By Marc Tranchemontagne, podiatrist, ex-member of Ordre des podiatres du Québec.
This text has no official value and was not approuved or revised by Ordre des podiatres du Québec.
Much has been done for podiatry to be recognized as a profession in Quebec but 1973, the year the Podiatry Bill passed, is seen as the real turning point.
Read the complete history.
It is difficult to determine with certainty the beginnings of podiatry in Quebec. The need for podiatric care has always existed, yet there are few records of this period.
After the war, around 1945-50, foot therapists had become more prevalent in Quebec society. There were individuals from the United States and from Europe who began to dispense foot care. Some Europeans even began to train others, but such training was incomparable to what is offered today. Regardless, this was the modest beginning of our great profession.
In the 1960’s, the period before legislators recognized the profession of podiatry in Quebec, there existed three podiatric associations. These associations grouped together those who shared the practice of foot care. They were: Association des podiatres de la province de Québec (APPQ), la Société de podiatrie du Québec (SPPQ), and Practiciens en podiatrie de la province de Québec (PPPQ). These associations do not exist today and unfortunately, there are no documents relating their activities or goals. In that light, a brief recall of their history appears to be necessary. In fact, those who remember this period will also remember the liveliness of these associations.
The APPQ had two DPMs, Claude Laliberté and Irving Kaufman. Their wish was to have the government legislate podiatry. They presented a private bill in 1948, which was rejected by the government. They would have to wait until 1974 to witness the legislation of podiatry.
The SPPQ had approximately 100 non-DPM members, founded in the 1940’s by Foch Melancon, Alyre Desjardins, Madeleine Brissette, and Bernard l’Heureux. This association was particularly active, especially after 1965. The president during these years Marc Desforges, would prove to be an exceptional motivator. Seminars, congresses, and updates in biology, chemistry, pharmacology, podiatric science, radiology were many and constant.
Lastly the PPPQ had 150 more moderate members. There existed a subtle rivalry between these associations. However, the 1974 legislation joined the three in the same professional Order. This forced merger would ease the tension between the three groups.
These associations had a relatively short lifespan of about ten years. They were the first forums of unprecedented podiatric activity in the province. The birth of podiatry began with them in the late 1960’s. At this point, there were two American-trained DPMs, about 250 podiatrists affiliated with one of the three associations, and approximately 200-300 unclassified others with varying backgrounds. Most were Europeans, where the profession had been recognized for some time at that point, and Quebecers who schooled in non-regulated programs. Foot care at this time had a certain popularity; proof being the success of the Wolfe Clinic in Montreal, where many Europeans and Quebecers practiced.
In the late 1960’s, the Quebec minister of health, Claude Castonguay began the important health care reform. The ‘carte-soleil’ (tr. sun card) was distributed and ensured universal access to care. A major governmental body, l’Office des professions, was created to help administer Quebec’s health professions.
Around 1969, the minister wished to recognize four new professions: audiology, denturology, chiropractic, and podiatry. This news stimulated the profession to organize seminars, congresses, and updates. These were necessary in the context of the creation of a new profession, which included the preparation of eventual admission exams. The associations followed common objectives of obtaining profession recognition and offering the best training to its members.
In 1973, the Podiatry Act was established and podiatry was born in Quebec. This new professional would be called a podiatrist.
Immediately, the Office des professions had to put in place mechanisms for admission to the new Order. Admission was not automatic. On top of having to prove that they practiced before enactment of the legislation, they would also need to successfully complete the admission exam.
The Office des professions recognized the three associations as middlemen for all podiatrists. Three expert examinators were chosen, one for each association: Claude Laliberté, Marc Desforges, and Jean-Guy Lambert. Each had at one point been president of his respective association. They began the exam process, which proved to be difficult for many. Initially, 350 people applied for admission. These candidates would attempt to complete a stressful and difficult exam process on which their future careers would rely. This first exam only allowed 70 candidates to pass. It was decided that these individuals had the attributes necessary for their practice to be safe to the public. This number was insufficient for the birth of the profession. A one-year recycling program was put in place for the remaining candidates. This program was administered by the new Order, under the wing of the Office des professions. 70 more candidates were admitted to the profession. In 1974, at the end of the program, the Ordre des podiatres (OPQ) had 140 members.
The first president of the OPQ, Claude Laliberté, DPM, was named by the Office des professions. He had a difficult task ahead of him. He had to establish the regulations of the Order, as well as ensure the management of the everyday workings of the OPQ. His presidency was short but a few months. Paul-André Mathieu took over to continue the elaboration of the first regulatory structure of the OPQ.
In order to perfect the actual level of training of the new podiatrists admitted to the profession, the OPQ had to offer a form of continuing education. A university program had to be found that could be adapted to the needs of the Quebec podiatrists. In the United States, at the New York College of Podiatric Medicine (NYCPM), a similar program had existed in the past, which could be restored for Quebec’s podiatrists. At the end of the 1970’s, NYCPM reactivated the program with the support of the OPQ. In 1982, the entire teaching staff of NYCPM participated in the one-year podiatric teaching of the Quebec podiatrists. This new certificate would be called the ‘Advanced Standing in Podiatric Medicine’ (ASPM). To my knowloedge members of OPQ were highly satisfied with the program, both for its quality and its thoroughness.
Over the years, the OPQ regulations were completed and therefore the duties and obligations of podiatrists were established. It’s at that point that podiatrists gave their approval to the most cruscial one: the recognition of foreign diplomas. This regulation was by far the most important for the future of Quebec podiatry. This regulation established for the first time that only one foreign diploma, the Doctorate of Podiatric Medicine (DPM) degree, would allow access to practice in the province of Quebec. In so doing, the government, through the Office des professions, had recognized that podiatry in Quebec required university training. As president of the OPQ at the time, I consented with this final Office des professions decision. The approval of this regulation occurred in the early 1990’s, 20 years after podiatry’s legal recognition. This government and Office des professions decision completed what all podiatrists at the time were striving for: a university education for future podiatrists (see section: History of Quebec Podiatric education).
Another important point in Quebec’s history of podiatry involves the international community. Although the strict daily management of the profession in Quebec does not require membership to national and international organizations, many professional corporations do maintain connections with colleagues overseas. The privilege of hosting international conferences is often obtained through theses connections. In 1995, the OPQ joined the International Federation of Podiatrists (IFP), an organization with 20-30 member countries. The goal was to organize an international conference in Canada under the direction of the OPQ. The conference was to be held in at the Palais des congrès in Montreal. The idea took about 10 years to develop and in 1995 the IFP awarded an international conference to the OPQ at a general meeting in Göteborg, Sweden. The director of international markets confirmed a potential windfall of 3 million dollars for the city of Montreal. I was even privileged enough to be awarded the title of Accredited Ambassador of the Palais des congrès for officially getting Montreal to be the futur host of the Canadian International Congress in Podiatry.
The International Congress was awarded to the United States, it was held in Boston in July 2004. It was a missed opportunity for podiatrists of Montreal, Quebec and Canada. Today, the United States are members of the IFP, as are DPM members of the Canadian Podiatric Medicine Association (CPMA). The non-DPM podiatrists of Quebec are therefore left behind.
Concerning the particular chapter of university training in Quebec, it took 20 years of concerted efforts carried out by many podiatrists to see the profession take its rightful place in a university. Érol Frechette, ex-president of the Conseil Interprofessionnel du Quebec, said it best: “Il importe que l’Université fasse sienne l’atteinte de l’objectif d’offrir la formation podiatrique au Québec.” Translated, this means that the chosen university had to make it their objective to offer podiatric education in Quebec.
This intention was confirmed in a letter sent to me by Université du Québec à Trois-Rivières on June 29th, 1994, when I was still president. The institution stated that teaching podiatry fell into its plan to develop programs that could complete its list of health-related disciplines.
The file was now officially a university matter. The university then needed to have the program accepted by varying groups. First was the Commission d’évaluation des projets de programmes de la Conférence des recteurs et des principaux des universities du Quebec (CREPUQ). Next was the Office des Profession which needed to confirm that the program was in conformity with the professional and health laws in place. Then the Comité des programmes of the Minister of Education had to authorize the financing for the new program of the doctorate in podiatry at Université du Québec à Trois-Rivières. Finally, the Minister of Education made its announcement. Not just one professional Order, but a large group was required to see this through.
And that is History.
Marc Tranchemontagne, podiatrist
Former president, Ordre des podiatres du Quebec, 1990-1995
Since its creation in 1974, the Ordre des podiatres du Québec (OPQ) had aspired to have a university program to train future podiatrists in the province of Quebec. Many presidents of the OPQ during these years made education a high priority.
From the beginning, the education of future podiatrists was an urgent matter. The OPQ recognized that their numbers were diminishing due to age. It became imperative to fill the void left by those retiring. The first to answer the call were the CEGEPs (Collège d’enseignement général et professionnel). These are Quebec schools that offer pre-university courses, which are mandatory for university admission. Possibly due to the need for new students or purely for the challenge, the Collège Rosemont was the first to offer a ‘turn key’ program. This school was in the process of developing or already had programs in medical technology, respiratory therapy, anaesthesia, embalming, auditory prosthetics, and acupuncture. The prestigious podiatric program would be a great addition to the mix. This was also looked upon favourably by the Office des professions du Québec (the Quebec government’s regulatory body for professions) who, at the time (70’s and early 80’s), seemed to encourage the arrival of these new technical college courses.
Paul Mathieu, podiatrist and president of the OPQ at the time, realized that the Collège Rosemont proposal was the object of many debates within the group. At that time, the OPQ approval was all that was needed to start the new program. However, some were sure that the other avenue of a university program was more appropriate for Quebec. Considering the momentum of educational change in Quebec during the 70’s and early 80’s, one must appreciate that the podiatrists already practicing had very profound convictions concerning the preferred university training. Against substantial opposition, the OPQ declined the CEGEP proposal, firmly believing that it was the right thing to do.
It is with Jean-Guy Lambert podiatrist and OPQ president from 1984-90, that the discussion with the university milieu began.
The choice of the first university to approach was difficult because nothing of the sort existed in Quebec or in Canada. Through repeated contact and presentations, the first hope was born in 1985. The Université de Montréal acquiesced to the OPQ’s demands and ordered a feasibility study. A committee of eight was put in place, with representatives from all medical specialties, including two podiatrists: Jean-guy Lambert and myself. Many meetings took place. The important points were:
1- The university’s acknowledgement to produce a Quebec curriculum that was equal and compatible with the American model;
2- The committee’s visit of the Pennsylvania College of Podiatric Medicine;
3- The completion of two academic and organizational documents and;
4- The submission of the completed file to the university authorities.
Then, the OPQ had to wait for a long time. Apparently, many presentations were needed for the Quebec government to proceed. The internal politics of the university and their influence on the program were also questioned. Unfortunately, after two years of work, the Université de Montréal decided to stop working towards the establishment of this program.
Regardless of this hesitation on the part of the Université de Montréal, the OPQ solicited other universities. The first to be contacted was Université de Sherbrooke. Meetings with the director of first cycle studies offered an interest in the podiatry program. The flame was rekindled yet only for a short time. The university later decided that the podiatry program was not in line with its curriculum objectives. The second contact was with McGill University through Dr. Carol Laurin of the Royal Victoria Hospital. That request ended up being denied too.
The 5th of March 1993 was the first time that the Université du Québec à Trois-Rivières (UQTR) was mentioned. At this point, the 30th of March 1993, when I was still president of OPQ, I received a letter from Mr. André Thibault, vice-rector of teaching and research at UQTR. On the 8th of June 1993, the board of the OPQ gave me the mandate of beginning talks with the authorities of UQTR. With the help of M. Érol Frechette, (of Érol Frechette Communications and ex-president of the Interprofessionnal Council of Quebec), the process began. A first meeting took place on June 21st, 1993 with Ms. Claire de la Durantaye, dean of first cycle studies and M. Rémi Tremblay, the person responsible for research and development of new programs at UQTR. An agenda of meetings was put in place. Many important items were discussed and completed. I requested the help of the podiatrist Glenn Hébert, president of the professional education committee of the OPQ at the time, as well as the podiatrist Robert Donaldson. This teamwork produced a solid and completely defined academic program and curriculum. M. Hébert wrote in a letter to the OPQ members in March 1995, stating that the program contained 186 university credits.
International contacts helped to complete certain parts of the feasibility study that were demanded by UQTR. Communication Érol Frechette was asked to collate these research results, as well as those documents that I could gather during my official presence at the 15th International Congress of the International Federation of Podiatrists (IFP) in London. With the help of the IFP president M. Robert van Lith and the two colleges of the IFP, the ICTPM (International College of Teachers of Podiatric Medicine) and the CLPUE (Comité de liasons des podologues de l’Union européenne), many documents were transmitted to aid in the completion of the feasibility study.
On June 29th 1994, the vice-rector of teaching and research at UQTR wrote me a letter in which he explained that the feasibility study had yielded favourable results. It was now possible to continue the completion of the program and present it to those responsible for new program evaluation at UQTR.
The most important issue and the one that the OPQ was waiting for was that UQTR made the objective of offering a podiatric program a priority for the university. The original OPQ mandate was thus completed.
The program of a first cycle doctorate in podiatric medicine took its rightful place within the objectives of UQTR. It would become for all those who collaborated on this monumental dossier the first fundamental step.
This donation to future OPQ administrators would prove to be particularly useful. Continuity would be assured for the profession. After my departure, Gérard Allart would be named president by interim on April 1st, 1995.
Marc Tranchemontagne, podiatrist,
Former president, Quebec Order of Podiatrists, 1990-1995
Special thanks to
Jean Guy Lambert, podiatrist, Former president, Quebec Order of Podiatrists
Paul-André Mathieu, podiatrist, Former president, Quebec Order of Podiatrists