Can anyone give me the scoop on Peds/PM&R? The pros and cons, where the programs are... Do I need to do a combined residency or can just do a straight PM&R residency and then do a additional fellowship in pediatrics? I've heard that if you don't do a combined residency that you are seen as an outsider in the peds/pm&r community? Any thoughts?
06-29-2003, 08:26 AM
I just completed a peds/PM&R residency in Cincinnati, so hopefully I can answer a few questions for you.
The ABPMR will have their first testing for certification (not boarding) in pediatric rehabilitation in November. In order to sit for the testing now you must complete either a four year PM&R categorical residency followed by a two year pediatric rehabilitation fellowship (which are being developed currently to be accredited) or a combined five year combined peds/PM&R residency followed by a one year pediatric rehabilitation fellowship. All of the details of what a fellowship should entail (research/clinical requirements, etc. are being debated)
All in all, there is a 6 year time period to sit for the certificate.
I am biased in thinking that a combined program is preferable to a categorical program but I will give you my reasons. First, I think that the number of normal children that you will see in your continuity clinics is a GREAT way to learn normal development and milestones to compare to the kids that you will see in your future peds rehab practice. In addition, the time you spend in the intensive care units (PICU/NICU) gives you the experience of knowing what these kids have been through and what they have been through before they come to you either in the inpatient unit or outpatient clinics. You get to manage neurological, neurosurgical, gastrointestinal and endocrinologic problems on the forefront prior to your peds rehab part of residency so that when problems arise, you know how to handle situations that arise or stabilize these problems until consultation is necessary. It may be possible in programs to do pediatric electives while on PM&R electives in some residency programs, but the continuity experiences, both in primary care as well as a dedicated pediatric rehab continuity clinic throughout the majority of your residency in a combined program would be difficult to come by.
Even in comparing the categorial resident's experience with the combined resident's experience in our program in Cincinnati, the extent of exposure to many outpatient clinic specialities (Myelomeningocele, Neuromuscular, Limb Deficiency and Brachial Plexus Clinics) is heavily weighted toward the combined residents as the categoricals have limited time at Children's Hospital.
I definitely don't know the data on t he numbers of physicians practicing that are double boarded vs fellowship trained, but I think most of those that are practicing are pretty easy going people and there isn't any disdain toward the way one person trained compared to the other. I think that looking at different types of programs will offer different opportunities. I think that there are four combined programs right now (Cincinnati Children's, Denver, Thomas Jefferson/DuPont and Temple) and Freida also lists MCV as well.
Good luck with looking at programs. I enjoyed my program very much and would recommend looking at Cincinnati if you're interested in a combined program All four of the pediatric rehab attendings are double boarded. Cincinnati Children's is a great place to train and the peds training program is very hospitable and welcoming to combined residents (they also have combined med/peds, peds/psych/child psych, peds/neuro and peds/genetics).
Let me know if you have any further questions.