"Best" programs for various sectors of PM&R

[agdoc04]

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I know the Super 6, but outside of these (and also where these may fall), what are the "best" programs for
1. SCI
2. TBI
3. MSK
4. Electrodx
5. Pediatrics

Etc......

If possible 4 or 5 programs under each would be very helpful.

 

[Finally M3]

I would say UMich strength's are MSK and Edx. I have no direct comparison for other progs, but through the grapevine, have heard RIC, UW have strong MSK exposure as well.

For Edx, Mayo, UW (Robinson), UTHSW (whatever it's called, where Dimitru is), tOSU (E. Johnson et al.) have good reps.

Hope this helps, and take it FWIW.

 

[ShrikeMD]

Dr. Dumitru is at UTHSC-San Antonio. Southwestern is in Dallas.

 

[Surfhog]

For EMG/NCS I would have to include my own program: Medical College of Wisconsin (Wertsch,Dillingham and Deltoro are well known in the world of EMG's and have published considerably) right up there with Mayo, Michigan, San Antonio's and UW.

MSK: Definitely RIC, I have met many of their residents as some of them do electives or fellowships at MCW and they definitely know their material.

SCI: Serious consideration has to be given to Kessler and UW.

 

[njdevil]

I have to put in a few philadelphia votes.

TBI - Temple U. with affiliation with Moss (model ctr)
SCI - Thomas Jefferson U with affiliation with Magee (model ctr)
EDX - Thomas Jefferson U with rotations with Dr Herbison (jeff) and Sridhara (moss).

 

[ShrikeMD]

I have to put in a few philadelphia votes.

TBI - Temple U. with affiliation with Moss (model ctr)
SCI - Thomas Jefferson U with affiliation with Magee (model ctr)
EDX - Thomas Jefferson U with rotations with Dr Herbison (jeff) and Sridhara (moss).

It is certainly reasonable to consider the Moss-affiliated programs for TBI, although the Model System designation, per se, isn't the primary reason. Most Model System sites have clinical faculty that can serve as teachers. As in any field, however, some are better teachers or investigators than others. For example, Baylor-Houston was "out" of the Model Systems for 5 years until one month ago, yet they easily would have qualified as a program worthy of providing the best teaching for Brain injury neurorehabilitation over that time period (and longer).

I think a better way of narrowing the field would be to look at the TBI model system sites with residency training programs in PMR that also have fellowship programs (in BI, of course). This will narrow the field to Kessler, Baylor-Houston/TIRR, MCV, Carolinas Medical Center (most of the time), Moss (sometimes).

Please note that this does NOT mean that other places aren't strong (such as Washington, Ohio State), but they typically don't have fellowship programs in BI.

 

[axm397]

I think a better way of narrowing the field would be to look at the TBI model system sites with residency training programs in PMR that also have fellowship programs (in BI, of course). This will narrow the field to Kessler, Baylor-Houston/TIRR, MCV, Carolinas Medical Center (most of the time), Moss (sometimes).

Please note that this does NOT mean that other places aren't strong (such as Washington, Ohio State), but they typically don't have fellowship programs in BI.

RIC has fellowships in : MSK/spine, pain, SCI, TBI/stroke, Peds, and I suppose it's also possible to do research.

We are also applying for model status for TBI and recently got our model SCI status back. Our pain fellowship is ACGME accredited in conjunction with the Northwestern Anesthesia department.

 

[ShrikeMD]

RIC has fellowships in : MSK/spine, pain, SCI, TBI/stroke, Peds, and I suppose it's also possible to do research.

We are also applying for model status for TBI and recently got our model SCI status back. Our pain fellowship is ACGME accredited in conjunction with the Northwestern Anesthesia department.

I would emphasize that the foundation for strong educational experiences in any subspecialty of rehab are based upon the strengths of the principal mentors. Fortunately, there are a few places throughout the country where one can find a combination of a 1) strong, well-structured academic residency training program; 2) a fellowship training program in the field of interest; 3) strong clinical mentors, and 4) strong research mentors. The NIDRR-funded "Model Systems" programs actually have very limited interaction with the residency training programs (if any), save for the fact that most are found in centers with strong clinicians AND investigators, who are, in turn, typically (but not always) found in academic centers with physiatry residency training programs. The original post wanted suggestions for which were the best centers for specific subspecialties within PMR, and I responded by saying that a combination of 1) fellowship training program, 2) affiliation with strong PMR program, and 3) affiliation with TBIMS was one way to differentiate some strong programs from other strong programs with an even broader foundation for clinical/research/educational excellence.

Regrettably, RIC has been consistently unsuccessful in their repeated attempts to apply for a TBI Model System, and their 2007 attempt met the same fate as earlier ones. This shouldn't reflect adversely on their ability to provide a strong educational exposure for their residents in BI. Indeed, few centers could provide stronger mentors in stroke neurorehabilitation than Dr. Harvey.

 

[paindefender]

Best in Scutwork NYU

 

[normalforce]

Best in Scutwork NYU

What....? The last post in Scutwork under NYU was from 14-Jan-2004 and it was from a medical student on an interview day. (http://www.scutwork.com/cgi-bin/links/review.cgi?ID=3032&d=1)

Paindefender, you have been trolling around in a lot of threads. Why?.....oh God why?...... Why do you hate PM&R so so much....... 🙄

 

[caedmon]

EMG is outstanding

MSK is excellent
There is the obvious strengths of the great sports med guys: Smith, Laskowski, Finnoff, Newcomer, but also many fellowship trained MSK faculty, sports and MSK fellowships available, and a large portion of outpatient referrals to PM&R for most MSK conditions.

 

[rehab_sports_dr]

I concur with many others, in that I wouldn't put too much into the model systems designation. I was at Kessler both when it was and wasn't a TBI model systems, and I can't say it made a huge difference. As a resident, it had no impact.

 

[Disciple]

What....? The last post in Scutwork under NYU was from 14-Jan-2004 and it was from a medical student on an interview day. (http://www.scutwork.com/cgi-bin/links/review.cgi?ID=3032&d=1)

I don't think he was referring to the website.

 

[njdevil]

I was merely adding programs to the list and mentioning the designation. The designation itself did not have anything to do with my suggestions. Consider the post without the designations, didn't know it would start a fairly fruitless debate. Might I add that having a fellowship program to offer has to do with more than teaching quality but political hoops, egos, paperwork, and funding to say the least.

 

[ShrikeMD]

A number of factors influence the ability to sustain a viable fellowship program. In Brain Injury, there are limited sources of funding when compared with SCI, as SCI has benefited from VA funding of their fellowship programs. Funding is the most important issue for creating and sustaining a fellowship program. Having said that, a funded fellowship program will be less competitive if 1) the mentors are not perceived to be strong teachers, 2) there is no affiliated physiatry residency training program (fellows still must pass part II of the boards), and 3) the geographic location is less desirable. Fellowship programs are a plus for an affiliated physiatry residency training program, as most fellows are eager to serve as an added teacher to the residents in the area of their specialization.

 

[Ligament]

University of Michigan;

I'd put the spine, msk, and interventional training at the very top anywhere.

EMG is great, certainly one of the top for EMG training. All EMG attendings are AAEM boarded before they are allowed to teach.

SCI and Peds inpatient training is excellent, would put it in the top ten.

O&P has got to be around the top 5 or so.

VERY weak in sports medicine. Achilles heel type issue.

 

[savealife]

Ligament, are you aware of anything that Michigan is doing to try to remediate their lack of Sports Medicine training?

 

[ampaphb]

I would like to propose that no current or former resident or staff should tout the virtues of their own program (seems like an inherrent conflict of intersts, IMHO)

 

[axm397]

I know the Super 6, but outside of these (and also where these may fall), what are the "best" programs for
1. SCI
2. TBI
3. MSK
4. Electrodx
5. Pediatrics

Etc......

If possible 4 or 5 programs under each would be very helpful.

OK - in the spirit of ampaphb's suggestion - NOT mentioning my own program:

1. SCI - Kessler
2. TBI - Baylor
3. MSK - Mayo
4. Electrodx - Ohio State, UT San Antonio, Michigan
5. Peds - Cincinatti

How's that? 🙂

 

[chauffeur]

Note: This is my experience as a resident. I can't comment on other places as I obviously haven't worked at any other place - except as a rotating med student.😳

Spine: Amazing all around comprehensive spine training. Fellows who come here after completing residencies at other big places are amazed at the number of procedures we get. We graduate with 150-200 spine injectons. We have a large multisdisciplinary spine center that Dr. Haig developed. There's a lot of research going on. You can walk down the hall and work and learn great skills from the PTs, OTs, and Pain Psychologists. Last year 4 of our residents applied for ACGME Pain spots and they all matched.

MSK: In addition to 2 clinic months, we have a continuity clinic one 1/2 day a week in which you see patients, order imaging, therapies, electrodiagnostic studies, inject joints, etc. These are your patients for the duration of residency - this is great because this is how you'll manage patients once you're in the "real world."

EMG: Also great. You see it all.

SCI: Model system. As our unit is a part of the hospital, we see it all from GBS, metastatic CAs, and other types of SCI.

Peds: You also see it all. Our unit is a part of the main children's hospital. I can't comment on comparison to other programs.

Sports medicine: Not that great, but you can use 2 elective months to get more exposure. I can't comment on comparison to other programs.

 

[ampaphb]

Note: This is my experience as a resident. I can't comment on other places as I obviously haven't worked at any other place - except as a rotating med student.😳

Spine: Amazing all around comprehensive spine training. Fellows who come here after completing residencies at other big places are amazed at the number of procedures we get. We graduate with 150-200 spine injectons. We have a large multisdisciplinary spine center that Dr. Haig developed. There’s a lot of research going on. You can walk down the hall and work and learn great skills from the PTs, OTs, and Pain Psychologists. Last year 4 of our residents applied for ACGME Pain spots and they all matched.

MSK: In addition to 2 clinic months, we have a continuity clinic one 1/2 day a week in which you see patients, order imaging, therapies, electrodiagnostic studies, inject joints, etc. These are your patients for the duration of residency - this is great because this is how you’ll manage patients once you’re in the “real world.”

EMG: Also great. You see it all.

SCI: Model system. As our unit is a part of the hospital, we see it all from GBS, metastatic CAs, and other types of SCI.

Peds: You also see it all. Our unit is a part of the main children’s hospital. I can’t comment on comparison to other programs.

Sports medicine: Not that great, but you can use 2 elective months to get more exposure. I can’t comment on comparison to other programs.

I would like to AGAIN propose that no current or former resident or staff should tout the virtues of their own program (seems like an inherent conflict of interests, IMHO)

 

[normalforce]

People want to know the best programs for various PMR sectors. Now, if you are not a member of a program, how are you really going to know if it is good or not. I do not want someone from any other program saying RIC had good/bad inpatient SCI, how the hell would they know. Reputation?

There is no way to "rank" a program in a sector of PMR without having been a resident at the program and actually rotating through. Period. I do not care who you know or don't know. Unless you have done it, your opinion is based on heresay, and not really valid.

Kind of like RIC being the best rehab hospital in the country, why.... Reputation. Is RIC the best, I don't know, there are a lot of rehab hospitals, so probably not.

So, I think people who are at programs should give their own opinions, just be honest. If your not honest, well, then you are doing a disservice to your colleagues and I hope you have trouble sleeping at night!

NF

 

[chauffeur]

I thought I clearly prefaced my previous post with a statement that my opinion is that of my program only. I have not worked as a resident in any other program. I can’t post about Robert Wood Johnson (UMDNJ) because I haven’t worked there. I do have a friend of a friend who says it’s a great place to be. I think I’d be doing a disservice to everyone else on here by posting 3rd hand info.

When I was evaluating programs a few years ago I learned a lot from other residents. I mean, I wasn't going to ask an attending if the residents were happy🙂 or unhappy🙁

Take everything with a grain of salt, ask around (to residents, other med students, physicians), visit programs and make a decision.

 

[Finally M3]

Ligament, are you aware of anything that Michigan is doing to try to remediate their lack of Sports Medicine training?

There is nothing built into the curriculum. However, there is ample opportunity if you are interested; one of our docs is the spine consultant for the UMich atheltics and Eastern Mich football team. Another of our newly minted attendings has been doing on-the-field research evaluating a novel measuring tool to evaluate head injuries on the field.