General PM&R Questions

[theanswer03]

Hey guys,

I am a newly minted 4th year who's considering PM&R. However, I have some very general questions to ask of the more experienced physiatrists ahead of me. I'll apologize in advance, because I'm sure a few, if not more, of these questions have been posted and answered before. Here goes:

1.) I know this is a really broad question, but what are the biggest positives about PM&R?

2.) What are the negatives? Do you know of anyone who has disliked pm&r, or gone back and changed their field?

3.) How much neurology is part of pm&r? If I don't particularly care for neuro, will i hate the field?

5.) Is outpatient pm&r mostly pain management, or did I get the wrong view of it? What, in general, is outpt pm&r like?

6.) I got right at national avg for step 1, but i've been mostly p4 or p2/3 for the rest of my classes, including 3rd year rotations. Should I have a problem matching? How many places do applicants typically apply to? How many PM&R letters do I need?

7.) How difficult is it to get a fellowship, and how many years long are the respective fellowships? I might be interested in sports medicine. Do most people do a fellowship, or just go into general PM&R?

8.) Is it hard to get a job out of residency? Would I be limited as to where I could work? What kind of salary offers do PM&R docs get out of residency?

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[PMR 4 MSK]

Hey guys,

I am a newly minted 4th year who's considering PM&R. However, I have some very general questions to ask of the more experienced physiatrists ahead of me. I'll apologize in advance, because I'm sure a few, if not more, of these questions have been posted and answered before. Here goes:

1.) I know this is a really broad question, but what are the biggest positives about PM&R?

2.) What are the negatives? Do you know of anyone who has disliked pm&r, or gone back and changed their field?

3.) How much neurology is part of pm&r? If I don't particularly care for neuro, will i hate the field?

5.) Is outpatient pm&r mostly pain management, or did I get the wrong view of it? What, in general, is outpt pm&r like?

6.) I got right at national avg for step 1, but i've been mostly p4 or p2/3 for the rest of my classes, including 3rd year rotations. Should I have a problem matching? How many places do applicants typically apply to? How many PM&R letters do I need?

7.) How difficult is it to get a fellowship, and how many years long are the respective fellowships? I might be interested in sports medicine. Do most people do a fellowship, or just go into general PM&R?

8.) Is it hard to get a job out of residency? Would I be limited as to where I could work? What kind of salary offers do PM&R docs get out of residency?

Many/most (all?) of your questions have been answered in stickies or previous threads, but i'll take stab.

1 - breadth of the field, MSK expertise, biomechanical proficiency, getting to spend time with your patients.
2 - Having to spend too much time with some of the patients. Lack of respect from other fields. Lack of knowledge by the general public and much of the medical fields of what we do, or even what a Physiatrist is.
3 - neuro is a huge part of PM&R - both inpt and outpt. You have to know the brain and spinal cord, peripheral nerves, etc.
4 - (Where'd it go?)
5 - No, out PM&R can be anything - f/u from inpt rehab, outpt management of disabilities, disability assessments, Independent Medical Exams, Sports, general MSK
6 - NRMP data can tell you averages. Apply broadly. The more money you have available, the more places you can potentially interview at.
7- depends on the fellowship - there are many in PM&R - pain, sports, spine, CVA, TBI, SCI, EMG, etc.
8 - In a large city, like NY, Chicago, LA, many markets are saturated and the demand is low. Demand is better in suburban and rural areas, but a Physiatrist will need a much larger population to work with than other specialists, like an orthopod. There are currently jobs available all over the country. Getting to do everything you want to do, in the one place you want to live, for the salary you'd like to have is rare. Most people sacrifice something. I sacrificed location.

 

[RUOkie]

Many/most (all?) of your questions have been answered in stickies or previous threads, but i'll take stab.

1 - breadth of the field, MSK expertise, biomechanical proficiency, getting to spend time with your patients.
2 - Having to spend too much time with some of the patients. Lack of respect from other fields. Lack of knowledge by the general public and much of the medical fields of what we do, or even what a Physiatrist is.
3 - neuro is a huge part of PM&R - both inpt and outpt. You have to know the brain and spinal cord, peripheral nerves, etc.
4 - (Where'd it go?)
5 - No, out PM&R can be anything - f/u from inpt rehab, outpt management of disabilities, disability assessments, Independent Medical Exams, Sports, general MSK
6 - NRMP data can tell you averages. Apply broadly. The more money you have available, the more places you can potentially interview at.
7- depends on the fellowship - there are many in PM&R - pain, sports, spine, CVA, TBI, SCI, EMG, etc.
8 - In a large city, like NY, Chicago, LA, many markets are saturated and the demand is low. Demand is better in suburban and rural areas, but a Physiatrist will need a much larger population to work with than other specialists, like an orthopod. There are currently jobs available all over the country. Getting to do everything you want to do, in the one place you want to live, for the salary you'd like to have is rare. Most people sacrifice something. I sacrificed location.

What he said. One other negative though: PM&R is a bit of a dumping ground though.
Another positive: Having patients give you a hug when they leave the office because "you were the first doctor to really listen to me"

 

[theanswer03]

Many/most (all?) of your questions have been answered in stickies or previous threads, but i'll take stab.

1 - breadth of the field, MSK expertise, biomechanical proficiency, getting to spend time with your patients.
2 - Having to spend too much time with some of the patients. Lack of respect from other fields. Lack of knowledge by the general public and much of the medical fields of what we do, or even what a Physiatrist is.
3 - neuro is a huge part of PM&R - both inpt and outpt. You have to know the brain and spinal cord, peripheral nerves, etc.
4 - (Where'd it go?)
5 - No, out PM&R can be anything - f/u from inpt rehab, outpt management of disabilities, disability assessments, Independent Medical Exams, Sports, general MSK
6 - NRMP data can tell you averages. Apply broadly. The more money you have available, the more places you can potentially interview at.
7- depends on the fellowship - there are many in PM&R - pain, sports, spine, CVA, TBI, SCI, EMG, etc.
8 - In a large city, like NY, Chicago, LA, many markets are saturated and the demand is low. Demand is better in suburban and rural areas, but a Physiatrist will need a much larger population to work with than other specialists, like an orthopod. There are currently jobs available all over the country. Getting to do everything you want to do, in the one place you want to live, for the salary you'd like to have is rare. Most people sacrifice something. I sacrificed location.

Thanks so much for the reply. I know most of this stuff has probably been posted elsewhere, and I apologize for my laziness ...

1.) those are all good positives for the field. I'm considering Family Medicine as well. Coming into this elective I'm doing, I would have said that I'm heavily leaning towards FM, actually. One of the things I really like about FM is that you can basically control how much or how little you want to work, and you have a very wide range of opportunities as far as which settings you can work in - inpt, outpt, ER, nursing home, urgent care. Obviously, PMR docs wouldn't be able to work in every setting, but in general, do you have good freedom of where you work (hosp vs outpt or both), how much you want to work (in terms of hours), and what procedures you can do, when you come out of residency? I know this question will change from person to person, but what is the lifestyle of an average physiatrist like out in the real world?

2.) no other questions

3.) Thanks for the input about the neuro aspect of PM&R. As far as the rehabilitation part of PM&R, such as the specifics of the different therapy modalities (PR, OT, speech therapy, etc) prosthetics, etc, what are you expected to know as an applicant and as a new resident? I'm certainly open to learning, but at this point in time I feel like I don't know anything about all of this. We really haven't been taught about these things at all in med school.

4.) sorry #4 disappeared ..

5.) no other questions

6.) How many interviews do applicants typically go on? How many interviews for transitional/prelim years did you do? Is it hard to get one of those spots?

7.) How many years are the sports medicine and MSK fellowships?

8.) no other questions

Do any PM&R jobs typically offer loan repayment, like FM jobs are known to do?

-Thanks again

 

[PMR 4 MSK]

Thanks so much for the reply. I know most of this stuff has probably been posted elsewhere, and I apologize for my laziness ...

1.) those are all good positives for the field. I'm considering Family Medicine as well. Coming into this elective I'm doing, I would have said that I'm heavily leaning towards FM, actually. One of the things I really like about FM is that you can basically control how much or how little you want to work, and you have a very wide range of opportunities as far as which settings you can work in - inpt, outpt, ER, nursing home, urgent care. Obviously, PMR docs wouldn't be able to work in every setting, but in general, do you have good freedom of where you work (hosp vs outpt or both), how much you want to work (in terms of hours), and what procedures you can do, when you come out of residency? I know this question will change from person to person, but what is the lifestyle of an average physiatrist like out in the real world?

2.) no other questions

3.) Thanks for the input about the neuro aspect of PM&R. As far as the rehabilitation part of PM&R, such as the specifics of the different therapy modalities (PR, OT, speech therapy, etc) prosthetics, etc, what are you expected to know as an applicant and as a new resident? I'm certainly open to learning, but at this point in time I feel like I don't know anything about all of this. We really haven't been taught about these things at all in med school.

4.) sorry #4 disappeared ..

5.) no other questions

6.) How many interviews do applicants typically go on? How many interviews for transitional/prelim years did you do? Is it hard to get one of those spots?

7.) How many years are the sports medicine and MSK fellowships?

8.) no other questions

Do any PM&R jobs typically offer loan repayment, like FM jobs are known to do?

-Thanks again

1 - wide variety, part time through full time, inpt or outpt, or both, clinic-based, hospital-based, group or solo, single or multi-disciplinary groups. Procedures you can do out of residency vary by program. Most should be able to do basic nerve blocks, joint injections, tendon injections. Some will do spinal procedures - epidurals and facets. Beyond that you'll need fellowship.

PM&R is a "lifestyle" field - it allows you to have a life outside of medicine. You are fully in charge of yourself and your career.

3 - incoming applicants should know the difference b/w PT and OT and what SP does. I would not expect much more.

6 - I don't personally know the answer, but multiple previous threads have discussed this.

7 - most fellowships are 1 year.

There is not much in the way of loan repayment for PM&R specifically, but you never know what you may find.

 

[Woodendoor]

Current PGY1, matched into PM&R, completing my prelim year now.
I'll just respond to number of applications because those at the attending level answered the others quite thoroughly. Also, I applied as part of the couples match.

PM&R
applied: ~ 30
received interview invites: 25
interviews attended: 15
programs ranked: 12

Preliminary year
applied ~13
received interview invites: 8
programs ranked: 8

I think 30 is much higher than an individual needs to, but I figured I'd rather cast a large net instead of having to back pedal and apply late if I didn't get enough interviews.