PM&R (interventional pain) vs. ER

[medicineman1]

anyone here ever torn between the thought of doing a PM&R residency with the plan of doing interventional pain vs. ER? The two pathways are so vastly different- although I am sure I would enjoy either route?! At the same time this makes no sense to me! any thoughts? I am 30+ years old, have finished an internship, and still dont know what I want to do with my life. Any thoughts?

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[edinOH]

Those two options are so vastly different I don't really know where to begin.

Not meaning to insult you but considering your choices, do you really have an honest understanding of the day to day life of each specialty? Certain aspects of the practice of medicine tend to be self selecting.

 

[EctopicFetus]

2 totally diff patients.. One is acute you see for a few hours and dispo.. PM&R is chronic people in rehab for a month or more. Spinal Cord Injuries etc. then with pain you will be in clinic all the time seeing the same group and having them sign "contracts" very very different.

Good luck though.

 

[kungfufishing]

I think if you really could be happy practicing EM or something else, do something else.

 

[CS_22]

2 totally diff patients.. One is acute you see for a few hours and dispo.. PM&R is chronic people in rehab for a month or more. Spinal Cord Injuries etc. then with pain you will be in clinic all the time seeing the same group and having them sign "contracts" very very different.

Good luck though.

I don't know... sometimes I see the same patients over and over again through the course of a month trying to evaluate & treat their "worser" pain. haha

 

[step1]

While I don't know you,
I notice PM&R's have
-compassion
-patience
-enjoy taking time with patients

While you may find several EP's with similar traits, the fact is that the ER doesn't often function this way in it application.

IMO, If you are thinking of interventional PM&R to begin with, you may possess certain qualities which may be better served and needed by going into that field.

 

[TexPre-Med]

While I don't know you,
I notice PM&R's have
-compassion
-patience
-enjoy taking time with patients

While you may find several EP's with similar traits, the fact is that the ER doesn't often function this way in it application.

IMO, If you are thinking of interventional PM&R to begin with, you may possess certain qualities which may be better served and needed by going into that field.

I agree. In the ED today, one physician was pissed that he had to see someone mentally challenged. EM is more call it as you see it. Honest truth and intermittent craziness.

PM&R pain is laid back, loving kindness IMO.

Its like comparing the mass of an elephant to a mouse. Who does that?

 

[TheMightyAngus]

I think if you really could be happy practicing EM or something else, do something else.

I've never heard this before.

 

[medicineman1]

Yes I realize the two fields are vastly different- although interventional pain is also far different that the bread and butter PMnR (ie spinal cord injury, TBI, stroke) etc. Its a spring board to get to interventional pain (a much more appropriate one than anesthesia in my opinion)

Many folks doing anesthesia want to do interventional pain is well, which is arguably completely different than the OR setting.

Nevertheless- I have had a blast doing ER during med school, and during internship.

Funny Im replying to my own post!

I think the hours and scheduling is much more controlable in a private practice IP practice, vs. the ER- although I have seen some sweet set ups with some folks in the ER 4 days on 4 days off etc.

The dignostic aspect of ER, I agree is much more fun!

Yes I know they are different, and its strange that I find both fields appealing, but I do. I think they are pros and cons to everything.

P.S. The whiny degenerates with no health insurance is a typical subset in the ED, not all that different an experience than the opiod addicted pt. showing up at your pain practice.

 

[Sweet Tea]

So the question is, do you want to follow the same patients long-term or don't you? And would you rather work in an office/clinic setting or in the ED? People say that the ED lifestyle is sweet, but it's still a choice; you're going to be working nights, overnights, weekends, and holidays, but when you're off you're off. Clinic life means that you have more of a set, 9-5 schedule (or 8-6, whatever), but you'll have most of your nights, weekends, and holidays free. You'll be on call, but I can't tell you what "on call" for a pain specialist is like as I have no idea. Totally different lifestyles; which one fits you better?