Another question about the Future of PM&R

[ampDO]

Hey all,

I am currently an intern at a program in California. I was accepted into a PM&R program in New York and am really looking forward to it. My only concern is that, most of the attendings and docs that I work with are very skeptical about PM&R as a specialty. They all seem to think that there is no real future in it and that jobs are becoming more and more scarce. This is especially true on the West Coast. I feel its an underrepresented specialty, but I believe there is and will always be a need for it. Most of my attendings are beginning to question my choice of specialty because they dont think there will be any jobs, especially if I do not do a fellowship.
Personally, I would eventually prefer to move back to California following my residency. However, I just wanted to know what anyone thought about the job prospects for outpatient and inpatient rehab in California and in general. I rotated through a couple hospitals on the east coast and saw a lot more outpatient rehab practices, however, I rarely if ever see an outpatient practice in California. Most rehab docs work as inpatient docs or do interventional procedures.
I still feel confident in my choice of specialty, however it is making me wonder why 90% of the attendings I speak with dont believe there are going to be many job opportunities in the field. Any thoughts on this would be appreciated. Thanks!

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[axm397]

Hey all,

I am currently an intern at a program in California. I was accepted into a PM&R program in New York and am really looking forward to it. My only concern is that, most of the attendings and docs that I work with are very skeptical about PM&R as a specialty. They all seem to think that there is no real future in it and that jobs are becoming more and more scarce. This is especially true on the West Coast. I feel its an underrepresented specialty, but I believe there is and will always be a need for it. Most of my attendings are beginning to question my choice of specialty because they dont think there will be any jobs, especially if I do not do a fellowship.
Personally, I would eventually prefer to move back to California following my residency. However, I just wanted to know what anyone thought about the job prospects for outpatient and inpatient rehab in California and in general. I rotated through a couple hospitals on the east coast and saw a lot more outpatient rehab practices, however, I rarely if ever see an outpatient practice in California. Most rehab docs work as inpatient docs or do interventional procedures.
I still feel confident in my choice of specialty, however it is making me wonder why 90% of the attendings I speak with dont believe there are going to be many job opportunities in the field. Any thoughts on this would be appreciated. Thanks!

I think many of us questioned our choices during our intern year - especially with internal medicine and subspecialty attendings trying to "recruit" us into medicine telling us we're "too good" for PM&R or that PM&R is boring and has no future. With the growing geriatric population, and the returning veterans, there's going to be even a bigger need for physiatry. In terms of inpatient rehab - there were two RIC grads last year who ended up in California - one in southern california and other other in northern. Kaiser permanente has a big inpatient rehab - i believe then even have a TBI fellowship. My friend who ended up in northern cali works for Kaiser and is pretty happy with the benefits and the pay. The other grad went to work for loma linda in southern california. Kaiser southern CA doesn't pay well and has very few PM&R openings.

I know ppl have accused me of being a naive optimist in the past but I think you can get a job anywhere and do anything as long as you are prepared to compromise on certain factors. if geographic location is most important, you may have to compromise on pay and practice setting. any big U.S. city is going to be saturated - not just in PM&R but in most other specialties.

The other big factor is connections - if you can network and meet other physiatrists in california while you are an intern, you can keep in touch with them and you may even be able to get a job with them later. I've seen some of my co-residents do that.

 

[lobelsteve]

I think many of us questioned our choices during our intern year - especially with internal medicine and subspecialty attendings trying to "recruit" us into medicine telling us we're "too good" for PM&R or that PM&R is boring and has no future. With the growing geriatric population, and the returning veterans, there's going to be even a bigger need for physiatry. In terms of inpatient rehab - there were two RIC grads last year who ended up in California - one in southern california and other other in northern. Kaiser permanente has a big inpatient rehab - i believe then even have a TBI fellowship. My friend who ended up in northern cali works for Kaiser and is pretty happy with the benefits and the pay. The other grad went to work for loma linda in southern california. Kaiser southern CA doesn't pay well and has very few PM&R openings.

I know ppl have accused me of being a naive optimist in the past but I think you can get a job anywhere and do anything as long as you are prepared to compromise on certain factors. if geographic location is most important, you may have to compromise on pay and practice setting. any big U.S. city is going to be saturated - not just in PM&R but in most other specialties.

The other big factor is connections - if you can network and meet other physiatrists in california while you are an intern, you can keep in touch with them and you may even be able to get a job with them later. I've seen some of my co-residents do that.

You sound like a realist to me.

PM&R is a growing field and I'm glad there are lots of folks going into general PM&R and not everyone is jumping on the Pain/Spine/MSk/Sports bandwagon.

 

[drvlad2004]

Hey all,

I am currently an intern at a program in California. I was accepted into a PM&R program in New York and am really looking forward to it. My only concern is that, most of the attendings and docs that I work with are very skeptical about PM&R as a specialty. They all seem to think that there is no real future in it and that jobs are becoming more and more scarce. This is especially true on the West Coast. I feel its an underrepresented specialty, but I believe there is and will always be a need for it. Most of my attendings are beginning to question my choice of specialty because they dont think there will be any jobs, especially if I do not do a fellowship.
Personally, I would eventually prefer to move back to California following my residency. However, I just wanted to know what anyone thought about the job prospects for outpatient and inpatient rehab in California and in general. I rotated through a couple hospitals on the east coast and saw a lot more outpatient rehab practices, however, I rarely if ever see an outpatient practice in California. Most rehab docs work as inpatient docs or do interventional procedures.
I still feel confident in my choice of specialty, however it is making me wonder why 90% of the attendings I speak with dont believe there are going to be many job opportunities in the field. Any thoughts on this would be appreciated. Thanks!

I also think that a few of the older PM&R attendings are also having difficulty adapting to the evolution of our field. Ironically, the NYC positions that have been offered have been primarily limited to inpatient rehab (SCI, TBI, stroke). Over the few years, grads from NYC programs have struggled and taken less desirable positions at much lower salaries with no partnership track. However, I have seen more positions in Cali as primarily outpatient. Through Kaiser Permanente alone, there are several rehab positions open, which are predominantly outpatient. The Kaiser salaries and benefits are really good in Northern Cal.

Nationally, there is huge need for physiatrists. The same people who say that the future of PM&R is bleak are also the ones who fail to step up as a trailblazer. I think that you have to fight the fight. There is no way in getting around politics. It is the same when we have to back up the evidence of our work amongst other specialties such as ortho, IM, etc. As a resident, I am further understanding the importance of continually proving to other fields that I am just good as them and confident in my own abilities. After having a good discussion with Dr. Fortin (Spine Fellowship In Fort Wayne, IN), he stressed the importance of being in the battle and never assuming that we have lost as physiatrists.

I think that our field has been in high demand and will be for a very long time. Obviously, the big cities like Chicago, Boston, NYC, and LA will always be hard to find a decent job. The same is true for all specialties. We truly make the best living as physicians in areas that are in need. It is not really from areas that are overpopulated. That works for lawyers and other professions.