List of 2007 PM&R program invites

[Disciple]

Any Harvard training program, given enough time will be linked with "elite" status simply because of the Harvard name.

Those applying really need to get over this type of ridiculous nonsense.

In general, the public and medical community don't know what a Physiatrist is or does.

"Elitist Physiatrist" is an oxymoron.

Unless you plan to work in a traditional inpatient setting, you will learn some rudimentary musculoskeletal skills during your residency, but the bulk of your expertise will be gained elsewhere or through independent study.

Your employers, if from different specialties, will have no clue as to the reputation of your residency, or what your curriculum consisted of.

Physiatry is changing so fast with it's scope of practice so poorly defined that your success will likely hinge largely on how you package your skills together and on your ability to market yourself.

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[kaizen]

While I agree that the Spaulding program is benefitting greatly from the Harvard name, the name is not all it has. The Columbia/Cornell program has a great name and location(for some) but has received average to poor reviews on this forum (with a few exceptions). Spaulding's generous elective time may very well offer the ability for one to tailor their 'packaged skills' and by your standards, be on the way to success. I understand that overall accomplishment is individually driven, but some places can make it easier/harder to acheive than others. Maybe the wording was misleading; the top residency programs are placed in the top by reputation. The list is skewed towards larger, older programs with university backing. Spaulding is relatively new, but it has a strong reputation. Some reputations may be deserved and still applicable...some not. That's what the applicants want to know. That's what makes these places more competitive than others. They believe that their chances of finding their desired training/future success are greater at one of these institutions. Even though success can be found anywhere, there are some crappy programs out there. If the separation of a few programs from the main list is what disturbs you most, that can be changed but it would only be aesthetics. Until we interview/rotate and find our personal number one, we initially sort by a few numbers, rumours and reputation. If you believe an institution's reputation is not deserved, help us out. tell us why. I have certainly added a few programs to my application list after speaking to those more knowledgeable than myself. I can't rotate at them all before I apply. While I respect your opinion, I detect your annoyance and think it is ill-placed.

Any Harvard training program, given enough time will be linked with "elite" status simply because of the Harvard name.

Those applying really need to get over this type of ridiculous nonsense.

In general, the public and medical community don't know what a Physiatrist is or does.

"Elitist Physiatrist" is an oxymoron.

Unless you plan to work in a traditional inpatient setting, you will learn some rudimentary musculoskeletal skills during your residency, but the bulk of your expertise will be gained elsewhere or through independent study.

Your employers, if from different specialties, will have no clue as to the reputation of your residency, or what your curriculum consisted of.

Physiatry is changing so fast with it's scope of practice so poorly defined that your success will likely hinge largely on how you package your skills together and on your ability to market yourself.

 

[rehab_sports_dr]

I would disagree that Harvard should be considered strong merely because it is associated with Harvard. In many fields, but PM+R in particular, the quality of the department does not neccessarilly match the reputation os the greater medical school.

For example, here is the US News and World Report rankings for the "best" medical schools:

1. Harvard University (MA)
2. Johns Hopkins University (MD)
3. University of Pennsylvania
4. University of California–San Francisco
4. Washington University in St. Louis
6. Duke University (NC)
7. Stanford University (CA)
7. University of Washington
9. Yale University (CT)
10. Baylor College of Medicine (TX)

This list very clearly does NOT match a list of what people would consider strong rehab reisdency programs, and actually contains what many people consider very poor rehab residency training programs.

So the merits of Harvard as a quality program has to be judged on its own merits.

For what it's worth, I consider Harvard a strong program, but probably not truly top tier. I think they are competitive, offer interventional exposure, and offer lots of elective time, and for those reasons has been raised to what is probably a higher reputation than has been fully earned yet.

Remember that programs can change pretty quickly, and what makes a program truly top tier is its ability to weather the changes that occur in their program and maintain a consistently high quality.

Washington, for example, has handled recent chair changes smoothly, consistently improved according to the desires of residents (e.g., the recent expansion of their MSK training), as has a decades-long track record of consistent excellence. That is how you become top tier.

UMDNJ/Kessler changed program directors 3 times during my residency, the kind of thing that could destabilitize a lesser residency program. Instead, it just went through one of the strongest periods in history of the residency, with 2 of the past 3 Elkins award winners, siginificant resident research and national leadership positions, hring of lots of talented new faculty, etc. That is what makes a program a consistently great program- a track record of handling the changes that occur and remaining at the forefront of the field.

Similar things could be very easilly said about RIC and Mayo.

In the particular case of Harvard, it has had a nice track record over the past fwe years, and everyone has nice things to say about the program. I know that I liked it very much back when I was interviewing 5 years ago. But they have also had some significant changes in recent years, the most important of which is that they just had a change in their chair. I suspect Harvard will handle this change very well and continue to be a top program. But they don't yet have the track record to establish that they will, and for that reason I would be a little cautious before I group them with the RIC's, Kessler' , Mayo, and Washington's of the world.

Just my 2 cents

 

[kaizen]

Thank you. That certainly makes sense to me.

 

[Disciple]

While I agree that the Spaulding program is benefitting greatly from the Harvard name, the name is not all it has. The Columbia/Cornell program has a great name and location(for some) but has received average to poor reviews on this forum (with a few exceptions). Spaulding's generous elective time may very well offer the ability for one to tailor their 'packaged skills' and by your standards, be on the way to success. I understand that overall accomplishment is individually driven, but some places can make it easier/harder to acheive than others. Maybe the wording was misleading; the top residency programs are placed in the top by reputation. The list is skewed towards larger, older programs with university backing. Spaulding is relatively new, but it has a strong reputation. Some reputations may be deserved and still applicable...some not. That's what the applicants want to know. That's what makes these places more competitive than others. They believe that their chances of finding their desired training/future success are greater at one of these institutions. Even though success can be found anywhere, there are some crappy programs out there. If the separation of a few programs from the main list is what disturbs you most, that can be changed but it would only be aesthetics. Until we interview/rotate and find our personal number one, we initially sort by a few numbers, rumours and reputation. If you believe an institution's reputation is not deserved, help us out. tell us why. I have certainly added a few programs to my application list after speaking to those more knowledgeable than myself. I can't rotate at them all before I apply. While I respect your opinion, I detect your annoyance and think it is ill-placed.

Reputations may be well deserved. It is this whole "elite" thing that is somewhat out of place. I know this is a phenomenon not uncommon to med-students and residents, but what I'm saying is to look at the big picture. This is Physiatry. Not Ortho, Derm or Cardiology.

In the past several years I've met alot of Physiatrists and recent grads from the entire spectrum of programs. What I've found is that there isn't a whole lot of difference in skill level and knowledge the first year out, unless you trained at a really bad program.

Do you really think someone graduating from Spaulding (if one had so made up his or her mind that it does not fit in the "elite" category) is going to be any worse off in any way in their career than someone that trained at U Wash or RIC? PM&R is a small enough field that "high- powered" single specialty groups in desirable locations that bring in higher revenue than smaller groups, and who may hire you based on your residency's reputation generally don't exist like they do in other specialties.

To give you an example of what I said regarding much of your training coming after residency, during residency I got pretty good spine training, got to go to PASSOR workshops and ISIS/NASS conferences, hands on interventional procedures, some chronic pain, learned to read plain films and MRI at a basal level, a good amount of sports med and 6 months of EMG. This was in a span of 20 or so months.

Now, to get where I really want to be I'm going to have to: become proficient in pump/stim/ peripheral nerve stim implantation, vertebroplasty and other misc. procedures, train in and become proficient in musculoskeletal ultrasound and ultrasound guided injections, improve my sports med skills, sharpen my EMG skills, acquire baseline knowledge about Worker's comp and med legal. I'm estimating needing another 2 maybe 3 years to get this all completed.

So, in my opinion, the best approach is to do your homework, don't put too much emphasis on the whole "tier" system (remember, this is Physiatry) and focus on matching somewhere in your geographical location of interest that will provide you the training you want in the most efficient manner possible.

 

[rehab_sports_dr]

My prior post didn't seem to get poster, so I apologize if I have two similar posts

> Reputations may be well deserved. It is this whole "elite" thing that is somewhat out of place. I know this is a phenomenon not uncommon to med-students and residents, but what I'm saying is to look at the big picture. This is Physiatry. Not Ortho, Derm or Cardiology.

I am not sure what that means. When applying for jobs, reputations matter. I am currently applying for academic jobs, and it has mattered tremendously that I have Kessler and RIC on my CV. For my friends who applied for private practice jobs out of residency, having Kessler on their resumes was the single biggest factor in them getting jobs.

The second biggest factor in getting jobs is probably having a large alumni network. Places like RIC, Kessler, Washington, Baylor, and Ohio State have huge alumni bases. Every job I have talked to so far has been familiar with some of my colleagues at either Kessler or RIC.

For example, after my most recent job interview, I was able to talk to both Elliot Roth (chair at RIC) and Joel Delisa (chair at Kessler) the next day, and they both made talking to me about my future a priority. These are some pretty important people to have on your side, and knowing that they have my back carries a lot of weight.

So I am not sure you mean when you say "this isn't derm, cardiology, or ortho."

>In the past several years I've met alot of Physiatrists and recent grads from the whole full spectrum of programs. What I've found is that there isn't a whole lot of difference in skill level and knowledge the first year out, unless you trained at a really bad program.

I respectfully disagree. Some of the very brightest people I have met have come from programs outside of the elite, and stars will be stars wherever they go.

That said, the density of stars is consistently higher at the elite programs. For example, on Part I of this year's board exam, half of the top 10 came from Kessler. This is not an aberration. 2 of the past 3 Elkins winners, and 5 Elkins winners overall (the most of any program), have come from Kessler. There are many reasons for this- an excellent well structured didactic series, the nation's leading board review course, etc. But other factors also include consistently getting top residents, and a culture of excellence that permeates throughout the residency. While there are many paths to excellence, at some programs those paths are easier to follow.

> Do you really think someone graduating from Spaulding (if one had so made up his or her mind that it does not fit in the "elite" category) is going to be any worse off in any way in their career than someone that trained at U Wash or RIC?

It depends on the person. There are many reasons someone should consider Spaulding over the other programs- at one point, I had them as #1 on my rank list, and there are many things to love about the program.

But I think it is unequivocally true that programs like RIC, Kessler, Washington, Mayo, and Baylor have longer track records of excellence. To me, it is like comparing Hyundai to Honda. In recent years, the reliability of Hyundai's has been as good or beter than Honda's. However, I think a purchaser would be wise to consider the 20+ year track record of Honda v. the 5+ year track record of Hyundai.

I don't deny the excellence of Harvard, but they are what they are- a great young program. I don't see any reason to seperate them from the other great young programs like Charlotte, Virgnia, and Pittsburgh. All of these programs are terrific, and for many people they will be better fits than the so-called elite programs. But until they have the long-term sustained track record, I wouldn't group them with the truly upper tier programs. I think the only reason people are doing so for Harvard as opposed to, say, Pittsburgh, is that they think there is something magical about the Harvard name. And I disagree with that belief.


>PM&R is a small enough field that "high- powered" single specialty groups in desirable locations that bring in higher revenue than smaller groups, and who may hire you based on your residency's reputation generally don't exist like they do in other specialties.

I respectfully disagree. I think if two candidates from Chicago are applying for a job, the candidate from RIC will have an edge over the candidate from Loyola. If two candidates are applying for a job in, say, Connecticut, and one is from Kessler and one is from Albert Einstein, the resident from Kessler will have an edge. This is for a few reasons:
1. The more established programs have better track records of producing quality residents, so the name of the residency to some extent acts as a "good housekeeping" seal of approval
2. The more established programs have bigger alumni networks
3. Independent of the direct alumni networks, there are informal networks. Upper tier programs have a lot of stars at them, and there is a greater probability that a resident can have a star attending put in a call on their behalf

> To give you an example of what I said regarding much of your training coming after residency, during residency I got pretty good spine training, got to go to PASSOR workshops and ISIS/NASS conferences, hands on interventional procedures, some chronic pain, learned to read plain films and MRI at a basal level, a good amount of sports med and 6 months of EMG. This was in a span of 20 or so months.

You may have. I don't know which residency you went to, but residents at a great many programs get great experiences. Still, the track record at the upper tier programs tends to be better

Talking to attendings nationally, many have mentioned that many residents think they have better training than they really have. For example, there is a concern nationally amongst the leadership in PASSOR that the general musculoskeletal training at most residency programs is insufficient, and this is true even at the really good residency programs. Nationally, most residency programs do very poorly in their exposure to prostheses and orthoses. Many residents go through residency without having to really manage SCI patients. There is huge variability in the quality of training.

The motivated resident can get that training if they want to anywhere. But even at places like Kessler and RIC, which everyone would consider in the upper tier, there are deficiencies. So to claim that all programs are providing adequate education is, in my opinion, false.

Furthermore, even at top tier programs, it takes a lot of work to really become competent. So, if you can make your life easier by going to a top tier program, it makes it much easier to make sure you develop the basic competencies. For many residents, this makes the difference between being good and being excellent.

 

[TUCOMSam]

I just have a suggestion... can we get back to the nature of this thread? All this banter is important info, but how about in a thread that is devoted to it. That said, no new interviews to report here.

 

[aspiring_painMD]

I thought I'd chime in on the current discussion re: elite programs. As a recent PM&R applicant, I did a rotation at RIC & Baylor, and took a careful look at the other 'top tiered' programs at UW, Kessler, Mayo both during my interview dates and afterwards as well by corresponding with residents.

I initially felt RIC was the program for me, as I enjoyed my rotation there and appreciated it great didactics. I was impressed with the attendings and most of the residents. The schedule was fairly rigid, and residents worked 10-12 hr days. From what I remember, there were only a few months of elective. One warning flag was that my major interest in PM&R is pain. Now there are lots of attendings and residents who dislike residents who go through PM&R with a pain management focus. So what's an aspiring pain MD to do? Anesthesiologist will also tell you, don't do anesthesiology if all you want to do is pain management. Perhaps, I should explain to you guys why I like interventional pain so much. I like procedures in general almost as much as I like patient care. I wish to not only follow my patients closely and help them with their psychosocial issues, but also helped them with innovative technologies.


The attitude I got at RIC is there are a lot of old school attendings who discouraged ppl from becoming 'needle jockeys.' When I asked about interventional pain electives, I received a rather lukewarm response. I asked residents if any PM&R staff members do any inteventions aside from steroid injections, like spinal cord stim, vertebroplasty, perc discectomy, RF ablation, and intrathecal pumps. There weren't any at the time, maybe there are now. This disappointed me as I felt these newer technologies are not only cool but some are promising for the future of pain management. It has a tremendous sports and spine center, but their only interventions when I interviewed there were steroid injections. To top it off, I met a resident who went into PM&R initially focused more on pain management, but warned me of his feeling that RIC is lacking in procedural pain management opportunities. I met this same attitude at Kessler. Dr Delisa actually told me that he feels this 'whole pain management' thing is just fad that may not pan out 10 yrs from now.

Meanwhile, other programs embraced the idea of interventions. There were many lesser known programs that were encouraging, but among the 'super six,' spaulding stood out the most. There is a huge wealth of pain electives at boston's elite hospitals available to you. If one wanted to pursue research in this field, there is probably no better place than boston. Other programs such as Mayo and UW also had great attitudes with regard to my interest. UW seemed to have the attitude of catering to their residents, no matter what they want. The PD there, who has now stepped down, asked resident applicants what they liked in a program and how they were taking steps to reshape their program to meet those needs. They had great, pro-resident attitudes and showed me that they really listened to resident needs.

My 2 cents is that rather than haggle all day over what's a truly elite or wannabe elite program, ask yourself what do you want to get out of residency. If you want to be a well-rounded inpt & outpt physiatrist, I believe ANY of the programs mentioned will prepare you well. RIC, with its structured didactics, would probably be a tad easier to become a knowledgeable, competent physiatrist, but in the end self-motivation and self-learning are most important, and so I decided not to choose RIC as #1. Given how broad PM&R is, if you have a specific interest, I would suggest you pursue it while at the same time developing competency in other aspects of the field (and internal medicine in general).

 

[Disciple]

Now there are lots of attendings and residents who dislike residents who go through PM&R with a pain management focus. So what's an aspiring pain MD to do? Anesthesiologist will also tell you, don't do anesthesiology if all you want to do is pain management.

What alot of Physiatrists don't understand is that it's advantageous to take a bright young future pain physician and indoctrinate him or her with Physiatric philosophy and make them an advocate for the field, rather than lose them to Anesthesia, Neuro or Psyche.

Dr Delisa actually told me that he feels this 'whole pain management thing is just fad that may not pan out 10 yrs from now.

And people wonder why Physiatry sponors subspecialization in pain medicine but hardly has any fellowships and is now set to lose at least half of the existing ones. Why we would want to take a large portion of our future diplomats and force them to have to turn to gas fellowships to get their training is beyond me.

My 2 cents is that rather than haggle all day over what's a truly elite or wannabe elite program, ask yourself what do you want to get out of residency. In the end self-motivation and self-learning are most important.

I'm glad someone understands. Physiatry is not like other specialties where your skill set is clearly defined upon leaving residency. The skill set that many Physiatrists in training are interested in is so ill defined that the bulk of it does not occur during residency training.

 

[Disciple]

> Reputations may be well deserved. It is this whole "elite" thing that is somewhat out of place. I know this is a phenomenon not uncommon to med-students and residents, but what I'm saying is to look at the big picture. This is Physiatry. Not Ortho, Derm or Cardiology.

I am not sure what that means. When applying for jobs, reputations matter. I am currently applying for academic jobs, and it has mattered tremendously that I have Kessler and RIC on my CV. For my friends who applied for private practice jobs out of residency, having Kessler on their resumes was the single biggest factor in them getting jobs.

The second biggest factor in getting jobs is probably having a large alumni network. Places like RIC, Kessler, Washington, Baylor, and Ohio State have huge alumni bases. Every job I have talked to so far has been familiar with some of my colleagues at either Kessler or RIC.

For example, after my most recent job interview, I was able to talk to both Elliot Roth (chair at RIC) and Joel Delisa (chair at Kessler) the next day, and they both made talking to me about my future a priority. These are some pretty important people to have on your side, and knowing that they have my back carries a lot of weight.

So I am not sure you mean when you say "this isn't derm, cardiology, or ortho."

You're missing the big picture, specifically regarding the place of Physiatry in the medical community. You're speaking regarding PM&R academics. I'm speaking more from a private practice standpoint. Large freestanding rehab hospital corporations aside, many Physiatrists will join multi-specialty groups i.e. Neurosurg, Ortho, Anesthesia, etc.. If any of these docs happen to be doing the hiring, it is unlikely that they will even be knowledgable as to what Physiatrists learn during residency. What they will expect is that you have some advanced skills (often not acquired during residency) and that you be able to produce. My comparison to Ortho and Cards refers to the size of the field. Young Orthopods seeking employment in major metropolitan areas will often join large (10-15+ surgeons) profitable groups that dominate large territories. These groups know their specialty and know which training programs are reputable. Aside from community inpt rehab corporations (typically offer poor starting salaries and little to no possibility for partnership), I have not seen large groups of musculoskeletal Physiatrists exist to operate in the same fashion.

>

In the past several years I've met alot of Physiatrists and recent grads from the whole full spectrum of programs. What I've found is that there isn't a whole lot of difference in skill level and knowledge the first year out, unless you trained at a really bad program.

I respectfully disagree. Some of the very brightest people I have met have come from programs outside of the elite, and stars will be stars wherever they go.

That said, the density of stars is consistently higher at the elite programs. For example, on Part I of this year's board exam, half of the top 10 came from Kessler. This is not an aberration. 2 of the past 3 Elkins winners, and 5 Elkins winners overall (the most of any program), have come from Kessler. There are many reasons for this- an excellent well structured didactic series, the nation's leading board review course, etc. But other factors also include consistently getting top residents, and a culture of excellence that permeates throughout the residency. While there are many paths to excellence, at some programs those paths are easier to follow.

Again, I was not speaking about test scores per se, but more from a standpoint of practicality. In meeting and working with graduates from other programs (some from "elite" programs some not) while at workshops, conferences, work interviews, whatever, I haven't found that much difference in terms of Physical exam skills, patient management or knowledge of the literature at the PGY-4 or new grad level (I am speaking regarding musculoskeletal, pain medicine and EMG, so I can't really refute your comment regarding board scores or rudimentary PM&R knowledge). However, I do stand by what I said regarding really bad programs.

>

Do you really think someone graduating from Spaulding (if one had so made up his or her mind that it does not fit in the "elite" category) is going to be any worse off in any way in their career than someone that trained at U Wash or RIC?

It depends on the person. There are many reasons someone should consider Spaulding over the other programs- at one point, I had them as #1 on my rank list, and there are many things to love about the program.

But I think it is unequivocally true that programs like RIC, Kessler, Washington, Mayo, and Baylor have longer track records of excellence. To me, it is like comparing Hyundai to Honda. In recent years, the reliability of Hyundai's has been as good or beter than Honda's. However, I think a purchaser would be wise to consider the 20+ year track record of Honda v. the 5+ year track record of Hyundai.

I don't deny the excellence of Harvard, but they are what they are- a great young program. I don't see any reason to seperate them from the other great young programs like Charlotte, Virgnia, and Pittsburgh. All of these programs are terrific, and for many people they will be better fits than the so-called elite programs. But until they have the long-term sustained track record, I wouldn't group them with the truly upper tier programs. I think the only reason people are doing so for Harvard as opposed to, say, Pittsburgh, is that they think there is something magical about the Harvard name. And I disagree with that belief.

Again, I refer to the place Physiatry has in the medical community. If entering a multispecialty group (predominantly comprised of practicioners from other specialties), the "Harvard" name will carry some weight. Having "Pittsburgh" on your CV isn't too shabby either. Above all else, they will expect you to be proficient and efficient with skills that are useful to their practice. And if those skills happen to fall outside the standard PM&R curriculum, well, then, that candidate better make sure they got the training somewhere.

>PM&R is a small enough field that "high- powered" single specialty groups in desirable locations that bring in higher revenue than smaller groups, and who may hire you based on your residency's reputation generally don't exist like they do in other specialties.

I respectfully disagree. I think if two candidates from Chicago are applying for a job, the candidate from RIC will have an edge over the candidate from Loyola. If two candidates are applying for a job in, say, Connecticut, and one is from Kessler and one is from Albert Einstein, the resident from Kessler will have an edge. This is for a few reasons:
1. The more established programs have better track records of producing quality residents, so the name of the residency to some extent acts as a "good housekeeping" seal of approval
2. The more established programs have bigger alumni networks
3. Independent of the direct alumni networks, there are informal networks. Upper tier programs have a lot of stars at them, and there is a greater probability that a resident can have a star attending put in a call on their behalf

Again, single vs. multispecialty groups. Though we may believe it be or wish it were so, Physiatry does not dominate musculoskeletal medicine. In the area I'm currently located (saturated with musculoskeletal and pain docs) everyone and their brother does Worker's Comp and med/legal. That includes Anesthesia, Physiatry, Ortho, Neurosurg, Chiropractors, Podiatrists, etc. with no one field dominating over the others. For Physiatrists to have an edge, they need skills that are advanced and progressive enough to be unique. With pure Physiatry groups, your program's rep may get you an interview, but when it comes down to the actual hire, a large part of the equation will be, Does this candidate have the advanced skills and speed/efficiency with those skills to bring revenue, patients and an added dimension to our practice at the lowest possible loss to the practice during the first 6-12 months?

>

To give you an example of what I said regarding much of your training coming after residency, during residency I got pretty good spine training, got to go to PASSOR workshops and ISIS/NASS conferences, hands on interventional procedures, some chronic pain, learned to read plain films and MRI at a basal level, a good amount of sports med and 6 months of EMG. This was in a span of 20 or so months.

You may have. I don't know which residency you went to, but residents at a great many programs get great experiences. Still, the track record at the upper tier programs tends to be better

Talking to attendings nationally, many have mentioned that many residents think they have better training than they really have. For example, there is a concern nationally amongst the leadership in PASSOR that the general musculoskeletal training at most residency programs is insufficient, and this is true even at the really good residency programs. Nationally, most residency programs do very poorly in their exposure to prostheses and orthoses. Many residents go through residency without having to really manage SCI patients. There is huge variability in the quality of training.

The motivated resident can get that training if they want to anywhere. But even at places like Kessler and RIC, which everyone would consider in the upper tier, there are deficiencies. So to claim that all programs are providing adequate education is, in my opinion, false.

Furthermore, even at top tier programs, it takes a lot of work to really become competent. So, if you can make your life easier by going to a top tier program, it makes it much easier to make sure you develop the basic competencies. For many residents, this makes the difference between being good and being excellent

I never claimed that all programs provide adequate education. However, in my opinion, if somone passes their boards, then they have acquired the basic competencies. I disagree that the motivated resident can get the training they want anywhere. Some programs are just too aloof to make the clinical affiliations or to provide the flexibility to allow this to take place.

My point above was not to emphasise the training I received, but the training I have not yet received and the additional time it's going to take to acquire it. Maybe the age thing is starting to get to me because I just left my twenties, but time is now starting to become an issue with me. Sooner or later, everyone has to get the bulk of their training over with and go make a living. A resident spending extra time (beyond ACGME requirements) in subject matter not useful to him or her, may have to spend extra time remediating their skills through fellowship, instead of using that fellowship to acquire new skills with which to advance their career.

Another post above outlines the occasional incongruence between reputation or "track-record" and providing the desired training in an efficient manner.

 

[Brooklyndo2.1]

So, to ask my obviously well versed seniors (not sarcasm, for once):
I am interested in pain, but also msk, sports, emg, and (hanging my head in shame for admitting a love for an inpatient specialty) Stroke.
Ive spent some time talking to senior residents and fellows of pain and sports/emg fellowships, and it seemed to me that they were doing the fellowships not so much for lack of skills but more because they were of the opinion that being "fellowship trained" and having that sticker would open significantly more doors for them.
So the first question,
is whether you believe that pain/msk/spine/sports etc fellowships are more beneficial in terms of the stamp they give you , or are they almost required in terms ofskill acquisition.(I understand that this is a highly individual case by case kind of situation, but im asking "in general".

Second,
What programs would be on your short list of providing spine/pain/emg experience while a resident?

third
Although ive read the usual threads about pain vs spine as subspecialties, im still somewhat fuzzy, so my question is, can you give me some examples of that you would refer to a spine physician vs and pain physician?

Fourth:
Am I totally delusional in terms of wanting to do a mix of spine/sports/emg/pain? with some stroke/tbi thrown in? Or is that improbable from a practical standpoint?

any help is greatly appreciated,
PM me if you dont want to post.
Thank you all.

 

[axm397]

So, to ask my obviously well versed seniors (not sarcasm, for once):
I am interested in pain, but also msk, sports, emg, and (hanging my head in shame for admitting a love for an inpatient specialty) Stroke.
Ive spent some time talking to senior residents and fellows of pain and sports/emg fellowships, and it seemed to me that they were doing the fellowships not so much for lack of skills but more because they were of the opinion that being "fellowship trained" and having that sticker would open significantly more doors for them.
So the first question,
is whether you believe that pain/msk/spine/sports etc fellowships are more beneficial in terms of the stamp they give you , or are they almost required in terms ofskill acquisition.(I understand that this is a highly individual case by case kind of situation, but im asking "in general".

Second,
What programs would be on your short list of providing spine/pain/emg experience while a resident?

third
Although ive read the usual threads about pain vs spine as subspecialties, im still somewhat fuzzy, so my question is, can you give me some examples of that you would refer to a spine physician vs and pain physician?

Fourth:
Am I totally delusional in terms of wanting to do a mix of spine/sports/emg/pain? with some stroke/tbi thrown in? Or is that improbable from a practical standpoint?

any help is greatly appreciated,
PM me if you dont want to post.
Thank you all.

A private practice physician I met a couple months ago is the medical director of a small in patient unit (so stroke/TBI pts included about 10 beds), and also runs an outpatient MSK/sports/pain practice with EMG. He rounds in the morning and has NPs and PAs stay on the unit so they can page him with issues. He then goes to his outpatient clinic site where they have an ambulatory surgery center with c-arms. He chooses not to do many interventional procedures but his partners perform them and he rents out the space to other interventional physicians. I can tell you he is doing VERY well.
He also has the option of consulting at a nursing home in the area. so yes, I think what you want to do is possible.

 

[rehab_sports_dr]

> So the first question,
is whether you believe that pain/msk/spine/sports etc fellowships are more beneficial in terms of the stamp they give you , or are they almost required in terms ofskill acquisition.(I understand that this is a highly individual case by case kind of situation, but im asking "in general".

I think fellowship should mostly be about skill acquisition. I am of the opinion that while the training of PM+R in standard MSK training is superior to other disciplines, it is still not as good as it should be. Disciple and I will have to agree to disagree about this, but I do not think most residents are where they should be to fully skilled in pain/msk/spine/sports.

The biggest issue I have regards the focus on procedurally based pain. Unless we have a strong grounding in the core neuromusculoskeletal assessment, then the best a fellowship trained PM+R interventionalist can hope to be is a less well-trained anasthesiologist. So unless you have the value-added of excellent assessment and evaluation skills, and are recommending prevention plans and "resolving beyond the resolution" of symptoms, then you really aren't doing your job as a physiatrist. I don't think most residents (and for that matter, most practicing attendings) are there yet skill wise. That, in my opinion, is why you should go to fellowship.

> Second, What programs would be on your short list of providing spine/pain/emg experience while a resident?

If I was doing it all over again, my clear top 4 would be, in no particular order, RIC, Kessler, Mayo, and Washington. In my mind, those 4 programs have the strongest and longest track records in providing the optimal spine/emg/sports/pain experience.

> Although ive read the usual threads about pain vs spine as subspecialties, im still somewhat fuzzy, so my question is, can you give me some examples of that you would refer to a spine physician vs and pain physician?

For me personally, I would refer anyone with an initial presentation of spine pain to a conservative comprehensive physiatrist who was skilled in all aspects of neuromusculoskeletal assessment. For anyone with chronic pain, I would only refer the patient to a multidisciplinary pain center that provided congnitive behavioral therapy, all therapy modalities, psych analysis. I would then have any interventional procedures done only in the contect of the multidisciplanary approach. I would NOT send a patient to a pain physician outside of the multidisciplinary model, since their is no evidence that their procedures, when used in isolation, work any better than other, less invasive practices in isolation, including cognitive-behavioral therapy.

> Am I totally delusional in terms of wanting to do a mix of spine/sports/emg/pain? with some stroke/tbi thrown in? Or is that improbable from a practical standpoint?

You can do it, but I would question the ability to do it excellently. Realistically, it is challenging to keep up on more than 1-2 literatures and maintain your skills to the highest level in those disciplines. Do some private practice docs do this? Yes. But I have never met anyone who does all of these things at a high level.

 

[kiwi219]

"The Super Six"
RIC:
Kessler: Kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo


Albert Einstein: weschay
Carolinas: fozzy40, thesage, theasam
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi
Loyola: dancerMD, lrsotnas, jonnylingo
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay
North Shore-LIJ: kaizen, P Willi, Kiwi219
NYU(Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219
Ohio State: bonjuju, jonnylingo
St. Vincent: jofutti, weschay, Kiwi219
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi,
bonjuju, weschay, jofutti
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO,
jofutti, koyaanisqatsi, weschay
U of AB: theasam
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago(Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay

 

[lobelsteve]

> So the first question,
is whether you believe that pain/msk/spine/sports etc fellowships are more beneficial in terms of the stamp they give you , or are they almost required in terms ofskill acquisition.(I understand that this is a highly individual case by case kind of situation, but im asking "in general".

I think fellowship should mostly be about skill acquisition. I am of the opinion that while the training of PM+R in standard MSK training is superior to other disciplines, it is still not as good as it should be. Disciple and I will have to agree to disagree about this, but I do not think most residents are where they should be to fully skilled in pain/msk/spine/sports.

The biggest issue I have regards the focus on procedurally based pain. Unless we have a strong grounding in the core neuromusculoskeletal assessment, then the best a fellowship trained PM+R interventionalist can hope to be is a less well-trained anasthesiologist. So unless you have the value-added of excellent assessment and evaluation skills, and are recommending prevention plans and "resolving beyond the resolution" of symptoms, then you really aren't doing your job as a physiatrist. I don't think most residents (and for that matter, most practicing attendings) are there yet skill wise. That, in my opinion, is why you should go to fellowship.

> Second, What programs would be on your short list of providing spine/pain/emg experience while a resident?

If I was doing it all over again, my clear top 4 would be, in no particular order, RIC, Kessler, Mayo, and Washington. In my mind, those 4 programs have the strongest and longest track records in providing the optimal spine/emg/sports/pain experience.

> Although ive read the usual threads about pain vs spine as subspecialties, im still somewhat fuzzy, so my question is, can you give me some examples of that you would refer to a spine physician vs and pain physician?

For me personally, I would refer anyone with an initial presentation of spine pain to a conservative comprehensive physiatrist who was skilled in all aspects of neuromusculoskeletal assessment. For anyone with chronic pain, I would only refer the patient to a multidisciplinary pain center that provided congnitive behavioral therapy, all therapy modalities, psych analysis. I would then have any interventional procedures done only in the contect of the multidisciplanary approach. I would NOT send a patient to a pain physician outside of the multidisciplinary model, since their is no evidence that their procedures, when used in isolation, work any better than other, less invasive practices in isolation, including cognitive-behavioral therapy.

1. We do not look at candidates that did not acquire an excelllent diagnostic skill set in residency.
2. The best trained PMR-Pain Fellows go on to be much better than 99% of the Gas-Pain docs at Pain/Spine. I am, and it is my job to make sure my fellows become so. It is our ability to correlate symptoms, imaging, and context that allows a more complete management appoach.
3. Referral patterns are set by Dr. to Dr. relationship and convenience. The type of practice (Pain/Spine) will factor little into referral patterns. You will get them to the Dr. that can get them better, and possibly someone who will them refer EMG's back to you.
4. Come watch us work! www.georgiapainphysicians.com or www.gapainphysicians.com We are switching our web managment companies.

 

[fozzy40]

What's going on with the Cali programs? Not a peep yet!

 

[kaizen]

What's going on with the Cali programs? Not a peep yet!

Based on last year's invite thread:

Stanford: predicted for this week
RIC, Spaulding, Colum/Cornell, UC-Davis, UCLA-VA: After Dean's letter is released

I propose a new invite system. Invites could be released once a week, on pre-selected dates and in batches. That way I only have to check my e-mail obsessively once a week.

 

[Brooklyndo2.1]

forget that, they should all send out every invite on the first day after you submit your app.
that way i can stop obsessig and can actually book my trips

 

[kaizen]

I heard from Columbia/Cornell today. There's goes that whole "waiting on the mspe" theory.

 

[dc2md]

"The Super Six"
RIC:
Kessler: Kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo


Albert Einstein: weschay
Carolinas: fozzy40, thesage, theasam
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi
Loyola: dancerMD, lrsotnas, jonnylingo
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay
North Shore-LIJ: kaizen, P Willi, Kiwi219
NYU(Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219
Ohio State: bonjuju, jonnylingo
St. Vincent: jofutti, weschay, Kiwi219
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi,
bonjuju, weschay, jofutti
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO,
jofutti, koyaanisqatsi, weschay
U of AB: theasam
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago(Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay
__________________

 

[kaizen]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo


Albert Einstein: weschay
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi
Loyola: dancerMD, lrsotnas, jonnylingo
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay
North Shore-LIJ: kaizen, P Willi, Kiwi219
NYU(Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen
Ohio State: bonjuju, jonnylingo
St. Vincent: jofutti, weschay, Kiwi219
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago(Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay

 

[Disciple]

> So the first question,
is whether you believe that pain/msk/spine/sports etc fellowships are more beneficial in terms of the stamp they give you , or are they almost required in terms ofskill acquisition.(I understand that this is a highly individual case by case kind of situation, but im asking "in general".

I think fellowship should mostly be about skill acquisition. I am of the opinion that while the training of PM+R in standard MSK training is superior to other disciplines, it is still not as good as it should be. Disciple and I will have to agree to disagree about this, but I do not think most residents are where they should be to fully skilled in pain/msk/spine/sports.

The biggest issue I have regards the focus on procedurally based pain. Unless we have a strong grounding in the core neuromusculoskeletal assessment, then the best a fellowship trained PM+R interventionalist can hope to be is a less well-trained anasthesiologist. So unless you have the value-added of excellent assessment and evaluation skills, and are recommending prevention plans and "resolving beyond the resolution" of symptoms, then you really aren't doing your job as a physiatrist. I don't think most residents (and for that matter, most practicing attendings) are there yet skill wise. That, in my opinion, is why you should go to fellowship.

I actually don't disagree with you here. There is a whole 'nother level of musculoskeletal medicine, which I'm sure you're experiencing this year. My point is that a "comprehensive" Physiatrist, maybe the Physiatrist of the future, should be able to do it all if we are to become the hands down leaders in musculoskeletal medicine. Why force our residents to choose between being great at musculoskeletal medicine and being a master of advanced interventional techniques? I want to have all these skills without training for the same length of time as a Neurosurgeon, and thus my emphasis on getting the training desired training in the most intense, focused and efficient manner possible. My thought process when considering fellowships (and maybe junior residents and med students should hear this), was: What can I learn on my own and what will take direct supervision? I chose to pursue "advanced" musculoskeletal training through independent study and self training. Sure it's going to take longer not having a true expert there correcting my mistakes and discussing cases with me, but when it comes down to it, nobody is going to stop me from reading, attending conferences and practicing examining my patients in whatever manner I see fit. Now, imagine trying to learn to do surgery on your own. Obviously it can be done, look at some of the first complete PM&R interventionalists. But personally, I don't like the idea of trying to get through my first 20 implants without direct supervision or without knowing how to handle the complications. Imagine your sphincter tone while hammering a trochar through a patient's pedicle for a Vertebroplasy when you don't really know how.

> Although ive read the usual threads about pain vs spine as subspecialties, im still somewhat fuzzy, so my question is, can you give me some examples of that you would refer to a spine physician vs and pain physician?

For me personally, I would refer anyone with an initial presentation of spine pain to a conservative comprehensive physiatrist who was skilled in all aspects of neuromusculoskeletal assessment. For anyone with chronic pain, I would only refer the patient to a multidisciplinary pain center that provided congnitive behavioral therapy, all therapy modalities, psych analysis. I would then have any interventional procedures done only in the contect of the multidisciplanary approach. I would NOT send a patient to a pain physician outside of the multidisciplinary model, since their is no evidence that their procedures, when used in isolation, work any better than other, less invasive practices in isolation, including cognitive-behavioral therapy.

As much as we as Physiatrists like to pontificate about how great our approach is to patients with musculoskeletal pain, actions speak louder than words. Nobody doubts our skills in structural musculoskeletal evaluation. However, they do question our competency with difficult interventional techniques and our ability to handle serious complications. As much as I'd like to argue to the contrary, the criticism is valid too many cases. So the fault lies with us. This is where we need to focus our efforts. The number of Interventional Physiatrists is going to continue growing at a staggering pace. We can let our standards continue to decline or we can do the right thing and make good quality interventional training available to the masses (our PM&R masses that is). You may forget, the first musculoskeletal fellowships 10+ years ago were started to teach basic musculoskeletal skills. Not advanced skills, but basic ones not offered in the vast majority of PM&R residency programs at the time. With the help and influence PASSOR we have surpassed this. It is time to take it to the next level.

And for that patient at the multidisciplinary pain center with chronic pain, CRPS, FBSS and central sensitization, who's going to put in their pump or stim? I would hope your first impulse wouldn't be to call your favorite Anesthesiologist or Neurosurgeon.

> Am I totally delusional in terms of wanting to do a mix of spine/sports/emg/pain? with some stroke/tbi thrown in? Or is that improbable from a practical standpoint?

You can do it, but I would question the ability to do it excellently. Realistically, it is challenging to keep up on more than 1-2 literatures and maintain your skills to the highest level in those disciplines. Do some private practice docs do this? Yes. But I have never met anyone who does all of these things at a high level.

Agree with you here. That kind of mix may work in a small town or rural area. In any densely populated region that is full of pain docs and musculoskeletal specialists it's going to be hard to get many referrals unless you focus most of your time, energy and resources gearing your practice in one specific direction.

 

[rehab_sports_dr]

Disciple, I think we probably agree about more than we disagree

> My point is that a "comprehensive" Physiatrist, maybe the Physiatrist of the future, should be able to do it all if we are to become the hands down leaders in musculoskeletal medicine. Why force our residents to choose between being great at musculoskeletal medicine and being a master of advanced interventional techniques?

I agree with you in theory, and I hope we move in that direction. At this time, though, I am concerned we are still lagging behind in the fundamentals of history and examination, and I have a hard time imagining learning the more advanced procedures in residency without compromising the core of hte speciality

> I chose to pursue "advanced" musculoskeletal training through independent study and self training. Sure it's going to take longer not having a true expert there correcting my mistakes and discussing cases with me, but when it comes down to it, nobody is going to stop me from reading, attending conferences and practicing examining my patients in whatever manner I see fit. Now, imagine trying to learn to do surgery on your own.

I agree the motivated individual may be able to do this, but it is hard to learn without frequent feedback. Even as a resident and fellow, you are often doing things without anyone really monitoring you. For example, some of my friends are attendings now, and they have commented to me about how few residents really know how to check muscle stretch reflexes. That's pretty core to what we do, but I would guess that less than 20% of graduating residents know how to check the pronator teres reflex, and that's actually one of the most important reflexes in the diagnosis of cervical radiculopathy, since it is the only C6-C7 reflex. That is just one smal example. I agree that residents can continue to learn after residency if they are motivated, but my suspicion is that if the residents weren't motivated to learn exam skills in residency, they probably won't be afterward

> But personally, I don't like the idea of trying to get through my first 20 implants without direct supervision or without knowing how to handle the complications. Imagine your sphincter tone while hammering a trochar through a patient's pedicle for a Vertebroplasy when you don't really know how.

Great point.


> We can let our standards continue to decline or we can do the right thing and make good quality interventional training available to the masses (our PM&R masses that is).

Word. We need to hold our specialty to high standards as we move forward.

> And for that patient at the multidisciplinary pain center with chronic pain, CRPS, FBSS and central sensitization, who's going to put in their pump or stim? I would hope your first impulse wouldn't be to call your favorite Anesthesiologist or Neurosurgeon.

I am skeptical about most of these procedures in isolation- the evidene isn't there. So my preference would be not to send a patient to anyone outside of the context of a multidisciplinary approach. I would feel comfortable sending hte patient to anyone who is working within that context, including physiatrists, but also the anasthesiologists and neurosurgeons. To me, unless I know the physiatrists has maintained their core physiatry skills, then they are simply a proceduralist with a less diverse skill set than the anasthesiologist. So I hope the physiatrists are maintaining and building on their other core skills.

 

[fozzy40]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo


Albert Einstein: weschay
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi
Loyola: dancerMD, lrsotnas, jonnylingo
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay
North Shore-LIJ: kaizen, P Willi, Kiwi219
NYU(Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen
Ohio State: bonjuju, jonnylingo
St. Vincent: jofutti, weschay, Kiwi219
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago(Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay

 

[Taus]

When are most of your interviews scheduled for? I have to pick my rotation schedule soon and want to try to get an elective or really flexible spot for the "prime" PM&R interview season. Thanks in advance

For those who have scheduled interviews...does December still seem like the popular month this year?

 

[dancerMD]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo


Albert Einstein: weschay
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi
Loyola: dancerMD, lrsotnas, jonnylingo
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay
North Shore-LIJ: kaizen, P Willi, Kiwi219
NYU(Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen
Ohio State: bonjuju, jonnylingo
St. Vincent: jofutti, weschay, Kiwi219
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago(Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md
U of Virginia: dancerMD
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay

 

[dc2md]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi
Loyola: dancerMD, lrsotnas, jonnylingo
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay
North Shore-LIJ: kaizen, P Willi, Kiwi219
NYU(Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen
Ohio State: bonjuju, jonnylingo
St. Vincent: jofutti, weschay, Kiwi219
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago(Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md
U of Virginia: dancerMD
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay

 

[fozzy40]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay
North Shore-LIJ: kaizen, P Willi, Kiwi219
NYU(Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen
Ohio State: bonjuju, jonnylingo
St. Vincent: jofutti, weschay, Kiwi219
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago(Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md
U of Virginia: dancerMD
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay

 

[Brooklyndo2.1]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay
North Shore-LIJ: kaizen, P Willi, Kiwi219
NYU(Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen
Ohio State: bonjuju, jonnylingo
St. Vincent: jofutti, weschay, Kiwi219
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago(Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md
U of Virginia: dancerMD, brooklyndo2.1
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay[/QUOTE]

 

[dancerMD]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen, dancerMD
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay
North Shore-LIJ: kaizen, P Willi, Kiwi219
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen
Ohio State: bonjuju, jonnylingo
St. Vincent: jofutti, weschay, Kiwi219
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md
U of Virginia: dancerMD, brooklyndo2.1
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay

 

[bonjuju]

Fozzy: check PM

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen, dancerMD
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay
North Shore-LIJ: kaizen, P Willi, Kiwi219
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen
Ohio State: bonjuju, jonnylingo
St. Vincent: jofutti, weschay, Kiwi219
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md
U of Virginia: dancerMD, brooklyndo2.1
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay

 

[AndyDufrane]

Fozzy: check PM

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen, dancerMD, AndyDufrane
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi, AndyDufrane
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay
North Shore-LIJ: kaizen, P Willi, Kiwi219
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen
Ohio State: bonjuju, jonnylingo
St. Vincent: jofutti, weschay, Kiwi219
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md
U of Virginia: dancerMD, brooklyndo2.1
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay

 

[Disciple]

.

 

[Disciple]

Disciple, I think we probably agree about more than we disagree

> My point is that a "comprehensive" Physiatrist, maybe the Physiatrist of the future, should be able to do it all if we are to become the hands down leaders in musculoskeletal medicine. Why force our residents to choose between being great at musculoskeletal medicine and being a master of advanced interventional techniques?

I agree with you in theory, and I hope we move in that direction. At this time, though, I am concerned we are still lagging behind in the fundamentals of history and examination, and I have a hard time imagining learning the more advanced procedures in residency without compromising the core of the speciality

Regarding many programs, you're proabably right about lacking fundamentals. However, this problem should be addressed at the residency level. I think it's the wrong approach to continue to support sub-standard MSK training that is remediated through a fellowship. All around very inefficient way to do things. Regarding training in advanced procedures during residency, and this is just my experience/opinion after 3 short months in fellowship, most so called "advanced" procedures including RF, discography and perc disc decompression are very safe and much easier to perform (in part due to needle stiffness) than say, trying to do a transforaminal with a 25G needle on a FBSS patient with large chunks of bone graft caked on the sides of their spine. Even with cervical transforaminals, the approach is not that difficult. Making sure there is no vascular uptake is the crucial part of the procedure, but the approach itself is not all that different from performing an S1. So, I see no problem with having residents perform these procedures.

The procedures that require a different skill set are implants and Vertebroplasty. So yes, these procedures probably require fellowship training.

I agree the motivated individual may be able to do this, but it is hard to learn without frequent feedback. Even as a resident and fellow, you are often doing things without anyone really monitoring you. For example, some of my friends are attendings now, and they have commented to me about how few residents really know how to check muscle stretch reflexes. That's pretty core to what we do, but I would guess that less than 20% of graduating residents know how to check the pronator teres reflex, and that's actually one of the most important reflexes in the diagnosis of cervical radiculopathy, since it is the only C6-C7 reflex. That is just one smal example. I agree that residents can continue to learn after residency if they are motivated, but my suspicion is that if the residents weren't motivated to learn exam skills in residency, they probably won't be afterward.

To be honest with you, I considered doing another fellowship (musculoskeletal) after completing this year. But, then I came to my senses and realized that maybe it's about time to settle down and open up shop somewhere. As Physiatrists (and I realize we're not nearly as bad as some other specialties) we need to be a little less dogmatic in our philosophies and a little bit more practical. We need to provide residents with skills for the 21st century. With Medicare cuts, 70% rule, Worker's comp reform, rising malpractice premiums we need to be ahead of the game with our skills and what we offer (proactive not reactive as physicians typically are). Take musculoskeletal ultrasound for example. Totally applicable to Physiatry and probably the next "big thing" as reimbursements for injections get cut. As with everything else, I'm sure this too will come to be abused over time. But as for now, this is something Physiatrists need to jump on.

> And for that patient at the multidisciplinary pain center with chronic pain, CRPS, FBSS and central sensitization, who's going to put in their pump or stim? I would hope your first impulse wouldn't be to call your favorite Anesthesiologist or Neurosurgeon.

I am skeptical about most of these procedures in isolation- the evidene isn't there. So my preference would be not to send a patient to anyone outside of the context of a multidisciplinary approach. I would feel comfortable sending hte patient to anyone who is working within that context, including physiatrists, but also the anasthesiologists and neurosurgeons. To me, unless I know the physiatrists has maintained their core physiatry skills, then they are simply a proceduralist with a less diverse skill set than the anasthesiologist. So I hope the physiatrists are maintaining and building on their other core skills

Why would a Gas pain-fellowship trained interventional Physiatrist have a less diverse skill set than an Anesthesiologist? Because of the their airway management skills? Knowledge of local anesthetics? By your reasoning, couldn't an Anesthesiologist who practices outpatient chronic pain be seen as a musculoskeletal specialist with a less diverse skill set than a Physiatrist?

I understand your point, but you need to realize that the "pain medicine" community wants all pain/spine/MSK docs to have the exact same skill set, indistinguishable from one another. Part of this is about being PC, part of it is about control. Hence, the new ACGME guidelines providing little mini rotations in different specialties over 12 months. I consider myself first and foremost a Physiatrist and don't agree with this attempted homogenization which I don't think can be accomplished through 1 year of additional training. It makes no sense to me why our specialty would take part in a subspecialty and revamped "ACGME" guidelines (destroying our accredited fellowships in the process) and then push our residents toward another specialty's fellowships instead of taking responsibility to provide the training ourselves emphasizing our philosophy.

 

[Tweetie123]

Hey guys!
I thought I'd join in on the fun!


"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen, dancerMD, AndyDufrane
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi, AndyDufrane, Tweetie123
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi,Tweetie123
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay, Tweetie123
North Shore-LIJ: kaizen, P Willi, Kiwi219, Tweetie123
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen, Tweetie123
Ohio State: bonjuju, jonnylingo
St. Vincent: jofutti, weschay, Kiwi219, Tweetie123
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti, Tweetie123
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219, Tweetie123
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md
U of Virginia: dancerMD, brooklyndo2.1
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay

 

[dancerMD]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen, dancerMD
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen, dancerMD, AndyDufrane
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi, AndyDufrane, Tweetie123
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi,Tweetie123
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay, Tweetie123
North Shore-LIJ: kaizen, P Willi, Kiwi219, Tweetie123
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen, Tweetie123
Ohio State: bonjuju, jonnylingo
St. Vincent: jofutti, weschay, Kiwi219, Tweetie123
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti, Tweetie123
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219, Tweetie123
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md
U of Virginia: dancerMD, brooklyndo2.1
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay

 

[hyper_74]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen, dancerMD
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen, dancerMD, AndyDufrane
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi, AndyDufrane, Tweetie123
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi,Tweetie123
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay, Tweetie123
North Shore-LIJ: kaizen, P Willi, Kiwi219, Tweetie123
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen, Tweetie123
Ohio State: bonjuju, jonnylingo
St. Vincent: jofutti, weschay, Kiwi219, Tweetie123
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti, Tweetie123
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kansas: hyper_74
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219, Tweetie123
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md
U of Virginia: dancerMD, brooklyndo2.1
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay

 

[P Willi]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen, dancerMD
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen, dancerMD, AndyDufrane
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi, AndyDufrane, Tweetie123
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi,Tweetie123
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay, Tweetie123
North Shore-LIJ: kaizen, P Willi, Kiwi219, Tweetie123
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen, Tweetie123
Ohio State: bonjuju, jonnylingo
Rush: P. Willi
St. Vincent: jofutti, weschay, Kiwi219, Tweetie123
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti, Tweetie123
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas, P. Willi
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kansas: hyper_74
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219, Tweetie123
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md, P. Willi
U of Virginia: dancerMD, brooklyndo2.1
U of Wisconsin: hyper_74, dancerMD, P. Willi
Wayne State: Brooklyndo2.1, weschay

 

[kaizen]

What's going on with the Cali programs? Not a peep yet!

Stanford's interview dates are 12/8, 12/22, 1/5, 1/19, 2/2. Hope that helps you plan.

 

[jofutti]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen, dancerMD
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen, dancerMD, AndyDufrane
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi, AndyDufrane, Tweetie123
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4, jofutti
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi,Tweetie123
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay, Tweetie123
North Shore-LIJ: kaizen, P Willi, Kiwi219, Tweetie123
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen, Tweetie123
Ohio State: bonjuju, jonnylingo
Rush: P. Willi, jofutti
St. Vincent: jofutti, weschay, Kiwi219, Tweetie123
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti, Tweetie123
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas, P. Willi
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kansas: hyper_74
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219, Tweetie123
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md, P. Willi
U of Virginia: dancerMD, brooklyndo2.1
U of Wisconsin: hyper_74, dancerMD, P. Willi
Wayne State: Brooklyndo2.1, weschay

 

[TUCOMSam]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen, dancerMD
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen, dancerMD, AndyDufrane
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi, AndyDufrane, Tweetie123
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4, jofutti
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi,Tweetie123
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay, Tweetie123
North Shore-LIJ: kaizen, P Willi, Kiwi219, Tweetie123
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen, Tweetie123
Ohio State: bonjuju, jonnylingo
Rush: P. Willi, jofutti, TUCOMSam
St. Vincent: jofutti, weschay, Kiwi219, Tweetie123
Stony Brook: Kiwi219
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti, Tweetie123
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas, P. Willi
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kansas: hyper_74, TUCOMSam
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219, Tweetie123
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md, P. Willi
U of Virginia: dancerMD, brooklyndo2.1
U of Wisconsin: hyper_74, dancerMD, P. Willi
Wayne State: Brooklyndo2.1, weschay

 

[Brooklyndo2.1]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen, dancerMD
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen, dancerMD, AndyDufrane
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi, AndyDufrane, Tweetie123
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4, jofutti
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi,Tweetie123
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay, Tweetie123
North Shore-LIJ: kaizen, P Willi, Kiwi219, Tweetie123
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen, Tweetie123
Ohio State: bonjuju, jonnylingo
Rush: P. Willi,jofutti,brooklyndo2.1
St. Vincent: jofutti, weschay, Kiwi219, Tweetie123
Stony Brook: Kiwi219,brooklyndo2.1
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti, Tweetie123
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas, P. Willi
U of Cincinnati: jofutti, Brooklyndo2.1
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kansas: hyper_74,brooklyndo2.1
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219, Tweetie123
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md, P. Willi
U of Virginia: dancerMD, brooklyndo2.1
U of Wisconsin: hyper_74, dancerMD, P. Willi
Wayne State: Brooklyndo2.1, weschay

 

[Triathlon]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen, dancerMD
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam
Columbia/Cornell: kaizen, dancerMD, AndyDufrane
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi, AndyDufrane, Tweetie123
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4, jofutti
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi,Tweetie123
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay, Tweetie123
North Shore-LIJ: kaizen, P Willi, Kiwi219, Tweetie123
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen, Tweetie123
Ohio State: bonjuju, jonnylingo
Rush: P. Willi,jofutti,brooklyndo2.1
St. Vincent: jofutti, weschay, Kiwi219, Tweetie123
Stony Brook: Kiwi219,brooklyndo2.1
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti, Tweetie123
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas, P. Willi
U of Cincinnati: jofutti, Brooklyndo2.1
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kansas: hyper_74,brooklyndo2.1, triathlon
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo, triathlon
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219, Tweetie123
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md, P. Willi, triathlon
U of Virginia: dancerMD, brooklyndo2.1
U of Wisconsin: hyper_74, dancerMD, P. Willi
Wayne State: Brooklyndo2.1, weschay

 

[Chadlinger]

What's up with U of Colorado? Are they waiting for MSPEs? Or am I just out of luck?

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen, dancerMD
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam, chadlinger
Columbia/Cornell: kaizen, dancerMD, AndyDufrane
East Carolina: jonnylingo, fozzy40, thesage, dc2md, chadlinger
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay, chadlinger
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi, AndyDufrane, Tweetie123
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4, jofutti
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi,Tweetie123
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay, Tweetie123
North Shore-LIJ: kaizen, P Willi, Kiwi219, Tweetie123
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen, Tweetie123
Ohio State: bonjuju, jonnylingo
Rush: P. Willi,jofutti,brooklyndo2.1
St. Vincent: jofutti, weschay, Kiwi219, Tweetie123
Stony Brook: Kiwi219,brooklyndo2.1
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti, Tweetie123
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity, chadlinger
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas, P. Willi
U of Cincinnati: jofutti, Brooklyndo2.1, chadlinger
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kansas: hyper_74,brooklyndo2.1, triathlon
U of Kentucky: jonnylingo, weschay, chadlinger
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo, triathlon, chadlinger
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219, Tweetie123
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md, P. Willi, triathlon
U of Virginia: dancerMD, brooklyndo2.1, chadlinger
U of Wisconsin: hyper_74, dancerMD, P. Willi
Wayne State: Brooklyndo2.1, weschay[/QUOTE]
William Beaumont: chadlinger

 

[koyaanisqatsi]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen, dancerMD
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam, chadlinger
Columbia/Cornell: kaizen, dancerMD, AndyDufrane
East Carolina: jonnylingo, fozzy40, thesage, dc2md, chadlinger
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay, chadlinger
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi, AndyDufrane, Tweetie123
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4, jofutti
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi,Tweetie123
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay, Tweetie123
North Shore-LIJ: kaizen, P Willi, Kiwi219, Tweetie123
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen, Tweetie123
Ohio State: bonjuju, jonnylingo
Rush: P. Willi,jofutti,brooklyndo2.1, koyaanisqatsi
St. Vincent: jofutti, weschay, Kiwi219, Tweetie123
Stony Brook: Kiwi219,brooklyndo2.1
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti, Tweetie123
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity, chadlinger
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas, P. Willi
U of Cincinnati: jofutti, Brooklyndo2.1, chadlinger
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40
U of Kansas: hyper_74,brooklyndo2.1, triathlon
U of Kentucky: jonnylingo, weschay, chadlinger
U of Michigan: dancerMD, brooklyndo2.1, kaizen
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo, triathlon, chadlinger
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219, Tweetie123
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju
UT Southwestern (Dallas): dc2md, P. Willi, triathlon, koyaanisqatsi
U of Virginia: dancerMD, brooklyndo2.1, chadlinger
U of Wisconsin: hyper_74, dancerMD, P. Willi
Wayne State: Brooklyndo2.1, weschay[/quote]
William Beaumont: chadlinger

 

[Theasam]

"The Super Six"
RIC:
Kessler: Kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, theasam
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo


Albert Einstein: weschay
Carolinas: fozzy40, thesage, theasam
East Carolina: jonnylingo, fozzy40, thesage, dc2md
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi
Loyola: dancerMD, lrsotnas, jonnylingo
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi,
JEB4
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay
North Shore-LIJ: kaizen, P Willi
NYU(Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO
Ohio State: bonjuju, jonnylingo
Schwab (U of Chicago): dancerMD, jofutti, TUCOMSam
St. Vincent: jofutti, weschay
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1,
koyaanisqatsi, bonjuju, weschay, jofutti
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam,
kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity, theasam
U of Chicago: koyaanisqatsi
U of Cincinnati: jofutti
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74
U of Kentucky: jonnylingo, weschay
U of Michigan: dancerMD, brooklyndo2.1
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo, theasam
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju, theasam
U of Wisconsin: hyper_74, dancerMD
Wayne State: Brooklyndo2.1, weschay

 

[rehabmd]

Regarding many programs, you're proabably right about lacking fundamentals. However, this problem should be addressed at the residency level. I think it's the wrong approach to continue to support sub-standard MSK training that is remediated through a fellowship. All around very inefficient way to do things. Regarding training in advanced procedures during residency, and this is just my experience/opinion after 3 short months in fellowship, most so called "advanced" procedures including RF, discography and perc disc decompression are very safe and much easier to perform (in part due to needle stiffness) than say, trying to do a transforaminal with a 25G needle on a FBSS patient with large chunks of bone graft caked on the sides of their spine. Even with cervical transforaminals, the approach is not that difficult. Making sure there is no vascular uptake is the crucial part of the procedure, but the approach itself is not all that different from performing an S1. So, I see no problem with having residents perform these procedures.

The procedures that require a different skill set are implants and Vertebroplasty. So yes, these procedures probably require fellowship training.



To be honest with you, I considered doing another fellowship (musculoskeletal) after completing this year. But, then I came to my senses and realized that maybe it's about time to settle down and open up shop somewhere. As Physiatrists (and I realize we're not nearly as bad as some other specialties) we need to be a little less dogmatic in our philosophies and a little bit more practical. We need to provide residents with skills for the 21st century. With Medicare cuts, 70% rule, Worker's comp reform, rising malpractice premiums we need to be ahead of the game with our skills and what we offer (proactive not reactive as physicians typically are). Take musculoskeletal ultrasound for example. Totally applicable to Physiatry and probably the next "big thing" as reimbursements for injections get cut. As with everything else, I'm sure this too will come to be abused over time. But as for know, this is something Physiatrists need to jump on.



Why would a Gas pain-fellowship trained interventional Physiatrist have a less diverse skill set than an Anesthesiologist? Because of the their airway management skills? Knowledge of local anesthetics? By your reasoning, couldn't an Anesthesiologist who practices outpatient chronic pain be seen as a musculoskeletal specialist with a less diverse skill set than a Physiatrist?

I understand your point, but you need to realize that the "pain medicine" community wants all pain/spine/MSK docs to have the exact same skill set, indistinguishable from one another. Part of this is about being PC, part of it is about control. Hence, the new ACGME guidelines providing little mini rotations in different specialties over 12 months. I consider myself first and foremost a Physiatrist and don't agree with this attempted homogenization which I don't think can be accomplished through 1 year of additional training. It makes no sense to me why our specialty would take part in a subspecialty and revamped "ACGME" guidelines (destroying our accredited fellowships in the process) and then push our residents toward another specialty's fellowships instead of taking responsibility to provide the training ourselves emphasizing our philosophy.

How do we solve the problem that the general public and the medical community really dont know what we do bc our specialty is so broad. Many people dont know that a physiatrist is a physician. I recently attended a CP conference in NYC and the orthopods and therapists were surprised to hear that phyiatrists do botox injections for spasticity, even though physaitry residents from a NYC program rotate through there. Our specialty is so broad that our referral sources dont know how diverse our expertise is. Since I have no interest or training in interventional PMR, I would make our specialty look bad if anyone approaches me about intervention pain rehab questions. The same happens when my PM&R residents rotate with pediatric orthopedic surgeons or pediatric rehab hospitals staffed by pediatricians. Ped orthopods and pediatricians, who are our referral source, can easily sense that most PMR residents, attendings or chairmen have little knowledge, skills or interest in caring for children with disability or pediatric sports injuries. While most of my family medicine or peds residents can define basics of peds sports medicine such as what is Osgood Schlatter, Sindig Larsen Johansen, or Severs disease, most of my graduating PMR residents cant. It is better for physiatrists to subspecialize and call themselves by their subspecialty eg interventional physiatrist, pediatric physiatrist, inpatient physiatrist, since our expertise is very different. Even our journals dont represent the breadth of our specialty-there are more articles on clinical, social and financial issues related to caring for children with disability in this month's Pediatrics(the official jounal of the AM Acad of Peds) than there have been all year in any of the PMR journals. The annual AAPMR assembly has only a handful of topics relevant to peds rehab whereas the annual Peds conference offered more than 50 lectures and workshops in 5 days through their councils on children with disability, council on developmental peds, and council on sports medicine, whicha re all open to board certified peds physiatrists. These pediatric councils are working together to reshape national policy, and are effective since they are considered to have a legitimate voice by the general public and medical community. I think our specialty has made great strides recently with the new subspecialties that integrate us with mainstream medicine, but there is still a great deal of damage that still needs to be undone to legitimize our specialty.

 

[backup]

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen, dancerMD, backup
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju,theasam, backup
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam, chadlinger
Columbia/Cornell: kaizen, dancerMD, AndyDufrane
East Carolina: jonnylingo, fozzy40, thesage, dc2md, chadlinger
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay, chadlinger
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi, AndyDufrane, Tweetie123
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4, jofutti
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi,Tweetie123
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay, Tweetie123
North Shore-LIJ: kaizen, P Willi, Kiwi219, Tweetie123
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen, Tweetie123
Ohio State: bonjuju, jonnylingo,backup
Rush: P. Willi,jofutti,brooklyndo2.1, koyaanisqatsi
St. Vincent: jofutti, weschay, Kiwi219, Tweetie123
Stony Brook: Kiwi219,brooklyndo2.1
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti, Tweetie123
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity, chadlinger, theasam
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas, P. Willi
U of Cincinnati: jofutti, Brooklyndo2.1, chadlinger
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40,backup
U of Kansas: hyper_74,brooklyndo2.1, triathlon
U of Kentucky: jonnylingo, weschay, chadlinger
U of Michigan: dancerMD, brooklyndo2.1, kaizen, backup
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo, triathlon, chadlinger, theasam
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219, Tweetie123
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju, theasam
UT Southwestern (Dallas): dc2md, P. Willi, triathlon, koyaanisqatsi
U of Virginia: dancerMD, brooklyndo2.1, chadlinger
U of Wisconsin: hyper_74, dancerMD, P. Willi
Wayne State: Brooklyndo2.1, weschay
William Beaumont: chadlinger

 

[Sovay]

heyall. apparently i'm late getting into the thread, but great job on setting it up. congrats on all the invitations, everyone.

"The Super Six"
RIC:
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen, dancerMD, backup, sovay
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju,theasam, backup, sovay
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam, chadlinger
Columbia/Cornell: kaizen, dancerMD, AndyDufrane
East Carolina: jonnylingo, fozzy40, thesage, dc2md, chadlinger
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay, chadlinger
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi, AndyDufrane, Tweetie123
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4, jofutti
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi,Tweetie123
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay, Tweetie123
North Shore-LIJ: kaizen, P Willi, Kiwi219, Tweetie123
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen, Tweetie123
Ohio State: bonjuju, jonnylingo,backup, sovay
Rush: P. Willi,jofutti,brooklyndo2.1, koyaanisqatsi
St. Vincent: jofutti, weschay, Kiwi219, Tweetie123
Stony Brook: Kiwi219,brooklyndo2.1
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti, Tweetie123
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity, chadlinger, theasam
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas, P. Willi
U of Cincinnati: jofutti, Brooklyndo2.1, chadlinger
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40,backup, sovay
U of Kansas: hyper_74,brooklyndo2.1, triathlon
U of Kentucky: jonnylingo, weschay, chadlinger
U of Michigan: dancerMD, brooklyndo2.1, kaizen, backup, sovay
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo, triathlon, chadlinger, theasam, sovay
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219, Tweetie123
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju, theasam
UT Southwestern (Dallas): dc2md, P. Willi, triathlon, koyaanisqatsi
U of Virginia: dancerMD, brooklyndo2.1, chadlinger
U of Wisconsin: hyper_74, dancerMD, P. Willi
Wayne State: Brooklyndo2.1, weschay
William Beaumont: chadlinger

 

[kaizen]

"The Super Six"
RIC:kaizen
Kessler: kaizen, fozzy40, Kiwi219, P. Willi, dancerMD
U of Washington: P. Willi, fozzy40, jonnylingo, ldiggity, JEB4, bonjuju, kaizen, dancerMD, backup, sovay
Spaulding:
Baylor Houston: fozzy40, TUCOMSam, koyaanisqatsi, lrsotnas, Brooklyndo2.1, kaizen,bonjuju,theasam, backup, sovay
Mayo: hyper_74, lrsotnas, P Willi, jonnylingo, bonjuju


Albert Einstein: weschay, dc2md
Carolinas: fozzy40, thesage, theasam, chadlinger
Columbia/Cornell: kaizen, dancerMD, AndyDufrane
East Carolina: jonnylingo, fozzy40, thesage, dc2md, chadlinger
Emory: TUCOMSam, lrsotnas, weschay, fozzy40
EVMS: jonnylingo, weschay, chadlinger
Indiana University: TUCOMSam, lrsotnas, Brooklyndo2.1, ampDO, Triathlon, hyper_74, P Willi
JFK: fozzy40, kaizen, TUCOMSam, koyaanisqatsi, AndyDufrane, Tweetie123
Loyola: dancerMD, lrsotnas, jonnylingo, fozzy40
LSU: dc2md
Marianjoy: TUCOMSam, triathlon, P willi, lrsotnas, jonnylingo, ampDO, jofutti, dc2md
MCV/VCU: jonnylingo, fozzy40, koyaanisqatsi
MCW: jonnylingo, lrsotnas, hyper_74, TUCOMSam, brooklyndo2.1, P. Willi, JEB4, jofutti
MetroHealth: bonjuju
Mt. Sinai: kaizen, jonnylingo, AndyDufrane, thesage, jofutti, koyaanisqatsi,Tweetie123
Nassau: dc2md, sblau001, P willi, Kiwi219, ampDO, weschay, Tweetie123
North Shore-LIJ: kaizen, P Willi, Kiwi219, Tweetie123
NYU (Rusk): TUCOMSam, fozzy40, dancerMD, jofutti, koyaanisqatsi, ampDO, Kiwi219, kaizen, Tweetie123
Ohio State: bonjuju, jonnylingo,backup, sovay
Rush: P. Willi,jofutti,brooklyndo2.1, koyaanisqatsi
St. Vincent: jofutti, weschay, Kiwi219, Tweetie123
Stony Brook: Kiwi219,brooklyndo2.1
Temple: fozzy40, kaizen, P willi, AndyDufrane, dancerMD, Brooklyndo2.1, koyaanisqatsi, bonjuju, weschay, jofutti, Tweetie123
Thomas Jefferson: Brooklyndo2.1, AndyDufrane, fozzy40, TUCOMSam, kaizen, ampDO, jofutti, koyaanisqatsi, weschay
U of AB: theasam
U Baylor: Brooklyndo2.1
U of Cali-Irvine: bonjuju, P. Willi, jonnylingo, ldiggity, chadlinger, theasam
U of Chicago (Schwab): dancerMD, jofutti, TUCOMSam, JEB4, koyaanisqatsi, lrsotnas, P. Willi
U of Cincinnati: jofutti, Brooklyndo2.1, chadlinger
U of Colorado: Brooklyndo2.1, dancerMD, jonnylingo, hyper_74, JEB4, fozzy40,backup, sovay
U of Kansas: hyper_74,brooklyndo2.1, triathlon
U of Kentucky: jonnylingo, weschay, chadlinger
U of Michigan: dancerMD, brooklyndo2.1, kaizen, backup, sovay
U of Minnesota: dancerMD, hyper_74
U of Missouri- Colombia: triathlon, jonnylingo, hyper_74, ampDO
U of NC: jonnylingo, triathlon, chadlinger, theasam, sovay
U of Penn: kaizen, fozzy40, dancerMD, Brooklyndo2.1, ampDO, koyaanisqatsi, Kiwi219, Tweetie123
U of Pitt: AndyDufrane, fozzy40, koyaanisqatsi, ampDO, bonjuju, theasam
UT Southwestern (Dallas): dc2md, P. Willi, triathlon, koyaanisqatsi
U of Virginia: dancerMD, brooklyndo2.1, chadlinger
U of Wisconsin: hyper_74, dancerMD, P. Willi
Wayne State: Brooklyndo2.1, weschay
William Beaumont: chadlinger