Hello I am a PGY-3 soon to be PGY-4 resident in PM&R and I think I can clarify a lot of what is being asked here. It is not uncommon for people, even attendings in other fields to have limited knowledge in what we do, so I am not surprised most people on here aren't really sure. The field is actually very broad and can be tailored a lot towards what your preferences are. What we really do is deal with diagnosing and managing the chronic medical complications from some form of disabling injury such as Spinal Cord Injuries, Brain Injuries, Strokes, MSK/Pain issues, Spasticity, Peds Issues(CP, Spina Bifida and others) and on the inpatient side would also do some more general debility rehab. Many of these pt populations can have significant complications such as spasticity, bowel/bladder dysfunction, neurocognitive deficits, agitation issues (TBI/CVA) that a lot of people from other fields aren't very good at managing and by taking care of these issues we are able to help our patients continue to lead their lives as functional/Independent as possible. This can be done on the inpatient side, outpatient side or a combination of both. There is also a significant MSK influence in our training and most grads should leave residency pretty comfortable with all kinds of Joint injections and management/Diagnosis of MSK issues. Some of us will go on to do Interventional Spine or Pain Medicine fellowships where you learn to do higher level procedures like Epidurals, RFA, Facet joint injections, Verteberoplasty/Kyphoplasty and sometimes even pain pump and spinal cord stimulator placement. Also, we all have to learn EMG's where we shock various nerves and needle certain muscles to try and diagnose or rate in severity various conditions that may not be clear based on exam or imaging. Ultimately there is a little something for everyone depending on you interests. Lifestyle as a PM&R resident/attending is usually pretty good as we have a much more predictable schedule as we don't often deal with emergencies. That doesn't mean we don't work hard though and work hours as a Resident vary greatly from program to program. The field is extremely DO friendly and you will find them at all/virtually all of the top programs in the US. I think there are so many DO's in PM&R because it is a natural fit by what we are taught as students to look at functional issues so many people gravitate that way. OMM may be taught if you are at an allopathic program, but that is largely dependent on faculty make up as well as how much time you are given to see patient's. If there are no DO's, or you are seeing patients in a crunched time period, you probably won't use much of it. OCGME programs probably have more emphasis on it though, but I am at an ACGME program with few DO faculty so I don't use OMM ever. Income also varies a lot depending on location and practice style (PP vs. employed vs academic) and while I think the current average is above primary care, it is not by a lot. However, I know people who make in the low 200's and they are working a lot less than do many PCP's I know and with way less headache. So while they might not be killing it in the bank, their lifestyle is probably as good as it gets in medicine. Other people who want to work real hard can easily make 300 plus, especially if you do an Interventional Spine or Pain Fellowship. There are people who do inpatient though and make more than those who do Spine stuff, but they are really working for it. I think if you were able to look at the per hour pay, we probably make close to what many other higher paying specialties besides what ER probably makes. Remember, while you see Orthopedic Surgeons making way more money on average, they also work a lot more hours and have to deal with a lot of other things such as ER call, Post op complications, Etc that we are not really dealing with. Also many Inpatient Rehabs now have hospitalists on staff so if there are medically complex patients with non rehab issues they are able to be consulted for co-management which makes your life much better. Let me know if I can answer or explain anything else. Hope this helps.
