Internal Medicine to PMR switch

[RecoveringStudentDO]

Hey guys i matched into internal medicine, but have recently found out about pmr , followed a pm and r resident who is an old friend....have to say that i like the work and lifestyle.

I'm a DO student with a 236 on step 1, did not take step 2
Comlex level 1 525, comlex level 2 615 , comlex pe pass first try.
top 10% of med school class, 3.7 gpa.

I know my scores seem good enough for PM and R, but i have no experience rotating in PMR....honestly didnt even know it existed until now thus i couldnt really rotate through it. I would not have any recs from PMR, only internal medicine and emergency medicine. But I feel like PMR rotations are not available at a lot of schools, thus many applicants may not have rotated through it to begin with.


what do you guys think?

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[RangerBob]

Your grades and scores are good (at least your ranking and USMLE--I don't know how to interpret Comlex scores).

Unfortunately, I am not sure any programs would consider you without any experience rotating through PM&R, and without any PM&R letters. Any PD is going to wonder how you know it's the right fit for you. And I think that's a valid question--why do you think it's the right fit for you? Don't get me wrong--it's a fantastic specialty, and I love it! But if you haven't spent time working with physiatrists, the multi-disciplinary rehab team, PM&R patients, etc., then it's hard to know fore sure if it's the specialty for you.

I am not aware of any PM&R residents who didn't rotate through the specialty. Many schools don't have a PM&R rotation at their primary hospital, but those students just apply for away rotations or for a PM&R rotation at an affiliated hospital.

If you just matched IM, that suggests you're still a student. Do you still have any time left where you could rotate through PM&R?

Obviously, trying to switch this early is a whole can of worms. Most would give you the advice to stay the course, and that your first choice (IM) was probably the correct one and that you should give it a shot before abandoning it. Fortunately, you need an intern year anyway for PM&R, and most do pre-lim IM, so you'd have to do that PGY1 year in medicine anyway.

 

[DMBandFan86]

I believe you would have to re-apply to the general match this year for a PGY-2 PM&R spot, assuming you complete your intern year and your IM residency lets you separate. Your comlex scores are fine, just above the average. What you need are solid LORs and a really compassionate personal statement about why you want to work with disabled patients. You should also be passionate about neuromusculoskeletal anatomy and electrodiagnostic studies, as you will spend a lot of time trying to master these skills during residency.

The lifestyle of PM&R can be variable, so don't be jumping on the speciality because you heard it has a good lifestyle. Many IM doctors end up with a very good schedule when all things are done with residency. With PM&R you have to work hard to make a lot of money. There are some docs working 7 days a week doing consults, IPR and outpatient clinics. You will also get home call in PM&R which you wouldn't ordinarily get in hospitalist medicine. No nights though (unless you end up at certain residency programs that have in-house night call). On the other hand there are PM&R doctors who are working 4-5 days a week without any call responsibilities. Just depends on what your interests are, how much money you want to make and where you end up. Now a days about half of the PM&R residents want to do fellowships in pain management/interventional spine or sports medicine.

Also, as an FYI, generally our population base is very complex and you will be dealing with a lot more social issues and long-term functionality issues. Many of our patients take a lot of time and care and that can take a personal emotional toll. I recommend you see some TBI patients and SCI patients.

 

[RecoveringStudentDO]

Thank you guys for taking the the time to reply. You really put things into perspective, especially shedding insight on the patient population, i admit i didnt really think of that at the time. Im going to arrange a rotation in pm and r, or go shadow my friend who just became an attending, i will know a lot more then.