Category Archive: PM&R

Spotlight Interview: How to Match in Physical Medicine and Rehabilitation

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A Physical Medicine and Rehabilitation (PM&R) Resident’s Perspective:  From an interview with a PM&R resident from Ohio.

 

Part of an interview series entitled, "Specialty Spotlights", which asks medical students' most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • How competitive is the PM&R match?

Matching in PM&R is not as competitive as some fields, such as radiology, neurosurgery, dermatology, etc. However, it also used to be a relatively unknown specialty. Medical student exposure to PM&R has improved and the number of applicants seems to be steadily increasing, so it is becoming more competitive.

 

  •  What must a student do to match well in PM&R?

A student looking to match well in PM&R should focus on the same things students would pursuing other specialties. Like any specialty, doing well on boards is important. Most programs have now instituted board score cut-offs for applicants, which are around 200-220 for USMLE Step 1. In general, students should perform well on their clinical clerkships throughout medical school, and a rotation is PM&R is preferred. Strong supportive letters of recommendation, including one from someone in PM&R, is preferred. At least some exposure to or participation in research is also a plus.

 

  • What are residencies looking for in a PM&R applicant?
PM&R residencies look for all the usual strengths in an applicant like good board scores and academic performance, good clinical performance on your clerkships, research exposure, etc. In my experience, PM&R residencies also tend to appreciate individuals with additional interests like sports and music. There are many in PM&R who followed non-traditional paths to medicine and may have had other careers first. Personality is also very important, as it takes pretty caring and compassionate people to be providers for individuals with disabilities as well as an ability to work with a multi-disciplinary team. In addition to a student's application, their interview day with a residency program will be very important

 

  • What should students look for in a PM&R residency?

If you are pursuing PM&R but not yet sure whether you want to do a fellowship, look for a well-rounded PM&R program with opportunities for exposure to the subspecialties. I looked for a program with a good balance of inpatient and outpatient clinical duties and wanted exposure to all the major areas: Sports/MSK, stroke, TBI (traumatic brain injury), SCI (spinal cord injury), amputation and pediatric rehab. I also looked for programs that had an ultrasound curriculum, as well as plenty of exposure to procedures including electrodiagnosis (EMG), botox, interventional spine and baclofen pumps. Beyond curriculum, the deciding factor in residency programs for me was finding a good “fit.” I paid close attention to interactions with residents, students, fellows and faculty on interview days to try and get a feel for whether this was a place I would like to train or not. 

 

  • Do you have any advice on the application, letters of recommendation, personal statements, or how to rank programs?

Like any other specialty, having a well-rounded application is important. Although board scores are important and used as a screening tool, residencies want to see much more than that. Do at least one rotation in PM&R, even if you have to arrange an away rotation. Also try and have at least one Letter of Recommendation from someone in PM&R. I looked for well-rounded programs to rank, but ultimately my rank list came down to finding a good fit on my interview day. Pick a program where you can see yourself being both well trained and happy for 4 years

 

  • What do you wish you knew before application/interview season?  

Although I did a lot of practice interview questions before my interviews, one question I didn’t have a great answer for was “So what is a Physiatrist?” I struggled with this question because the scope of our field is pretty broad, but having a decent answer will help guide your personal statement and save you the embarrassment if asked on the interview trail

 
  • What other advice do you have for students applying for PM&R residency?  

People like to say “plenty of money and relaxation,” and although the lifestyle is good there are long days and hard days. We take care of very sick patients, many of which have experienced something catastrophic, and as their physiatrist we can be their greatest advocate or on some days just their cheerleader. In PM&R, you have to be willing to wear many different hats. Also, make sure you write “PM&R” NOT “PMNR,” and know how to pronounce “Physiatrist.”  

 

Editor's Note: Applying for residency or preparing for your interviews? I highly recommend First Aid for the MatchThe Successful Match: 200 Rules to Succeed in the Residency Match, and The Residency Interview: How To Make the Best Possible Impression .


 

Spotlight Interview: Why Did You Choose Physical Medicine and Rehabilitation (PM&R)?

 
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A Physical Medicine and Rehabilitation PM&R) Resident’s Perspective: From an interview with a PM&R resident from Ohio.. 

Part of an interview series entitled, "Specialty Spotlights", which asks medical students' most burning questions to physicians of every specialty.  See what doctors from every specialty had to say about why they chose their specialty and how to match in their residency.

 

  • What attracted you to physical medicine and rehabilitation (PM&R)?

I initially explored PM&R because I always had an interest in neurophysiology and neuroanatomy, and I knew that physiatrists took care of patients with stroke, traumatic brain injury, spinal cord injury, and other disorders of the nervous and musculoskeletal systems. During my first rotation in PM&R was when I learned that physiatrists primary focus in helping their patients is by improving function. This focus on function is ultimately what attracted me to PM&R, because enabling patients with different abilities to function can substantially affect quality of life. Another aspect of PM&R that attracted me to the specialty was working with a multidisciplinary team to provide care. 

 

  • Describe a physiatrist's typical work day?

The workday of a typical physiatrist is quite regular, usually from about 8am to 5pm, but this can vary somewhat depending on your type of practice. There are many physiatrists who only do outpatient clinic, while others do both inpatient and outpatient. 

 

  • What type of lifestyle can a physiatrist expect?  

Lifestyle of a physiatrist can be somewhat variable depending on practice setup and location, but overall is considered to be well balanced relative to other specialties in medicine. We also have a high job satisfaction. PM&R is a very family friendly field, with plenty of free time and family time. Most physiatrists do not work nights, but there is some call coverage for those with inpatient duties. On average, call is usually about one week and one weekend per month, but can be less frequent depending on size of the department. Primary (first) call at large hospitals is most often covered by residents and fellows, and the attending is only called when needed. Call does usually include rounding on the weekend, which is usually brief.

 

  • What is the potential salary of a physiatrist?

The average salary of a physiatrist is around $180,000-190,000. 

 

  • What is the job market like for PM&R?

The job market for physiatrists is excellent both immediately following completion of residency as well as after advanced fellowship training

 

  • What can you tell us about PM&R subspecialties?

Another advantage to training in PM&R is that there are many options for subspecialty training. PM&R residents can pursue fellowship in many areas including the following: Interventional Pain/Spine, Sports Medicine, Cancer Rehabilitation, Stroke Rehabilitation, Traumatic Brain Injury, Spinal Cord Injury, Pediatric Rehabilitation Medicine, Neuromuscular Medicine/EMG, Informatics and Research. Most of the clinical fellowships are 1 year of additional training, and Pediatric Rehabilitation Medicine can be 1 year for those who completed a combined residency and 2 years for those who completed a general PM&R residency 

 

  • What are the potential downsides of PM&R that students should be aware of?

Although I did not consider salary when making my career decisions, it is an important consideration for students to think about as many of us have student loan debt and families to provide for. One potential downside of PM&R that students should be aware of is reimbursement changes for procedures, particularly electrodiagnostic testing. The salary I mentioned earlier is at or just below the average for all physicians.

 

  • What else would you tell medical students who are considering PM&R?

I highly recommend considering a career in PM&R. It is a fairly small field of medicine but it is growing and evolving, with so many exciting possibilities particularly with advances in technology. Being a physiatrist is incredibly rewarding. It is difficult to describe what it feels like when you see someone who had a stroke, spinal cord injury, or amputation walk again, but it’s pretty awesome to be a part of the team making that happen 

 

Editor's Note: For more help choosing a specialty in medicine, I highly recommend one or both of these two great books. I found both very useful.