Um...Turns out I was taught this "skill". Your comments spurred me to check my personal files. I saved the handouts/electronic files of most of the rehab-associated grand rounds/didactic/small group sessions I attended during med school and residency (yeah – I'm a tool that way) and was definitely given info on this topic at every level. I now recall being lectured about this particular issue during residency – and being bored out of my mind. IMHO, giving this info on day 1 of residency is a big mistake. New residents quite frankly are not that interested in policy and admin skills. Even when they are told it's important. During my PGY-2 year my thoughts were not on billing, coding, or reimbursement. Instead – I wanted to really learn my spinal cord anatomy, refine my physical exam skills, prepare for journal club. Through repeated observation and discussion with my attendings however, I did learn about proper documentation, admission criteria, FIM scores, etc.
Can't speak for all programs, but some do teach this "skill". With a good residency the groundwork will be laid. Whether someone learns it is another matter. So although most everybody wants to shy away from inpatient rehab, a motivated resident from a good program could emphasize this component of his/her education, and could conceivably perform as a medical director fresh out of residency. People have done it before. PMR4MSK already told us based on his experience it wasn't worth the effort straight out of residency. And I know of at least one other colleague in academia who is currently doing this. He's not happy either. N=2. Take it for what it's worth.
But just because you can do something, doesn't mean you should. Remember how steep your learning curve was the first year after residency/fellowship? Why would you want to subject yourself to the additional hassles of an admin position fresh out of residency? I wouldn't underestimate the value of a few years experience before moving forward.
Being a Medical Director of a unit is very challenging for an inpatient unit, as it is for a Directorship for any sort of medical unit, surgical service line, or clinic.
Residency in my experience, does not teach physicians the skills to be a Medical Director in any service line at all. Reason is:
(a) physicians are not taught adequate business skills or understanding of the economics of healthcare. Most residents I meet do not even know the difference between Medicare A or B. This is not their fault; its the problem of not being taught the skills needed to prepare you for practice.
(b) physicians in general develop poor skills as negotiators and networking. Example: Call for consult at 4PM - resident on other side displays obvious annoyance at the call.
This does not fly in the business world, and especially among hospital administrators. I believe a lot of this stems from the way residents are paid - there is no incentives
(c) Medical Directors must devote time and effort into quality control and assurance. Residency teaches you to manage patients medically, individually. Directorship requires managing populations.
(d) Leadership and administrative skills are not taught. You are either born with them or not, just as natural physician researchers cannot be molded from someone who doesn't have that aptitude.
Medical Directorship as others have mentioned, is a lot of work and can be a hassle if you are not ready for it. However, if you are looking to become something beyond a clinician its a great stepping stone. Be warned though, do not become a director straight out of residency regardless of your field. You will be overwhelmed most likely. It is best to sharpen your clinical skills for at least 2 years. Many administrators and hospital executives will not respect a straight out of residency graduate, frankly. Most are nice, but they know you don't know what you're doing and it is true.
Good luck if this is something you are interested in. I'm a Medical Director and I enjoy this aspect of my job quite a bit.
