1 PM&R LOR enough?

[end stage fibro]

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I just finished a 4th year elective at a smaller university program in NY, which went very well and where I secured a strong LOR. I'm almost sure that I'd like to apply to PM&R, but I was wondering if one letter is enough. I have a few other high-quality letters that I'd be submitting, most likely from IM and psych. any recommendations?

 

[PMR 4 MSK]

I just finished a 4th year elective at a smaller university program in NY, which went very well and where I secured a strong LOR. I'm almost sure that I'd like to apply to PM&R, but I was wondering if one letter is enough. I have a few other high-quality letters that I'd be submitting, most likely from IM and psych. any recommendations?

2 is more common, but one very good one from PM&R coupled with very good LORs from others will probably do well enough. Part of it will be whether or not you've been exposed to most of PM&R. If you only did oupt MSK/sports, it probably would not be enough.

 

[fozzy40]

What kind of rotation was it? What diagnoses/populations did you see?

 

[end stage fibro]

the goal of the rotation was to expose students to a lot of PM&R. I did 1 week inpatient, 1 week consults, 1 week MSK/outpt, 1 week EMG, and attended several lectures. After I finished my duties for the day (standard stuff- admit patients, follow them, write notes, etc) I went to the outpatient clinic and consult service to see if I could help out more, or I would go check on my old patients from inpatient service. i feel that i got a pretty good survey of pm&r.

 

[fozzy40]

Sounds like you got a pretty good overall rotation. If your application has some "red flags" (i.e. failed step 1, below average grades, breaks in training) I would consider doing another PM&R rotation to get a 2nd great letter. If you are limited in your ability to setup an audition rotation, then 1 should be sufficient.

 

[40YardDash]

instead of getting 2 LORs from PM&R, what about getting a 2nd LOR from a subspecialty of PM&R like say traumatic brain injury or an MSK rotation instead of doing 2 intro PM&R rotations to get 2 letters... im currently trying to setup my 4th year rotations and plan on doing 1 intro to PM&R (thats one LOR) and 3 rotations in subspecialty of PM&R like pain, MSK, TBI, or possibly sports (one of these would be my 2nd LOR)... is this the way to go or should i scratch one of the subspecialites and aim for 2 PM&R rotations to get two letters?

 

[fozzy40]

I'm sure everyone will have an opinion but here is mine...

That's great that you want to see as much as you can during 2 rotations! Just be careful to not spread yourself too thin. You want to be visible to the attendings and residents so that they can appreciate your interest but also your work ethic and knowledge base. I think this is the key to getting a good LOR. Also, make sure to let the attending know that you are interested in getting a LOR upfront so they know to keep an eye on your progress.

 

[Ludicolo]

Sounds like you got a pretty good overall rotation. If your application has some "red flags" (i.e. failed step 1, below average grades, breaks in training) I would consider doing another PM&R rotation to get a 2nd great letter. If you are limited in your ability to setup an audition rotation, then 1 should be sufficient.

Agree.

instead of getting 2 LORs from PM&R, what about getting a 2nd LOR from a subspecialty of PM&R like say traumatic brain injury or an MSK rotation instead of doing 2 intro PM&R rotations to get 2 letters... im currently trying to setup my 4th year rotations and plan on doing 1 intro to PM&R (thats one LOR) and 3 rotations in subspecialty of PM&R like pain, MSK, TBI, or possibly sports (one of these would be my 2nd LOR)... is this the way to go or should i scratch one of the subspecialites and aim for 2 PM&R rotations to get two letters?

I recommend intro+subspecialty, rather than intro+intro.

From the LOR standpoint, doesn’t make a difference. What you are aiming for here are two different physiatrists with whom you’ve worked closely, that can vouch for your work ethic, skills, and “fit” for PM&R. Doesn’t matter what subspecialty they come from.

From the educational/overall PM&R experience standpoint, I wouldn’t recommend two introductory rotations unless one is an away/audition rotation and that’s all that’s offered. If you can get in-depth exposure to a couple of PM&R subspecialties – especially if one rotation happens to be inpatient and another one outpatient – you’ll be better off IMHO.

 

[40YardDash]

I'm sure everyone will have an opinion but here is mine...

That's great that you want to see as much as you can during 2 rotations! Just be careful to not spread yourself too thin. You want to be visible to the attendings and residents so that they can appreciate your interest but also your work ethic and knowledge base. I think this is the key to getting a good LOR. Also, make sure to let the attending know that you are interested in getting a LOR upfront so they know to keep an eye on your progress.

sorry fozzy... was this response for the OP or for my question regarding getting 2 LORs?

 

[40YardDash]

Agree.



I recommend intro+subspecialty, rather than intro+intro.

From the LOR standpoint, doesn’t make a difference. What you are aiming for here are two different physiatrists with whom you’ve worked closely, that can vouch for your work ethic, skills, and “fit” for PM&R. Doesn’t matter what subspecialty they come from.

From the educational/overall PM&R experience standpoint, I wouldn’t recommend two introductory rotations unless one is an away/audition rotation and that’s all that’s offered. If you can get in-depth exposure to a couple of PM&R subspecialties – especially if one rotation happens to be inpatient and another one outpatient – you’ll be better off IMHO.

thanks.. appreciate the response

 

[fozzy40]

sorry fozzy... was this response for the OP or for my question regarding getting 2 LORs?

Sorry, that what for you 40YardDash🙂

 

[40YardDash]

Sorry, that what for you 40YardDash🙂

thanks fozzy.

 

[DrMattOglesby]

does the idea of LORs from one intro + one subspecialty allow for garnering a LOR from a Family Med doc in Sports Medicine (and having the intro one in Physiatry)?

 

[Ludicolo]

does the idea of LORs from one intro + one subspecialty allow for garnering a LOR from a Family Med doc in Sports Medicine (and having the intro one in Physiatry)?

It does if you can't for some reason gather two PM&R letters. As long as your LORs confirm your awesomeness, you'll be ok.

 

[40YardDash]

It does if you can't for some reason gather two PM&R letters. As long as your LORs confirm your awesomeness, you'll be ok.

I hope im not stealing the thread here but can any of the attendings or residents describe the ideal student? Other than showing up early, reading about your patients, having a good attitude, staying late, having a supply of good jokes... Thanks

 

[fozzy40]

-Look interested
-Don't fall asleep during lectures (personal pet peeve and I've caught plenty of students)
-Be helpful to your residents by making appointments, running imaging CDs over to radiology, help with discharge paperwork
-At the same time, be helpful but no so overzealous that you are in the way of the resident

 

[40YardDash]

-Look interested
-Don't fall asleep during lectures (personal pet peeve and I've caught plenty of students)
-Be helpful to your residents by making appointments, running imaging CDs over to radiology, help with discharge paperwork
-At the same time, be helpful but no so overzealous that you are in the way of the resident

thanks for the advice

 

[DOctorJay]

I hope im not stealing the thread here but can any of the attendings or residents describe the ideal student? Other than showing up early, reading about your patients, having a good attitude, staying late, having a supply of good jokes... Thanks

in procedural areas ANTICIPATION is a key skill that makes you look like a star. if you know what's coming next and can speed up things for your attending/resident they will love you for it and hopefully teach you more because of it.

 

[40YardDash]

in procedural areas ANTICIPATION is a key skill that makes you look like a star. if you know what's coming next and can speed up things for your attending/resident they will love you for it and hopefully teach you more because of it.

thats great advice... thanks. So, things like knowing when the patient will be discharged and having the discharge notes ready, having admission notes ready, consult notes. anything else? what do u mean by procedural areas? Please excuse my ignorance

 

[end stage fibro]

thats great advice... thanks. So, things like knowing when the patient will be discharged and having the discharge notes ready, having admission notes ready, consult notes. anything else? what do u mean by procedural areas? Please excuse my ignorance

your white coat should be stuffed with alcohol pads, gauze, needles, etc. if the procedure needs 1 of something, have 4 in your pocket. it makes you look good and helps everything run much more smoothly. or be ready to hand something over before your attending/resident asks for it.

edit: oh, also, if theyre doing a procedure, put some gloves on in the beginning- even if you think you're just gonna be observing. a few times it's been a resident and like 3 students in the room and the resident will need help. while the other students are twiddling their thumbs over who will get to help, you'll be ready to go. learned this the hard way several times

at least that's what i think doctorjay meant

 

[40YardDash]

your white coat should be stuffed with alcohol pads, gauze, needles, etc. if the procedure needs 1 of something, have 4 in your pocket. it makes you look good and helps everything run much more smoothly. or be ready to hand something over before your attending/resident asks for it.

edit: oh, also, if theyre doing a procedure, put some gloves on in the beginning- even if you think you're just gonna be observing. a few times it's been a resident and like 3 students in the room and the resident will need help. while the other students are twiddling their thumbs over who will get to help, you'll be ready to go. learned this the hard way several times

at least that's what i think doctorjay meant

ok thanks for the advice shwin

 

[DOctorJay]

shwin's response is pretty good. apply it to everything you see.

if you're in the fluro suite you will see what it takes to "turn the room over". find a step or two to help with (clean the table, wheel the patient out, consent the next patient, etc), the few minutes saved on each case means you end the day 15-30 min earlier or maybe you just have some extra time to relax at lunch. your residents/fellows/attendings will appreciate that.