Neurology vs PM&R

[imajin78]

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Hi i am a 3rd year med student, and i was interested in doing neurology, however with the recent trend to doing pm&r, i was interested in what the real difference between the two were..Both manage strokes, both do emg's... Which is more profitable? Thanks <img src="confused.gif" border="0">

 

[drusso]

Depends...neuro is more acute oriented and deals almost exclusively with CNS related disorders. PM&R is more chronic disease oriented and does more musculoskeletal, sports, spine, occ med, etc. PM&R is a better avenue for interventional techniques and training. Both do electrodiagnostic medicine and pain management. The lifestyle and hours are better in PM&R. Some people say that the future of PM&R is uncertain because of changes in fhe funding of inpatient rehab, but the physiatrists I talk to say that while changes are occurring, these won't negatively impact the field to the extent that critics say so.

There's plenty of neuro in rehab if that's your interest, even a few combined programs. I was considering both and chose PM&R because I wanted the musculoskeletal training and procedures that neuro did not offer. I also like the "big picture" "holistic" orientation of PM&R. Pretty much the only procedures that neurologists do are lumbar punctures...although this may changes with advances in interventional field.

Good luck.

 

[Neurogirl]

From what I've seen, there are many more differences between the two fields than similarities. However, to be honest, I don't have that much experience with PM&R. My only real interaction with them has been during neuro rotations, specifically, when managing stoke, spinal cord injury and traumatic brain injury. Regarding management, neurologists usually manage the actual injuries and physiatrists manage the rehab from the injuries. It's true that neurologists don't do many proceedures (mainly LPs and nerve biopsies), unless they do interventional pain mgmt (pretty uncommon). Also, regarding EMGs and NCS, it's my understanding (correct me if I'm wrong) that most initial diagnostic studies are done by the neurologist and progress studies are done by the physiatrist. Neurologists also do EEGs and diagnose and/or treat diseases of the CNS and peripheral nervous system (dementias, epilepsy, peripheral neuropathies, pain, stroke, infections(encephalitis/meningitis), non-surgical trauma (spinal cord and traumatic brain injury), MS, headache, cancer, Parkinsons disease, Huntingtons disease, muscular dystrophy etc., etc.)

Like drusso said, it all depends on what your interests are. If you like rehab, sports med, occ med, interventional med etc., go PM&R. If you like neuro, then go that route. I think both fields can be quite profitable...it mainly depends on how many procedures and electrodiagnostic studies you do. I know several neurologists who do quite well.

 

[imajin78]

thanks neurogrl and drusso, both your replys were helpful...

 

[drusso]

Both physiatrists and neurologists can both be specialty board certified in electrodiagnostic medicine. Both the neurologists or physiatrists do initial and or follow-up studies. In some places PM&R runs the electrodiagnostic labs (such as Univ of Washington) in others neuro does.