic@lsuhsc.edu
In Australia following on from the Commonwealth Government plans for National Registration, Plans for National Course Accreditation are being established.
I believe strongly, and without prejudice, that having our research podiatrists being the clinical educators of each new generation of podiatrists has been the greatest impediment to the growth of podiatry outside of the US. WIth respect, my experience has been that university based podiatry academics are there primarily to research something of interest (commonly something esoteric in biomechanics), and have had limited postgraduate education (or interest) in such things as drug prescribing and surgical care. They teach things as they too were taught, and the mindset is very much of learning basic chiropody care and following this some time spent on orthotics and a smattering of diabetes and rheumatology etc. Full stop. Its been like that since the 1970's, and as we approach 2010, all of the Commonwealth curriculi look very similar, very primitive, and very out of date.
While I agree in part LL, I think it is difficult in the current climate of universities attracting funding and the amount of research that must be done to generate that interest, to make a sudden shift. To do as you suggest, especially within Australia, mean the limited Pod surgeons would need to dramatically pick up the pace with publications, PhD's, research and teaching skills to make the department attractive. This combined with the disparity of the scope of practice and public awareness of what a podiatrist does and in what setting within a country makes it even more problematic. That document Steve flagged is a great step towards at least national standardization however doesn't address some of the basic disparities of podiatrist in the public setting, community health, schools, etc that happens between states.
A tad off topic but as the class of podiatrist was brought up, I think there also needs commitment from those in the profession to perform a vital role in education and support of students and new graduates. If you don't agree with the training, what can you do about it? Do you take students on placements? Do you have a skill set that may be valuable and that your uni lacking? Can you make contact to see what research projects are happening that you can refer patients in for or even be part of yourself. Is there clinical supervision jobs available in the uni clinic's? We don't expect a clinician of many years experience to walk in and suddenly start a research project and yet we expect those with primarily and academic background to supervise clinics.
i think the longer we continue to see an "us" and "them" between clinicians and researchers, the longer we will complain about the students coming out and the direction of the education settings. I agree we need to step up in our training and education, especially now that we see the changes in degrees like medicine etc. We do need to continue to evolve. Hopefully this is something each of the Uni's are considering each time competencies are review and expanded.
__________________
Cheers,
Cylie.... in a permanent state of confusion
i think the longer we continue to see an "us" and "them" between clinicians and researchers, the longer we will complain about the students coming out and the direction of the education settings. I agree we need to step up in our training and education, especially now that we see the changes in degrees like medicine etc. We do need to continue to evolve. Hopefully this is something each of the Uni's are considering each time competencies are review and expanded.
Bug
I don't wish to see an "us and them" situation. We are all part of the same gene pool, in professional terms.
However, compared to organised medicine - there is only a "them" on the podiatry front (a clinician perspective) in most of the Commonwealth.
I can appreciate the historical need for podiatric researchers to become embedded within university frameworks. This is the norm amongst most professions. What has lacked is a commensurate growth in postgraduate clinical skills development to support the professions' growth (relative to other countries), alongside the previously mentioned undergraduate skills escalation.
When we start seeing local TAFE Colleges running allied health (podiatry) assistants courses (ie non- "at risk" care) , you know it is time to raise the bar within our own educational institutions towards a bigger role in the health of the community.
In organised medicine and dentistry, for example, this educational void is filled by the various (often Royal) Colleges. They take on the role of postgraduate education and training, in conjunction with state health departments in a symbiotic service provision/training model. This is obvious, since you can't teach medical graduates absolutely everything in one degree.
However there is a long history of core podiatry education achieving significant skills development since even the 1960's - one just needs to look across the Pacific.
However, in reality, what would be wonderful is if we could put many, many more podiatric graduates into a similar pathway towards higher degrees of (recognised) professional capabiilty/scope of practice in their chose field of endeavour. Perhaps the ANZPAC group can make this a reality long term?
I do still feel strongly that we can do more to educate more capable graduate podiatrists (eg with prescribing capabilites a la ? Latrobe) to make better use of the 4 years, especially when compared to (graduate) 4 year medical degrees.
LL
(PS - yes, I do try to do my bit, and teach in undergraduate podiatry subjects, along with providing placements etc)
__________________
***************************************** Remember, it's just a foot.
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Thanks LL - I agree whole heartly. I also wasn't implying you where putting the "us" and "them" out there at all. However I think the longer anyone is are out of formalised teaching institutions the more I see it happening.
Quote:
However, in reality, what would be wonderful is if we could put many, many more podiatric graduates into a similar pathway towards higher degrees of (recognised) professional capabiilty/scope of practice in their chose field of endeavour. Perhaps the ANZPAC group can make this a reality long term?
I really think this is the key. We are such a teeny tiny profession. We need to continue to turn out quality grad's to fill the jobs continually available. I'm not sure if we continue to lose as many from the field each year as we have new grad's still while at the same time have pathways and support for continuing ed. It will come, I think the commitment is there, the framework still needs work.
__________________
Cheers,
Cylie.... in a permanent state of confusion
With due respect to all on this forum, and all podiatrists everywhere, this really is an issue of scope of practice - and all that comes with it.
Unfortunately, though it is wonderful to talk about all the wonderful things we can do with pieces of plastic inside shoes, there is a massive difference between a podiatrist who practices surgery/prescribe drugs, and those who don't. This is not an issue of ego, intelligence or competency - it is a matter of training.
I agree with your comments and it can be applied to my country also. But, it would be important to consider different health care systems impact on this attempt to standardize teaching levels and scope of practice for podiatry worldwide. It is not a minor subject.
Standardize teaching levels
) I recall that students in the UK all sat the same exams, set by the Society of Chimopodists, hence there was a norm in the UK at least. Like I said, I could be wrong as it was before my time, but I remember my mates in the years above me sitting Society papers. I can't believe that this is twenty years ago!
Re: Standardize teaching levels
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