I'm not a big fan of combined PM&R and other discipline residencies
One thing I didn't realize upon entering residency is the cost of sitting for the boards and maintenance of certification
The cost of the PM&R boards approaches $3000, and you have to renew every 10 years. In addition, many of us will choose certification in EMGs through AANEM, Pain certification, perhaps SCI certification, etc. Those also have associted costs.
I know of several attendings within our system who are double boarded in PM&R and IM. Most have chosen NOT to maintain their certification in IM. While they use some skills related to IM, those skills also fall under the scope of practice of PM&R. Its just an added expense.
Additionally, most of us will be at minimum 29 upon finishing residency, and perhaps into your 30s. The extra 2 years of combined residency might mean something to you then. You might find yourself at the end of residency considering a fellowship, but feeling like you've already committed yourself to 5 years of residency and want to move on with your life.
So, except in the rare case where you truly see yourself practicing 2 seperate disciplines, I would advise sticking to just 1 residency. If you desire additional learning, do a fellowship for 1 year. Or you could also simply make your first job in a place where you can learn the skills you desire (e.g., take a job with a heavy load of stroke patients to learn more about stroke rehab before moving on to your more desired job).
