pm&r vs internal medicine

[icebreakers]

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hi, i'm a third year and i'm having a big dilemma over choosing between pm&r and internal medicine(which i would definetely choose a fellowship).

I feel like i love both of them. but sometimes i've read comments on this forum and heard people say things that honestly worry me.

I would really like to enter a field (this sounds silly but is very true) where i feel like i'm making an important difference in someon'es life. where i feel intellectually stimulated, where i feel knowledgeable and where i feel like a doctor. At the same time, i also do not want my career in medicine taking me from everything else that makes me who I am, like my other interests, passions, family, etc. i'm not sure if someone who is a cardiologist or heme/onc doctor can practice only 3-4days a week. from what ive heard, in pm&r you have the choice to do this, and you still make an impact in your patients lives...and the money is good. is this all true? it seems too good to be true than.

but i have to stress that there are moments in medicine where i love the thought processes that come up and are required for making a differential. in pm&R (i have not yet done an elective, but at the same time, i feel the way the system and schedculing is set up is that i need to have a good idea as to what i want to do before i even apply...b/c i need to know about my field specific letters, possible reserach, away elective planning etc.._) seriously, ifeel like i stress over this issue everysingle day. it also takes away from my clerkship experience.

plus. anyone else struggled in 3rd year in the sense that after a while in every rotation, its difficult just getting out of bed. feeling like you' are kind of bound to this 10hr plus committment a day...and you cant do anything about it. don't get me wrong, i love this field...and i think sometimes its kind of unfair (well, a blessing iguess) that we get to be paid for what we do...although we earn it after all the hard work. but i do love this field. but i just want med school to end and have more control over my life. anyone else have this problem? is it common? i'm constantly looking for the light at the end of the tunnel.

but, yes any people out there struggled with choosign between medicine and pm&r? how di dyou ultimately make the decidsion?

 

[ermonty]

I have to agree with the above post. Loved my medicine rotation, want to make a difference, also want to have a decent life away from my job. I've got my PM&R rotation lined up for next year. Heres hopin 👍 it feels right!

Monty

 

[glazed]

Icebreakers--
it seems to me that you are asking all the right questions, and putting a lot of thought into your future. It is a pretty difficult decision, isn't it? I, too, really enjoyed my medicine rotation, and the problem-solving skills internal medicine requires. When I got to PM&R rotations, I was a little frustrated with the apparent loss of diagnostics until I started appreciating the subtleties of the specialty-- as is the case with each specialty. Even cardiology seems like it would get boring doing the same workups over and over, but what seems to drive the best clinicians is appreciating the subtle differences in each patient and giving them the best care possible. AND, most glaringly, I have realized during my internship (prelim med) that I'm a big picture type of guy, and the details are killing me. Anyway, I hope this helps-and good luck with the rest of your rotations.

 

[beeda]

My thoughts, based on my experiences (MSIV):

If you really like internal medicine (i.e. diagnosing and treating medical conditions) then PM&R may not be for you. Most of the "medicine" that you do in PM&R is done on the inpatient wards, and that is generally pretty basic med management. When rehab patients begin to have complicated medical issues, usually IM gets consulted.

However, there is a lot more to PM&R than internal medicine (just like there is a lot more to internal medicine than just medical management). From TBI to interventional spine to amputee medicine and everything in between, there is still MUCH to diagnose, contemplate, and puzzle your mind over in rehab.

If the hospital is your thing, you love IM, and you are sort of on-the-fence about rehab or rehab management, then inpatient rehab will probably not be a really fun alternative to IM. If you are talking about variety of diagnoses, and delving into the intricacies of helping a patient return to maximal function and enjoy life, then there is MUCH to be had in the field of PM&R. It just depends on what set of puzzles is more interesting to you!