A DPM is a Doctor of Podiatric Medicine, a physician who specializes in diagnosing and treating conditions of the foot, ankle, and related structures of the lower leg. DPMs complete four years of podiatric medical school followed by three to four years of surgical residency training, making them the only physicians whose entire education centers on the lower extremities.
What DPMs Are Trained to Do
Podiatric physicians are experts in the vascular, neurological, dermatological, and musculoskeletal systems of the foot and ankle. That broad foundation means a single DPM can treat a skin condition like athlete’s foot, manage nerve pain from a pinched nerve in the ankle, fit custom orthotics for flat feet, or perform reconstructive surgery on a bunion. Common conditions they handle include plantar fasciitis, heel spurs, diabetic ulcers, toe and hindfoot fractures, ingrown toenails, and structural deformities.
Within the profession, DPMs can further specialize in surgery, orthopedics, sports medicine, pediatrics, dermatology, geriatrics, diabetic foot care, or public health. A DPM working in a hospital wound care center may spend most of their time treating diabetic foot ulcers, while one in private practice might focus primarily on sports injuries or children’s foot development.
Education and Residency Requirements
The prerequisites for entering podiatric medical school are identical to those for MD and DO programs: undergraduate coursework in biology, chemistry, organic chemistry, and physics, plus a competitive entrance exam score. Once admitted, podiatric medical students spend four years in a curriculum that mirrors much of traditional medical school. At institutions like Des Moines University, podiatric students complete the same basic science courses as osteopathic medical students.
After earning the DPM degree, graduates enter a three- to four-year residency in podiatric medicine and surgery. These residencies include rotations in both inpatient and outpatient settings, covering surgical and nonsurgical management. Almost every state requires at least one year of accredited graduate medical education before issuing a license, and three-year residencies are rapidly becoming the standard. After residency, DPMs can pursue board certification through the American Board of Podiatric Medicine, which requires passing both a didactic and a case-based examination along with holding an active license.
Procedures: Office, Outpatient, and Hospital
The range of procedures a DPM performs is wider than many people expect. Simple procedures like removing an ingrown toenail or performing a skin biopsy happen right in the office under local anesthesia. More involved surgeries, including bunion correction, bone spur removal, flat foot correction, ankle arthroscopy, and tarsal tunnel release, are typically done at an outpatient surgery center where you go home the same day.
Complex operations like ankle fusion, ankle replacement, foot or toe amputation, and full reconstruction surgery require a hospital stay. The setting depends on the severity of the procedure, the anesthesia needed, and how much monitoring you’ll need during recovery.
Scope of Practice Varies by State
One important detail that surprises many patients: what a DPM is legally allowed to treat depends on where they practice. Nearly every state permits DPMs to perform surgery on the foot and ankle, but the rules diverge when it comes to the lower leg. States like Alaska, Florida, Illinois, and Pennsylvania allow DPMs to operate on both the ankle and leg. Others, like Alabama and Mississippi, restrict DPMs to the foot only. California permits nonsurgical treatment of the leg but not surgery. Michigan allows leg surgery up to but not including the knee, while Maryland limits it to below the midcalf.
These differences are written into each state’s practice act, so a DPM who moves from one state to another may gain or lose the ability to perform certain procedures. If you’re considering ankle or lower leg surgery with a podiatrist, it’s worth confirming that the procedure falls within your state’s scope of practice.
DPM vs. Orthopedic Surgeon
The most common point of confusion is the difference between a podiatrist and an orthopedic surgeon. Both can treat foot and ankle problems, but they arrive at that overlap from opposite directions.
A DPM spends their entire medical education focused on the foot and ankle. An orthopedic surgeon earns an MD degree, then completes five years of residency covering the entire musculoskeletal system: spine, hips, shoulders, hands, and joints throughout the body. Some orthopedic surgeons then do an additional fellowship specifically in foot and ankle surgery, but many treat a much broader range of conditions.
For an isolated foot or ankle problem, like a bunion, plantar fasciitis, or a diabetic wound, a DPM is often the most direct route to specialized care. If your foot or ankle issue is connected to problems elsewhere in your body, such as hip pain altering your gait or arthritis affecting multiple joints, an orthopedist may be better positioned to look at the bigger picture.
Why DPM Care Matters for Diabetes
One area where podiatric care has the strongest evidence behind it is diabetes management. People with diabetes face a significantly higher risk of foot ulcers, infections, and amputations due to nerve damage and poor circulation in the lower extremities. Regular foot exams and early intervention from a DPM can catch problems before they become limb-threatening.
A systematic review and meta-analysis published in Diabetes Research and Clinical Practice found that multidisciplinary care teams that include podiatric physicians reduced major amputation rates by an estimated 39 to 56 percent. That’s a meaningful reduction for a complication that dramatically changes quality of life. For anyone with diabetes, establishing a relationship with a DPM before problems develop is one of the most effective preventive steps available.