§ 20-54 — Qualifications for general practice, medical and nonsurgical treatment of the ankle and surgical treatment of the ankle. Licensure. Exception for surgery under the direct supervision of a physician or surgeon. Effect of license on hospital privileges.

Connecticut § 20-54

• Jurisdiction: Connecticut
• Title 20: Professional and Occupational Licensing, Certification, Title Protection and Registration. Examining Boards
• Ch. 375: Podiatry

Text

(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 Connecticut 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 Connecticut 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 Foot and Ankle Surgery or the American Board of Podiatric Medicine, or said boards' successor organizations, 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) A 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, after the podiatrist provides documentation to the Department of Public Health of the following: (1) (A) Graduation 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) current board certification or qualification in reconstructive rearfoot ankle surgery by the American Board of Foot and Ankle Surgery, or its successor organization; or (2) (A) graduation prior to June 1, 2006, from a residency program in podiatric medicine and surgery that was at least two years in length and accredited at the time of graduation by said council, and (B) current board certification or qualification in reconstructive rearfoot ankle surgery by the American Board of Foot and Ankle Surgery, or its successor organization. For purposes of this section, “surgical treatment of the ankle” includes all soft tissue and osseous procedures, including 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, insertion and removal of retrograde tibiotalocalcaneal intramedullary rods and locking screws up to the level of the myotendinous junction of the triceps surae and Chopart joint-level amputation, but does not include the surgical treatment of complications within the tibial diaphysis related to the use of external fixation pins, the performance of total ankle replacements or the treatment of tibial pilon fractures. (d) The Department of Public Health shall implement a mechanism for (1) a podiatrist to provide the documentation required pursuant to subsection (c) of this section as part of the initial licensure application, and (2) credentialing boards and the public to access the names of podiatrists who submitted the documentation required pursuant to said subsection. Any podiatrist who, on October 1, 2018, held a standard ankle surgery permit issued by the department shall be considered to have met the documentation requirements set forth in said subsection. (e) A licensed podiatrist who is board certified in foot and ankle surgery by the American Board of Foot and Ankle Surgery, or its successor organization, may engage in the surgical treatment of the ankle, 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 under the provisions of subsection (c) of this section, as appropriate, may independently engage in ankle surgery procedures. (f) The Department of Public Health's issuance of a license to a podiatrist to independently engage in surgery 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. A podiatrist's privileges and scope of practice for foot surgery are not impacted by the podiatrist's privileges or scope of practice for ankle surgery. See Sec. 19a-88 re annual renewal of licenses.

Legislative History

(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; P.A. 13-305, S. 4; P.A. 18-168, S. 70; P.A. 24-112, S. 1.) 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; P.A. 13-305 amended Subsec. (d) by deleting provision re exception for performance of tibial and fibular osteotomies, amended Subsec. (e) by substituting “qualification” for “certification” in Subdiv. (1)(B), and amended Subsec. (h) by adding provision requiring commissioner to adopt regulations not later than July 1, 2015; P.A. 18-168 amended Subsec. (b) by replacing “American Board of Podiatric Surgery or the American Board of Podiatric Orthopedics and Primary Podiatric Medicine” with “American Board of Foot and Ankle Surgery or the American Board of Podiatric Medicine, or said boards' successor organizations,”, substantially amended Subsecs. (c) and (d) including by adding provisions re surgical treatment of the ankle, deleted former Subsec. (e) re permit to independently engage in advanced ankle surgery procedures, redesignated Subsec. (f) as new Subsec. (e) and amended same to delete provisions re podiatrist qualifications to engage in surgical treatment of the ankle, deleted former Subsecs. (g) and (h), redesignated Subsec. (i) as Subsec. (f) and amended same to add provision re podiatrist's privileges and scope of practice, and made technical and conforming changes; P.A. 24-112 amended Subsec. (c) by making a technical change and adding provision authorizing podiatrists to perform Chopart joint-level amputations. Cited. 207 C. 674.