What is a podiatrist?
A podiatrist is a healthcare professional who assesses, diagnoses and treats problems of the feet and lower limbs. Depending on where they work, this can include the ankle and the lower leg.
In the UK, “podiatrist” and “chiropodist” are protected titles. To use either title, a podiatrist must be registered with the Health and Care Professions Council (HCPC) and meet its standards, including the HCPC Standards of conduct, performance and ethics and the standards of proficiency for chiropodists and podiatrists.
Most podiatrists qualify through an HCPC-approved degree in podiatry, usually a three-year BSc, or through a degree apprenticeship. The course combines anatomy, physiology, pathology and pharmacology with supervised clinical placements. Once registered, a podiatrist keeps their registration by renewing it every two years and keeping up continuing professional development (CPD).
People see a podiatrist for foot pain, discomfort, numbness or swelling, for problems with their nails or skin, or for foot care when they have a condition such as diabetes.
Conditions a podiatrist can diagnose and treat
- Foot injuries, such as sprains and strains
- Foot pain and discomfort caused by arthritis, rheumatoid arthritis or gout
- Diabetic foot problems, such as infections, ulcers and nerve damage (neuropathy)
- Structural foot problems, including hammer toes, bunions, flat feet and high arches
- Skin conditions, such as verrucas (warts), corns, calluses and athlete’s foot
- Nail problems, including ingrown toenails and fungal nail infections
- Heel pain, such as plantar fasciitis
Assessment and diagnosis
A podiatrist usually starts by taking a medical history and asking about the symptoms.
They then examine the foot and lower limb, looking for swelling, skin changes, circulation and sensation, and may ask the patient to walk so they can assess gait. Depending on what they find, they may arrange further tests, such as:
- Imaging, including X-ray, ultrasound or MRI, to show fractures, soft tissue injuries and other structural problems.
- Vascular assessment, such as Doppler testing, to check the blood supply to the feet.
- Neurological assessment, such as monofilament testing, to check for loss of sensation, for example in diabetic neuropathy.
- Blood tests, arranged with the patient’s GP or the wider team, where an inflammatory or other condition is suspected.
Treatment
Once a podiatrist has made a diagnosis, they agree a treatment plan with the patient, working with the GP, a consultant or the wider team where needed. Treatment can include:
- Nail surgery under local anaesthetic, for example for ingrown toenails
- Treatment of corns, calluses, verrucas and wounds, including diabetic foot ulcers
- Orthotics, such as insoles and braces, and advice on footwear
- Exercise programmes and advice for musculoskeletal problems
- Medicines, within the limits of the podiatrist’s HCPC annotations: podiatrists with the relevant annotation can sell, supply or administer certain medicines, and some are qualified as independent or supplementary prescribers. Some also give steroid injections where they are trained and authorised to do so
Podiatric surgery
Some podiatrists go on to train as podiatric surgeons. This involves several years of postgraduate surgical training after registration, leading to Fellowship in podiatric surgery with the Royal College of Podiatry. Podiatric surgeons carry out surgery on the bones and soft tissues of the foot, such as bunion and hammer toe correction.
Are podiatrists doctors?
No. Podiatrists are registered healthcare professionals, regulated by the HCPC, not medical doctors regulated by the General Medical Council. Their training is in the foot and lower limb, and they often work alongside GPs, diabetes teams, vascular teams and orthopaedic surgeons.
Professionalism course for podiatrists
A podiatrist facing a complaint, an HCPC concern or a fitness to practise investigation will be asked to show insight, reflection and remediation against the HCPC standards. The professionalism course for podiatrists covers the HCPC Standards of conduct, performance and ethics and gives a dated CPD certificate that can be used in a response to the HCPC and in a CPD record.
The CPD course linked from this guide, Professionalism and Professional Standards for HCPC Regulated Health & Care Professionals, is by Probity & Ethics, written by Dr Shehzad Iqbal, CPD certified and accredited by The CPD Certification Service (provider no. 13197) and offered since 2020.
