I am interested in PM&R but..

[sarah saad]

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Hello everyone,🙂

I am 4th year medical student,
Until now I am very confused about the specialty that I am going to choose!
Right now, I am interested in PMR> I really love helping people, esp. disabled, I love team work, I am optimistic, Patient, easy going….
Another thing is that my city really need physiatrists,
One problem I have>> that I am not that interested in neurology, and what I know that it is very important.
So, is this a big issue!
Can I be interested in neuro with time!
Another Q:
What knowledge should I have, and what skills I need to be a good physiatrist?

thanks 🙂

 

[PMR 4 MSK]

Don't have to be interested in neuro, you just gotta learn it - CNS and PNS, PSNS/SNS, etc. Know structures, pathways and syndromes seen with various injuries and diseases.

It depends on what you don't like about neuro. We don't do extensive neuro testing like a neurologist, we don't do seizures. Many (most?) PM&Rs avoid headache patients.

I've given suspected diagnoses of Parkinson's disease to several patients in the past few month, but send them to neuro for definitive Dx and Tx.

PM&R is a huge field, and it's easy to find a niche that combines what you lke and avoids what you don't.

Your knowledge base right now should be basic and advanced medicine. Don't concentrate on much else for your internship. There's plenty of time to learn the PM&R stuff in residency. Most of what you need to learn comes after residency anyways... 😉

 

[RUOkie]

Probably the most important traits to be a good physiatrist are patience and firmness. Regardless of what type of PM&R you do, you will see a lot of "somatic dysfunction" (symptom magnification). You see this in all fields of medicine, but slightly higher in ours. The good physiatrists learn how to tell people what they don't want to hear; all the while, having them smile on their way out. (ie. "you need to exercise to make your back feel better, even though you will hurt a little worse for a few days, but you don't need a surgery", or; "you need to use your left hand, even if it makes a mess. Otherwise, you will not recover from your stroke"

We have a very "no pain, no gain" type of field. You need to be patient and compassionate both to engender rappor, and since most problems do not get better quickly.

You need to be firm, so that the patient gets better!

I hated my neurology rotation in Medical school. However, I can do a mean neuro exam. I know my neuroanatomy, and frequently make bets with my friend the neurologist about location of brain lesions (we are about 50/50!)

 

[PtownPMR]

Somatic dysfunction is not symptom magnification. Somatic dysfunction is an actual diagnosis that means impairment or alteration in function of related components of the somatic system: skeletal, myofascial, and related vascular, lymphatic, and neural components. Somatic dysfunction is real, treatable and billable!

I am not sure exactly what you are referring, but it sounds like you might be referring to somatization.

Probably the most important traits to be a good physiatrist are patience and firmness. Regardless of what type of PM&R you do, you will see a lot of "somatic dysfunction" (symptom magnification). You see this in all fields of medicine, but slightly higher in ours. The good physiatrists learn how to tell people what they don't want to hear; all the while, having them smile on their way out. (ie. "you need to exercise to make your back feel better, even though you will hurt a little worse for a few days, but you don't need a surgery", or; "you need to use your left hand, even if it makes a mess. Otherwise, you will not recover from your stroke"

We have a very "no pain, no gain" type of field. You need to be patient and compassionate both to engender rappor, and since most problems do not get better quickly.

You need to be firm, so that the patient gets better!

I hated my neurology rotation in Medical school. However, I can do a mean neuro exam. I know my neuroanatomy, and frequently make bets with my friend the neurologist about location of brain lesions (we are about 50/50!)

 

[sarah saad]

Thanks for help 🙂