PM&R and the Future

[nsap102]

Hey,

I know this type of thread has been on before, but those other threads eventually changed topic and went off in another direction...so I'm reposting:

I'm trying to experience PM&R vicariously, so the more detailed the better.

Besides, this will give you a chance to bat for your specialty

In terms of PM&R
1. What's the outlook for this field - Are there websites specifically analyzing this question? If so, please post. Furthermore, where is the demand?

2. Would a shrinking economy have any effect on this field?

3. Are jobs limited by certain factors? i.e. geography. An internist may practice anywhere in the country. What about PM&R docs?

4. Salaries?

5. Compensation - what I mean by this: is it going to be a headache to spread butter on your bread? In general IM there is tons of paper work and issues dealing with compensation for private practice. There were instances where I felt that more time was spent on thinking about the hassle of compensation than on patient. Does PM&R have this problem?

6. What's the average day in the life of a PM&R resident? (yes, this question has a lenghty answer, but this one is very important).

7. Social Issues: how much social work type stuff do you have to do? In IM wards I had to arrange for outpt PT/OT, and constantly hound the case management/ social services crew to find placement etc... for the patient. Does this occur in PM&R and to what extent?

8. More hounding and Coordination: For lack of better words. This is really an extension of Q7. Do you find yourself chasing lab results or any other results? Do you have to chase other departments making sure they are doing what they are supposed to do for you patient? Following up MRI's etc...

7. Who's an ideal candidate for a PM&R residency? Who is not? This question is for everyone, especially the Cheifs

8. What's the average day in the life an Attending PM&R - non-specialist. Hours? How many rehab centers/clinics etc do you usually go to? Dr. Russo, I believe you may have some invaluable input into this.

9. What are the Cons of this field? Who is not suited for this field? Have you seen colleagues who didn't preform well in this specialty? Are any of your colleagues unhappy in this specialty? Why?

10. What are the Pro's of this feild? Do you wake up in the morning enthralled to get to work? Please share your excitement. How does this field compare to other specialties like Neuro/Ortho/Rheum? What are the differences??

Thank you

---

Members don't see this ad.

 

[bjolly]

7. Social Issues: how much social work type stuff do you have to do? In IM wards I had to arrange for outpt PT/OT, and constantly hound the case management/ social services crew to find placement etc... for the patient. Does this occur in PM&R and to what extent?

8. More hounding and Coordination: For lack of better words. This is really an extension of Q7. Do you find yourself chasing lab results or any other results? Do you have to chase other departments making sure they are doing what they are supposed to do for you patient? Following up MRI's etc...

These two are going to depend much more on the hospital you are at and how it functions, than on what specialty you are in. If your hospital has effficient case management/social work/lab etc, those things should happen without you having to hound anyone. PM&R patients probably need a lot of social work type services, compared to some specialties, but the key is to find a hospital where these things are handled smoothly by the people whose job it is to handle them.

 

[Disciple]

Hey,

I know this type of thread has been on before, but those other threads eventually changed topic and went off in another direction...so I'm reposting:

I'm trying to experience PM&R vicariously, so the more detailed the better.

What specialty are you in now?

Are you thinking of switching fields?

 

[nsap102]

Hi Disciple,
Yes, I'm switching specialty.
http://forums.studentdoctor.net/showthread.php?t=576337

I'm interested in getting answers to specific questions from experienced people like yourself.

 

[PMR 4 MSK]

In terms of PM&R
1. What's the outlook for this field - Are there websites specifically analyzing this question? If so, please post. Furthermore, where is the demand?

My opinion is the outlook is good, but on the outpt side. Inpt is going to have to fight harder to survive.

Demand highest in small to medium-sized cities.

2. Would a shrinking economy have any effect on this field?

People still have pain and disability. Likely shift more people to Medicare and Medicaid.

3. Are jobs limited by certain factors? i.e. geography. An internist may practice anywhere in the country. What about PM&R docs?

PM&R would have a lot harder time walking into a town and setting up shop - need recruitment and medical community support. Small field = less opportunities, but less people competeing for them.

4. Salaries?

plenty of data out there about that - see stickies

5. Compensation - what I mean by this: is it going to be a headache to spread butter on your bread? In general IM there is tons of paper work and issues dealing with compensation for private practice. There were instances where I felt that more time was spent on thinking about the hassle of compensation than on patient. Does PM&R have this problem?

I don't - but I have plenty of smart people who do the worrying for me.

6. What's the average day in the life of a PM&R resident? (yes, this question has a lenghty answer, but this one is very important).

I'm too far out from residency to say what hours the kiddies are let out of the playpen these days.

7. Social Issues: how much social work type stuff do you have to do? In IM wards I had to arrange for outpt PT/OT, and constantly hound the case management/ social services crew to find placement etc... for the patient. Does this occur in PM&R and to what extent?

Outpt = almost none. Inpt = social worker either saves your butt or not.

8. More hounding and Coordination: For lack of better words. This is really an extension of Q7. Do you find yourself chasing lab results or any other results? Do you have to chase other departments making sure they are doing what they are supposed to do for you patient? Following up MRI's etc...

That is of the utmost importance in any field - you have to have a good tracking system. You cannot trust patients to f/u on their own, and you cannot trust any other doctor to do what they need to do. I track every referral, every lab (not many) every MRI (many), etc. Actually my nurse does most of it, but I'm responsible for everything.

7. Who's an ideal candidate for a PM&R residency? Who is not? This question is for everyone, especially the Cheifs

I think you forgot how to count.

The simple answer - anyone who has a sincere interest in it. In that case its just a matter of your scores and interviewing skills to determine how good a program you get into. The lower tiers sometimes fill slots with idoits who could not get into their chosen field, but the program needs a warm, semi-concious body to get their money from Medicare.

8. What's the average day in the life an Attending PM&R - non-specialist. Hours? How many rehab centers/clinics etc do you usually go to? Dr. Russo, I believe you may have some invaluable input into this.

I used to do 1/2 time inpt and 1/2 outpt - 4 hours each/day. Going to more than 1 facility/day can eat a lot of your time.

9. What are the Cons of this field? Who is not suited for this field? Have you seen colleagues who didn't preform well in this specialty? Are any of your colleagues unhappy in this specialty? Why?

Again, Idiots for whom PM&R was their back-up or the only thing they could get into. I've never met an unhappy physiatrist. I'm sure there are some.

Biggest Con - Identity Disorder

10. What are the Pro's of this feild? Do you wake up in the morning enthralled to get to work? Please share your excitement. How does this field compare to other specialties like Neuro/Ortho/Rheum? What are the differences??

Thank you

I've never woke up a day in my life enthralled to go to work. If my job was to get into a boat and cast fishing lines all day, I'd be enthralled. If I were a professional video-game tester, I'd be enthralled.

Neuro was too academic for me.
Ortho - not my personality.
Rheum - not for me only because I couldn't stand the thought of doing 3 years of IM first. That and I don't like to Rx meds much.

 

[Disciple]

Hey,

I know this type of thread has been on before, but those other threads eventually changed topic and went off in another direction...so I'm reposting:

I'm trying to experience PM&R vicariously, so the more detailed the better.

Besides, this will give you a chance to bat for your specialty

In terms of PM&R
1. What's the outlook for this field - Are there websites specifically analyzing this question? If so, please post. Furthermore, where is the demand?

No specific websites that I know of. The demand is everywhere, and will grow with the baby boomers. The difference is average starting salary depending on services offered and geographic region.

2. Would a shrinking economy have any effect on this field?

Somewhat. I've had a good number of patients lose their health insurance in the past 6-12 months. When that happens, they forego things like MRIs, epidurals, EMGs, etc.

3. Are jobs limited by certain factors? i.e. geography. An internist may practice anywhere in the country. What about PM&R docs?

Plenty of jobs, even on the coasts. The difference is the starting salary and benefits, and the difference can be quite substantial. Looking beyond the starting salary, it also takes alot more business savvy to compete/grow your practice in certain geographic regions.

4. Salaries?

Again, depends on services offered. There is wide variability (all inpt, all outpt, all procedural, no procedures, mixed, etc.). Just as in other specialties, procedural services bring in more in collections than E&M.

5. Compensation - what I mean by this: is it going to be a headache to spread butter on your bread? In general IM there is tons of paper work and issues dealing with compensation for private practice. There were instances where I felt that more time was spent on thinking about the hassle of compensation than on patient. Does PM&R have this problem?

There is definitely alot of paper work in PM&R private practice, but by no means should you be making less than the average salary for primary care, whether you do procedures or not. In general, I do not do procedures, EMGs, etc. on patients unless it is pre-authorized by their insurance carrier.

6. What's the average day in the life of a PM&R resident? (yes, this question has a lenghty answer, but this one is very important).

This is extremely variable and program specific. The hours can resemble anywhere from IM residency to Derm/Path residency. If you do not want long hours, do not go to an inpatient heavy program.

7. Social Issues: how much social work type stuff do you have to do? In IM wards I had to arrange for outpt PT/OT, and constantly hound the case management/ social services crew to find placement etc... for the patient. Does this occur in PM&R and to what extent?

I have an outpt practice, so most of my social work revolves around disability forms and occasional letters dictated for work restrictions, etc. From what I remember from residency, it was usually the IM service hounding the social worker, who in turn would hound me

8. More hounding and Coordination: For lack of better words. This is really an extension of Q7. Do you find yourself chasing lab results or any other results? Do you have to chase other departments making sure they are doing what they are supposed to do for you patient? Following up MRI's etc...

Again, I have an outpt practice, so the reports of any labs/MRIs I order are faxed to may office. If I want reports from tests someone else ordered, I have my staff call the lab/imaging center, etc. If you're doing inpt, I suppose you could hire a PA/NP to do that stuff for you.

7. Who's an ideal candidate for a PM&R residency? Who is not? This question is for everyone, especially the Cheifs.

Someone with a good bedside manner/social skills, someone who is dedicated to the specialty. Unless you're being interviewed by a lazy attending, in which case it probably doesn't matter.

For the most part, this is a specialty with alot of patient/family interaction.

8. What's the average day in the life an Attending PM&R - non-specialist. Hours? How many rehab centers/clinics etc do you usually go to? Dr. Russo, I believe you may have some invaluable input into this.

Can't answer specifically on this one. From what I've seen, the hours can be quite long.

9. What are the Cons of this field? Who is not suited for this field? Have you seen colleagues who didn't preform well in this specialty? Are any of your colleagues unhappy in this specialty? Why?

a. The cons of the field are its relative obscurity, despite being in existance for 80 years or so. Ironically, most other physicians I run across in private practice have some understanding of what a Physiatrist is. This was not the case during residency. Some other cons are that you often have to prove that you are an expert in X,Y or Z, instead of it being assumed.

Those I have seen who were unhappy in the field or did not do well, are generally those who weren't really interested in the specialty in the first place. You'll find that there are a good number of Physiatrists in practice who wanted to be in a different specialty, or didn't really like any specialty, and chose Physiatry because they thought it would be easy.

10. What are the Pro's of this feild? Do you wake up in the morning enthralled to get to work? Please share your excitement. How does this field compare to other specialties like Neuro/Ortho/Rheum? What are the differences??

The pros are patient satisfaction (you spend enough time with patients that they tend to remember you when they do well), breadth of the field (being an ill-defined specialty can have its advantages), income, lifestyle.

For me, it was the one specialty that provided the opportunity to have a true comprehensive orthopedic practice (non-surgical).

Neuro/Ortho/Rheum are obviously better known specialties, with a better research base. You're not going to have to convince people of your expertise in these specialties.

On the other hand, you're not going to be able to venture out in these specialties to the degree you will be able to in PM&R. There will be advances is these specialties from time to time, but for the most part, you'll be doing the roughly the same thing when you start practice as when you retire. I know more than one Physiatrist who has been able to do a 180 degree turn, without leaving the specialty, as their interests/priorities changed over time.

 

[Bleurberry]

I'd like to know if there's a great deal of variability from outpatient practice to practice. I hear some physiatrists have very little patient contact.
Are some Physiatrists very hands off and more "the captain of the ship" so to speak, while others are directly treating their patients?

 

[PMR 4 MSK]

I'd like to know if there's a great deal of variability from outpatient practice to practice. I hear some physiatrists have very little patient contact.
Are some Physiatrists very hands off and more "the captain of the ship" so to speak, while others are directly treating their patients?

I don't know any physiatrists without patient contact - its how we get paid.

 

[Bleurberry]

I don't know any physiatrists without patient contact - its how we get paid.

That's great to hear!

 

[bkpa2med]

Is there an upside as a DO and being able to use OMM effectively, when it comes to programs?

 

[nsap102]

Disciple and PMR 4 MSK Thank you for answering those questions.

 

[MSKalltheway]

Is there an upside as a DO and being able to use OMM effectively, when it comes to programs?

I think that will be largely dependent upon the program and how comfortable the attendings are with the use of OMM. To have the training cannot hurt though.

 

[PMR 4 MSK]

Is there an upside as a DO and being able to use OMM effectively, when it comes to programs?

Program directors, who ultimate make the final call in rank lists, are unlikely to think to themselves, "I've got 2 DO's here, one does OMM effectively, the other doesn't, so the first guy gets ranked higher."

For allopathic programs, in general it's American-trained MD, then American-trained DO, then IMG. I'm sure they'd take a stellar DO over an ok MD, but going DO to MD residency is usually giving up some points.

 

[bkpa2med]

Program directors, who ultimate make the final call in rank lists, are unlikely to think to themselves, "I've got 2 DO's here, one does OMM effectively, the other doesn't, so the first guy gets ranked higher."

For allopathic programs, in general it's American-trained MD, then American-trained DO, then IMG. I'm sure they'd take a stellar DO over an ok MD, but going DO to MD residency is usually giving up some points.

Thanks for the input.

 

[Bleurberry]

Program directors, who ultimate make the final call in rank lists, are unlikely to think to themselves, "I've got 2 DO's here, one does OMM effectively, the other doesn't, so the first guy gets ranked higher."

For allopathic programs, in general it's American-trained MD, then American-trained DO, then IMG. I'm sure they'd take a stellar DO over an ok MD, but going DO to MD residency is usually giving up some points.

Although this sounds good, I'm going to step in and disagree. Particularly because I just joined PCOM's class of 2013, #1 choice, and worked very hard to get in.

It's difficult to speak in generalities anymore. There is more DO integration into ACGME programs than ever before. This can't be explained by "excellent MD candidate dry spells", where more adequate DOs were luckily on hand - in reserves.
I live in Philly, obviously, so perhaps I see things a bit skewed from the national norm, and that's ok. But DO's live and breathe in every Pennsylvania program, and Philly should be a good indicator of current and future trends. PCOM is in the company of Drexel, Penn, Jefferson and Temple, after all.

 

[PMR 4 MSK]

Although this sounds good, I'm going to step in and disagree. Particularly because I just joined PCOM's class of 2013, #1 choice, and worked very hard to get in.

It's difficult to speak in generalities anymore. There is more DO integration into ACGME programs than ever before. This can't be explained by "excellent MD candidate dry spells", where more adequate DOs were luckily on hand - in reserves.
I live in Philly, obviously, so perhaps I see things a bit skewed from the national norm, and that's ok. But DO's live and breathe in every Pennsylvania program, and Philly should be a good indicator of current and future trends. PCOM is in the company of Drexel, Penn, Jefferson and Temple, after all.

Good, we need more diversity. My understanding is DO's are more heavily concentrated around the DO schools, such as in PA.

Searching NMRP stats, I find anything that DO's in allopath are on the rise, slightly. However, it has risen from 5.6% in 2004 to 6.2% in 2008. Absolute #'s are up from 1315 in 2004 to 1551 in 2008, but the total # of allopath positions offered are up as well. There's a flat line of 70% of DO applicants matching 2000 - 2007 across all specialties.

For DO's in PM&R programs, it's been right around 20 - 25% over the past several years. 2008 up from 2007, but 2007 down from 2006.

 

[2mannings1cup]

Lovepark,

It is so important to see how enthusiastic you are about starting medical school and how much you enjoy learning about your future medical career. Congrats on your acceptance to medical school.

I believe that one of the most important lessons that we learn during medical is about perspective.

There are always outstanding physicians who train in any program configuration that one can think of...

 

[ampaphb]

Although this sounds good, I'm going to step in and disagree. Particularly because I just joined PCOM's class of 2013, #1 choice, and worked very hard to get in.

It's difficult to speak in generalities anymore. There is more DO integration into ACGME programs than ever before. This can't be explained by "excellent MD candidate dry spells", where more adequate DOs were luckily on hand - in reserves.
I live in Philly, obviously, so perhaps I see things a bit skewed from the national norm, and that's ok. But DO's live and breathe in every Pennsylvania program, and Philly should be a good indicator of current and future trends. PCOM is in the company of Drexel, Penn, Jefferson and Temple, after all.

Maybe I am mistaken, but given that you are either a college senior or a PCOM first year, what first-hand experience do you base your conclusions on?

Personally, my experience has been that PMR is spot on with his assesment.

 

[Bleurberry]

Maybe I am mistaken, but given that you are either a college senior or a PCOM first year, what first-hand experience do you base your conclusions on?

Personally, my experience has been that PMR is spot on with his assesment.

ampaphb,

Here's PCOM's 2008 match list.

http://www.pcom.edu/Student_Life/Student_Affairs_Main/Match_List.html

and in 2007 the match's for PM&R were:

Hospital of the University of Pennsylvania
SUNYHealthSciencesCenter
TempleUniversityHospital
PM&R wise, too...
One of the co-chief resident's at the RIC right now is from PCOM, and last years chief resident at Univ. of Washington was PCOM.

A fascinating trivia piece; PCOM's general surgery track is so popular in philadelphia, they made it a DO/MD program this year. I don't know any other DO residency that's been opened to MD's by popular demand, but there you go.

Maybe it's best that I don't argue PMR's point, rather offer the caveat and stand down for now.

I remember you too, ampaphb, we had an interesting conversation over the phone. Yep, 30 years old, PCOM Class of 2013. Temple University Spanish Literature major. You're from Long Island but you live down south now, right?

 

[Bleurberry]

Lovepark,

It is so important to see how enthusiastic you are about starting medical school and how much you enjoy learning about your future medical career. Congrats on your acceptance to medical school.

I believe that one of the most important lessons that we learn during medical is about perspective.

There are always outstanding physicians who train in any program configuration that one can think of...

That's my premise, thanks for speaking up. I think it's a bit like buying a car and then seeing the same make and color everywhere you go, where at one point, you thought yours was a unique choice. Places like Michigan, Pennsylvania, these places have DO's in practically every specialty, and many of them are ACGME program grads. (We're speaking comparitively, since there's less than 60k DO's out there actively practicing medicine). One of my great friends father was the first DO nephrologist up in Michigan, in fact.

Cheers. And I'm particularly excited about PM&R. Very much so.
Warm wishes,

 

[bkpa2med]

That's my premise, thanks for speaking up. I think it's a bit like buying a car and then seeing the same make and color everywhere you go, where at one point, you thought yours was a unique choice. Places like Michigan, Pennsylvania, these places have DO's in practically every specialty, and many of them are ACGME program grads. (We're speaking comparitively, since there's less than 60k DO's out there actively practicing medicine). One of my great friends father was the first DO nephrologist up in Michigan, in fact.

Cheers. And I'm particularly excited about PM&R. Very much so.
Warm wishes,

Dude, I hate when that happens too!

 

[TexasPhysician]

ampaphb,

Here's PCOM's 2008 match list.

http://www.pcom.edu/Student_Life/Student_Affairs_Main/Match_List.html

and in 2007 the match's for PM&R were:

Hospital of the University of Pennsylvania
SUNYHealthSciencesCenter
TempleUniversityHospital
PM&R wise, too...
One of the co-chief resident's at the RIC right now is from PCOM, and last years chief resident at Univ. of Washington was PCOM.

A fascinating trivia piece; PCOM's general surgery track is so popular in philadelphia, they made it a DO/MD program this year. I don't know any other DO residency that's been opened to MD's by popular demand, but there you go.

Maybe it's best that I don't argue PMR's point, rather offer the caveat and stand down for now.

I remember you too, ampaphb, we had an interesting conversation over the phone. Yep, 30 years old, PCOM Class of 2013. Temple University Spanish Literature major. You're from Long Island but you live down south now, right?

I'm not argueing either way on this, but how does this statement prove your point? PM&R only fills approx. 60% of its spots with US allos every year. Sometimes less. This leaves maybe more than 40% of spots for DOs, FMGs, etc. every year. PCOM got 3 of those spots. What does this prove?

 

[Bleurberry]

I'm not argueing either way on this, but how does this statement prove your point? PM&R only fills approx. 60% of its spots with US allos every year. Sometimes less. This leaves maybe more than 40% of spots for DOs, FMGs, etc. every year. PCOM got 3 of those spots. What does this prove?

I guess it doesn't? I'm not nearly as positional as you're suggesting.
Anyway, here's more match lists if you're interested:
http://forums.studentdoctor.net/showpost.php?p=7295031&postcount=1

 

[Finally M3]

Holy off-topic, batman! I thought this was the residents thread, not the allo v. osteo pre-med thread.

 

[WaterAvatar]

yes.... but can you make a lot of money?

 

[TRAMD]

Hey,

I know this type of thread has been on before, but those other threads eventually changed topic and went off in another direction...so I'm reposting:

I'm trying to experience PM&R vicariously, so the more detailed the better.

Besides, this will give you a chance to bat for your specialty

I didn't read all the other replies so there may be repeats

In terms of PM&R
1. What's the outlook for this field - Are there websites specifically analyzing this question? If so, please post. Furthermore, where is the demand?

I don't know about websites but there are lots of jobs out there in a wide range of practice types from academic to private and inpatient to outpatient. Once you are in residency you will get a lot of job offers in the mail.

2. Would a shrinking economy have any effect on this field?

It will see the same changes as other fields with an added bonus of being small so I doesn't come on the radar as much for payment cuts because not as much will be saved.

3. Are jobs limited by certain factors? i.e. geography. An internist may practice anywhere in the country. What about PM&R docs?

There is less need the smaller the community. You won't find many physiatrists in small towns. You probably need at least 20k-50k to support a physiatrist. New York has the most with about 10 per 100,000. I believe Mississippi has the fewest with about 1 per 100,000. So yes, there are greater limits on practice locations than IM.

4. Salaries?

Search online. It varies a lot with most falling between $150k-$300k. It is slightly higher on average than IM.

5. Compensation - what I mean by this: is it going to be a headache to spread butter on your bread? In general IM there is tons of paper work and issues dealing with compensation for private practice. There were instances where I felt that more time was spent on thinking about the hassle of compensation than on patient. Does PM&R have this problem?

Yes, all specialties do. You need to do certain things to get paid for what you do and it is just worse if you are managing your own billing.

6. What's the average day in the life of a PM&R resident? (yes, this question has a lenghty answer, but this one is very important).

Depends highly on how inpt/outpt your rotation is. In an entirely average day you would round on a few patients on the inpatient ward, see a few patients in clinic with rehab or pain needs, do a few EMGs, do a couple injections, go to team rounds with the therapists and be home by 5 PM.

7. Social Issues: how much social work type stuff do you have to do? In IM wards I had to arrange for outpt PT/OT, and constantly hound the case management/ social services crew to find placement etc... for the patient. Does this occur in PM&R and to what extent?

This would be highly dependent on the hospital you are at but is probably a bit worse overall in PM&R per patient but you usually are going through a smaller total number of patients so it is hard to say. In PM&R you are going a bit further to provide a truly safe environment where the patient can do well. In IM you just want them off your ward to somewhere where they won't die soon enough for it to be considered your fault.

8. More hounding and Coordination: For lack of better words. This is really an extension of Q7. Do you find yourself chasing lab results or any other results? Do you have to chase other departments making sure they are doing what they are supposed to do for you patient? Following up MRI's etc...

This is highly dependent on the hospital environment. It will usually be worse at a teaching hospital. In IM you will have a higher volume of these hassles to deal with but in PM&R follow-up by consults is usually not as reliable as other docs don't tend to consider rehab patients to be as acute as other patients on the medical floors. Basically PM&R will have less lab value chasing but more consult hounding.

7. Who's an ideal candidate for a PM&R residency? Who is not? This question is for everyone, especially the Chiefs

I cannot completely define this but I feel that having a strong feeling of caring for your patients and being able to make friendly and trusting relationships with patients, colleagues and ancillary staff are keys. We also don't have enough academics and need more!

8. What's the average day in the life an Attending PM&R - non-specialist. Hours? How many rehab centers/clinics etc do you usually go to? Dr. Russo, I believe you may have some invaluable input into this.

Don't know, only a resident.

9. What are the Cons of this field? Who is not suited for this field? Have you seen colleagues who didn't preform well in this specialty? Are any of your colleagues unhappy in this specialty? Why?

Cons I have seen are some especially needy and ungrateful patients. I don't like when patients complain to me about therapists or nursing staff when I know it is the patients unreasonable demands or expectations are the problem. Another con is that your pager goes off so infrequently that each incidence takes on more negative feeling. You won't perform well if you are scared to touch a patient. This is a very hands-on field. If you are too uptight and too demanding of others you will not do well in this field because you frequently have to accept small successes as big ones. "You felt stool in your rectum! ALRIGHT!!"

10. What are the Pro's of this field? Do you wake up in the morning enthralled to get to work? Please share your excitement. How does this field compare to other specialties like Neuro/Ortho/Rheum? What are the differences??

Some pros are high satisfaction, an overall laid-back feeling and a great lifestyle. Seeing a TBI patient go from confused, falling down and fighting you off on admission to walking up to you and giving you a hug and telling you "thanks" on discharge is extremely satisfying.

 

[Cp22kjer]

Thanks for all the good info PMR, Disciple, and TRAMD.

I've really enjoyed shadowing in the physical medicine department over the past year. I'll only be a first year in the Fall but I look forward to learning more about it when a rotate in 3rd/4th year.

 

[DrJosephKim]

Because of the growing geriatric community (baby boomers), I see PM&R as a booming field (pardon the pun).

 

[phoenix0610]

See, I keep on trying to turn people on to this whole geriatric/pm&r link but no one is listening-they are my two absolute favorite parts of medicine!

 

[bkpa2med]

See, I keep on trying to turn people on to this whole geriatric/pm&r link but no one is listening-they are my two absolute favorite parts of medicine!

Keep it quiet until we all match and then speak up about it

 

[Xardas]

I'll give this a shot

Hey,

I know this type of thread has been on before, but those other threads eventually changed topic and went off in another direction...so I'm reposting:

I'm trying to experience PM&R vicariously, so the more detailed the better.

Besides, this will give you a chance to bat for your specialty

In terms of PM&R
1. What's the outlook for this field - Are there websites specifically analyzing this question? If so, please post. Furthermore, where is the demand?

I think outlook is generally good. While its not the best known field, those that do know the field recognize the value and refer consistently and are appreciative. Some previous posters indicate they feel inpatient outlook is not as good; I disagree somewhat, I still think inpatient has good opportunities. Inpt in the past was almost too easy for too much money -- its had to come back to earth.

2. Would a shrinking economy have any effect on this field?

Shrinking economy has effect on ALL fields. Even fields like anesthesia have had to cancel interviews on applicants. Be thankful that in general medicine is more recession resistant no matter the specialty, but not recession proof.

Only something like E.R. is recession proof!

3. Are jobs limited by certain factors? i.e. geography. An internist may practice anywhere in the country. What about PM&R docs?

Yes they can but there are less jobs so you many not be able to say practice in the exact area but may have to settle for a region of a state.

4. Salaries?

There are many answers for this one.

5. Compensation - what I mean by this: is it going to be a headache to spread butter on your bread? In general IM there is tons of paper work and issues dealing with compensation for private practice. There were instances where I felt that more time was spent on thinking about the hassle of compensation than on patient. Does PM&R have this problem?

The practice of medicine in the US = paperwork. If you feel paperwork is beneath you be careful... signing your name when you enter the adult world is something you have to be wary of... don't pawn everything off on an assistant. I've seen surgeons get in big doo doo not paying attention!

6. What's the average day in the life of a PM&R resident? (yes, this question has a lenghty answer, but this one is very important).

The resident's lifestyle is almost too easy.. it is not reflective of the fact that attendings typically put in a lot of work! But it is worth it in some regards!

7. Social Issues: how much social work type stuff do you have to do? In IM wards I had to arrange for outpt PT/OT, and constantly hound the case management/ social services crew to find placement etc... for the patient. Does this occur in PM&R and to what extent?

Social issues abound in PM&R but exist in most patient care centered fields. Believe me, the trauma and neurosurgeons I know have to deal with social stuff all the time too. They may claim they ignore it but when they go into a patient's room they still have to hear it!

8. More hounding and Coordination: For lack of better words. This is really an extension of Q7. Do you find yourself chasing lab results or any other results? Do you have to chase other departments making sure they are doing what they are supposed to do for you patient? Following up MRI's etc...

A good physician always is looking out for what his patient's results are.

7. Who's an ideal candidate for a PM&R residency? Who is not? This question is for everyone, especially the Cheifs

All fields look for the same traits: hard working, professional, ethical, enthusiastic.

8. What's the average day in the life an Attending PM&R - non-specialist. Hours? How many rehab centers/clinics etc do you usually go to? Dr. Russo, I believe you may have some invaluable input into this.

9. What are the Cons of this field? Who is not suited for this field? Have you seen colleagues who didn't preform well in this specialty? Are any of your colleagues unhappy in this specialty? Why?

You are not suited for this field if you feel you'd rather be something that the public has a better idea of what you do is, i.e. 'hi I'm a radiologist.' If you have that type of mentality this is not for you; it is not a criticism, but we want people that are comfortable in their own skin. Things will eventually change for hte better though imo.

10. What are the Pro's of this feild? Do you wake up in the morning enthralled to get to work? Please share your excitement. How does this field compare to other specialties like Neuro/Ortho/Rheum? What are the differences??

I'd rather do other things, such as say, cover professional or college football, but I know this pays the bills!

Thank you