Advice from attendings

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TRAMD

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I am going to start a rotation in a week with the physiatry group that I would like to practice with someday. They are an outpatient practice with quite a bit of interventional spine thrown in. I am wanting advice on what I can do or how I can prepare to impress them. What kinds of things would impress you from an intern with very little real PM&R training at this point? I know that personality issues are also important and can't be "studied". I plan to be perfect on physical exam techniques. Should I know about injections (joint or spine/fluoro) or EMGs? Would knowing techniques of these be important or would indications and interpretation of results be more important? What are good resources for this information? I appreciate any advice, thanks!
 

PMR 4 MSK

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Show up, express interest in everything and ask as many questions as you can without being annoying. Discuss cases in depth at the end of the day. Most of we physiatrists are academically-oriented (in the heart, but not the pocketbook)and love to teach.

No one expects you to know much yet, but you will impress them by knowing muscle innervations, the brachial plexus and functional anatomy. Get a copy of Tan's Practical Manual of PM&R - kinda like a Wash Manual for PM&R (at least in my day). Read about the major cases you saw during the day so you can discuss similar cases later.
 

axm397

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I am going to start a rotation in a week with the physiatry group that I would like to practice with someday. They are an outpatient practice with quite a bit of interventional spine thrown in. I am wanting advice on what I can do or how I can prepare to impress them. What kinds of things would impress you from an intern with very little real PM&R training at this point? I know that personality issues are also important and can't be "studied". I plan to be perfect on physical exam techniques. Should I know about injections (joint or spine/fluoro) or EMGs? Would knowing techniques of these be important or would indications and interpretation of results be more important? What are good resources for this information? I appreciate any advice, thanks!

show up early stay late, show interest, read up on cases. i dont' think they would expect you to know fluoro injections and EMGs but try to remember and learn things they teach you and carry over to the next day so they see that you are quick to learn.

Be observant - see where you might be able to help them save time - i.e. set up for injections, passing the gel, tape, etc. for EMGs, etc. Noticing little details and showing that you want to help will go a long way. I try not to "cost" my attendings time - so if I can try to save them time by doing the small scutty stuff - then I can use that time to get taught.

Definitely make sure you get to know the staff and you are liked by them. secretaries, nurses, assistants - all can have influence. Sometimes doing the small stuff mentioned above ends up helping the nurses and assistants which will make them like you more. (help transfer a patient to table and off table, etc.)
 

Finally M3

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If you are going to be in fluoro suite a bit, familiarize yourself with the anatomy of the spine, and look for labeled oblique radiographs online. Or, if you have access to it, peer through a copy of Fenton's "Image Guided Spine Intervention".
 

TRAMD

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Thanks for all the great advice! I will take it all in and do my best!
 
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