Current PM&R PGY-2 trying to finding my niche of interest.

KYTopgun

5+ Year Member
Jan 30, 2014
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  1. Medical Student
Hello everyone,

I am current PGY-2 in PM&R having trouble finding my niche in this specialty. When I choose this specialty I thought it would be great to interact with patients long term and improve their function and find creative ways to solve there ADL issues. There are also many procedures and opportunities to use new and exciting rehab technology such as brain to computer interfacing, robotics, and virtual reality. The lifestyle was also a plus.

After going through my intern year in medicine I now feel unsatisfied with my work thus far in PM&R. I also feel that I am different person now than I was in 4th year when I made my specialty choice. For example, thus far in my PM&R rotation outpatient, I have found that chronic pain patients drain me, there is not enough time to a well thought and good MSK exam and there is no time to make creative solutions for patients. I also work with an interventional pain doctor and yes the procedures are cool, but they lose their luster after you have seen and done so many. On the inpatient side I feel it's more like medicine lite with a lot more social issues that have been sent to us by other specialties. So I feel like I am focusing more on them not being readmitted vs the treatment plan. It is not satisfying to me to handle a patient's acute medical issues just so they can participate in PT. I feel I am missing that diagnostician side of being a physician. On top of that it is draining to handle the dispo of multiple of patients who may not have the personal or family resources at home.

I have learned that I more interested in the problem solving vs managing and more interested in acute vs chronic issues. For example having someone with syncope and you as the physician have to problem solve is it neuro vs cardiac vs some other etiology. Now I know could have stayed in internal medicine, but it was the opportunity to see nervous system and msk pathology that attracted me to PM&R. I have also learned that I like the pace of inpatient or hospital based practice vs outpatient.

What are your thought? Is there a niche within PM&R that will satisfy my goals?
Are there more opportunities to get involved in these "rehab technologies" or are they not used in clinical practice and just a rarity?
 

gainey77

7+ Year Member
Jan 4, 2012
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Try to tough it out to PGY-3. Look up some of the old threads about this and you’ll see that people generally go through a specialty crisis PGY-2 year. PGY-3 year you start to get a glimmer of why we matter, what we do well and why it is a worthwhile field.
 
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