I'm not sure your question is clear " 'do you what you want when you want specialties'"... umm? Rotate with a general PM&R physician before you make any conclusion about the field. There are so many options for PM&R and with the baby boomer population there will be more opportunities in the future. I've worked with doctors who take new patients and specifically treat young athletes to geriatrics (falls) needing more specialized care (gait, biomechanics, etc) that few other fields can treat. I've also seen physicians who base their practice more off "inpatient consults" and then follow the patient in an outpatient setting (TBI, CVAs, Multi-trauma, and SCI injuries). A lot of the reimbursements vary based on the insurance the patient has but the scope of PM&R is huge ranging from pediatrics to geriatrics. With patients living longer, through medical advances, PM&R is able to help people return home and function...whether they have MS, Parkinson’s, Cancer, Cardiac Rehab, Pulmonary Rehab, Wounded Veterans, Low Back Pain, Diabetic wounds, etc. Needless to say we are not worried about our "patient base."