Full Scope Podiatry Model in Ontario

The College of Chiropodists of Ontario, along with key system partners including the Ontario Podiatric Medical Association, the Chiefs of Ontario, the First Nations Health Managers’ Association, the Northwestern Ontario Municipal Association, and the Federation of Northern Ontario Municipalities support the shift to the Full Scope Podiatry Model (FSPM) to help streamline and modernize registration pathways for healthcare professionals who practise foot care in Ontario. The FSPM would expand and broaden the current Chiropody Model in place in Ontario, once again to include active registration in the chiropody and podiatry classes.

The Chiefs of Ontario passed a resolution at their June 2023 Annual General Meeting in support of the FSPM, in recognition of the benefits the FSPM will have in addressing triple the rates of lower limb amputations experienced in Northern Ontario, including First Nations communities.

The FSPM is a path forward to address the critical shortage of chiropodists and podiatrists in Ontario whose specialized skills and training are needed to help reduce the 85% of lower limb amputations that are preventable. The unique skills and training of both chiropodists and podiatrists have been shown to provide the intervention necessary to prevent or reduce lower limb amputations when patients have sufficient access to chiropody and/or podiatry services and treatments. By removing the ban on podiatry that currently prevents the registration of qualified footcare professionals in the podiatry class, the number of qualified footcare professionals in Ontario will increase.

The transition to the FSPM in Ontario can be very simply done with 1 small amendment to the Chiropody Act and will include the following:

  • College Name Change to College of Podiatrists of Ontario
  • Registrant Name Change to “Podiatrists” and “Podiatrist/Podiatric Surgeon”
  • Expanded Scope for all qualified registrants – Full Scope Podiatry (modeled on the existing models in BC, Alberta and Quebec)
  • Program of Podiatry in the Province and bridging programs for chiropodists
  • Removal of Legislative Ban Preventing the registration of Podiatrists

Why Is There A Ban On Registering Podiatrists?

In 1991 the then Ontario government made a policy decision to restrict registration of footcare specialists in Ontario to one scope of practice and one title. This was intended as a cost saving measure that has, unfortunately, had many unintended consequences. The scope of practice and title was restricted to that of a chiropodist and the chiropody scope of practice, which is not as broad as that of a podiatrist. The result is that those practitioners with training and education as Doctors of Podiatric Medicine (DPMs) were no longer permitted to be registered as podiatrists with a broader scope of practice than chiropodists. Over the past 30 years of the Chiropody Model, the unintended consequence has been a failure for the number of needed footcare specialists to keep pace with the demands of Ontario’s aging population. The best approach to resolve the shortage is to expand the current model to the FSPM and ensure that Ontarians have access to high-quality footcare specialists in adequate numbers.

Research: The research available supports the move to the FSPM to appropriately address the high rates of preventable lower limb amputations and to ensure better access to chiropody and podiatry in Northern Ontario and for First Nations communities.

Data extracted from the following reports underscore the benefits of transitioning to the Podiatry Model:

  • Shah, B. R., Frymire, E., Jacklin, K., Jones, C. R., Khan, S., Slater, M., Walker, J. D., & Green, M. E. (2019). Peripheral arterial disease in Ontario First Nations people with diabetes: a longitudinal population-based cohort study. CMAJ open, 7(4), E700–E705. https://doi.org/10.9778/cmajo.20190162
  • Loewen, K., Vigliarolo, J., Lance, B., Rockley, M., Schreiber, Y., Kivi, C., Dwyer, C., & Kelly, L. (2017). Rates of diabetes-related lower-limb amputation in northwestern Ontario: an incidence study and introduction of a standardized diabetic foot ulcer management protocol. Canadian Journal of Rural Medicine, 22(3), 100+. pdf (srpc.ca)

The FSPM will reduce the need for lower limb amputations and reduce hospitalizations of patients, enabling practitioners to meet current healthcare needs within the field without unnecessary delay and duplication of healthcare services and ensuring a more effective and efficient delivery of high-quality foot care to patients. The FSPM will most strikingly provide much needed footcare to Northerners and First Nations communities that available research data shows to have been traditionally underserviced.

It is expected that modernizing to a FSPM will attract more qualified podiatrists to the province. Based on comparative data, Ontario’s footcare needs can be met by over 3000 registered chiropodists and podiatrists in the province.

Additional resources:

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