Podiatry is a branch of medicine concerned specifically with foot and lower leg health. As with many branches of health care, podiatry involves working with patients to both prevent and cure, or to offer long term treatment for particular conditions.
Previously known as chiropody and chiropodists, podiatry in the UK has become a much more focused and serious discipline in the last decade or two, and the name change reflects the wider role modern podiatrists play in healthcare.
What do podiatrists do?
Podiatrists are highly trained healthcare professionals. They are clinical practitioners who are able to diagnose, treat and advise on a comprehensive range of problems, injuries and conditions of the foot, ankle and leg from below the knee. They are also able to give advice on a variety of issues such as footwear, as well as treating infections, and helping to relieve foot pain.
Some podiatrists choose to focus their podiatric knowledge and experience in a specialist branch, such as surgery, dermatology, sports health and medicine, diabetes management or pediatrics.
Podiatrists undertake several roles in their daily work, from diagnosis and treatment to advice on self-care and problem prevention. A qualified and registered podiatrist working in general practice deals with many different foot care issues each day. Some of these issues may involve:
- Diagnosing broken bones in feet. Patients may visit and report swelling, tenderness and pain in a foot or in toes, only to discover they have one or more fractures.
- Treating problem nails. Many patients visit podiatrists seeking advice and treatment for toenail problems. These include nails which are in growing, overly thick, or blighted by a fungal infection. Some podiatrists have undertaken training to deliver laser treatment for the latter problem.
- Nuisance foot problems such as verrucas, corns, bunions, calluses and athlete’s foot are very common, and they tend to make a patient’s life very miserable indeed. Podiatrists are able to identify the problem, provide a course of safe treatment, and also advise on the management or prevention of these problems in the future.
- Patients with fallen arches, also called flat feet, are just one group who benefit from a podiatrist’s ability to identify and respond to a patient’s need for extra help. Orthotics are specially designed shoe inserts which may be insoles, arch supports, heel cushions or the like, which are designed to provide relief to the wearer. Some orthotic inserts work to change the structure of the foot itself, others are for comfort only.
- Assessing footwear for suitability. Podiatrists are generally more than happy to advise families and patients of any age on their footwear. Many everyday foot and ankle problems could be avoided if we all wore better fitting and more comfortable shoes.
- Monitoring the foot health of diabetic patients. This is a crucial role for podiatrists, as a side effect of diabetes is poor circulation, which in turn can lead to possible damage to, and ultimately loss of, lower limbs.
- Advising on foot exercises. Podiatrists are trained to demonstrate and share knowledge on a variety of exercises to improve lower limb health. These are especially crucial for patients who are either immobile or move very little.
What kind of training or qualifications are needed to practice?
All practitioners in the UK are required to have completed a BSc (Honours) degree in Podiatry. This takes three years (4 in Scotland) and places are very competitive.
Each university has its own criteria for entry, but most require applicants to have:
- at least 5 GCSEs (grades A - C) including science, English and maths
- 2-3 A levels, with at least one being a biological science
- a certain number of UCAS points
- a personal interview
Applicants with alternative qualifications, such as relevant qualifications from different awarding bodies or an adult access to education course, or who have relevant experience, may also be considered.
Clinical training is part of the degree course, with placements to be successfully completed every year. Undergraduates must record a thousand hours of clinical practice in order to graduate.
Podiatry students are expected to consistently demonstrate empathy and a professional, caring attitude towards patients, along with an understanding of how podiatry helps clients. Excellent communication skills and a pleasant attitude are essential for a podiatrist to practice successfully.
Ongoing professional development may involve attending short courses, where a particular aspect of the job can be studied further, or existing skills refreshed. Alternatively, there are also opportunities for those interested to study podiatry at postgraduate level. Master of Science courses with specialties in surgical or forensic aspects of podiatry are popular, as are research degrees.
A Podiatry MSc allows current practitioners to develop their knowledge and skills to an advanced level, gaining an advanced professional qualification which opens doors to future promotion opportunities.
Those interested in the science side of podiatry can pursue a Forensic Podiatry MSc. This involves studying topics such as the relationship between footprints and the way a shoe is worn. Forensic podiatrists often work alongside the police to make sense of criminal evidence.
Those who choose to enroll for an MSc Theory of Podiatric Surgery may be looking to gain advanced theoretical knowledge, or to develop their practical experience in the surgical field.
A number of podiatrists choose to go into teaching, making a commitment to train and nurture the next generation of foot care specialists.
Where do the professionals work?
Qualified and registered podiatrists can choose to work in a wide variety of settings. As well as completing a recognised undergraduate degree programme, a podiatrist must register with the Health & Care Professions Council (HCPC), before they can legally practice.
Some podiatrists are employed by the NHS. They may work in a hospital, where they could be based in a specialised clinic. They may also treat outpatients or provide podiatry services to patients on the wards. Other NHS podiatrists are based in a general practice surgery or local health centre.
Private clinics employ podiatrists too. Many such clinics are multidisciplinary, so clients may well see a podiatrist as part of a mixed-care plan involving physiotherapists, chiropractors, osteopaths, acupuncturists and sports masseurs.
A large number of podiatrists choose to become self-employed. Of these, some set up a workspace in their home, others make home visits to clients, a percentage open a clinic of their own, and the rest work on a self-employed basis as a locum, in the community, or in a private health clinic.
There is always plenty of work available for freelance podiatrists, and some choose to specialise in working with a particular patient group, such as the elderly, patients in residential care or patients requiring home visits. They may also work with athletes and performers, two groups who always need regular help with their feet.
Qualified and experienced podiatrists are able to capitalise on their experience and skills, to find well paid work on cruise ships or in winter holiday resorts.
Podiatry is an ancient and very valuable branch of medicine, which plays an important role in the everyday fitness, health and life quality of the majority of the population, at some point or another through their life.
This branch of medicine has a scope which can be surprising to those who are unfamiliar with it, but the ongoing and positive results of podiatry look set to continue to expand and flourish.