Education, Training and Certification of Foot and Ankle Surgeons
Approved by the ACFAS Board of Directors November 2025
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Surgery, and/or in Reconstructive Rearfoot/Ankle Surgery by the American Board of Foot and Ankle Surgery (ABFAS) are the only board-certified physicians specifically trained to diagnose and treat surgical problems of the foot and ankle. They are an integral part of the healthcare team, and combined with all other podiatric physicians, treat the majority of foot and ankle related surgical issues in the U.S.
Each ABFAS Board Certified Foot and Ankle Surgeon has:
- Completed four years of Podiatric Medical School.
Identical in length to allopathic and osteopathic medical schools, the podiatric medical school curriculum covers basic and clinical sciences, including, but not limited to general anatomy; pathology; biochemistry; pharmacology; general medicine; surgery; pediatrics; behavioral sciences; and ethics. Unlike allopathic and osteopathic medical schools, the podiatric medical school curriculum also provides intensive foot and ankle specialty specific education beginning in the first year. - Completed post-graduate Podiatric Medicine and Surgery (PMSR) Residency (formerly known as PSR, PM&S-24 or PM&S-36).
Similar to, and often integrated with residencies for MDs and DOs, podiatric surgical residency programs require training in general surgery, internal medicine, medical imaging, emergency medicine, anesthesiology as well as other non-podiatric specialties. The critical difference, though, is in the volume of cases and time spent in foot and ankle specific training. Podiatric surgical residency programs, which are a minimum of three years, provide substantial case diversity and volume requirements in foot, rearfoot and ankle surgery. Doctors of Podiatric Medicine will have demonstrated a cognitive knowledge of foot and ankle surgery, including the diagnosis and treatment of general medical problems and surgical management of foot and ankle diseases, deformities, and/or trauma, and those structures that affect the foot, ankle, and leg.1
The Board Certification Difference
The American Board of Foot and Ankle Surgery (ABFAS) certifies foot and ankle surgeons who have successfully completed a comprehensive and demanding certification process. To qualify for surgical certification examination, candidates must have completed a Council on Podiatric Medical Education (CPME) accredited 4-year podiatric college followed by completion of a CPME accredited 3-year minimum residency program. Candidates then become Board Qualified by completing Part I of the examination process which includes two examinations: Didactic and a Computer Based Patient Simulation (CBPS). All Board Qualified foot and ankle surgeons must have an active and unrestricted state podiatric medical license as well as surgical hospital privileges. The final step is the hallmark of surgical board certification which includes a rigorous case review process. Upon successful completion, an ABFAS Diplomate must maintain certification by being surgically active, obtaining 100 CMEs every five years, and participation in a longitudinal continuous certification process.
The critical differences between Board Certified Foot and Ankle Surgeons (DPMs) and Board-Certified Orthopedists (MD/DOs) are:
- The ABFAS certification process involves examination specific to the foot and ankle. The vast majority of the ABFAS board certification examination is relevant to the foot, ankle and lower leg.
- The ABFAS certification process involves proving experience specifically in the performance of foot and ankle surgical procedures, whereas the ABOS does not.
- The ABFAS certification process certifies podiatric physicians specifically in foot and ankle surgery. There is no foot and ankle specific certification process for orthopaedic surgeons.
The Practice Difference
All surgical specialists including the foot and ankle surgeon (DPM) are credentialed and privileged by hospitals, surgery centers, medical centers and educational institutions in a standardized process, specified by recognized accrediting organizations.2 This process, however, may not require board-certified orthopaedists to demonstrate any special skills or training in foot and ankle surgery, whereas foot and ankle surgeons (DPMs) must demonstrate training and experience specific to the foot and ankle to obtain privileges.
- Board Certified and Board Qualified Foot and Ankle Surgeons (DPM) exclusively limit their practice to the care of the foot and ankle, whereas the majority of general orthopaedists treat a multitude of musculoskeletal complaints throughout the entire body.
- Board Certified and Board Qualified Foot and Ankle Surgeons (DPM) and orthopaedists are both required to attend Continuing Medical Education courses on a yearly basis to maintain state licensure.
1 ABFAS Information and Requirements for Board Certification
2Recognized accrediting organizations include the Joint Commission; the Accreditation Association for Ambulatory Health Care; the
American Osteopathic Association; the American Association for Accreditation of Ambulatory Surgery Facilities, Inc.; National
Committee for Quality Assurance; the organization formerly known as URAC, and others.
The American College of Foot and Ankle Surgeons is a professional society of over 8,00 foot and ankle surgeons. Founded in 1942, the College’s mission is to advance excellence in foot and ankle surgery to achieve superior patient outcomes.