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PM&R and Pain

Discussion in 'Pain Medicine' started by savealife, Feb 19, 2007.

  1. savealife

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    I posted this thread over on the PM&R discussion board, but my goal is to get as many opinions as possible so that I can make a very educated decision when it comes to my career path. Therefore I've posted it here too. Sorry if this is against the proper protocol of the forums.

    Hi everyone... I'm an MSIII at an allopathic Northeastern medical school, and I'm very interested in PM&R.

    I think everyone here has been beating around the same bush for quite some time, so I was hoping that people "in the know" could shed some light on this situation for me. I am 100% sure that I want to do interventional pain medicine, the broad spectrum type of pain medicine offered in anesthesiology departments across the country and in a few PM&R departments, NOT the interventional spine fellowship that is offered at a lot of PM&R departments (just too narrow a spectrum for me). With all of the recent changes in the pain medicine fellowship process, should someone that is confident that they want to do Pain Medicine go into PM&R?

    I don't want to get to the end of my residency and realize that I have either no shot or very little shot at getting into pain medicine, but by the same token, I don't really have an interest in anesthesiology either. I would appreciate the response of the people "in the know" as it pertains to this topic.

    Thank you,
    savealife
     
  2. Ligament

    Ligament Interventional Pain Management
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    I am a physiatrist in an anesthesiology based pain fellowship and would not have done it any other way. However, if I was more interested in cancer pain management or acute pain management an anesthesiology based residency would have been more useful. It WILL be harder landing a spot as a physiatrist except at some very progressive fellowships, and that is something you'd have to accept.

     
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  3. amyl

    amyl ASA Member
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    any idea which ones are progressive?
     
  4. spinal

    spinal Junior Member
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    you dont get it do you?
    What are the odds of becoming a pain physician by getting into the PM&R or Anesthesiology-- do the math dude.
     
  5. mille125

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    easy man... he is just a medical student
     
  6. OP
    OP
    savealife

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    First of all, your response doesn't make any sense, spinal. Go back and re-read it. I really have no idea what you're saying, but I am assuming that you're trying make fun of me for not realizing that anesthesia is the easier route to get a pain fellowship.

    That simply wasn't my question. My question was, is it REASONABLE TO ASSUME that with the changes being made in pain medicine that I will be able to obtain a pain fellowship (anesthesia or PM&R) in 5 years when I am applying.

    Secondly, if you have nothing better to do than to find innocent questions on message boards and then criticize/insult the people looking for answers to their questions, then I feel very badly for you. I can't even put into words how embarassed I felt FOR YOU after reading that response. I hope that angry edge doesn't correspond to your bedside manner.

    In any case, if anyone else has any more information regarding my original question (and amyl's follow-up question), it would be much appreciated.

    -savealife
     
  7. C Fiber

    C Fiber Member
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    First of all. Rules with ACGME, anesthesia programs must not discriminate against PMR. In fact, more programs are "forced" into admitting PMR candidates. But the progressive programs actually value input from PMR fellows with all the ortho/MSK/neuro patients. Try looking into these programs - UCLA, UCI, UCSF, Cleveland, Mayo, MD Anderson, UTSouthwestern, Harvard, Univ Florida - Miami,...just off of top of my head. i know these programs have admitted PMR fellows before. I don't regret my training in PMR, however it was harder to get a position. Good luck.
     
  8. mid|ine

    mid|ine Interventional Spine
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    I think your best bet is anesthesia. Anesthesia training will give you the best procedural background as well as emergency management. That being said, there are alot of things it wont give you. Find a VERY flexible prelim program and do alot of rotations in PM&R and Neuro. These will really give you a much better background in physical exam, especially for the pain related issues you will be dealing with.
     
  9. octrode

    octrode Junior Member
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    I think the best combo is PMR residency with anesthesia pain fellowship or strong ACGME pmr pain fellowship-- truly the best of both worlds.
    ITs the damn finest job on the planet.
    You will love it-the money is rapidly leaving though.
     
  10. octrode

    octrode Junior Member
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    Furthermore-- if you are a strong resident you will not have a problem getting an anesthesia fellowship Especially with the new acgme rules.
    The unspoken assumption is often correct: if you are a physiatrist you are a slacker, the exception proves the rule-- and thank goodness there are plenty of exceptions.
    I am a physiatrist so i can speak with impunity. I do think the physiatry training is superior for training you for the diagnostic and humanistic demands of pain medicine. If you continue to demand more of yourself than your training program you will find the environment of PMR is an excellent one for preparing you for pain. Regarding your proceedural aptitude, it is just that: an aptitude. You can learn the skills many places.
    You need: compassion, facility with the physical exam, a comprehensive understanding of the CNS and PNS anatomy and functional musuloskeletal anatomy, good hands, a good knowledge of the literature, and a damn fine and loyal staff.
    You can only suceed with the above components.
    good luck.
     
  11. drusso

    Physician Moderator Emeritus Lifetime Donor Verified Expert Verified Account 10+ Year Member

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    I credit your enthusiasm but urge you to practice humility.
     
  12. Hemisphere

    Hemisphere Junior Member
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    or else what, your people will invade her planet? lol...
     
  13. Lizard1

    Lizard1 Member
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    i've heard that Emory's Pain program has really picked up this year and improved greatly(from a direct source). I also know that they have been strong-armed into taking PM&R and neurology residents so that should also be a place to consider as well as the other's mentioned
     

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