On 5 October 2023, the Podiatry Board of Australia and AHPRA announced an independent review into the regulation of podiatric surgeons. Click above to learn more and how to make a submission to the review.
The Australian Orthopaedic Foot and Ankle Society (AOFAS) is the peak professional body for foot and ankle treatment in Australia. It consists solely of medically trained orthopaedic surgeons who have completed a degree in Medicine, obtained registration as a medical practitioner, worked as a junior medical doctor in the public hospital system; then subsequently completed specialist surgical training under the supervision of the Royal Australasian College of Surgeons (RACS) and the Australian Medical Council (AMC). After completing this rigorous medical and surgical training, Members of AOFAS have then gone onto complete further subspecialty fellowship training in foot and ankle surgery. Members work in public and private hospitals, providing evidence-based, comprehensive care for patients with pathology of the foot and ankle.
Public perception is that the title ‘surgeon’ is synonymous with a highly trained medical doctor, with additional training in surgery. A patient will assume a person calling themselves a surgeon will not only have undergone rigorous training, but also be governed and audited by other medical practitioners who are extensively trained in surgery. A medically trained surgical trainee will undergo years of exposure in public hospitals, providing emergency care for patients and performing hundreds of both emergency and elective cases each year, supervised by a senior surgeon. They rotate through multiple hospitals, including rural Australia, to obtain sufficient experience to become a safe and competent Orthopaedic Surgeon.
On the other hand, “Podiatric Surgeons” are general podiatrists who declare themselves surgeons after completing some additional and it would be fair to say, inconsistent training. They have no experience working in the public system in Australia, and subsequently have a different caseload and exposure, as podiatric training is largely limited to private podiatry practices and small day surgery centres. “Podiatric surgeons” do not rotate or train through the public hospital system, nor have experience in general or orthopaedic trauma in Australia. “Podiatric surgeons” undertake short three month rotations internationally, but these very countries where these rotations take place, do not recognise Australian “Podiatric surgeons” who have briefly attended these international hospitals in an observational role, and restrict their practice. Conversely, Australian trained Orthopaedic Surgeons’ qualifications are recognised universally by international hospitals and the majority of Australian trained Orthopaedic Surgeons will complete up to two years of subspecialty international training in foot and ankle surgery, treating patients directly in close collaboration with other international medically trained surgeons.
The Australian College of Podiatric Surgeons (ACPS) has made numerous submissions to the Medical Services Advisory Committee (MSAC) in an attempt to achieve the same recognition for their services as medically trained Orthopaedic Surgeons. All of these submissions have been overwhelmingly rejected by MSAC, and as a result, patients of “Podiatric surgeons” do not receive any medicare rebates. This results in significant out-of-pocket costs for patients who are often unaware of these costs or even the exact qualifications of their “surgeon” until after their consultation.
Despite clear differences in training, supervision, pathway to fellowship and ability to provide post-operative care, current federal law states “Podiatric surgeons” are able to call themselves a “Surgeon”. The AOFAS are concerned that this creates confusion and misperception amongst patients, who often mistakenly believe that their so-called “Surgeon” is medically trained.
In the interests of patient safety, AOFAS supports the current and ongoing Senate inquiries into the misuse of the title “Surgeon”. In the interests of protecting society and all Australians, we strongly believe that the title “Surgeon” should only be utilised by medically trained doctors with specialist qualifications in surgery, governed and supervised by the Royal Australasian College of Surgeons (RACS) under the umbrella of the Australian Medical Council. We encourage patients to carefully assess the qualifications of the “Surgeon” providing their care so an informed choice can be made. We want patients to be able to clearly discriminate between medically trained doctors and podiatrists, and firmly believe that restricting the application of the title “Surgeon” to medically trained doctors trained and recognised by RACS, will allow patients to understand the qualifications of the person providing their care.
On 5 October 2023, the Podiatry Board of Australia and AHPRA announced an independent review into the regulation of podiatric surgeons1. While podiatric surgeons are a small sector of the podiatry profession, they have a much higher rate of notifications than podiatrists. This has prompted the Podiatry Board to commission this review into the regulation of podiatric surgery, to ensure that patients are receiving good information and appropriate care2.
The review is looking at the current regulatory framework and risks to patient safety in podiatric surgery, to ensure the appropriate standards, guidance and processes are in place2.
Common concerns raised include:
2. Independent review of the regulation of podiatric surgeons: Consultation paper, 20 October 2023