Connecticut Podiatry Licensing: The Four-Year Route and Ankle Documentation

Connecticut licenses podiatrists through its Department of Public Health (DPH), with the Connecticut Board of Examiners in Podiatry. For a podiatrist already licensed elsewhere, it offers two routes that skip the exam, and one of them asks for almost nothing beyond proof of clean practice. The complexity in Connecticut is not the license. It is the ankle, which the license covers only in tiers.

What is the four-year route?

DPH's page for "Applicants Licensed in Another US State for at Least 4 Years" says the department may issue a license to someone who:

• holds a current license in at least one other US jurisdiction in the same profession;
• has practiced for at least four years;
• has every license, current or expired, in good standing, has never had a license revoked or disciplined anywhere in the US, has no complaint, allegation or investigation pending, and has never surrendered a license while under investigation; and
• pays the same fees as other applicants.

The only documents are verifications of every state license you hold or have held, sent directly to DPH. The online application asks a question about four years of licensed work experience, and DPH says that if you answer yes, "you will not be required to provide transcripts, verification of any training or be required to complete an examination." The fee is $565.

The catch is the clean record. "Never had a license ... disciplined" is absolute on this route. A podiatrist with any past discipline, however minor, uses the waiver route instead, where DPH has more discretion.

When does the waiver of examination route fit?

Under C.G.S. 20-57, DPH may accept a National Board certificate or another state's license "in lieu of the written examination" if the applicant graduated from a recognized podiatry school, comes from a state whose standards are "equal to or higher than" Connecticut's, and is in good professional standing. No license issues while discipline is pending or a complaint is unresolved. DPH's waiver page lists the documents, each sent from the source:

1. A Federation of Podiatric Medical Boards disciplinary inquiry.
2. Verification of every out-of-state license, current or expired.
3. The current licensure statutes, regulations and policies of the state where you are licensed, sent from that state.
4. The online application with a photograph, and the $565 fee.

DPH reviews the file administratively, decides eligibility and notifies you in writing, and asks applicants to allow four to six weeks. If it finds your state's requirements are not equal to Connecticut's, you can still pursue a license by meeting the full first-time requirements: two years of prepodiatry college coursework including chemistry, physics or mathematics, and biology; a CPME-accredited DPM; APMLE Parts I to III; official transcripts; and the FPMB disciplinary inquiry. Connecticut's requirements page lists no residency year. Scores now go to boards through your own Meazure Learning Connect account; see where APMLE scores come from now.

Does a Connecticut license cover the ankle?

In three tiers, under C.G.S. 20-50 and 20-54. The definition of podiatric medicine includes the foot and ankle, "in accordance with section 20-54," and that section is where the conditions sit.

Nonsurgical ankle care. A podiatrist who is board qualified or certified by the American Board of Foot and Ankle Surgery (ABFAS) or the American Board of Podiatric Medicine (ABPM) may provide medical and nonsurgical treatment of the ankle (20-54(b)). Displaced ankle fractures are limited to the initial diagnosis and the initial attempt at closed reduction, and tibial pilon fractures are excluded.

Independent ankle surgery. Under 20-54(c), a podiatrist may independently perform ankle surgery after giving DPH documentation of either:

• graduation on or after June 1, 2006, from a three-year CPME-accredited residency in podiatric medicine and surgery, plus current ABFAS board certification or qualification in reconstructive rearfoot ankle surgery; or
• graduation before June 1, 2006, from a CPME-accredited residency at least two years long, plus the same current ABFAS certification or qualification.

The statute defines "surgical treatment of the ankle" broadly: soft tissue and osseous procedures including ankle fracture fixation, fusion, arthroscopy, external fixation pins and retrograde tibiotalocalcaneal rods up to the myotendinous junction of the triceps surae, and Chopart joint-level amputation. It excludes total ankle replacements, tibial pilon fractures and surgical treatment of complications in the tibial diaphysis from external fixation pins. DPH lists total ankle replacement surgery in a Connecticut hospital as a separate topic on its podiatry page.

Supervised ankle surgery. An ABFAS-certified podiatrist without the filed documentation may perform ankle surgery under the direct supervision of a physician who holds hospital privileges for the procedure, or of a podiatrist who has filed it (20-54(e)).

How do you file the ankle documentation?

DPH's ankle surgery page asks for a verification form documenting your residency and its length, and verification of current ABFAS certification or qualification in reconstructive rearfoot ankle surgery, both sent directly from the source. The statute lets you file it with your initial license application (20-54(d)), which is the efficient way for a surgeon moving to Connecticut. Once accepted, DPH emails you and adds an indicator to its license lookup and its downloadable roster, "where it can be confirmed by credentialing boards, hospitals and the public." Podiatrists who held a standard ankle surgery permit on October 1, 2018, are treated as having met the requirement.

The documentation is not hospital privileges. Section 20-54(f) says it does not obligate any hospital or outpatient surgical facility to grant privileges, and C.G.S. 20-50a requires podiatric surgery needing more than local anesthesia to take place in an accredited hospital or surgery center, by a podiatrist accredited by that facility's credentials committee. Privileging is its own file; see hospital privileging, FPPE and OPPE on our sister site and hospital privileges and a state license.

Which other registrations does Connecticut require?

Prescribers need a Connecticut Controlled Substance Registration from the Department of Consumer Protection's Drug Control Division. DPH notes it is "a prerequisite for the Federal Drug Enforcement Administration registration," so the state registration comes first and the DEA registration for your Connecticut address second. See state controlled-substance licenses. DPH's fees page lists $565 for an initial license and $570 for renewal, and podiatry does not appear on DPH's list of license types with continuing education requirements.

How can we help with Connecticut?

For most experienced podiatrists, Connecticut is our Podiatrist License by Endorsement service, $799 per state: we confirm which route your record fits, prepare the online application for your signature, request verifications from every state that licensed you and, on the waiver route, the FPMB inquiry and your state's statutes and rules. For surgeons, the Ankle and Scope Credential Add-On ($499 per state) assembles the residency verification and ABFAS documentation so DPH can accept it with the license. The $199 DEA and State Controlled-Substance Registration service handles the Department of Consumer Protection registration and the DEA registration in the right order. You sign everything and pay DPH, DCP and DEA directly. The Connecticut state page and the scope by state page keep the details current, and ankle surgery scope by state compares Connecticut's tiers with other states.