Sec. 20-54. Qualifications for general practice, medical and nonsurgical treatment of the ankle and surgical treatment of the ankle. Permits. Exception for surgery under the direct supervision of a ph
Sec. 20-54. Qualifications for general practice, medical and nonsurgical treatment of the ankle and surgical treatment of the ankle. Permits. Exception for surgery under the direct supervision of a physician or surgeon. Regulations. Effect of
permit on hospital privileges. (a) No person other than those described in section 20-57 and those to whom a license has been reissued as provided by section 20-59 shall
engage in the practice of podiatry in this state until such person has presented to the
department satisfactory evidence that such person has received a diploma or other certificate of graduation from an accredited school or college of chiropody or podiatry approved by the Board of Examiners in Podiatry with the consent of the Commissioner
of Public Health, nor shall any person so practice until such person has obtained a license
from the Department of Public Health after meeting the requirements of this chapter.
A graduate of an approved school of chiropody or podiatry subsequent to July 1, 1947,
shall present satisfactory evidence that he or she has been a resident student through
not less than four graded courses of not less than thirty-two weeks each in such approved
school and has received the degree of D.S.C., Doctor of Surgical Chiropody, or Pod.
D., Doctor of Podiatry, or other equivalent degree; and, if a graduate of an approved
chiropody or podiatry school subsequent to July 1, 1951, that he or she has completed,
before beginning the study of podiatry, a course of study of an academic year of not
less than thirty-two weeks' duration in a college or scientific school approved by said
board with the consent of the Commissioner of Public Health, which course included
the study of chemistry and physics or biology; and if a graduate of an approved college
of podiatry or podiatric medicine subsequent to July 1, 1971, that he or she has completed
a course of study of two such prepodiatry college years, including the study of chemistry,
physics or mathematics and biology, and that he or she received the degree of D.P.M.,
Doctor of Podiatric Medicine. No provision of this section shall be construed to prevent
graduates of a podiatric college, approved by the Board of Examiners in Podiatry with
the consent of the Commissioner of Public Health, from receiving practical training in
podiatry in a residency program in an accredited hospital facility which program is
accredited by the Council on Podiatric Education.
(b) A licensed podiatrist who is board qualified or certified by the American Board
of Podiatric Surgery or the American Board of Podiatric Orthopedics and Primary Podiatric Medicine may engage in the medical and nonsurgical treatment of the ankle and
the anatomical structures of the ankle, as well as the administration and prescription of
drugs incidental thereto, and the nonsurgical treatment of manifestations of systemic
diseases as they appear on the ankle. Such licensed podiatrist shall restrict treatment of
displaced ankle fractures to the initial diagnosis and the initial attempt at closed reduction
at the time of presentation and shall not treat tibial pilon fractures. For purposes of this
section, "ankle" means the distal metaphysis and epiphysis of the tibia and fibula, the
articular cartilage of the distal tibia and distal fibula, the ligaments that connect the distal
metaphysis and epiphysis of the tibia and fibula and the talus, and the portions of skin,
subcutaneous tissue, fascia, muscles, tendons and nerves at or below the level of the
myotendinous junction of the triceps surae.
(c) No licensed podiatrist may independently engage in the surgical treatment of
the ankle, including the surgical treatment of the anatomical structures of the ankle, as
well as the administration and prescription of drugs incidental thereto, and the surgical
treatment of manifestations of systemic diseases as they appear on the ankle, until such
licensed podiatrist has obtained a permit from the Department of Public Health after
meeting the requirements set forth in subsection (d) or (e) of this section, as appropriate.
No licensed podiatrist who applies for a permit to independently engage in the surgical
treatment of the ankle shall be issued such permit unless (1) the commissioner is satisfied
that the applicant is in compliance with all requirements set forth in subsection (d) or
(e) of this section, as appropriate, and (2) the application includes payment of a fee in
the amount of one hundred dollars. For purposes of this section, "surgical treatment of
the ankle" does not include the performance of total ankle replacements or the treatment
of tibial pilon fractures.
(d) The Department of Public Health may issue a permit to independently engage
in standard ankle surgery procedures to any licensed podiatrist who: (1) (A) Graduated
on or after June 1, 2006, from a three-year residency program in podiatric medicine
and surgery that was accredited by the Council on Podiatric Medical Education, or its
successor organization, at the time of graduation, and (B) holds and maintains current
board certification in reconstructive rearfoot ankle surgery by the American Board of
Podiatric Surgery, or its successor organization; (2) (A) graduated on or after June 1,
2006, from a three-year residency program in podiatric medicine and surgery that was
accredited by the Council on Podiatric Medical Education, or its successor organization,
at the time of graduation, (B) is board qualified, but not board certified, in reconstructive
rearfoot ankle surgery by the American Board of Podiatric Surgery, or its successor
organization, and (C) provides documentation satisfactory to the department that such
licensed podiatrist has completed acceptable training and experience in standard or advanced midfoot, rearfoot and ankle procedures; or (3) (A) graduated before June 1, 2006,
from a residency program in podiatric medicine and surgery that was at least two years
in length and was accredited by the Council on Podiatric Medical Education at the
time of graduation, (B) holds and maintains current board certification in reconstructive
rearfoot ankle surgery by the American Board of Podiatric Surgery, or its successor
organization, and (C) provides documentation satisfactory to the department that such
licensed podiatrist has completed acceptable training and experience in standard or advanced midfoot, rearfoot and ankle procedures; except that a licensed podiatrist who
meets the qualifications of subdivision (2) of this subsection may not perform tibial and
fibular osteotomies until such licensed podiatrist holds and maintains current board
certification in reconstructive rearfoot ankle surgery by the American Board of Podiatric
Medicine, or its successor organization. For purposes of this subsection, "standard ankle
surgery procedures" includes soft tissue and osseous procedures.
(e) The Department of Public Health may issue a permit to independently engage
in advanced ankle surgery procedures to any licensed podiatrist who has obtained a
permit under subsection (d) of this section, or who meets the qualifications necessary
to obtain a permit under said subsection (d), provided such licensed podiatrist: (1) (A)
Graduated on or after June 1, 2006, from a three-year residency program in podiatric
medicine and surgery that was accredited by the Council on Podiatric Medical Education, or its successor organization, at the time of graduation, (B) holds and maintains
current board certification in reconstructive rearfoot ankle surgery by the American
Board of Podiatric Surgery, or its successor organization, and (C) provides documentation satisfactory to the department that such licensed podiatrist has completed acceptable
training and experience in advanced midfoot, rearfoot and ankle procedures; or (2) (A)
graduated before June 1, 2006, from a residency program in podiatric medicine and
surgery that was at least two years in duration and was accredited by the Council on
Podiatric Medical Education at the time of graduation, (B) holds and maintains current
board certification in reconstructive rearfoot ankle surgery by the American Board of
Podiatric Surgery, or its successor organization, and (C) provides documentation satisfactory to the department that such licensed podiatrist has completed acceptable training
and experience in advanced midfoot, rearfoot and ankle procedures. For purposes of
this subsection, "advanced ankle surgery procedures" includes ankle fracture fixation,
ankle fusion, ankle arthroscopy, 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 insertion and removal of retrograde tibiotalocalcaneal intramedullary rods
and locking screws up to the level of the myotendinous junction of the triceps surae,
but does not include the surgical treatment of complications within the tibial diaphysis
related to the use of such external fixation pins.
(f) A licensed podiatrist who (1) graduated from a residency program in podiatric
medicine and surgery that was at least two years in duration and was accredited by the
Council on Podiatric Medical Education, or its successor organization, at the time of
graduation, and (2) (A) holds and maintains current board certification in reconstructive
rearfoot ankle surgery by the American Board of Podiatric Surgery, or its successor
organization, (B) is board qualified in reconstructive rearfoot ankle surgery by the American Board of Podiatric Surgery, or its successor organization, or (C) is board certified
in foot and ankle surgery by the American Board of Podiatric Surgery, or its successor
organization, may engage in the surgical treatment of the ankle, including standard
and advanced ankle surgery procedures, without a permit issued by the department in
accordance with subsection (d) or (e) of this section, provided such licensed podiatrist
is performing such procedures under the direct supervision of a physician or surgeon
licensed under chapter 370 who maintains hospital privileges to perform such procedures or under the direct supervision of a licensed podiatrist who has been issued a
permit under the provisions of subsection (d) or (e) of this section, as appropriate, to
independently engage in standard or advanced ankle surgery procedures.
(g) The Commissioner of Public Health shall appoint an advisory committee to
assist and advise the commissioner in evaluating applicants' training and experience
in midfoot, rearfoot and ankle procedures for purposes of determining whether such
applicants should be permitted to independently engage in standard or advanced ankle
surgery procedures pursuant to subsection (d) or (e) of this section. The advisory committee shall consist of four members, two of whom shall be podiatrists recommended
by the Connecticut Podiatric Medical Association and two of whom shall be orthopedic
surgeons recommended by the Connecticut Orthopedic Society.
(h) The Commissioner of Public Health shall adopt regulations, in accordance with
chapter 54, to implement the provisions of subsections (c) to (f), inclusive, of this section.
Such regulations shall include, but not be limited to, the number and types of procedures
required for an applicant's training or experience to be deemed acceptable for purposes
of issuing a permit under subsection (d) or (e) of this section. In identifying the required
number and types of procedures, the commissioner shall seek the advice and assistance
of the advisory committee appointed under subsection (g) of this section and shall consider nationally recognized standards for accredited residency programs in podiatric
medicine and surgery for midfoot, rearfoot and ankle procedures. The commissioner
may issue permits pursuant to subsections (c) to (e), inclusive, of this section prior to
the effective date of any regulations adopted pursuant to this section.
(i) The Department of Public Health's issuance of a permit to a licensed podiatrist
to independently engage in the surgical treatment of the ankle shall not be construed to
obligate a hospital or outpatient surgical facility to grant such licensed podiatrist privileges to perform such procedures at the hospital or outpatient surgical facility.
(1949 Rev., S. 4552, 4556; 1949, S. 2274d; 1955, S. 2273d; 1963, P.A. 247; 1971, P.A. 124; 1972, P.A. 232; P.A. 76-113, S. 4; P.A. 77-614, S. 323, 610; P.A. 80-484, S. 25, 176; P.A. 81-472, S. 133, 159; P.A. 91-113, S. 3; P.A. 93-381, S.
9, 39; P.A. 95-257, S. 12, 21, 58; P.A. 06-160, S. 1; P.A. 07-252, S. 25, 34.)
History: 1963 act added provision re one who has received a degree equivalent to a D.S.C. or Pod. D; 1971 act added
requirements applicable to persons graduating from approved podiatry colleges after July 1, 1971; 1972 act allowed mathematics study as alternative to physics study for graduates after July 1, 1971; P.A. 76-113 deleted citizenship requirement
for applicants; P.A. 77-614 replaced department of health with department of health services, effective January 1, 1979;
P.A. 80-484 substituted "license" for "certificate", required presentation of credentials to health services department rather
than to board of examiners, required consent of health services commissioner for approval of schools or colleges and
deleted requirements that applicant be or intends to become a resident, that he be of good moral character and that he have
received from board of examiners a certificate of qualification; P.A. 81-472 made technical changes; P.A. 91-113 amended
section to clarify residency programs for graduates of podiatric colleges and to specify that diploma or certificate must be
from an accredited school or college; P.A. 93-381 replaced department and commissioner of health services with department
and commissioner of public health and addiction services, effective July 1, 1993; P.A. 95-257 replaced Commissioner and
Department of Public Health and Addiction Services with Commissioner and Department of Public Health, effective July
1, 1995; P.A. 06-160 designated existing language as Subsec. (a) and made technical changes therein for the purpose of
gender neutrality, and added Subsec. (b) defining "ankle" and authorizing certain qualified or certified licensed podiatrists
to engage in medical and nonsurgical treatment of the ankle; P.A. 07-252 amended Subsec. (a) by eliminating requirement
that applicants present evidence of a high school education or its equivalent, made a technical change in Subsec. (b) and
added Subsecs. (c) to (i) establishing qualifications for obtaining a permit to engage in surgical treatment of the ankle,
standard ankle surgery procedures and advanced ankle surgery procedures and establishing qualifications for engaging in
standard and advanced ankle surgery procedures without a permit, establishing an advisory committee to assist and advise
commissioner in evaluating applicants' credentials, requiring adoption of regulations specifying credentials necessary to
obtain a permit for engaging in standard or advanced ankle surgery procedures and preserving rights of hospitals and
outpatient surgical facilities re granting privileges to perform procedures.
See Sec. 19a-88 re annual renewal of licenses.
Sec. 20-51 et seq. cited. 207 C. 674.