PM&R vs. Med/Peds

[lifeaseyeknowit]

Hi,
I am currently a fourth year medical student that is still somewhat oscillating between PM&R vs. Med/Peds. I realize that it is starting to get late in the game but I am having a lot of trouble trying to decide on which I think would be the "better" decision.

The aspects of PM&R that appeal to me include the opportunity to work with some really sick patients and a lot of really healthy patients, do more than simply stabilize patients or throw meds at them, the holistic outlook, the opportunity to do procedures, the lifestyle, the overall philosophy.
The aspects of Med/Peds that appeal to me include the wide variety of issues, a very solid knowledge-base in the fundamentals of medicine, the ability to work with some really cute & awesome children (some really sick and some really healthy; less common with Peds PM&R), the realization that you will see any population and can truly prevent so much for them and overall, just having a solid foundation in acute and chronic diseases.

I really seem to enjoy both and am still troubled in trying to choose one. I think when all is said and done, I really enjoy PM&R but the two things that seem to be lacking in it include few interactions with kids that may be fairly healthy / not severely impaired, and not as strong of a grasp on the fundamental important aspects of medicine. However, Med/Peds seems to have a slightly less holistic approach and less options for procedures.

Please share with me if you think one of the above is untrue or why you would decide PM&R over Med/Peds. Thanks for your help!

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[Hemisphere]

seems you have thought it out well... the choice is yours...
I can only give you some more food for thought...

1) why did you choose med/peds over family practice?
2) you can apply for sports medicine fellowships after family practice or PM&R, possibly also med/peds too, and see "healthy" kids, teens and adults" and do the procedures you are talking about after learning all the medicine and pediatrics... but you can also go into sports medicine from PM&R too and get a head start on developing your muscloskeletal physical exam, knowledge, and procedural skills.
3) don't think of med/peds as not having a holistic outlook - a holistic outlook is *your* outlook, get the training you need, do what your seniors say, but then after you finish residency you can decide what outlook you will take and how you will decide to practice, for example you can train in acupuncture or other holistic forms of medicine from either specialty.
4) think about what rotations you like best during medical school and what you want to be doing for the next 3 or 4 years and after. would you rather focus on the disease - med/peds focus - manage medicines, diabetes, give vaccines, order colonoscopies, spend most of your time in the acute hospital, and medical or pediatric clinics - or focus on the disability the disease is causing for the patient and how to best restore their quality of life? PM&R focus - ordering medicine consults to manage very acute situations, focusing on team leadership and managing patients who need multiple services, nursing, PT, OT, wheelchairs, adaptive equipment, bracing, post-surgical issues, spend most of your time in rehabilitation hospital and clinics, be able to talk about patient social situations and help coordinate a safe discharge plan from the hospital, and ensure all appropriate services are in place, so that patients can do what they need to get through their daily routines

 

[Hemisphere]

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[DOctorJay]

In my residency program our Peds rotations are great experiences. You don't see only really sick kids either. Sure you see a lot of CP, spina bifida, developmental delay, but you also get the really cute plagiocephaly kids every once in a while as well as the club foot and scoli's who are basically healthy with some msk issues. Depending on your area you may be the person to see the adolescent sports injuries as well - I saw a couple high level athletes during my month.

I've never met an unhappy PM&R doc and I've really never met an unhappy Peds PM&R doc.

 

[topwise]

I personally found peds PM&R to be very depressing. I liked the peds ortho aspect as well as the kids with CP or SB, but a lot of the inpatients I had were kids with traumatic brain injury or other tragic stuff. The worst were the burn victims that were the victims of child abuse. Some of the stuff I saw on the peds rehab unit still really haunts me.