Podiatric Medicine as a Career

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As a podiatrist, also known as a doctor of podiatric medicine (D.P.M.), you are trained to provide care for one of the most complex structures of the human body, the foot. You learn to diagnose and treat disorders, diseases, and injuries of the foot and lower leg, including corns, calluses, ingrown toenails, bunions, heel spurs, and arch problems; ankle and foot injuries, deformities, and infections; and foot complaints associated with arthritis, diabetes, and other diseases. Your education in podiatric medicine teaches you state-of-the-art treatment techniques involving surgery, orthopedics, dermatology, physical medicine, and rehabilitation.

You will benefit from pre-professional education that incorporates biology, organic and inorganic chemistry, physics, and other science courses typical of premedical students. Strong communication skills, both oral and written, are valued during your professional education and practice. Professional programs also expect you to be involved in extracurricular and community activities, and most require a personal interview and letters of recommendation as part of the admission process.

Your initial professional education provides classroom instruction in basic sciences, including anatomy, chemistry, microbiology, pathology, and pharmacology. Clinical rotations in private practices, hospitals, and clinics encompass the third and fourth years. During rotations, you learn to take general and podiatric histories, perform routine physical examinations, interpret tests and findings, make diagnoses, and perform therapeutic procedures.

Upon graduation with the D.P.M. degree, you are eligible to pursue a hospital-based residency program, lasting two to four years, where you receive advanced training in podiatric medicine and surgery and serve clinical rotations in anesthesiology, internal medicine, pathology, radiology, emergency medicine, and orthopedic and general surgery. Licensure, as specified by each state, is required for professional practice. Certification may be required for professional advancement.

The U.S. Bureau of Labor Statistics expects employment of podiatrists to increase 10 percent through 2026, about as fast as the average for all occupations. More people will turn to podiatrists for foot care because of the rising number of injuries sustained by a more active and increasingly older population. Opportunities will be better for board-certified podiatrists because many managed-care organizations require board certification.

According to the American Podiatric Medical Association (APMA):

  • Demand for podiatric medical services is increasing because foot and ankle disorders are among the most widespread and neglected health problems.
  • As more Americans engage in exercise and fitness programs, they become aware of the limits that foot and ankle pain places on full participation.
  • The number of older Americans is increasing almost three times as fast as the population as a whole, creating demand for the services of podiatric medical practitioners.
  • Specialties in podiatric medicine may include surgery, sports medicine, biomechanics, geriatrics, pediatrics, orthopedics, and primary care.

If you have a scientific aptitude, manual dexterity, strong interpersonal skills, a friendly bedside manner, the ability to collaborate with others in the healthcare team for your patients' benefit, and a temperament for the entrepreneurial enterprise of a private practice, a career in podiatric medicine may be just right for you.

Sources: American Podiatric Medical Association, Inc.; US Bureau of Labor Occupational Outlook Quarterly; http://ExploreHealthCareers.org

Demographics Associated with Podiatric Medicine

There are approximately 14,000 licensed podiatrists in the United States. Over the next eight to ten years, many of the "baby boomer" podiatrists will reach retirement age and leave practice. These podiatrists entered practice at a time when class sizes at the colleges of podiatric medicine were large (over 600 graduates per year). In recent years, class sizes of most programs in the country have been much smaller (the class of 2006 has 414 students — more than either the class of 2004 or 2005); therefore, as these "baby boomer" podiatrists leave practice, they will not be replaced in the pipeline by a similar number of graduating podiatrists. This will result in an overall reduction in the number of practicing podiatrists.

B. Number of Podiatrists Currently Practicing in the Southwest

The 1999 projections from the Liaison Committee of the American Podiatric Medical Association indicated that Nevada, Colorado, and New Mexico are at or below the forecast for podiatric physicians required in metropolitan areas with HMO and integrated network plans and non-metropolitan areas. Arizona is at or below the forecast of podiatric physicians required in metropolitan areas with fee-for-service plans.

C. Department of Labor Projections

In 2001, the U.S. Department of Labor projected a 10-20 percent increase in the need for new podiatrists through 2008.

D. The Competition Fallacy

Some podiatrists see their peers as competition and believe that a smaller number of podiatrists would be good for business. The recent APMA 2002 Podiatric Practice Survey clearly refutes that reasoning. Podiatrists who practice in groups earn substantially more than those practicing alone. A minimum number or "critical mass" of a profession's members is required to achieve the needed level of visibility to achieve success. This is true on both the local and the national level. To quote Jon Hultman, DPM, MBA, "If you believe that there are too many DPMs, you are neither recognizing the obvious favorable demographics which are poised to increase the future demand for podiatric medical services nor considering the untapped demand that is currently out there."

The 2000 Survey of Attitudes Toward Foot Care conducted by the APMA Department of Public Relations revealed that, not only are the most common foot problems treated at least as often by a non-podiatrist as they are by a podiatrist, but many times more patients with foot complaints see no doctor at all. Greater visibility resulting from more podiatrists and more group practices will attract those patients who do not know who to see or who have been unsuccessful with self-care.

E. Population Growth

A recent study by Health Affairs suggested that the United States will be facing a shortage of physicians. The forecast was based upon two findings. First was that previous population predictions for the United States have underestimated growth by 10 percent. Second, the number of hours worked by physicians is estimated to decline by 20 percent. Thus, the shortage of physicians will become severe, and they predict a deficit of 200,000 physicians by 2020. This same logic applies to the podiatry profession.

Public Need

A. Growth in Diabetes

Statistics from the United States and around the world clearly show epidemic growth of diabetes. The number of diabetic patients in the U.S. is rapidly climbing past 18,000,000. (King) In 1992 the percentage of the 65+ population in Arizona with diabetes was 7.2 percent. (U.S. Census Bureau) The incidence of foot pathology in diabetes is great. Podiatrists are critical members of the diabetes health care team. A disproportionate share of the morbidity and mortality from foot complications falls on Native Americans and Mexican Americans. (Burrows, Bennett, Carter, Hanis, Lee, Jasmanda, Will) The population of Mexican-Americans in the U.S. has increased dramatically over the past several decades. (U.S. Census Bureau) In 1999, 31.8 percent of the Arizona population were members of a minority. In 2000, 20.8 percent of Arizonans were Mexican-Americans. One-fifth of the population in Maricopa County and in the city of Glendale is of Mexican-American descent as well. (U.S. Census Bureau)

B. The "Graying" of America

As the percentage of older Americans increases steadily each year, the need for foot and ankle care will become increasingly important to maintaining a healthy lifestyle. In 1995, the percentage of Arizonans aged 65 and older was 13.7, well above the national average. The percentage growth in the Arizona population 85 and older from 1985 to 1995 was 88.9 percent, second only to Nevada (105.5 percent increase). (U.S. Census Bureau). By 2003, 20 percent of the U.S. population will be older than 65 years, up from 12.4 percent in 2000. (U.S. Department of Health and Human Services) As the large population of "baby boomers" ages, it is entering the time of life associated with greater foot care needs.


APMA 2002 Podiatric Practice Survey, Al Fisher Associates, Inc.; http://www.APMA.org

2000 Survey of Attitudes toward Foot Care, APMA Dept of Public Relations; http://www.APMA.org

Bennett PH, Burch TA, Miller M: Diabetes Mellitus in American (Pima) Indians. Lancet 2:125-128, 1971.

Burrows NR, Geiss LS, Engelgau MM, Acton KJ: Prevalence of diabetes among Native Americans and Alaska Natives, 1990-1997: an increasing burden. Diabetes Care 23:1786-1790, 2000.

Carter JS, Pugh JA, Monterrosa A: Non-insulin-dependent diabetes mellitus in minorities in the United States. Ann Intern. Med. 125:221-232, 1996.

Hanis CL, Ferrell RE, Baron SA, et al: Diabetes among Mexican-Americans in Starr County, Texas. Am J. Epidemiol. 118:649-672, 1983.

Hultman JA: A Strategic Look at the APMA 2002 Podiatric Practice Survey, APMA News, March 2003, pp 15-21.

Jasmanda HW, Haan MN, Liang J, et al: Diabetes as a Predictor of Change in Functional Status among Mexican Americans. Diabetes Care 26:314-319, 2003.

King H, Rewers M: Global estimates for prevalence of diabetes mellitus and impaired glucose tolerance in adults: WHO Ad Hoc Diabetes Reporting Group. Diabetes Care 16:157-177.

Lee ET, Howard BV, Savage PJ, et al: Diabetes and impaired glucose tolerance in three American Indian populations aged 45-74 years: the Strong Heart Study. Diabetes Care 18:599-610, 1995.

U.S. Census Bureau: Population by age, Hispanic origin, race, and sex: March 1999. Current Population Survey Internet release, March 8, 2000. Available from http://www/bls.gov/cps/home.htm/

Will JC, Strauss KF, Mendlein JM, et al: Diabetes mellitus among Navajo Indians: findings from the Navajo Health and Nutrition Survey. J. Nutr. 127 (Suppl. 10):2106S-2113S, 1997.

Cooper et al., Health Affairs, January/February, 2001.

Administration on Aging, U.S. Department of Health and Human Services. A Profile of Older Americans 2001. Available at https://oig.hhs.gov/reports-and-publications/oas/aoa.asp


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