Part 65, Podiatry

1. To meet the professional education requirements for licensure in this State, the applicant shall present evidence of:
   1. the completion of a program in podiatric medicine registered by the department, or completion of a program in podiatric medicine determined by the department to be the equivalent of a registered program; and
   2. having received the degree Doctor of Podiatric Medicine, or the equivalent as determined by the department, from a school offering a program which meets the requirements of paragraph (1) of this subdivision.
2. Courses failed in a school of podiatric medicine, for which credit has been granted toward meeting the requirements of a degree in podiatric medicine awarded by another school of podiatric medicine, may not be counted toward meeting the requirements of this section.

Each applicant for licensure who meets the requirements of section 65.1(a) of this Part shall pass an examination in the basic and clinical sciences and an entry-level clinical skills examination in accordance with the following:

1. Examination for basic and clinical sciences.
   1. An applicant who is a graduate of a school of podiatric medicine acceptable to the department may fulfill the examination requirement in the basic and clinical sciences by submitting evidence of having achieved grades acceptable to the department on Part I and Part II of the examination of the National Board of Podiatric Medical Examiners, Inc. or an examination determined to be comparable in content that does not unreasonably restrict access to the profession.
   2. The department may accept licensure examinations in the basic and clinical sciences of other states given prior to January 1, 1972 as fulfilling the written examination requirements for licensure.
2. Examination for entry-level clinical skills. All applicants for licensure who are graduates of schools of podiatric medicine acceptable to the department shall also be required to pass the Podiatric Medical Licensure Examination for States (PM Lexis) or an examination determined to be comparable in content that does not unreasonably restrict access to the profession.
3. The passing score on each part of the examination for basic and clinical sciences shall be 75.0 as determined by the board.
4. The passing score on the examination for entry-level clinical skills shall be 75.0 as determined by the board.

For issuance of a license to practice podiatry, all individuals who apply for licensure on or after July 1, 2000 shall have completed at least one year of supervised postgraduate hospital training in podiatry which is acceptable to the department. To be acceptable, such training shall be approved by the Council on Podiatric Medical Education or an equivalent organization which is acceptable to the department, or shall be approved by the department based on a review of the postgraduate hospital training, including but not limited to an examination of the following: the resources of the sponsoring institution, the teaching staff, the program design, the criteria for the selection of residents, the duties and responsibilities of residents, and the supervision of residents. Such one year of supervised postgraduate hospital training in podiatry shall mean a period of not less than 11 calendar months of full-time training or the equivalent, as determined by the department.

To be certified to administer or prescribe narcotics as authorized under section 7001 of the Education Law, a podiatrist licensed to practice in New York shall either:

1. have graduated from a college of podiatric medicine on or after May 1, 1972; or
2. have graduated from a college of podiatric medicine prior to May 1, 1972 and successfully completed a 12-hour program of study of narcotics as applicable to podiatric practice offered by a college of podiatric medicine and approved by the department.

1. A program of continuing education, within the meaning of subdivision (9) of section 7004 of the Education Law, shall consist of courses of instruction approved in advance by the State Board for Podiatry. The instructors of such courses shall be members of the faculty of a college of podiatric medicine accredited by the Council of Education of the American Podiatry Association, or authorities in the health sciences specially qualified, in the opinion of the State Board for Podiatry, to conduct such courses.
2. The person or organization conducting any such course shall submit a request for advance approval on forms provided by the department, and shall maintain such records concerning the course of instruction, the faculty, the enrollment and participation of podiatrists in such course, and such other matters as may be required by the State Board for Podiatry. The person conducting such course shall submit to the State Board for Podiatry, within 60 days after completion thereof, the names of those podiatrists who have participated, together with the number of hours each has satisfactorily completed.
3. To qualify for reregistration, a podiatrist shall have completed 1-4/10 hours of continuing education coursework for each month of the preceding registration period in which the podiatrist was registered to practice. The coursework must be taken from a provider approved by the department. To qualify for reregistration, at least two thirds of the continuing education coursework shall be in the areas of podiatric medicine and surgery. The remaining hours may be in the areas of health sciences and ethics related to the practice of podiatry.
4. An applicant for reregistration who is unable to meet the continuing education requirement due to circumstances beyond his control may apply to the board for a waiver of all or part of such requirement. The board may, in its discretion, require the completion of additional hours of continuing education in the succeeding registration period.

1. In accordance with section 7006(4) of the Education Law, an unlicensed person providing supportive services to a licensed podiatrist, incidental to and concurrent with such podiatrist personally performing a service or procedure, may operate radiographic equipment under the direct supervision of a licensed podiatrist, as defined in subdivision (b) of this section, for the sole purpose of foot radiography, provided that the following requirements are met:
   1. the type of radiographic equipment that is operated by the unlicensed person is the type of radiographic equipment approved by the New York State Department of Health for use by such an unlicensed person; and
   2. the unlicensed person has successfully completed a course of study of at least eight clock hours of in-person instruction, approved by the department pursuant to section 65.7 of this Part, prior to such operation of the radiographic equipment.
2. For purposes of this section, under the direct supervision of a licensed podiatrist means: supervision of radiographic procedures based on instructions given by a licensed podiatrist in the course of a procedure who remains in the podiatry office where the radiographic services are being performed, personally diagnoses the condition to be treated, personally authorizes the procedures and determines that the radiographic exposure of the foot should be made and the part or parts of the patient's foot which shall be exposed; and before dismissal of the patient, evaluates the services performed by the unlicensed assistant.
3. The supervising licensed podiatrist shall retain a copy of the certificate of completion, verifying that the unlicensed person has successfully completed a course of study approved by the department pursuant to section 65.7 of this Part, for a period of 22 years after the unlicensed person last provided radiographic services under the direct supervision of the licensed podiatrist.
4. The supervising licensed podiatrist shall be professionally responsible for ensuring that, prior to permitting an unlicensed person to operate radiographic equipment for the purpose of foot radiography, all of the requirements of this section have been met and that adequate safety protections are in place, consistent with the use of the radiographic equipment by an unlicensed person and the training obtained by the unlicensed person to perform radiographs of the foot.
5. Nothing in this section shall be construed to permit an unlicensed person to receive exposed and processed radiographs for the purpose of performing diagnostic interpretation or to practice podiatry, as such practice is defined in section 7001 of the Education Law.

1. Purpose. The purpose of this section is to set forth standards for a course of study required to be completed by unlicensed persons before such unlicensed persons may operate radiographic equipment for the sole purpose of foot radiography, while under the direct supervision of a licensed podiatrist, in accordance with the requirements of section 7006(4) of the Education Law and section 65.6 of this Part, and to establish requirements for providers of such a course of study.
2. Approval of course of study. To be approved by the department for purposes of section 7006(4) of the Education Law and section 65.6 of this Part, the course of study shall meet the requirements of this section and be approved by the department pursuant to the procedures of this section.
3. Standards for the course of study.
   1. Providers. The course of study shall be offered by degree-granting institutions that offer registered programs in the health professions or equivalent programs, hospitals or health facilities regulated pursuant to Article 28 of the Public Health Law, professional associations representing the health professions, or other entities that have as a purpose the provision of education or training on health care subjects to health professionals.
   2. Admission requirements.
      1. Candidates for admission to the course of study shall meet the following requirements:
         1. be at least 18 years of age;
         2. hold at least a high school diploma or its equivalent; and
         3. be of good moral character.
      2. All candidates for admission shall be required to submit a formal written application.
   3. Course of study.
      1. The course of study shall contain at least eight clock hours of in-person instruction.
      2. The instruction shall include the following content areas:
         1. basic radiation safety for the patient and the operator, and infection control techniques;
         2. positioning the patient for a podiatric radiograph;
         3. production of the radiograph; and
         4. developing radiographs.
      3. The course of study shall require the candidate to train on and operate radiographic equipment on nonhuman models. Such operation must be under the direct in-person observation and supervision of a licensed podiatrist who shall ensure the safe operation of the equipment. The equipment must be approved by the New York State Department of Health for use by an unlicensed person while under the direct supervision of a licensed podiatrist.
      4. The course of study shall require the unlicensed person to demonstrate competency in the operation of radiographic equipment for the purpose of foot radiography through successful completion of a practical examination using such equipment on nonhuman models and a written examination. Such practical examination must be under the direct in-person observation and supervision of a licensed podiatrist who shall ensure the safe and competent operation of the radiographic equipment.
      5. The provider shall prepare in written form and make use of a detailed curriculum, which describes learning objectives and competencies achieved by the course of study.
   4. Instructors. The course of study shall be taught by instructors who have demonstrated by training, education, and experience their competence to teach the course content prescribed in paragraph (3) of this subdivision.
   5. Facilities and equipment. The course of study shall be supported by adequate facilities, equipment, and other physical resources, including but not limited to, the type of radiographic equipment approved by the Department of Health for use by unlicensed persons while under the direct supervision of a licensed podiatrist. The provider must conform to all applicable statutes, rules and regulations relating to radiation safety standards.
4. Responsibilities of providers of the course of study.
   1. A provider of the course of study shall execute a certification of completion for each person successfully completing the course of study.
   2. Within 21 calendar days of the completion of course of study, the provider shall transmit a certification of completion to the person successfully completing the course of study for that person's use in documenting such completion.
   3. The provider shall retain in its files for not less than six years from the date of the conclusion of each session of the course of study: a copy of the certification of completion for students who successfully completed the course of study; a record of the dates of the course of study; the written applications submitted by all students who were admitted to the course of study; attendance in the course of study; the written curriculum for the course of study; instructors who taught the course of study; examination results; and such other matters as determined by the department to confirm participation in the course of study.
   4. In the event that the provider discontinues offering the course of study, upon such discontinuance, all records retained pursuant to paragraph (3) of this subdivision shall be transferred to the department.
5. Application for approval of course of study.
   1. Providers seeking approval of a course of study pursuant to this section shall submit to the department an application on forms prescribed by the department and a fee of $500 for the review of such course of study and the issuance of a permit from the department to become an approved provider.
   2. The department shall review the information contained in such application and may request and review additional information and may conduct site visits to ensure compliance with the requirements of this section.
6. Term of approval of course of study.
   1. The course of study shall be approved for a period of six years, except that the approved status of such course of study may be terminated during this term by the department in accordance with subdivision (g) of this section.
   2. At the expiration of said term, a provider may reapply to the department for approval of the course of study by following the requirements of subdivision (e) of this section, including payment of a required fee of $500, for the renewal of the permit from the department to be an approved provider for an additional six-year term.
7. Review of course of study.
   1. The department may review the course of study during the term of approval to ensure compliance with the requirements of this section and may request information from a provider and may conduct site visits, pursuant to such review.
   2. A determination by the department that the course of study offered by a provider is inadequate, incomplete, or otherwise unsatisfactory pursuant to standards set forth in this section shall result in the denial or termination of the approved status of the course of study.

(a)  Definitions.  As used in this section:

(1)  “Accrediting agency acceptable to the department” shall mean an organization accepted by the department as a reliable authority for the purpose of accrediting podiatric residencies and as having accreditation standards that are applied in a fair, consistent, and nondiscriminatory manner.

(2)  “Certification standards acceptable to the department” shall mean standards accepted by the department as reliable for the purpose of granting board qualification and certification to podiatrists engaged in reconstructive rearfoot and ankle surgery and applied in a fair, consistent, and nondiscriminatory manner.

1. (b)  For issuance of a privilege to perform podiatric standard ankle surgery, as that term is used in Education Law section 7001(2), the applicant shall:

   (1)  file an application with the department;

   (2)  be licensed as a podiatrist in the state;

   (3)  pay a fee of $220 to the department; and

   (4)  either:

   (i) (a)  have graduated on or after June 1, 2006 from a three-year residency program in podiatric medicine and surgery that was accredited by an accrediting agency acceptable to the department; and

   (b)  be certified in reconstructive rearfoot and ankle surgery by a national certifying board having certification standards acceptable to the department; or

   (ii) (a)  have graduated on or after June 1, 2006 from a three-year residency program in podiatric medicine and surgery that was accredited by an accrediting agency acceptable to the department; and

   (b)  be board qualified but not yet certified in reconstructive rearfoot and ankle surgery by a national certifying board having certification standards acceptable to the department; and

   (c)  provide documentation acceptable to the department that he or she has acceptable training and experience in standard or advanced midfoot, rearfoot and ankle procedures that consist of not less than 10 ankle procedures in the five years immediately preceding application, provided that not less than five procedures shall be osseous procedures and not less than five procedures shall be soft tissue procedures, and further provided that procedures performed in a residency program in podiatric medicine may be used to satisfy the requirements of this clause, if performed within the time constraints of this clause; or

   (iii) (a)  have graduated before June 1, 2006 from a two-year residency program in podiatric medicine and surgery that was accredited by an accrediting agency acceptable to the department; and

   (b)  be certified in reconstructive rearfoot and ankle surgery by a national certifying board having certification standards acceptable to the department; and

   (c)  provide documentation acceptable to the department that he or she has acceptable training and experience in standard or advanced midfoot, rearfoot and ankle procedures that consist of not less than 20 ankle procedures in the five years immediately preceding application, provided that not less than 10 procedures shall be osseous procedures and not less than 10 procedures shall be soft tissue procedures.

   (c)  For issuance of a privilege to perform podiatric advanced ankle surgery, as that term is used in Education Law section 7001(2), the applicant shall:

   (1)  file an application with the department;

   (2)  be licensed as a podiatrist in the state;

   (3)  pay a fee of $220 to the department; and

   (4)  either:

   (i) (a)  have graduated on or after June 1, 2006 from a three-year residency program in podiatric medicine and surgery that was accredited by an accrediting agency acceptable to the department; and

   (b)  be certified in reconstructive rearfoot and ankle surgery by a national certifying board having certification standards acceptable to the department; and

   (c)  provide documentation acceptable to the department that he or she has acceptable training and experience in advanced midfoot, rearfoot and ankle procedures that consist of:

   (1)  not less than 10 ankle procedures in the five years immediately preceding application, provided that not less than five procedures shall be osseous procedures and not less than five procedures shall be soft tissue procedures, and further provided that procedures performed in a residency program in podiatric medicine may be used to satisfy the requirements of this subclause, if performed within the time constraints of this subclause; and

   (2)  not less than 15 procedures in the following categories in the ten years immediately preceding application, which shall include the specified numbers for each type of procedure, provided that procedures performed in a residency program in podiatric medicine may be used to satisfy the requirements of this subclause, if performed within the time constraints of this subclause, and further provided that the same procedure may be used to satisfy the requirements of both this subclause and subclause (1) of this clause, if it, in fact, meets the requirements of both:

   (i)  not less than three ankle fracture fixation procedures, which may include, but are not limited to:

   (A)  the insertion or removal of external fixation pins into or from the tibial diaphysis at or below the level of the myotendinous junction of the triceps surae; and

   (B)  the insertion and removal of retrograde tibiotalocalcaneal intramedullary rods and locking screws up to the level of the myotendinous junction of the triceps surae;

   (ii)  not less than three ankle fusion procedures; and

   (iii)  not less than one ankle arthroscopy; or

   (ii) (a)  have graduated before June 1, 2006 from a two-year residency program in podiatric medicine and surgery that was accredited by an accrediting agency acceptable to the department; and

   (b)  be certified in reconstructive rearfoot and ankle surgery by a national certifying board having certification standards acceptable to the department; and

   (c)  provide documentation acceptable to the department that he or she has acceptable training and experience in advanced midfoot, rearfoot and ankle procedures that consist of:

   (1)  not less than 20 ankle procedures in the five years immediately preceding application, provided that not less than 10 procedures shall be osseous procedures and not less than 10 procedures shall be soft tissue procedures; and

   (2)  not less than 15 procedures in the following categories in the ten years immediately preceding application, which shall include the specified numbers for each type of procedure, provided that procedures performed in a residency program in podiatric medicine may be used to satisfy the requirements of this subclause, if performed within the time constraints of this subclause, and further provided that the same procedure may be used to satisfy the requirements of both this subclause and subclause (1) of this clause, if it, in fact, meets the requirements of both:

   (i)  not less than three ankle fracture fixation procedures, which may include, but are not limited to:

   (A)  the insertion or removal of external fixation pins into or from the tibial diaphysis at or below the level of the myotendinous junction of the triceps surae; and

   (B)  the insertion and removal of retrograde tibiotalocalcanneal intramedullary rods and locking screws up to the level of the myotendinous junction of the triceps surae;

   (ii)  not less than three ankle fusion procedures; and

   (iii)  not less than one ankle arthroscopy.