In relation to limited residence and limited fellowship permits in the area of podiatric medicine

The proposed legislation would amend section 7008 of the Education Law to extend the duration of limited residency permits to allow permit holders to complete the residencies that they undertake to meet the postgraduate training requirements for licensure. It also establishes a limited fellowship permit to authorize fellows to participate only in approved fellowship programs and to assure that they are appropriately supervised. The proposed legislation would also amend section 7005 of the Education Law to expand the student exemption to students enrolled in approved podiatry programs in other jurisdictions.

Summary of the Provisions of the Bill:

Section 1 amends section 7008 of the Education Law to authorize the Department to issue limited fellowship permits, in addition to limited residency permits, to graduates of a program of professional education in podiatry registered by the Department or accredited by an accrediting agency acceptable to the Department. The bill also extends the duration of the permits from one year to three years and provides for the oppor- tunity for the permits to be renewed for additional one-year periods when necessary to permit the completion of an approved post-graduate residency or fellowship in podiatric medicine. The bill also establishes a fee for a limited fellowship permit of $105, and the fee for renewal of a limited fellowship permit shall be $50.

Section 2 authorizes students to engage in clinical practice under the supervision of a licensed podiatrist as part of a program in an approved school of podiatry by making them exempt persons.

Section 3 sets forth an immediate effective date.

Statement in Support of the Bill:

Presently, in order to be eligible for licensure as a podiatrist, indi- viduals must complete at least one year of supervised postgraduate hospital training in podiatry. The only way to get the required training is through a hospital-based residency program. Those programs are a minimum of 3 years in length, and some are longer. In order for resi- dents to have the authority to provide the clinical services performed in podiatric residency programs, Education Law section 7008 was added to create limited residency permits. Such permits are necessary to enable applicants for licensure to complete the required clinical training and to permit residents to complete their nationally accredited training programs.

Since the enactment of Education Law section 7008, the length of podia- tric residency programs has increased. Current law limits the duration of a limited residency permit to one year, and it may only be renewed for one or two additional years at the discretion of the Department. As a result, permit holders may be unable to complete the residencies that they undertake to meet the postgraduate training requirements for licen- sure as a podiatrist and that are required for specialty board certif- ication. Therefore, this bill amends Education Law section 7008 to authorize an initial three year limited residency permit, with annual renewals thereafter, at the discretion of the Department, to enable the limited residency permit holder to complete his or her residency.

In addition to residency programs, there are additional opportunities for postgraduate training in podiatry through podiatric fellowship programs which afford participants the opportunity to receive advanced training in a specialty area. Currently, there are three fellowship programs in New York State which are approved by the Council on Podia- tric Medical Education. Two of these programs are in wound care, and the third is in wound care and tissue healing. The three programs have a total of 10 fellowship positions. The opportunity to participate in podiatric fellowship programs provides an opportunity for New York licensed podiatrists to develop their skills in specialty areas, thus benefitting the New York residents whom they serve. Fellowships also attract podiatrists from other jurisdiction to come to New York, which may lead them to relocate in this state, where New York patients would be able to benefit from their advanced training.

Some fellows are not licensed in New York, as a result of which they would be unable to practice in this state without a credential authoriz- ing them to do so. Moreover, the fellowship programs typically involve treating parts of the body that are not within the scope of practice of podiatry. In this they are similar to residency programs, for which limited residency permits were enacted to authorize such treatment. Thus, even those podiatrists who are licensed in New York would require a credential to authorize the expanded scope of practice.

Amending Education Law section 7008 to include limited fellowship permits, will assure that fellows participate only in approved fellow- ship programs and that they are appropriately supervised.

Finally, this bill makes necessary changes to the student exemption provision of Education Law section 7005. Most professions have a statu- tory student exemption which enables students enrolled in approved educational programs to participate in clinical training which is a necessary component of their educational programs. In many professions, the law enables students in educational programs accredited by an accrediting agency acceptable to the Department to perform clinical services under supervision. This allows for students enrolled in programs in other jurisdictions, as well as those in New York programs, to receive clinical training in New York.

In podiatry, however, the student exemption is very narrow, and as a result only students enrolled in the single podiatry college in New York may practice under the exemption. Since most other states do not have such narrow exemptions, students enrolled in the single New York podia- try program, are able to, and do in fact, perform clinical rotations in other states. Making student training opportunities more available in the state would both provide reciprocal opportunities for podiatry students in other states and reinforce the educational programs in New York facilities. This bill seeks to address that problem by amending Education Law section 7005 to expand the student exemption to students enrolled in approved podiatry programs in other jurisdictions.

Budgetary Implications of the Bill:

Additional revenue may be obtained from the fees gathered by issuing limited fellowship permits, in addition to the existing fee of $105 which is collected for limited residency permits.

Prior Legislative History:

This is a new bill.

Effective Date:

This act shall take effect immediately.