PM&R vs. Neurology

[SportsMed09]

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I have been pretty set on PM&R after researching it here and talking to/shadowing a physiatrist, but I would like to know about the neurologic side of rehab. When I was at the hospital this week during my IM core rotation, one of our patients had a stroke due to clot embolization (he has A fib). I was impressed with how the neurology team was there, assessing the site of the lesion via PE. I know that neurologists do more acute things like diagnosis, whereas rehab would be more chronic. But I was wondering if there are instances where rehab docs get to diagnose neurologic disorders? Would that be possible, even if only in a private practice setting? Or is that something that you'd never get to experience in rehab?
I also am curious about other similarities and differences b/w the two fields. I think they're both pretty interesting, but if any attendings could shed some light or residents who were torn could help it, I'd appreciate it.

 

[Shalom77]

Check out these previous threads as well:

http://forums.studentdoctor.net/showthread.php?t=443395&highlight=neurology

http://forums.studentdoctor.net/showthread.php?t=405971&highlight=neurology

 

[SportsMed09]

Thanks, that was pretty helpful. Unlike uthopeful in the 2nd thread, I have great interest in sports medicine and in msk medicine overall. That's the thing that making PM&R appealing to me, that I could learn about both msk and neuro. What was thedeciding point for you that helped you pick PM&R?

 

[Diamox]

Thanks, that was pretty helpful. Unlike uthopeful in the 2nd thread, I have great interest in sports medicine and in msk medicine overall. That's the thing that making PM&R appealing to me, that I could learn about both msk and neuro. What was thedeciding point for you that helped you pick PM&R?

Didn't want the pain of going through neuro with all the geeks.

 

[PMR 4 MSK]

I was impressed with how the neurology team was there, assessing the site of the lesion via PE.

You should be able to do it too by the end of your PGY2.

 

[caedmon]

During PM&R training you should learn your neuro exam cold. I feel very confident in my neuro exam and have picked up on several neurologic diagnosis in patients sent for other problems. There is a top neurology program at our institution. We do some rotations with great attendings in neurology and I feel like our neurlogic exam is on par with their residents in most instances. We often pick up on missed findings when patients come over to rehab after an acute neurologic illness. For example, we had a patient come to rehab with after a stroke with a dense "right upper extremity hemiparesis", when in fact it was a dense hemiapraxia that we picked up. He had near full strength and could react to automatic actions such as hand shaking. We may not be the ones doing the acute diagnosis in the ED, but there will always be diagnoses to pick up on. We often tend to emphasis the functional deficits related to their lesion. These things aren't necessarily picked up or predicted by MRI. Just make sure you train somewhere that will teach you a great neurologic exam.