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Physical Therapy or Physiatry

Discussion in 'Pre-Physical Therapy' started by El Curandero, Dec 25, 2011.

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  1. El Curandero

    El Curandero

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    Merry Christmas everyone!

    I have a small dilema that I told myself I would resolve during winter break..by small I mean what I'm going to be doing for the rest of my life hopefully.:eek: Title basically says it all. I originally narrowed it down to psychology, pt, or physiatry but i decided I didn't really want to work with mentally insane patients (no offense to any psychologists..or patients). :rolleyes: I've narrowed it down to a list of pros and cons for both options but then again lists only go so far and I want some people with more knowledge(experience) to give me their opinions. A TLDR of pros and cons would be..

    Physical Therapy:
    Pros-
    1. Shorter amount of school
    2. Only learning about what I'm interested about
    3. Less loans
    4. Getting paid to travel :thumbup:
    5. Actually performing the techniques and excercises
    Cons-
    1. Less control in a hospital setting
    2. Cannot order X Rays
    3. Cannot prescribe meds (I don't believe meds should be used as much as they are now..but obv in some cases both physical therapy treatments and meds together can achieve better results than either alone)
    Physiatry:

    Pros-
    1. More $
    2. More control
    3. Can do more procedures than pt (injections, meds, x rays)
    4. Easier to open up a private practice
    Cons-
    1. A tremendous amount of school (8 years after undergrad is a little daunting)
    2. Tremendous amount of student loans
    3. I have to take orgo and calc 2 (not a huge con but still a difference if I go Physiatry route)
    4. I was lead to believe they do more managing and not much actual clinical treatment (tell me if I'm mistaken)
    5. Residency (Fill me in on the average res hours for physiatry)
    6. Learning a lot about things I'm necessarily not intrested in..
    TLDR: Is the tremendous amount of school worth it in your opinion to become a physiatrist over a physical therapist?
  2. bearcatbbal22

    bearcatbbal22

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    have you looked into becoming a PA (physician assistant).. only 2 years of grad school
  3. El Curandero

    El Curandero

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    Yeah but I would never become a PA. Not only is a PA program harder to get into than med school (10% acceptance rate) but theres no room for PA physiatry, which is what I would be intrested in doing if I went to med school.
  4. Shyster

    Shyster

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    Actually the University of St. Augustine currently has an Orthopedics Physician Assistant (OPA) program they just started earlier in May of this year. Check it out.
  5. DancerFutureDPT

    DancerFutureDPT Pre-Med and Pre-Health Academic Advisor Moderator

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    Here are my questions for you:

    1. How important is being an MD to you? Is it worth the extra school, loans, residencies, etc.? (keep in mind that some PM&R residencies may require you to do a year in surgery, internal medicine, or something else first. I know radiology and some other specialties require a year in some other field first, and PM&R may be one. I'm not totally sure).

    2. If you go to PT school, especially since a lot of schools are housed within medical schools so you'll share some facilities, are you going to be looking at the med students with envy wishing you were doing that instead?

    Don't do PT if you're viewing it as the "easier" option (I lived with a med student last year - there were definitely things we were doing that were much "harder" than she did, academically). Your pro/cons list is a good start, but ultimately you need to decide what you want to do.

    I know it's said a lot on here, but shadow multiple people in each profession to see which is a better fit for you. Shadow inpatient and outpatient in both PM&R and PT. Don't just shadow but talk to them about their experiences as well.
  6. El Curandero

    El Curandero

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    I mean honestly..it's easier to become a PT then a Physiatrist. Med school is all year round while PT that cannot be said. This is just my opinion but I'm looking at it from a realistic perspective. I do not care about the MD title but the fact is is that they are allowed to do more procedures to help their patients than PTs at this time are not allowed to perform is what Physiatry has over PT in my interests. I'm not going to make my decision on "possibilities" of PTs procedure allowance to expand. Basically I think I need to ask myself if 5 more years of training is worth it to do procedures like ordering xrays, prescribing medication, ect. :confused:
    Last edited: Dec 26, 2011
  7. El Curandero

    El Curandero

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    This is interesting although I don't know if Ortho PA can work in Physiatry because it's such a small niche in medicine. I really just want to work in rehabilitation, would they even be allowed to use physical therapy as a form of treatment?
  8. Bones26

    Bones26

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    Programs may vary, but most PT programs go year round. I haven't heard of one that follows a traditional August to May schedule. Our school has 4 weeks off for Winter Break, a one week Spring Break, and a two week break in between spring and summer semesters. There's also a two week break in between summer and fall. Rinse and repeat.
  9. goyo1010

    goyo1010 Muahahaha

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    As the previous poster already mentioned, the typical entry-level DPT program is year-round, with a 4-week winter break and a 1-2 week break in between the Spring/Summer and Summer/Fall semesters. However, it does take less time to become a licensed PT, academically speaking.

    Your decision between physical therapy and physiatry should be based on what you will be able to do once you get integrated into the workforce. As your Pros/Cons list in your original post, you have to determine if you would rather manage than actually provide the treatment. Although, as a physiatrist, you would be trained in many things PTs are trained it, you won't have the same aptitude per say. But if you were a PT, your scope of practice would be much more limited than an M.D.'s. Although the DPT students are now being trained to screen for certain conditions that would not be in a PT's scope of practice, M.D.'s would be better trained to deal with those kinds of things in terms of ability to diagnose.

    And of course, the whole schooling comes in. If you decide physiatry is what you may want to do, do you feel like you will be able to go through those years of med school, residency, fellowship, etc? Because if not, then you just racked up tons of loans for nothing, if you don't finish.

    I know it's a hard choice; it was the same issue I had in college when deciding which route to take. Medicine or Physical Therapy? But I fell in love with PT after shadowing and seeing their interaction with their patients and how closely they worked with each patient, even though their goal is to never see their patients' faces in rehab after their done!
  10. El Curandero

    El Curandero

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    You did bring up a good point about actually seeing your patients. I know doctors are the only ones who can perform some procedures and thus they have to do it but they really don't get the same interaction as they would if they were a PT. About the management question..my main goal is start up my own private practice (been a dream of mine) so either way I do feel like eventually I'll be doing more management than patient care anyway. And another good point is if I even have it in myself to finish the amount of school that becoming a Physiatrist brings. :rolleyes: I've always been good at school but I'll admit it's not hard to get me stressed out LOL. It's a really hard decision and I appreciate everyone's advice but I guess the only thing I can do at this point to make up my mind is to shadow boths PTs and Physiatrists. This should give me a better idea of what I would be doing day to day.
  11. El Curandero

    El Curandero

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    Yea I def know that getting your DPT degree is no easy feat don't get me wrong and I might very well be a holder one day, but as far as training goes the MD is def more rigorous and time consuming (being on call and residency) then getting your DPT, which is a huge challenge within itself. What does that say about becoming a Physiatrist :laugh:
  12. markelmarcel

    markelmarcel

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    Also just wanted to chime in that my PT program is year round. 3 days off for Thanksgiving, 2 weeks at Christmas and that's it. I think maybe one week in the summer before we start clinical. No month long breaks, no spring breaks, no nothing. (That's one of the reasons, although it's mostly due to the modified-PBL curric. that my school graduates you in 2.5 years)
  13. DancerFutureDPT

    DancerFutureDPT Pre-Med and Pre-Health Academic Advisor Moderator

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    Would a PA be able to prescribe PT? Yes. Would they be able to perform PT? No. Neither can physiatrists. The only profession that will allow you to actually perform "physical therapy" is as a physical therapist (or a physical therapy assistant). The APTA is very adamant about the wording of treatment like that. I'm sure PM&R docs do some treatment that is analogous to some of the things PTs do, but they aren't PTs so they're not going to do treatment in the same way or to the same extent.

    I could be totally off, as my experience with physiatrists is limited (I went to see one once when I needed to get a script for PT for my snapping hip syndrome since I'm not in an open access PT state)...she was practicing alongside orthopods and sports medicine docs seeing patients in the exact same way - ordering x-rays, doing exams, etc. She wasn't rehabbing patients by any means. Granted, not all physiatrists are like that, because it depends on your practice area. If you're working in a rehab hospital as a physiatrist, you're more likely to see the same patients consistently and more long-term rather than a 15 minute exam one time. But, I don't think you're going to be seeing patients for hour long sessions several times per week (or per day, as is the case with some rehab PT patients). I think it would be more like overseeing the care and like the others have said, management of the patient's care rather than lots of hands-on influence in treatment.

    I definitely think shadowing is the best way for you to decide which side of rehabilitation you want to work on. That way you can see what they really do from people who are actually making their living doing it - you can ask the physiatrist what their schooling was like, if they had to do rotations or residencies in other fields, etc., to see if it's what you want to do.

    Also, how important is prescribing meds and ordering x-rays to you? I thought it was weird that PTs couldn't prescribe those things when I first started school as well, but we learned quickly that it's really not that vital to what we're doing. Having films is helpful, but not always necessary. And I know you said you didn't want to worry about what may happen in the future, but by the time you get to grad school PTs may have that ability to prescribe those things, depending on the healthcare/PT lobbyists and APTA and all that. I wouldn't base my decision on what may or may not happen in the future, either, but I would think about how important you think that really is to what you want to do. Or you can always do what a friend of mine did, and decide to join the Army - PTs in the military can prescribe drugs and x-rays since they're under a different practice act. :)
  14. Bones26

    Bones26

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    Nothing. No need to get defensive. You made an incorrect statement, and I wanted to help you so that you have the correct information to make a decision.
  15. TheOx777

    TheOx777 Moderator Emeritus

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    Not sure what I can add to what's already been iterated but.... I'll add my $0.02.

    -If having a higher level or financial security and "power" in a hospital/clinic setting is important then going the physiatry route is probably the profession you should choose. That said, I know of numerous ppl who go into med school/med school stories where individuals are dead set on a specialty and end up changing their minds after rotations. Medicine, like many other fields, can be caddy! PM&R is sometimes "looked down" on by compared to other specialties. I would implore you to NOT let this dictate your choice or specialty if you choose the medicine route, but this can be a con in the grand scheme of things.

    -If you are interested in a career where one should be a master of anatomy(MSK and/or NMSK) and biomechanics then PT is the route you should probably choose. There are some very exciting things going on with the profession as it continues to make inroads; however there are several challenges(i.e. unrestricted Direct Access, reimbursement, therapy caps). You will almost undoubtedly spend more time with patients than if you were physiatrist. If you want the possibility of s stronger patient-clinician relationship then you will probably get this from PT.

    At the end of the day, it really depends on what you value. Each profession has its pros/cons so I would shadow both for professions in multiple settings so that you can really get a "day in the life" perspective.

    FYI: At my DPT program, we are in school all year around, and we definitely spend more "in-class" time than our MD colleagues. I am still in the process of ascertaining/understanding which education model is better!
  16. El Curandero

    El Curandero

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    Lol no thanks for the advice I wasn't being defensive..

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