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  Australasian College of Podiatric Surgeons Postal Address: PO Box 248 Collins Street West Vic 8007 Telephone: 61 3 9286 1888 Facsimile: 6 3 9286 1880 ACN 087 751 97 9 March 2007 ACPSMI CORREYO5 Dr Kim Slater President Australian Orthopaedic Foot Ankle Society North Sydney Sports Centre 286 Pacific Highway CROWS NEST NSW 2065 Dear Dr Slater Thank you for the opportunity to respond to the letter sent on 4 December 2006. Podiatric surgeons in Australia have a commitment to clear and open communication with all registered health care practitioners. We are aware that each crafi group can make a valuable contribution to the benefit of the surgical care of patients. The College is committed to interdisciplinary co-operation and interchange for the benefit of patients. Again, we extend an invitation to the Australian Orthopaedic Association and the Royal Australasian College of Surgeons to become involved in the selection, training and examination of podiatric surgeons. We feel that this level of co-operation and interchange between our two groups will benefit those members of the Australian community who require foot surgery services. This outcome is what you rightly suggest should underpin the policies of both our organisations. I sincerely believe that if we could engage in positive dialogue the Australian community would truly be the eventual beneficiary. Hopefully your current preference to concentrate upon restriction and undermining of an existing competitive group is able to be moderated. I will also take this opportunity to better elucidate the extent of the education and training of podiatric surgeons in Australia. In the early days of podiatric surgery in both the United States and the United Kingdom, orthopaedic surgeons displayed a similar level of opposition and prejudice to podiatric surgeons. The legislating authorities recognised this as inter-disciplinary turf issue that fkequently occurs between many professions with overlapping competencies and skills set. Australian podiatrists can be licensed to practise in the United States and the United Kingdom. There are several current registrars, and Fellows, who have spent considerable time within the National Health Service in the United Kingdom and institutions within the United States to augment their training. The Australasian College of Podiatric Surgeons encourages these external rotations. The model for podiatric surgery training in Australia is based on the medical/surgical model and in that regard is very similar to that of the US and the UK.  So that there is no confusion about the legality of podiatric surgery, the definition of podiatry, as enacted by all states of Australia includes surgery as part of the scope of practise. All Commonwealth Accredited podiatric surgeons are registered podiatrists in their state of residence. All Commonwealth Accredited podiatric surgeons have completely fulfilled the obligations of the Australasian College of Podiatric Surgeons, State registration authorities and Commonwealth authorities. All Fellows of the Australasian College of Podiatric Surgeons are accredited by the Commonwealth Department of Health and Ageing. Difference between a registered Podiatrist and an Accredited Podiatric Surgeon There is a significant difference in training and accreditation between a registered podiatrist and an Accredited Podiatric Surgeon. A podiatrist becomes registered after completing an undergraduate course in podiatry. Podiatrists receive an undergraduate level (pass or honours) university education in the traditional disciplines of medicine such as physiology, microbiology, anatomy, pharmacology, pathology, dermatology, biomechanics and clinical practice. Podiatric surgeons are required to undergo a three-part postgraduate training process that includes an academic component, a research component and a clinical training component. Registered podiatrists who wish to become podiatric surgeons must complete accredited post graduate level units in podiatric surgery, diagnostic imaging, general medicine, advanced pharmacology and pathology, epidemiology and biostatistics. Podiatric surgical registrars must also have a minimum of two years internship in the field of general podiatric practise and have completed their academic component before being able to apply to the Australasian College of Podiatric Surgeons for an accredited training post. Accreditation and training In addition to the undergraduate and post-graduate core medical science units of their academic component, podiatric surgical registrars are required to complete an approved Masters level (research or course-work) research project in the field of podiatric surgery. Supervised comprehensive surgical training is also undertaken by each podiatric surgical registrar, with this component'of the program typically taking between four and six years to complete. Furthermore, all registrars must complete specific rotations through other medical disciplines such as vascular surgery, orthopaedic surgery, radiology, anaesthetics and other specialties as negotiated. As mentioned previously, international rotations are also used to provide an opportunity to consolidate and broaden general surgical and medical knowledge of the podiatric surgical registrar. They are seen as important in developing an understanding of the role of podiatric surgery within differing health systems. Podiatric surgery registrars are required to maintain detailed logbooks of their participation throughout the progressive practical training program prior to being eligible to sit for the comprehensive practical and final oral examinations. The examination process is carried out by a multi-disciplinary panel of examiners under the aegis of the ACPS. The ACPS awards the qualification of Fellow of the Australasian College of Podiatric Surgeons to successful candidates. The College will then submit the candidate's name to The Department of Health and Aging so that they may be listed as An Accredited Podiatric Surgeon under Section AAA of the Health Insurance Act 1973 It is neither a State nor Commonwealtl~ equirement that podiatric surgeons are required to have a medical degree. The federal government accredits podiatric surgeons through a specific process. In your letter, you state that: ...We also believe that the public has the right to differentiate between surgeons who are medically trained, and those who are non medically trained and currently this is not the case, with Podiatric Technicians sic) calling themselves doctor and surgeon in various states . Page 2  There are two important issues to consider in relation to this statement. Firstly, podiatric surgery is legal. It is regulated by both State and Commonwealth legislation. On this basis, dogmatism should not stand in the way of someone's livelihood. Secondly, it is our understanding that there are a large number of oral surgeons in Australia who are not medical practitioners who call themselves Doctor and Surgeon . On this basis, there should be no discrimination for the practice of our craft in Australia. Should patients have choice in their provider of these surgical services? The Commonwealth Minister for Health and Ageing says yes, patients should have a choice, and has passed legislation whose aim is to ...increase choice for consumers. The Minister has also passed legislation specific to the needs of podiatric surgeons. This legislation recognises the Australasian College of Podiatric Surgeons, as the authorised body for the training of podiatric surgeons. The policy of the ACPS is to encourage cross fertilisation with our orthopaedic colleagues, including as stated above, increased involvement in accreditation and training processes. Co- operative dialogue between our groups can lead to improvements in clinical outcomes for the community. Perhaps you could reconsider your position. I am happy to meet with you informally to further discuss your specific concerns with podiatric surgery. Yours sincerely Mark Gilheany President Page 3


Nov 27, 2018


Nov 27, 2018
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