Are Biomechanics Emphasized Enough In Podiatric Education?

There is a prevailing notion that most podiatric students want to become accomplished podiatric surgeons as opposed to “experts in biomechanics of the foot.” However, educators and authors strongly emphasize the biomechanical knowledge of form and function as essential to being a successful podiatrist. “Biomechanical training sets podiatrists apart from other disciplines that treat the feet,” notes one established biomechanics author. It is also the critical foundation for those who wish to become podiatric surgeons. After all, more than a few educators call podiatric surgery “applied biomechanics.” One podiatric educator concurs, noting that many poor surgical outcomes can be attributed to a surgeon not having a firm grasp of biomechanics principles. Clearly, there are large discrepancies between the schools when it comes to biomechanics education. While a few schools have a specific department dedicated to biomechanics, others do not and one school has recently decreased the number of contact hours required for biomechanics. Another problem is finding qualified and dedicated people to teach biomechanics. One biomechanics expert laments that “many faculty members are not familiar with the latest theories or research in biomechanics,” and adds that the leading voices in biomechanics may teach part-time at the colleges but tend to “go into practice to earn a much better living.” Are there feasible solutions? Some suggest an improved emphasis in the following areas. • Incorporate biomechanics into the surgical courses. In addition to offering five courses dedicated to biomechanics, an educator at the new Arizona Podiatric Medical Program (AZPod) at Midwestern University says the program will integrate biomechanics throughout many of the surgical courses. • Emphasize more hands-on education in biomechanics. Perhaps the best existing models for podiatric biomechanics are the programs offered at the California School of Podiatric Medicine (CSPM) at Samuel Merritt College and the New York College of Podiatric Medicine (NYCPM). CSPM has a formal biomechanics department, three semesters of biomechanics and a lab where students can practice a biomechanical exam, gait evaluation and casting for orthotics. NYCPM has three functional orthopedics courses and courses in biomechanics, sports medicine, physical therapy, padding and strapping. Third-year students at both schools also receive biomechanical training in the clinic setting, seeing patients with a dedicated clinician. Some biomechanics educators would like to incorporate a biomechanics rotation into the program for fourth-year students. Ideally, the rotation would give students “the opportunity to examine, cast, dispense and do a follow-up on patients who receive orthotics.” However, educators concede that adding a quality rotation to an already highly structured fourth year may be difficult with the time constraints. • Address the lack of post-graduate training in biomechanics. From 1975 to 1999, the California college offered a one-year fellowship in biomechanics, which has been widely praised as a vital cornerstone for many of the profession’s leading authorities on the subject. Bringing back the fellowship not only at CSPM but potentially at all the schools may help facilitate a new generation of biomechanics educators, according to those in the know. Educators also emphasize that developing residencies for biomechanics training is another key need for the profession. Principles of biomechanics may not be as glamorous as applying a new surgical device but many say they are the key foundation to learning all aspects of podiatry. Hopefully, we’ll see this emphasized more universally at the colleges and other levels of podiatric education in the future.