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Thama

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That does look very interesting & seems to encompass the disease processes I'm interest in. So would you think that neural repair & rehabilitation fellowships/careers really tend to be more academic in nature? I did some research before medical school & none during it. Not sure I have any interest in a research career in me anymore. I also don't feel all that qualified to do research.
The more unusual a fellowship track is, the more likely it is to be primarily research driven. This case is a great example: you want to do a "neural repair" fellowship, and yet neurology as a field has essentially zero meaningful therapeutics to offer in this area. This means you can do one of two things: pretend to be a neurologist from the 1950s and just shrug your shoulders after diagnosis, or get into the lab and develop something you can offer your patients.
 
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neglect

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Hello all,

I'm very interested in the acute/subacute/chronic management of SCI, TBI, & other neural injuries. I'm having trouble finding out more information about these types of residencies. They seem to be fairly limited options for fellowships, but does anyone know where I can best go about learning more about these types of fellowships? Would I be at a disadvantage for being a neurologist rather than physiatrist? I know that everyone matched SCI last year with spots left open, but was wondering if physiatry really has a better grasp for these conditions than I would based on my training. Also, does research tend to be more of a requirement for these fields? Several programs I've looked at have had dedicated research months or even a research year.

I'm really interested in seeing a patient acutely & managing them long-term in the clinic. Are there other fellowships I should be looking into that have that sort of feel? Maybe vascular/stroke has these opportunities as well? I'd think I could pick out any chronic debilitating disease (e.g., MS, movement disorders, etc.) & be able have long-term patient follow up.

Any thoughts?

I've looked at SCI Fellowship - Academy Spinal Cord Injury Professionals, Inc. & Brain Injury Medicine Fellowships - Association of Academic Physiatrists for some information.

Here was an AAN submission on neurorehabilitation as well: Emerging Subspecialties in Neurology: Neurorehabilitation

I’m still more than a little confused by what inpatient rehab doctors actually do. The diagnosis was made by the primary team (it was a stroke). Hopefully it gets treated with tPA or IA to improve outcome. Then workup to find the source. Then fix the problem(s) to prevent future strokes. The patient is perhaps still messed up, so goes to rehab for PT. I get that they need a responsible doctor while in an inpatient setting as a box-checking duty. But seriously, what is the purpose of inpatient rehab when the diagnosis, treatment, workup, and medication plan is fairly set?

I’m not trying to be insulting BTW.
 

Bostonspine

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I’m still more than a little confused by what inpatient rehab doctors actually do. The diagnosis was made by the primary team (it was a stroke). Hopefully it gets treated with tPA or IA to improve outcome. Then workup to find the source. Then fix the problem(s) to prevent future strokes. The patient is perhaps still messed up, so goes to rehab for PT. I get that they need a responsible doctor while in an inpatient setting as a box-checking duty. But seriously, what is the purpose of inpatient rehab when the diagnosis, treatment, workup, and medication plan is fairly set?

I’m not trying to be insulting BTW.
Treatment is done. Someone got to teach them how to self cath trail meds so they they toliet properly after strokes, MS, SCI.
Post stroke rehab depends on severity, some people go home and do outpatient if a patient has minimal needs they go to SNF or LTAC if they have advance medical need and can't participate in therapy. Acute inpatient rehab requires advance medical needs such as medical management like in tbi various mood stabilizer, typical and atypical antipsychotic, management of autonomic dysrelexia, dysautonomia, adjustment disorder pre-existing psych issues, sleeping aids, cognitive stimulants and other general medical problems. The point is before you belittle an entire specialty please take some effort to find out what they actually do. My point is lots of medical management to be done.
 
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neglect

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Treatment is done. Someone got to teach them how to self cath trail meds so they they toliet properly after strokes, MS, SCI.
Post stroke rehab depends on severity, some people go home and do outpatient if a patient has minimal needs they go to SNF or LTAC if they have advance medical need and can't participate in therapy. Acute inpatient rehab requires advance medical needs such as medical management like in tbi various mood stabilizer, typical and atypical antipsychotic, management of autonomic dysrelexia, dysautonomia, adjustment disorder pre-existing psych issues, sleeping aids, cognitive stimulants and other general medical problems. The point is before you belittle an entire specialty please take some effort to find out what they actually do. My point is lots of medical management to be done.

Please don't be miffed. Asked an honest question - in order to find out what you actually do. I literally had no idea. All I see are 30 page rehab notes that end with: gait problems regardless of the etiology, then it seems to be a game with insurance payers.
 

Bostonspine

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Please don't be miffed. Asked an honest question - in order to find out what you actually do. I literally had no idea. All I see are 30 page rehab notes that end with: gait problems regardless of the etiology, then it seems to be a game with insurance payers.
I just answered the question a lot of stuff, like all specialties they are good bad and a lot of average 30-page notes are a function of EMRs I struggle to find a plan of cares on daily bases so I understand. PM&R is different in most fields in that it centers on a principle of overcoming impairment rather than a system in the body. A lil Orth, a lil Rheum, a lil Neuro, a lil peds, a lil medicine. Can be very interesting or very boring all at the same time. but its a really interesting to see things on a lockdown traumatic brain injury unit. high acuity. also in rehab only 80% of patients have to meet criteria so every now and then you get some crappy admits that doesn't make sense dumped on you unit to clear space from the floor for gait dysfunction cause they can't go home. But that hospital politics. like you alluded to they would call you if the patient already has a clear diagnosis cause the work is done.
 

psyguru

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anyone taking the Brain Injury Medicine Boards next week?
 
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