Patient safety is jeopardized when supervision requirements are reduced for podiatrists learning how to perform invasive, advanced ankle surgery.

• This bill (S6693B/A4613B) authorizes partial and total ankle replacement (TAR) by podiatrists which is a reversal of previously excluded language and a high-risk procedure that is not required in core podiatric residency training. TAR is one of the most technically demanding procedures in surgery, with significantly higher complication and revision rates when performed by low-volume or inadequately trained surgeons. The complexity and risk of this procedure demand training and oversight consistent with orthopaedic surgical pathways.
   
• Extends operative authority to soft tissue of the leg below the tibial tuberosity, marking what we believe is the first time NYS statute has included leg tissue in the definition of podiatric surgical scope. This is not a technical fix and is a significant expansion of surgical authority.
   
• Expands wound care without protections to consult with vascular or plastic surgery even though these wounds often involve systemic pathology and multi-disciplinary care.
   
• Loosens credentialing standards, allowing board-qualified (but not boardcertified) podiatrists to pursue advanced surgical privileges. Board-qualified status does not demonstrate proven competency. While the bill retains the statutory requirement for “direct personal supervision,” the sponsor’s memo suggests a more flexible interpretation, including supervision outside the room or based on department chair approval. We are concerned that such an approach could weaken the high standard of oversight expected in surgical training across other disciplines.