How late is too late to commit to PM&R?

[Kardio]

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Early M3 here at an established DO school. I never cared much for OMM, MSK, ortho, or athletics (lol) - I’ve always seen myself as someone destined for neurology or an IM/subspecialty. However, I’ve absolutely loved the time I’ve spent with PM&R so far. The medicine, the workflow, and the patients are all very appealing to me.

I’ve always read that this is a field that cares about commitment more than stats. If that’s the case, how long do I have before I need to start loading all my eggs into the PM&R basket?

 

[j4pac]

I don’t think I even knew PM&R existed until mid way through my 3rd year

 

[DMBandFan86]

Developing an appreciation for rehab through rotations is what they are looking for. Write that info in your personal statement and talk about it during interviews. They want to know why you want to go into rehab, not necessarily how long you have wanted.

 

[flapjack3d]

Honestly you don’t even NEED a Pm&r rotation to match somewhere. Not everywhere offers them. Of course it helps a lot though. Just have to know the specialty and have well thought out why you want to be a physiatrist.

 

[JBM16BYU]

While you maybe don't need audition/sub-I rotations elsewhere, it is important to make sure you have a full grasp of the field, both the inpatient (spinal cord injury, brain injury, stroke, cancer, etc.) side and the outpatient (EMG, musculoskeletal, spine, pain, sports, spasticity) side. Programs will want you to have a broad experience and to want the broad experience of PM&R given in residency, not simply "I am doing PM&R because I love Pain" or "I am doing PM&R because I love Sports." You may have thoughts of doing either or neither of those in the future, but it is important to keep an open mind to all of the possibilities in PM&R since you may change your mind during residency. I usually recommend trying to rotate in at least 2 PM&R settings (outpatient and inpatient), volunteering with sports coverage, volunteering with adaptive sports / Special Olympics, trying to attend AAPM&R/AAP/AOCPMR meeting, being a member of the prior 3 listed as well as potentially AANEM (EMG/Neuromuscular), SIS (Spine/Pain), or AAPM (Pain) which are free to students, and trying to present posters at conferences of case reports (very doable as a medical student).

 

[j4pac]

Honestly you don’t even NEED a Pm&r rotation to match somewhere. Not everywhere offers them. Of course it helps a lot though. Just have to know the specialty and have well thought out why you want to be a physiatrist.

I likely wouldn’t rank an applicant that didn’t have exposure.

 

[DMBandFan86]

While we end up doing some palliative care with inpatient rehab, I don’t want you to think that is a main purpose of PMR. You’d be better served doing a PC fellowship. There are cancer rehab specific fellowships, but generally PC is doing the palliative treatment and we are focused on rehab medicine, pain and function.

Generally, these type of patients choose to try rehab as they didn’t want PC. Sometimes they still end up needing hospice, but besides coordinating care, GOC discussions and some med changes, I typically defer end of life care until they are in someone else’s care.

 

[j4pac]

Sorry to bump an old thread, but I'm in a similar boat with seeing myself destined for something like neuro/IM. I'm also indifferent to MSK/OMM/sports/spine. However I feel drawn to rehab and palliative care type of medicine.

Would you please expand more on what you loved about PM&R?

I’m always a little concerned about an applicant that has little to no interest in MSK. Even for the providers that do primarily inpatient, MSK is a huge part of what we do. I agree with DM’s recommendation to look at other specialties including Neuro, IM, and FP. Palliative care isn’t exactly a competitive fellowship, and doing PM&R with the goal of doing cancer/palliative seems a long route to ultimately arrive to where you can be much quicker with FP/IM

 

[Iamnew2]

I’m always a little concerned about an applicant that has little to no interest in MSK. Even for the providers that do primarily inpatient, MSK is a huge part of what we do. I agree with DM’s recommendation to look at other specialties including Neuro, IM, and FP. Palliative care isn’t exactly a competitive fellowship, and doing PM&R with the goal of doing cancer/palliative seems a long route to ultimately arrive to where you can be much quicker with FP/IM

Agree with J4pac. MSK affects essentially 100% of patients regardless of what aspect of PM&R someone goes into.

 

[Kardio]

Sorry to bump an old thread, but I'm in a similar boat with seeing myself destined for something like neuro/IM. I'm also indifferent to MSK/OMM/sports/spine. However I feel drawn to rehab and palliative care type of medicine.

Would you please expand more on what you loved about PM&R?

Liked the flow of working in a rehab. Enjoyed addressing the patient’s tangible and immediate concerns rather than abstract ‘doctor-esq’ concerns (eg, patients don’t really care what their potassium is, but we certainly do).

Ultimately I came to agree with what has been stated above; I didn’t have enough interest in MSK to keep PM&R on my mind throughout MS3 and will be applying to another field.