PM&R Match Statistics

[Sartre79]

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I'm interested in PM&R, but wonder why the USMLE scores are about 10 points on average lower than other fields like Internal Medicine, Neuro, etc. Also, How can I get more exposure to PM&R as an M2? Thanks

 

[tchoupdoc]

I'm interested in PM&R, but wonder why the USMLE scores are about 10 points on average lower than other fields like Internal Medicine, Neuro, etc. Also, How can I get more exposure to PM&R as an M2? Thanks

Smaller applicant pool, because those few students who know what we do think that it is distasteful, so we get applicants who feel lucky to get a spot.

I chose this field because I wanted a lifestyle specialty and didn't have the scores to compete for any of the others. Even with the figures you quote above, I wouldn't get looked at now.

Perfect match for me. The two close friends who out and out told me NOT to do it-- one of them AOA? One has quit medicine, the other is on his second residency because he hated his first specialty so much.

 

[tchoupdoc]

I'm interested in PM&R, but wonder why the USMLE scores are about 10 points on average lower than other fields like Internal Medicine, Neuro, etc. Also, How can I get more exposure to PM&R as an M2? Thanks

Find a PMR doc at your school. Email them. ask if you can shadow them at work.

Wouldn't recommend residents...

 

[PMR 4 MSK]

I'm interested in PM&R, but wonder why the USMLE scores are about 10 points on average lower than other fields like Internal Medicine, Neuro, etc. Also, How can I get more exposure to PM&R as an M2? Thanks

Possibly selection bias - since less people apply for it per spot than other fields, so only a few programs get the pick of the litter. Hot shots with high scores typically looking for high profile fields.

We get some geniuses going into PM&R, but they get balanced out with some real idiots who are just looking for a home.

Besides just finding a local PM&R to shadow, find a local therapy center or just the PT dept at your hospital and see what kind of patients they treat - you'll see what kind of patients you would be treating in PM&R.

 

[Disciple]

I'm interested in PM&R, but wonder why the USMLE scores are about 10 points on average lower than other fields like Internal Medicine, Neuro, etc.

It has to do with the whole What is a Physiatrist? problem that we have.

How does the saying go? perception is 99% of reality.

 

[MSKalltheway]

I'm interested in PM&R, but wonder why the USMLE scores are about 10 points on average lower than other fields like Internal Medicine, Neuro, etc. Also, How can I get more exposure to PM&R as an M2? Thanks

In my experience, students either

1) Dont know about the field, or dont find out about it until its too late
2) Use it as a back up if they dont match ortho (this is common) or another lifestyle specialty
3) Self-selected into something that gives them a better chance at matching given the results of Step 1

Its unfortunate that an exam has been bastardized to become an achievement test in the match rather than a true P/F licensing tool like in my father's day, but I guess thats just the way it is.

When more people find out about the field, that average board score is going to go way up. I'm just glad I'm getting in before it gets more competitive, esp since the trend towards that has already begun. As I tell people in my class about the field (and as an MS3, EVERYONE wants to know what you want to do) more and more people start to show some serious inquiry about it. As an aside, EVERY resident I've told so far has said "NICE lifestyle!" One intern joked with me and said "oh, so you dont want to work huh?" Then again, I'm on surgery right now, they are probably just jealous. 😀

And to get more experience, shadow, shadow, shadow. Thats all I've got for you. If there is enough PM&R in your area, see some inpatient, see some outpatient. See pain management, sports and/or spine, TBI, SCI, ortho, stroke. Seeing all of these things will help out when/if you go to match, since you can show you actually know what youre talking about. If your school has a dept, then you should be pretty good to go.

 

[nilla_wafer]

So, I have complete respect when asking the following:

What knowledge of basic medicine does a physiatrist use that a physical therapist doesn't? Besides the license to prescribe medication, it seems that a physical therapist could have all that you really need to help people rehabilitate. The knowledge base seems isolated to anatomy and some physio. I may be wrong, but what do physiatrists and physical therapists out there think?

 

[LTS6776]

Our (PM&R doctors) understanding of the underlying disease process or disability helps us formulate goals and lead the team to come up with the most appropriate treatment plan, which often includes multiple therapy discliplines (OT, speech, respiratory, psych, etc... not just PT), medications, procedures, and referrals to specialist consultants. Our ability to "speak the lingo" of both rehab professionals and other physicians enables us to serve as liaisons between the two worlds. We are also specially trained to diagnose and treat complications of disability. We also perform electrodiagnostic studies and many do other procedures including botox injections and other forms of spasticity management, peripheral joint injections, and interventional spinal procedures. While we work closely with physical therapists, I don't think most physical therapists would feel able to completely manage the rehabilitation of a complex patient nor would I or my colleagues feel comfortable doing the actual therapy session. As for the basic sciences, the only thing from my first two years of medical school I don't routinely use has been histology. Biochemistry, Anatomy, Physiology, Pathology, Nutrition, etc... have all been quite relevant, as has physics from college.

 

[Hemisphere]

what happened to your histology, lol?
another example/thing rehab docs do is help decide which patients are good candidates for inpatient rehab vs. outpatient vs home therapy vs subacute level rehab. while social workers and the therapists themselves have some say... it is the physiatrist who can see all the sides... for example, how does histology play into this? would you accept a patient into your rehab hospital if their histology and staging indicated a very poor prognosis or would you recommend subacute rehab or hospice? can you differentiate between a patient who is being dumped to your hospital early due to financial pressures or lack of a proper diagnosis vs one whose medical treatment has been completed? basically as the rehab doctor you and your team are going to have to rehab the patient then discharge them to home... sometimes after months in the hospital... are they medically safe to go home?? that requires all the medical science you ever learned my friend given the variety of diagnosis a rehab doctor might come across including spinal cord injury, TBI, stroke, cancer, heart attack, complications of numerous surgeries for example strokes following a CABG (now you have 2 problems), transplants, COPD, medical debility, inpatient rehab medicine is the last stop for very complicated, sick patients. with all the pressure on all doctors these days to discharge and shorten hospital stays, rehab admissions has to keep a sharp eye on who they are trying to send to your rehab unit, accept appriopriate patients, and discharge them safely to home from both medical and legal standpoints. just one example of where all that medical training comes into play.

in the outpatient setting its more of the procedures and diagnosing that rehab docs do which require lots of medical knowledge. EMG's for example require knowledge of physiology of muscle and nerve and also anatomy of the muscle and nerve. knowledge of the disease processes that can affect muscle and nerve, including genetics and genetic diseases... prescribing requires pharmacology. even embryology is important given the pediatric population including spina bifida, congential limb defects requiring prostheses, etc. etc., diagnosing patients referred to you with numbness and tingling, weakness, walking difficulty, etc, requiress knowledge of neurolgy, orthopedics, radiology, rheumatology, etc. the physiatrist is also uniquely "whole patient" minded focusing on anything and everything biopsychosocial that could be influencing functional outcomes to enlist any medical and allied professionals for the complete treatment plan, whereas therapists generally think about the problems within their domains PT (mostly lower extremities) OT (upper extremities and ADL's) speech therapy etc.

 

[topwise]

With the caveat that I think a good PT is worth a million bucks, you would be surprised how little ANY person who didn't attend medical school knows about medicine. Most people (including PTs) don't know much about most common illnesses, medications, etc. And as someone else pointed out, they're not trained to do any of our procedures. While a PT could diagnose some msk injuries, they can't treat beyond doing PT interventions. And they can't run a rehab unit because they can't manage medical issues.

And conversely, I am not trained to do what a PT does. They're actually two very different jobs, believe it or not. 🙂

 

[Sartre79]

Smaller applicant pool, because those few students who know what we do think that it is distasteful, so we get applicants who feel lucky to get a spot.

I chose this field because I wanted a lifestyle specialty and didn't have the scores to compete for any of the others. Even with the figures you quote above, I wouldn't get looked at now.

Perfect match for me. The two close friends who out and out told me NOT to do it-- one of them AOA? One has quit medicine, the other is on his second residency because he hated his first specialty so much.

I'm curious about what you meant by "distasteful".

 

[tchoupdoc]

I'm curious about what you meant by "distasteful".

I'll keep it short: on inpatient rehab, the diagnosis has usually been made, the bad news has NOT been delivered-- or if it has been, not accepted or understood-- and recovery will take a long, long time, if it ever occurs. I recall a four extremity amputee secondary to flesh-eating staph. ID had signed off, surgery had signed off, plastics had signed off, psych had signed off. The only white coats left were the rehab service.

This field is not for everyone.

 

[ShrikeMD]

So, I have complete respect when asking the following:

What knowledge of basic medicine does a physiatrist use that a physical therapist doesn't? Besides the license to prescribe medication, it seems that a physical therapist could have all that you really need to help people rehabilitate. The knowledge base seems isolated to anatomy and some physio. I may be wrong, but what do physiatrists and physical therapists out there think?

There is some overlap between the knowledge bases of the two professions for particular neurological and orthopedic conditions, but a gross asymmetry between the depth and breadth of the medical knowledge base between the two.

Physiatrists use an extensive amount of basic & advanced medicine, particularly in the neurology and non-surgical orthopedic fields, (as well as more internal medicine than I would have preferred to practice.)

Establishing the diagnoses, and the influence of concurrent diagnoses on the overall clinical presentation are among the skills that lie at the core of what I do as a physiatrist. This skill set is considerably beyond the training and experience of most physical therapists, even with the token doctorates (DPTs) they are passing out now (at considerable expense to new grads.)

Wafer, you will almost certainly see this if you decide to pursue clinical rotations in any of our subspecialties, whether it be MSK, Spine/Pain, BI, SCI, Peds, etc.

Sorry if I offend anyone with this response.

 

[PMR 4 MSK]

So, I have complete respect when asking the following:

What knowledge of basic medicine does a physiatrist use that a physical therapist doesn't? Besides the license to prescribe medication, it seems that a physical therapist could have all that you really need to help people rehabilitate. The knowledge base seems isolated to anatomy and some physio. I may be wrong, but what do physiatrists and physical therapists out there think?

My bias - a very good therapist can probably diagnose a MSK problem as well as a decent physiatrist, because 90% of what we see is common stuff. But a good therapist also knows thier limitations - the ones in my clinic rely on us for proper diagnosis.

In many places, therapists are so used to an Rx reading "PT: eval and treat." with MAYBE a diagnosis, or at least a symptom (e.g. "Dx: Back pain"), that they are forced to become diagnosticians, and some do feel they are the equals (or better) of physicians. Compared to an FP or IM for MSK, they probably are, compared to a well-trained physiatrist, no way.

Therapists impliment the hands-on treatment ordered by an MD. When PT's get their way and have direct-access to patients without an MD order, which they will likely have soon, this theory will be better tested.

But a therapist has a small set of tools to work with - their hands, exercise advise and education, e-stim, US, etc. MD's have the same + medications, ability to utilize better diagnostic tools (CT, MRI, x-ray, labs, etc. that a PT will never have adequete training in), injections and surgery.

In theory, the PT/OT/SP are part of the team treating the patient, not the anagonstic anti-MD like naturopaths and their similar ilk.

 

[jamshid007]

I'm interested in PM&R, but wonder why the USMLE scores are about 10 points on average lower than other fields like Internal Medicine, Neuro, etc. Also, How can I get more exposure to PM&R as an M2? Thanks

Where did you get these numbers from?
pmr is getting very competitive in the past 3-4 years. its not the same anymore. These may be old figures.

like 5 years ago there were 70 spots open for scramble. people would just wait for scramble than going through the match.

Last year there were only 12 spots nationwide. None in the West, only 4 in the East!

I would like to know where these figures are from?

 

[rxexercise]

I would imagine from the last nrmp charting match outcomes data (2007). PM & R Step I mean was 209, while IM was 222. Data from 2005 and 2006 is similar...with PM & R near the bottom for Step I/II scores.

 

[Sartre79]

Where did you get these numbers from?
pmr is getting very competitive in the past 3-4 years. its not the same anymore. These may be old figures.

like 5 years ago there were 70 spots open for scramble. people would just wait for scramble than going through the match.

Last year there were only 12 spots nationwide. None in the West, only 4 in the East!

I would like to know where these figures are from?

Charting outcomes

 

[paindefender]

Where did you get these numbers from?
pmr is getting very competitive in the past 3-4 years. its not the same anymore. These may be old figures.

like 5 years ago there were 70 spots open for scramble. people would just wait for scramble than going through the match.

Last year there were only 12 spots nationwide. None in the West, only 4 in the East!

I would like to know where these figures are from?

Residents matching in PM&R in 2007 had the lowest USMLE Step 1 scores and the second lowest USMLE Step 2 scores.

PM&R had the second lowest percentage of applicants who are AOA members

PM&R residents had the second fewest number of research experiences, abstracts, publications, and presentations of all applicants

In 2003, PM&R has had the second lowest percentage of spots being filled by U.S. Allopathic graduate (56%). In 2008 it was 47%.

 

[drusso]

Does anyone know how *satisfied* physiatrists are as whole with their career decisions?

 

[Sartre79]

Residents matching in PM&R in 2007 had the lowest USMLE Step 1 scores and the second lowest USMLE Step 2 scores.

PM&R had the second lowest percentage of applicants who are AOA members

PM&R residents had the second fewest number of research experiences, abstracts, publications, and presentations of all applicant
In 2003, PM&R has had the second lowest percentage of spots being filled by U.S. Allopathic graduate (56%). In 2008 it was 47%.

I still haven't gotten a satisfactory answer as to why this is (at least in my mind). For instance, people say not to go into Neuro b/c all you do is diagnose and give the pt. some drugs, etc. So, it is kind of gloomy. Is there something about PM&R that makes it non-desireable? What is the day in the life of a Physiatrist I guess? What kind of pt. population do they serve?

 

[Disciple]

Does anyone know how *satisfied* physiatrists are as whole with their career decisions?

Why?


What do you suspect a survey would show?

 

[Taus]

Why?


What do you suspect a survey would show?

I don't intend to speak for him, but I assume it would show who is truly getting the last laugh...

 

[Disciple]

was thinking something else,

but would like to see what drusso thinks.

 

[Sartre79]

Don't get me wrong either, I'm NOT trying to bash the specialty....I'm actually interested in it.....just trying to kick the tires b/f buying. I know that I would have to do a rotation in it to be sure...but I'm the kinda guy who likes to know every detail/opinion.

 

[drusso]

was thinking something else,

but would like to see what drusso thinks.

I don't know. I guess I was thinking that physiatrists may just be a dumb, but happy lot... or maybe physiatrists tend to make the center of their lives something other than work...the old "Plenty of money & relaxation" argument...

 

[Llenroc]

Who gives a **** about AOA anyway.

My experience with the USMLE was that - unlike the tests preceding - it had less to do with smarts, and more to do with motivation to study. The people who were eyeing surgery or other such careers definitely tried harder for the exam than people like me (with previously high SAT, MCAT scores) who went into medical school to train for a job, not a lifestyle. My plan was originally to go into Internal Medicine (before I learned of PM&R), for which I knew even before hand that you didn't need to kill yourself for on the UMSLE. I swear to God I studied the bear minimum, with a goal of getting at least a 185, just so that I wouldn't have to retake it.

That said, my USMLE score was above the national average.

Let's not beat around the bush here, PM&R does have low board scores. But in my experience, it's decently competitive. In fact I would say it's moreso than a host of other specialties that have higher board scores like Internal Medicine, Pediatrics, Family Medicine, etc. Just look at how few unmatched spots there are.

 

[predodoc]

Im applying right now and what supprised me is to see many programs take only 2-6 residents a year.

 

[paindefender]

Who gives a **** about AOA anyway.

I always hear that from mediocre students who don't have the slightest chance to be elected.

 

[drusso]

I've always been curious what percentage of physiatrists beat rush hour traffic home from work? Similarly, I suspect that if you survey hospital cafeterias, you will find a higher percentage of physiatrists at the front of the buffet line. And, I've often suspected that PM&R docs compete better for the cardio machines at the university gym after work compared to their other specialist peers.

All of which leads me to consider that perhaps the specialty should change its tag-line from "Physicians adding quality to life," or whatever the lastest version is to something more like, "Physiatry: The short ROAD in medicine for the rest of us." 👍

 

[paindefender]

I've always been curious what percentage of physiatrists beat rush hour traffic home from work? Similarly, I suspect that if you survey hospital cafeterias, you will find a higher percentage of physiatrists at the front of the buffet line. And, I've often suspected that PM&R docs compete better for the cardio machines at the university gym after work compared to their other specialist peers.

All of which leads me to consider that perhaps the specialty should change its tag-line from "Physicians adding quality to life," or whatever the lastest version is to something more like, "Physiatry: The short ROAD in medicine for the rest of us." 👍

Dave you are right. If your goal is to be at the front of the buffet line and compete for cardio machines, rehab is a good choice.

 

[Sartre79]

What kind of patients do PMR normally see? I know they are Stroke victims, Amputees, etc. But, are they mostly geriatric in nature? A wide spectrum? Medicare? Medicaid pts? etc?

 

[Disciple]

Yes,

These are traditional PM&R type patients.

You should know, however, that nowadays, there are quite a few community (and a few academic) PM&R practices that are 100% orthopedic, procedures, EMG +/- sports med.

Proportion Medicare/Medicaid is probably not vastly different than most other specialties. Medicaid likely much lower outside of academia.

 

[Disciple]

Don't get me wrong either, I'm NOT trying to bash the specialty....I'm actually interested in it.....just trying to kick the tires b/f buying. I know that I would have to do a rotation in it to be sure...but I'm the kinda guy who likes to know every detail/opinion.

So, here's what I was thinking.

Overall, the satisfaction rate is probably not that much different from other specialities.

For every successful Physiatry private practicioner, or academician who truly enjoys their work, there if probably a counterpart lazy Physiatrist who is in the profession because they couldn't get into the specialty they were really interested in, or because they weren't really interested in any specialty and wanted something where they thought they wouldn't be working very hard.

The "lazy" Physiatrist tends to become disgruntled, because they ultimately end up with the jobs that other Physiatrists don't want (see other threads with residents complaining about certain attendings at their programs).

The "lazy" Physiatrist still makes up a significant proportion of the specialty because it's easy to match into.

Why is it easy to match into? Because it's still a relatively obscure field.

If you're a gunner at your school, what are you thinking (most likely)? Ortho, Derm, Rads, Neurosurg, ENT? Your school may not even have a PM&R department, much less a good, easily accessible elective available.

Physiatrists who are happy with their career choice typically have a genuine interest in the field or were lucky enough to stumble onto the field and have a good elective experience during their 3rd or 4th years of med-school.

If you're in primary care, your opinion of Physiatry is generally going to be shaped by your experience with PM&R during your residency training, which is likely to be calling for PM&R consults to get patient's off of your inpt service. Most primary care residents (and also residents from other specialties) aren't going to be exposed to the breadth of services Physiatrists have to offer, because in most cases, Physiatrists are not yet able to assert themselves in these roles in academic centers. So, most physicians who have some interaction with Physiatrists during their training, are going to pass on these negative opinions to up and coming medical students, encouraging them to go into other fields. This is a political and marketing issue with Physiatry, but one that is finally being addressed. We've been fairly successful in changing the opinions of physicians in community settings, but even then, we're often trying to overide first impressions.

So there are some of the pros and cons of this specialty. If you can come to terms with the negatives, the positives are definitely on par with the traditional "ROADs" specialties.

 

[dreambig2night]

What are my chances of matching into top PM&R programs with an average performance on the COMLEX. 500/82?....averge rank in class, 85+% on year I&II grades

I am interested in PM&R but am I competitive for the Top programs?

I would also need help in interpreting average COMLEX scores vs average USMLE scores..I know 185 is passing on USMLE but whats an average score on it? and is an average score on the USMLE/COMLEX a good score for matching into PM&R.

🙂

 

[predodoc]

What are my chances of matching into top PM&R programs with an average performance on the COMLEX. 500/82?....averge rank in class, 85+% on year I&II grades

I am interested in PM&R but am I competitive for the Top programs?

I would also need help in interpreting average COMLEX scores vs average USMLE scores..I know 185 is passing on USMLE but whats an average score on it? and is an average score on the USMLE/COMLEX a good score for matching into PM&R.

🙂

Avg for usmle is usually in the 218 range with a stdev of like 23. This was for my test but maybe its increased for more recent tests.
As far as being competitive, Im not real sure. I feel like I have been competitve this year as a DO but I did pretty well on step 1.

 

[Ludicolo]

What are my chances of matching into top PM&R programs with an average performance on the COMLEX. 500/82?....averge rank in class, 85+% on year I&II grades

I am interested in PM&R but am I competitive for the Top programs?

I would also need help in interpreting average COMLEX scores vs average USMLE scores..I know 185 is passing on USMLE but whats an average score on it? and is an average score on the USMLE/COMLEX a good score for matching into PM&R.

🙂

Although you started with the dreaded “what are my chances…” , this turned out to be an interesting, fun question (well, for me anyway).

The average USMLE step I score for PM&R applicants who matched is 208, which is below the average for all US seniors who matched in any specialty (221) and independent applicants who matched (215) [ref: NRMP Charting Outcomes in the Match, August 2007]

Comparing COMLEX to USMLE is a different beast entirely. Difficult because the content is different. Some programs prefer you to also take the USMLE, to allow easier comparison with allo applicants. As far as I know, there’s been only one study on the topic, looking at a small cohort of Kirksville DO students who took both COMLEX and USMLE (Slocum PC, Lauder JS. How to predict USMLE scores from COMLEX-USA scores: a guide for directors of ACGME-accredited residency programs. J Am Osteopath Assoc 2006;106;484-5). Limited study. Take it for what it's worth.

As many people have said before, scores are just one facet to the PM&R application, and not necessarily the most important. We look at the whole picture, including LORs, rehab rotations, grades, personal statement, interview, etc.


Then we reject you…

 

[DCHawk10]

I was wondering if anyone could tell me what would be a safe number of interviews to shoot for to "ensure" a match in PMR. I have heard around 8, but wanted to ask some others so I don't regret declining/canceling interviews...Traveling costs, scheduling problems, and limited time off from rotations are making it difficult to go to all the interviews I would want to go to.

 

[dc2md]

I was wondering if anyone could tell me what would be a safe number of interviews to shoot for to "ensure" a match in PMR. I have heard around 8, but wanted to ask some others so I don't regret declining/canceling interviews...Traveling costs, scheduling problems, and limited time off from rotations are making it difficult to go to all the interviews I would want to go to.

34. but 8 would probably do. now if u think you're not a very strong candidate (being honest with yourself) or not a very good interviewer, make it 10-12. but most people can't handle doing that many...b/c of course you'll have to do those prelim medicine interviews too.

 

[dreambig2night]

ok....lets say I like a PM&R program soo much that I ask them for another month rotation in PM&R....I mean I really want to match in that program!

Will doing another rotation help me and will they be more inclined to look at me favorably if I do it or am I just wasting my time?

thanks for the previous replies.

 

[dc2md]

not necessarily. if you're a mediocre student (as far as your application -- scores, experience, research, background, extracurriculars) then doing a extra month as one of the top programs isn't going to make a difference. but of course being seen around the hospital by the program director, chair, coordinator, chief resident will help. devoting yourself to PMR that month and showing a LOVE for PMR will help. one of the biggest things i'm trying to do when i interview is determine if someone is applying for PMR because they want the easier lifestyle and more cush residency, or if they truly love neuromusculoskeletal medicine.

 

[dreambig2night]

not necessarily. if you're a mediocre student (as far as your application -- scores, experience, research, background, extracurriculars) then doing a extra month as one of the top programs isn't going to make a difference. but of course being seen around the hospital by the program director, chair, coordinator, chief resident will help. devoting yourself to PMR that month and showing a LOVE for PMR will help. one of the biggest things i'm trying to do when i interview is determine if someone is applying for PMR because they want the easier lifestyle and more cush residency, or if they truly love neuromusculoskeletal medicine.

I will be a DO...need I say more?👍

But yes, I do like neuromusculoskeletal medicine and that is one of the main reasons why I am pursuing PM&R. Thank you for your reply.

 

[Brooklyndo2.1]

I will be a DO...need I say more?👍

But yes, I do like neuromusculoskeletal medicine and that is one of the main reasons why I am pursuing PM&R. Thank you for your reply.

actually yes, you DO need to say more... waaay more.
Ive seen to many ostepathic residents/students/attendings who have no love for msk , and are still trying to get into rehab, so yes, say more, and try to be original (good luck)
🙂