Model Systems?

[JEGK]

In looking into PM&R programs, I've come acrossed the phrase "participates in model systems for spinal cord injury, traumatic brain injury, burns and multiple sclerosis..." What does this mean and what is it's importance?

Thanks!!

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[Ludicolo]

In looking into PM&R programs, I've come acrossed the phrase "participates in model systems for spinal cord injury, traumatic brain injury, burns and multiple sclerosis..." What does this mean and what is it's importance?

Thanks!!

SCI, TBI, or Burn Model Systems Centers (I am not aware of an MS model system) are partially government (NIDRR) funded institutions that care for a significant number of patients with these injuries, perform research on the rehab care of these conditions, and gather longitudinal data for a national database in order to assess/improve short and long term functional outcomes for these subsets of rehab patients. A lot of the demographic/epidemiologic info we learned regarding SCI and TBI comes from Model Systems data.

From a choosing a residency standpoint, is it important? If you are primarily interested in inpatient rehab, perhaps. You will likely get decent exposure to SCI and/or TBI if you rotate at a Model Systems Center. You should have more opportunities for SCI or TBI research if that sort of thing interests you. The Model Systems, for the most part, tend to be associated with well-respected residency programs.

Does it mean, if you match at a non-Model Systems program, that your education in SCI or TBI or burns will be lacking? Not necessarily.

 

[Therapist4Chnge]

Here is a list of the participating hospitals: http://www.spinalcord.uab.edu/show.asp?durki=104757&site=1226&return=21392 There are some quality programs in there, though it depends on what you want out of your training.

 

[Ludicolo]

For completeness:

SCI: http://msktc.washington.edu/sci/findms.asp
TBI: http://msktc.washington.edu/tbi/findms.asp
Burns: http://msktc.washington.edu/burn/findms.asp

 

[j4pac]

This is a pretty good thread. On my interview trail the term "model system" was frequently thrown around...and it sounded important, so the natural inclination is to consider that program important in that regard. But the truth is that the model systems were established by our government to longitudinally tract brain injuries, spinal cord injuries, and burn injuries. The programs are selected primarily based on the numbers that they see. So a program having a model X...primarily means that the program sees a larger load and that there is some sort of research being conducted on that facet of PM&R. It doesn't speak to the complexity of those patients. It doesn't explain the quality of care for those patients. It doesn't explain the quality of education for that topic for its residents.

For instance...Mayo has a model Brain, but not a model SCI program. Is the exposure to brain any better than SCI? No. Is the Brain rotation any harder than SCI? No. We see a substantial percentage of medically complicated non-traumatic SCIs...and the sickest patient's on our inpatient ward are typically SCI patients. The numbers may be slightly lower...but the difference is probably surpassed by the complexity of the patients.

Just something for those of you who are on the interview trail and trying to make sense of all of the lingo.

 

[Tromner]

I would suggest that applicants think about a Model system designation as a specific but not sensitive marked of quality (is that right?). There are now many high quality centers for SCI/TBI that do not participate in the model system program but programs with the designation can be assumed to have at least a minimum quality and quantity of care (in addition to research that is likely not relevant to resident training). It's probably over emphasized and shouldn't make or break your choice of program.
If you want to go into TBI, I'd bet Mayo has a good program since it's a model system.
If you want to go into SCI, I'd bet Mayo has a good program since it's still Mayo...