There were many PMR topics i disliked and find useless in a pain fellowship and beyond, such as Orthotics/prosthetics, SCI, TBI to name a few.
Really?
I recently did an IME on patient with a Tibialis Posterior tendon tear where I had to comment on what kind of orthosis he should get.
Had another IME on a patient with SCI and conus injury after L1 burst fracture, fusion T11-L3 with chronic back pain and paraplegia. Was asked to comment on future care for pain management and maintainence care (labs, urodynamic studies, etc.) for the SCI.
I hope you were joking about MSK only taking a few months to learn. I tried to focus most of residency on learning musculoskeletal evaluation, and to this day still attend lectures/workshops by Michael Geraci, Gary Gray, etc. to improve my skills.
In my opinion, a cookie cutter set of manual muscle testing, DTR's, straight leg raise and sensory exam to light touch is not that great of an exam.
Learning MSK is not simply pulling out your old muscle/nerve charts from medschool 1st year anatomy, it's learning/visualizing how the muscles, bones and tendons move
in concert that makes the subject matter difficult, and even more difficult to conceptualize.
Orthotics and Prosthetics (essentially questions about biomechanics/kinematics) has on average been one of the lower scoring sections on SAE and PM&R board exams for the past several years. Now, picture one of your chronic pain patients walking down the hall (antalgic gait, cane he/she may or may not need in the wrong hand, increased anterior pelvic tilt/lumbar lordosis, Pes Planus, no radicular symptoms-just lumbar/buttock and trap/interscapular pain)
If you can't evaluate him, it's either opiates or let the physical therapist figure out what's wrong.