Podiatry Trainees a place-based workforce solution

Queensland Health (QH) Podiatrists provide essential early intervention for patients with  chronic diseases (i.e. diabetes, peripheral vascular disease, neurological conditions) and active foot disease (i.e. ulceration, infection, and deformity). Podiatry interventions reduce hospitalisation, prevent ulceration and amputation, and improves quality  of life. At a system level, podiatrists reduce demand on acute services and healthcare costs by minimising length of hospital stays, lowering surgical burden, and supporting multidisciplinary care across hospitals and community health services.

A recent QH  report evaluated the cost-effectiveness of high-risk foot funding return on investment of $8 for every $1 invested in earlier access to high-risk foot services[4]. Chronic national workforce shortages have led to drastically low workforce numbers in QH Podiatry  Services. Vacancy rates average 10% of 115 FTE (and as high as 24%) over the past five years (double the average allied health vacancy rate)[5]. Student enrolments into podiatry courses declined by 17.3% (2016-2022) coupled with course closures, resulting  in regional and remote podiatry services generally unable to attract students or recruit graduates[2]. Attraction of new workforce to regional, rural and remote locations rely on showcasing the local community and clinical diversity to students on clinical  placement. Low utilisation of available clinical placements (17%) means traditional workforce attraction pipelines are not viable[3]. Podiatry degrees are traditionally delivered on-campus at university due to the significant hands-on training requirements,  meaning regional & remote students wanting to study Podiatry must relocate to study on-campus. A novel approach to tertiary courses in healthcare is emerging. Place-based education emphasises connections between the learning process and the physical place  where learning occurs[6]. For Queensland Health, this place-based course delivery means we can train our podiatrists, at home in their local communities within our highly skilled podiatry teams.

Conversations in Townsville led to a fundamental imperative: we want Queensland high school students to stay in their local community and study Podiatry. The Podiatry workforce shortage needed universities to fundamentally change the way they delivered podiatry courses so that students could learn remotely while maintaining  the dexterity required by a hands-on clinical profession. Charles Sturt University (CSU) have developed a place-based course that requires students to be partnered with a local Podiatry service. Whilst the university provides online tutorials, lectures and  learning content; the podiatry service provides work-integrated learning and opportunities to work alongside Podiatrists and other clinicians. In addition, the hybrid nature of the course requires short duration, on-campus blocks to directly teach specific  skills that cannot be taught online and provides moderation of clinical practice and quality assurance by the university. QH podiatry services collaborated to embrace this first-of-its-kind, place-based podiatry university course.

QH Podiatry created a statewide  podiatry trainee recruitment program that employs local regional and remote students while studying this new place-based Podiatry degree. Hybrid, place-based learning is a wonderful combination of academic rigor and apprenticeship style experiences. This modernised  approach will enable our health system to sure up workforce pipelines of talent, specifically in our regional and remote communities.

As we now have students from their first year of university, a phased approach will  occur to develop their skills in our organisation over a four-year period. Firstly, trainees will be utilised in a delegated task framework, essentially utilising the trainees as clinical assistants. As their clinical skills and knowledge grow; we will then  utilise Entrustable Professional Activities (EPA’s) to support the expansion of their clinical caseloads. EPA’s for podiatry will be developed in future projects to ensure a structured approach to trainee clinical service delivery. Podiatry is a niche profession  with smaller workforce numbers than our medical or nursing counterparts. Promotion and awareness of podiatry as a profession presents a significant challenge. Not only what a podiatrist does and what a rewarding career it is; but also promoting the crucial  role a podiatrist plays in our public health system.

Diabetes and other chronic conditions can cause serious foot problems, which can lead to hospital visits, amputations, and high healthcare costs. These foot problems include: not being able to feel the feet,  poor blood flow, wounds, and infections. Unlike the private sector, podiatrists within QH play a vital frontline role to prevent hospitalisations and complications such as amputations for people with high-risk feet. A recent QH report evaluated the cost-effectiveness  of high-risk foot funding and found a return on investment of $8 for every $1 invested in earlier access to high-risk foot services[4]. Developing the podiatry workforce pipeline is essential for delivering this care into the future. From an educational perspective,  podiatry is excited to follow Nuclear Medicine’s lead and support novel university course delivery that enables students to stay in our regional and remote communities while studying a bachelor degree.

As more universities embrace hybrid place-based modes  of delivery; we as Queensland Health need to incorporate these students into our hospital & health services. This Podiatry example can be applied to various other healthcare courses. Various forms of place-based learning, such as degree apprenticeships, have  been utilised as healthcare workforce solutions for many years in other countries. Australian healthcare courses have not yet adopted these place-based approaches. With such a resounding solution to the podiatry workforce shortage; our focus now will be supporting  the podiatry departments to supervise these new trainees and develop the framework that allows the growth in the trainees clinical practice over time. We would like to acknowledge nuclear medicine as leaders in supporting place-based learning. The podiatry  workforce would like to offer support to other healthcare professions considering hybrid place-based trainees.

References

1. Queensland Health, Workforce gap analysis: Part A – The system view. 2025, State  of Queensland (Queensland Health).

2. Kaminski, M.R., et al., Motivators and barriers for studying podiatry in Australia and New Zealand: A mixed methods study. J Foot Ankle Res, 2024. 17(3): p. e70004.

3. Queensland Health. Allied health placement information  for education providers. 2026; Available from: https://www.careers.health.qld.gov.au/students-and-graduates/clinical-placements/education-provider-information/allied-health-placement-information-for-education-providers.

4. Griffith University, An economic  evaluation of a novel funding model for diabetic foot disease: Findings report (Report_Revised_v.2_CLEAN_20/12/2022). 2022.

5. Queensland Health, Data provided by the Office of the Chief Allied Health Officer. 2025, Queensland Health.

6. Yemini, M., L. Engel,  and A. Ben Simon, Place-based education - a systematic review of literature. Educational Review (Birmingham), 2025. 77(2): p. 640-660.

7. Queensland Health, Podiatrist trainee program – student scholarships and programs. 2026. 8. Australian Podiatry Association.
(2022). National Podiatry Workforce Summit Report 2022. https://www.podiatry.org.au/advocacy/resources/workforce-summit-report