PM&R vs Neuro

[cyanocobalamin]

I tried to look through and search the threads to see if anyone had considered both PM&R and neuro; if you did look at both why did you choose one over the other?

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[Gauss]

I tried to look through and search the threads to see if anyone had considered both PM&R and neuro; if you did look at both why did you choose one over the other?

there was another thread on this that you may want to look at. Basically it comes down to how much of a diagnostician you want to be. Neuro loves to hunt for the lesion and enjoys the satisfaction in arriving at a diagnosis. PM&R is more interested in understanding what the results of the lesion are and how to add function/improve quality of life. However some areas of rehab are more into diagnostics: sports, pain, EMG.
What a neurologist once told me is that if you don't salivate over some obscure lesion/bizarre disease you probably aren't gonna be a neurologist.

 

[ptolemy]

I tried to look through and search the threads to see if anyone had considered both PM&R and neuro; if you did look at both why did you choose one over the other?

I also am not interested in PM&R, and am going into neuro, but I do know the PM&R chair at rush in chicago is double boarded neuro/pm&R and sees mainly TBI patients.

 

[Stinky Tofu]

I also am not interested in PM&R, and am going into neuro, but I do know the PM&R chair at rush in chicago is double boarded neuro/pm&R and sees mainly TBI patients.

See my previous reply.

 

[bustbones26]

I think of it this way, since a great number of rehab patients will be victims of head injury, spinal cord injury, stroke, you need to have a solid knowledge of neuro as a PM&R in order to understand that patient's injury and how to go about planning their rehab. As far as diagnosing a neurological condition, offering medical managment of said conditions, that is the neurologist job.

Now, where I am hazy is on the whole EMG/NCV thing. Seems as if both Neuro and PM&R docs are trained to do these and in some cases, a PM&R doc could potentially earn quite a referral practice of doing these studies. Now i have heard all kinds of opinions about this, I have heard some neurologist state that PM&R docs do not get the training they do, SOme PM&R docs are good, some are bad, etc. etc. SO perhaps some others can shed some light on this subject.

 

[DigableCat]

It's 4PM Monday and I am waiting for an inpatient to come downstairs so that I can do a "STAT" CIDP vs Peripheral Neuropathy workup for "weakness"

Who ordered it? Neurology service.

 

[Finally M3]

I think of it this way, since a great number of rehab patients will be victims of head injury, spinal cord injury, stroke, you need to have a solid knowledge of neuro as a PM&R in order to understand that patient's injury and how to go about planning their rehab. As far as diagnosing a neurological condition, offering medical managment of said conditions, that is the neurologist job.

Now, where I am hazy is on the whole EMG/NCV thing. Seems as if both Neuro and PM&R docs are trained to do these and in some cases, a PM&R doc could potentially earn quite a referral practice of doing these studies. Now i have heard all kinds of opinions about this, I have heard some neurologist state that PM&R docs do not get the training they do, SOme PM&R docs are good, some are bad, etc. etc. SO perhaps some others can shed some light on this subject.

I thought that the standard for PM&R residencies was for residents to perform at least 200 EMGs during their training so they could qualify to sit for the electrodiagnostic boards. On the interview trail, this varied greatly (with the most being over 800). Obviously, the more you do, the more you see, and thus, better you are...this applies both to Neuro as well as PM&R, since Neuro also has to get exposure to EEG/Sleep, etc. during their training.

As for the size/scope of a referrals for EMG, you got to work it, baby! It becomes more of a combo of timeliness & how useful your exam is to a referring doc as well as your clinical skill. No one is going to refer to you if your exams suck and you take forever to forward the study results.

PS I love that quote of yours, Bustbones

 

[drusso]

Both PM&R and Neuro are qualified to do EMG's. Opinions about who is better is grounded in ego and not fact. There have been several past presidents of the American Academy of Neuromuscular and Electrodiagnostic Medicine who have been PM&R trained. Daniel Dumitru MD, PhD is a physiatrist and has authored one of the most popular electrodiagnosis texts in the field. The newly proposed ACGME Neuromuscular Medicine Fellowship will be open to graduates from both PM&R and neurology.

ACGME Common Program Requirements for Neuromuscular Medicine

Past Presidents of the AANEM

Ditto with DigableCat: I'm always doing EMGs referred from neuro.

 

[DigableCat]

The newly proposed ACGME Neuromuscular Medicine Fellowship will be open to graduates from both PM&R and neurology.

I wonder what the big whoop is about getting fellowship training in EMGism...

Maybe it has something to do with the PTs lobbying for the right to be able to do EMG/NCS independently...I don't know.