Ralph

We seem to have a different interpretation of the word ‘meaningful’. And
yes I was asking you to be specific to the Society as opposed to the BChA
or Unison or the Institute. The four examples you cite are nothing more
than proficient housekeeping for any representative organisation. I was
thinking about something else altogether. Perhaps I will give it some
thought and post what I consider the professional objectives might be.

I admire the way the subject has been sidetracked into indemnity insurance
and I’m sure you mean to return to the primary topic – podiatric surgery –
before too long. I wonder if I can prompt you?

There was a lot of questions raised by Borthwick and Dowd at the
conclusion of their paper, in particular the difficulties facing the
profession in the establishment of this speciality and the continuing
hostility from the RCS and BOA. I’ve tried to expand on these points from
the point of view of the profession asking whether the continuing dispute
with the medical establishment might be harming the prospects for the
wider profession of podiatry. As chair-elect of the Society and a
prominent podiatric surgeon yourself, I guess you are in an influential
position when it comes to deciding future strategy on this issue – a
strategy that will undoubtedly affect us all. Would you care to share your
views and perhaps listen to some of ours?

I wonder also if I may be able to tempt you with a little hypothetical
conundrum?     What, do you suppose, would be the reaction of the Royal
College of Surgeons, the British Orthopaedic Association and the wider
medical community, if the following were suggested to them?

For podiatrists who wished to practice as foot and ankle surgeons they
would be able to access a guaranteed assisted placement through a medical
degree providing they held a BSc in Podiatric Medicine and had completed
three years post-graduate employment within the NHS. The candidate would
receive a Band 5 salary for the duration of the course and would be exempt
from tuition and course fees (if they are applicable for medicine). On
completion of their medical course they would undertake the usual
residency rotations with one final year with a foot and ankle team. The
training and regulation would be the responsibility of the Royal College
of Surgeons.

These students would bring with them the knowledge of the foot from a
podiatric perspective; most likely a greater understanding of gait and
propulsive mechanics. From the medical school’s perspective, they would
make the ideal candidate. I realise that many of the podiatric surgeons
are highly regarded and respected and have made many positive
contributions in improving patient care. They are technically proficient
and bring a different dimension to established surgical practice in the
foot. But I wonder if that contribution might not have been greater if
they had undertaken the same the same study as our medical colleagues?
Surely you must agree that, in most cases, the potential would be far
greater? The most likely barrier to that appears to be the cost and time
involved with such a route. We shouldn’t compromise on the time – but if
assisted place schemes were introduced for podiatrists that removed the
financial constraints, would you not think that this might be the better
road to go down, if for no other reason but to end the damaging
relationship with the medical fraternity. If not, why?

Best wishes

Mark Russell

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