Applying without a rotation

[USN Doc 214]

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Good evening, all. I am hoping to get some advice on applying/matching to PM&R. I am an atypical applicant so let me give my story first.

I have completed an internship and have been practicing medicine in the Navy and I will be reaching the end of my obligation within the next couple of years. I am planning to pursue a civilian residency after I get out. I performed well in medical school, have good board scores, and can get solid LORs from internship and beyond. The biggest gap in my application is my evident exposure to the field.

My medical school did not have a PM&R residency program and neither does the Navy, so I did not give it much thought during medical school. During my internship I worked with a PM&R doc and he really introduced the field to me. From then I tried to get some more exposure, mostly through any community physicians. I am stationed at a somewhat remote base, my day job has kept me busy, and am gearing up for deployment. Through all of that, finding time to spend with a local PM&R doc has been difficult. From what I read on program websites, many would like a candidate to have completed a PM&R rotation and have a LOR from a physician in the field.

How should I approach this as I gear up for the application process? While I admit, due to the breadth of the field, I have had less exposure than ideal, but I feel that I have a good working understanding PM&R. I have found that the community guys have seemed to find a niche, thus limiting the exposure that I would have otherwise received at a teaching institution. I do not want to come across as the guy who spun the wheel and landed on PM&R, but I feel like I'm fighting an uphill battle with the circumstances. I can assure anyone that during my time out of training, I have been constantly thinking about what I want to do with the rest of my life. Any advice or comments would be greatly appreciated!

 

[Want2Bdoc]

I had a classmate who matched at one of the "top 5" PM&R programs & did not do a formal PM&R rotation. For him, he discovered the specialty late in the 3rd year of school and then couldn't find an open rotation in time for interviews. Instead, he constructed his 4th year rotations to mimic the areas within PM&R as much as possible. My recommendation would be include your working with the PM&R docs in your PS and see if the PM&R doc you worked with in your internship will write you a LOR. Good Luck 🙂

 

[Cdvfdrs]

I sent you a message. I am a Navy GMO that just matched.

 

[j4pac]

You're not too atypical. I am a FS applying for PGY-2 2016 cycle this year. I have a fellow FS who works in my clinic who will be doing the same.

I was fortunate enough to realize that I wanted to do PM&R during med school...so I have a LoR. I put all of my eggs into the Walter Reed basket throughout medical school and internship. I still hope to get into that program...but I have come to the realization that it is unlikely.

There are over 70 PM&R residencies...I plan on getting into one of them. I plan on applying to most of the PGY-2 programs this year...and if I don't match into WRAMC (I hate the new acronym)...then I will apply to the PGY-1 programs next year. If I can't match...it is time to move on to a different profession. I will stay in the military up until the time I get into residency.

I have known a handful of military-> civilian PM&R residents and most programs are interested. You stand out from the crowd and have priceless experience and will likely kill your personal statement and interviews. There may be a handful of the more bullheaded programs that won't take you...but most will give you strong consideration, especially if you meet minimum requirements. Not being able to rotation is a problem...but I think that most programs understand that rotating is not practical for a guy who is practically an attending. It hasn't hurt the guys I have previously known.

 

[holyhekshler]

First off, thank you for your service, I think it will only help you in the match. I am applying in PM&R this year so my advice is only what I have heard gearing up to apply from a school that doesn't have a PM&R residency. The PM&R faculty that I spoke to definitely pushed me to do as many away rotations as possible, both to gain experience, see what residency in PM&R is like and get letters (which I actually couldn't do from my aways in the end, very frustrating). If you are not applying this year I think you should make every attempt to do at least 1 rotation month somewhere with a residency. I know that might not be possible. A lot of programs even do 2 week rotations for visiting students. I'm not sure how it works, you'd have to figure out if you could get malpractice coverage for the month or you might have to deal with 'observer' status. I'm sure residencies/schools who take visiting students could explain how it would work for you if you call them. Most take visitors year round. If you apply early and broadly for away rotations this should hopefully be doable. Of course, a LOR isn't guaranteed even if you do a month somewhere which is the really crappy part. If you can connect to anyone to make a call for you (maybe the person you worked with could help?) that would be easier. If you just can't rotate no matter what becasue of logistics then ok, I would say do whatever it takes to get a letter from whoever local in PM&R, and make it a priority to find time to work with them (your vacation weeks?. I would at least contact programs and make the attempt. Of course this will not be fun at all but it seems like PM&R is getting increasingly competitive and if you feel like it is truly the best fit then a few weeks out of your life to make some connections to get a letter will be worth it. Good luck to you!

 

[DryHopped]

First off, thank you for your service, I think it will only help you in the match. I am applying in PM&R this year so my advice is only what I have heard gearing up to apply from a school that doesn't have a PM&R residency. The PM&R faculty that I spoke to definitely pushed me to do as many away rotations as possible, both to gain experience, see what residency in PM&R is like and get letters (which I actually couldn't do from my aways in the end, very frustrating). If you are not applying this year I think you should make every attempt to do at least 1 rotation month somewhere with a residency. I know that might not be possible. A lot of programs even do 2 week rotations for visiting students. I'm not sure how it works, you'd have to figure out if you could get malpractice coverage for the month or you might have to deal with 'observer' status. I'm sure residencies/schools who take visiting students could explain how it would work for you if you call them. Most take visitors year round. If you apply early and broadly for away rotations this should hopefully be doable. Of course, a LOR isn't guaranteed even if you do a month somewhere which is the really crappy part. If you can connect to anyone to make a call for you (maybe the person you worked with could help?) that would be easier. If you just can't rotate no matter what becasue of logistics then ok, I would say do whatever it takes to get a letter from whoever local in PM&R, and make it a priority to find time to work with them (your vacation weeks?. I would at least contact programs and make the attempt. Of course this will not be fun at all but it seems like PM&R is getting increasingly competitive and if you feel like it is truly the best fit then a few weeks out of your life to make some connections to get a letter will be worth it. Good luck to you!

Could you elaborate on why you couldn't get LORs from your away rotations?

 

[holyhekshler]

Could you elaborate on why you couldn't get LORs from your away rotations?

It was just one month away for me so far, the other will be a little too late to get a letter for this cycle. I have a few friends this happened to as well. Sometimes places have you rotate for like 1 week on 1 service, then switch, then do some outpt with a bunch of different people, not really forming a 'bond' with any particular attending. It's very luck of the draw if you get someone who you can really connect to in a week (I've known many people who have had this happen as well and have been able to make it work), I had an attending that said he would do it and then didn't respond to my follow up emails. I was able to work it out to get letters from people locally so I'm ok but it was a really frustrating experience.

 

[Jitter Bug]

I think if you can fulfill the requirement in spirit that will go a long way. Can you find a PM&R doc in your area, take a few vacation days and shadow him or her? Maybe a week or a few half days spread out over a few weeks? And go out for a long lunch and talk about the pros and cons of PM&R practice, and see if they would write you a letter. It's not a rotation, but there is value given to you spending "a week in the life" of a PM&R doctor. It doesn't matter if you can't DO anything while shadowing. Sounds like vacation days are precious commodities with a deployment coming up but it may be worth it to bite the bullet. Otherwise see if you can shuffle your own duties to get a few hours in of shadowing during 9-5, while you work early or late to stay caught up with your own practice.

Good Luck