PMR NorthEast Residencies

[erasmus31]

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Hi all,
I am an MSIII and recently gained an interest in PMR, but I have no idea how competitive PMR is, and which programs are less competitive. If I were to apply, I would want to stay in the North East, particularly, CT, NY, NJ, Mass, RI, or Vermont.

If anybody can give ANY insight to programs in these states, and tell me which ones are easier to land a residency in, I would greatly appreciate it. I will be a US grad, with very good LOR so far, but my Step 1 is pretty low, and my class rank is low also.

Thanks!!!

 

[prefontaine]

It is impossible to get a PM&R slot in CT, RI and VT.

Spaulding and Kessler are most competitive.

Next tier RWJ and Manhattan programs (except St V).

Other NYC and Boston programs.

Relative easiest...Syracuse, Albany, Stonybrook, Buffalo and any other place most applicants do not want to live.

Hi all,
I am an MSIII and recently gained an interest in PMR, but I have no idea how competitive PMR is, and which programs are less competitive. If I were to apply, I would want to stay in the North East, particularly, CT, NY, NJ, Mass, RI, or Vermont.

If anybody can give ANY insight to programs in these states, and tell me which ones are easier to land a residency in, I would greatly appreciate it. I will be a US grad, with very good LOR so far, but my Step 1 is pretty low, and my class rank is low also.

Thanks!!!

 

[paz5559]

It is impossible to get a PM&R slot in CT, RI and VT.

Spaulding and Kessler are most competitive.

Next tier RWJ and Manhattan programs (except St V).

Other NYC and Boston programs.

Relative easiest...Syracuse, Albany, Stonybrook, Buffalo and any other place most applicants do not want to live.

Reason why the above is misleading, false, or at least why I disgaree:

1) The reason it is impssible to get a PM&R slot in VT, RI, or CT is because there ARE no PM&R PROGRAMS in those states

2) While Spaulding is a strong residency program, and may have fewer slots than Kessler, or the Philadelphia programs, it is not in the same league as Kessler by retutation at present. This may be unfair, and others may disagree, but I know of no -one in accademic circles who would place Spaulding in their top 5, other than top 5 in the Northeast (for me, Kessler, Spaulding, Jeff, Temple, and any of Sinai,Columbia/Cornell, or JFK)

3) Buffalo is heads and shoulders about the other "less desireable" programs by reputation, funding, and nationally recognized faculty

 

[erasmus31]

Can someone tell me why St. Vincent's Manhattan is easier to get in/less desirable program? I heard this in another post, and someone actually said the program might be in trouble someway (?) I know other residencies there can be fairly competitive, so I am curious why it is so different for PMR.

 

[paz5559]

Can someone tell me why St. Vincent's Manhattan is easier to get in/less desirable program? I heard this in another post, and someone actually said the program might be in trouble someway (?) I know other residencies there can be fairly competitive, so I am curious why it is so different for PMR.

PM&R is different in lots of cities or regions than the norm, and here I will offend with overgeneralizations and broad strokes:

Generally, the best hospital/residencies in Virginia are at UVA, while in PM&R, MCV is clearly the best known program in the state while UVA is a program still trying to build a reputation.

Generally, the best hospital/residencies in Philly are at Penn, while in PM&R, Temple and Jeff are clearly programs of national renown while Penn is a program still trying to build a reputation.

Duke is clearly a great medical center and med school. They don't even HAVE a PM&R residency.

On the East and West coasts, how many other specialties have thei best programs in Washington and New Jersy, rather than in NY and California?

The great programs in our field have history, and legacy. This is not to say Dave Cifu, Kasey Kerrigan, or other young turks can't create something great, just that it takes time to do so, and reputtions are made (and lost) at a glacial pace in our field

But enough pontificating - why isn't St. V's a top notch program in PM&R? Cause mostly what the program is is Dr. Murali's fifedom, and thus rather than a broad ranging experience, what you get is a somewhat skewed exposure, based on her personal interests. Oh and did I mention she is married to the Chairman of the Department of Neurosurgery? I will leave you to connect the dots youself.

 

[prefontaine]

The original post does not ask about PA, nor is there a question about reputation. They are interested in ease of acquiring a position. I was answering the question, not going off on a tangent about reputations.

Many of the applicants I have interviewed this year have been granted interviews at Kessler and not at Spaulding. Spaulding is a difficult program to get into and they have had most of their applicants come from their top ten rankings in recent years.

Reason why the above is misleading, false, or at least why I disgaree:

1) The reason it is impssible to get a PM&R slot in VT, RI, or CT is because there ARE no PM&R PROGRAMS in those states

2) While Spaulding is a strong residency program, and may have fewer slots than Kessler, or the Philadelphia programs, it is not in the same league as Kessler by retutation at present. This may be unfair, and others may disagree, but I know of no -one in accademic circles who would place Spaulding in their top 5, other than top 5 in the Northeast (for me, Kessler, Spaulding, Jeff, Temple, and any of Sinai,Columbia/Cornell, or JFK)

3) Buffalo is heads and shoulders about the other "less desireable" programs by reputation, funding, and nationally recognized faculty

 

[paz5559]

The original post does not ask about PA, nor is there a question about reputation. They are interested in ease of acquiring a position. I was answering the question, not going off on a tangent about reputations.

Many of the applicants I have interviewed this year have been granted interviews at Kessler and not at Spaulding. Spaulding is a difficult program to get into and they have had most of their applicants come from their top ten rankings in recent years.

The original posts asks about the "Northeast", as well as specific states, so I don't believe including PA was out of line.

Spaulding may have fewer spots this particular year, but a program with one or two open positions in any given year does not automatically become more selective on an overall basis just because of a one year aberration.

As for my tangent, first, please note I acknowledged it tacitly in my post, and secondly, if you truly believe that reputation and ease of acquiring a position are not intimately related, well then, by all means, tell me how that can be so.

Lastly, where is it you interview candidates? It is no secret that I am at LSU, so out with it, and please don’t give me this anonymity nonsense - if you are going to tout your information, please give us all the opportunity to evaluate the source of the opinion, rather than merely hiding behind a veil of secrecy.

In reading your prior posts, it appears you at least were an accademic DO at as osetopathic school. If that is still the case, what kind of residency candidates are you interviewing? And are you really naive enough to believe that candidates will TELL you all of the schools they have or will be interviewed at?

 

[DigableCat]

As far as I know, the number of people interviewed also have a direct correlation with the number of spots available. Hence, the more spots a program has, the more interviews they will grant.

And sometimes, you really can't make sense of interview offers. When I was applying a friend of mine got an interview at UC IRVINE and not at STANFORD. I got an interview at STANFORD and not at UC IRVINE. Why? Who knows????

 

[axm397]

In response to the original question,

I would advice the poster to just apply to all the programs in the geographic region he/she is interested in. THEN see how many interview offers come in, go from there. There's no point figuring out which programs are more competitive, etc. as a MSIII ---> what were your plans? to only apply to those "less competitive" programs?

I would try to set up electives at the programs you would consider a "reach" and just cast your net wide. It's really not that much difference in the cost of applying. Besides, you only apply once, and it may alter your career - it's a small price to pay.

Also, I don't know who your LOR is from but you need to get at least 2-3 LORs from physiatrists.

PM&R has gotten a lot more competitive and the applicant pool is getting stronger. However, there are programs you will be able to match in if you play the cards right. You can't change your step 1 score or your class rank - but you can get more LORs, do some PM&R research, put effort into your personal statement, and take step 2 early.

hope this helps

 

[Stinky Tofu]

Reason why the above is misleading, false, or at least why I disgaree:

1) The reason it is impssible to get a PM&R slot in VT, RI, or CT is because there ARE no PM&R PROGRAMS in those states

2) While Spaulding is a strong residency program, and may have fewer slots than Kessler, or the Philadelphia programs, it is not in the same league as Kessler by retutation at present. This may be unfair, and others may disagree, but I know of no -one in accademic circles who would place Spaulding in their top 5, other than top 5 in the Northeast (for me, Kessler, Spaulding, Jeff, Temple, and any of Sinai,Columbia/Cornell, or JFK)

3) Buffalo is heads and shoulders about the other "less desireable" programs by reputation, funding, and nationally recognized faculty

I have nothing but the utmost respect for the program at Kessler and it was one of my top choices. Since coming to Spaulding, my respect for Kessler has only increased because two of our best attending are graduates (Dr. O'Connor and Dr. Krivickas). I believe they produce some of the top graduates in the country and they have amazing faculty members there. I hardly ever get into debates as to which programs are the 'best', but I think it's unfair to say that we aren't in the same league as Kessler.

Anyway, 'best' residency can mean different things to different people. When I was a medical student, it was important to know the following things: 1) Placement into PM&R and non-PM&R fellowships. 2) Nationwide job opportunities both within PM&R and outside of PM&R. 3) Quality of residents. 4) Quality of program. 5) Training of faculty members in my area of interest. 6) Do residents stay on as faculty or do they want to go elsewhere to work?

These things were important to me and I'm not saying that they should be important to everyone. Based on these six things, I still feel that Spaulding is at least as good as any program in the country. Last year our graduates finished the Neurology EMG fellowship at MGH and the Anesthesia Pain fellowship at Children's Hospital. This year, our graduates are going to the following places: 1) Two are staying on as faculty. 2) One is going to RIC for the Peds fellowship. 3) One turned down both the MGH Neurology EMG Fellowship and the Furman Pain fellowship for the Spaulding Pain fellowship. 4) One is headed to an Anesthesia Pain fellowship at Harvard. 5) One is headed to Texas to join a group practice.

I feel that the access that we have to non-PM&R fellowships within the Havard community is a reflection of how our residents have performed and are viewed by the other specialties here. Since we work closely with the Neurologists, Spine Surgeons, and Anesthesiologists, getting letters of recommendation from them in addition to the letters from SRH attendings has been a tremendous asset in obtaining job and fellowship offers nationwide. I think it's fair to say that Kessler has a better overall program and reputation within PM&R than we do, but I don't think this has necessarily translated into attracting better medical students, getting better job offers, being offered better fellowships, and retaining graduating residents. In these areas, I think we do just as well as any of the other 'top' programs.

 

[rehabmd]

Excellent point Stinky. The future of physiatrists(MD and DO) in rehab medicine depends on our ability to integrate and earn the respect of physicians in other specialties and attracting top MD/DO students, just as derm and optho, two other lifestyle specialties have managed to do. What does it say about how we are perceived as a specialty when ours is a specialty in which a significant number of rehab chairmen are not even physiatrists, eg LIJ (neuro), Col/Cornell(neuro with neurorehab fellowship), Jamaica Hospital(PhD in psychology), Yale(ortho) and NYH of Queens(ortho). Now how many orthopedic or neuro attendings can you think of who answer to a rehab chairman? How many neuro or otho depts are run by a rehab chairman? Not too many bc it is a matter of self-respect. We have to be in sync with the role we play in the medical community. Are we going to baby sit patients on inpatient units working as glorified medical interns while PTs get direct access for an amazing outpatient musculoskeltal and neuromuscular rehab practice? Many physiatrists in outpatient settings are resigned to working with workers comp patients that no body else wants bc we have poor relationships with neuro, anesthesia, ortho docs. They still dont trust our outpatient skills. Most PTs have better relationships and referrals. The number of inpatient beds in NYC progrmas continues to grow and the number of high quality residents to stay on as faculty continue to dwindle. Look on the websites of the programs and see where all the junior attendings are coming from. Do you know that hiring of all medical attendings, including the position of rehab vice-chairman, is decided by physical/occupational therapists at of one of the renowned progrmas mentioned above. It is the hospital leadership that has empowered them bc they are perceived to be better trained to provide outpt rehab services. Your rehab chairman will never tell you that. Why does the AMerican College of Sports Medicine allow family practictioners but not physiatrists? Why are psychiatrists and pediatricians allowed do neurodevelopmental DISABILITY fellowships and physiatrists cant, even though physiatrists were integral consultants in the creation of the fellowship? WHy did the old-school physiatry leadership refuse to participate when the Amer Board of Internal Medcine wanted to create an integrated Rehab and Internal MEd Geriatric fellowship? THe current leadership is fearful to integrate but it is the young residents and attendings and the future of field that they are not investing in. THe rehab chairs at the big hospitals always boast about being the dept that loses the least money for the hospital, but it is at the expense of our education as physicians and development as a legitimate specialty.

 

[drusso]

RehabMD,

All I can say is that I agree with you and that it will take the talents, energy, and hardwork of people like yourself to make changes happen. I think that reasons behind the problems you identify are complex, but undoubtedly a component of it is simple apathy and turfism.

I sometimes feel like PM&R "went to sleep" around 1965 and is now barely waking up again. I've come to call it the "Rip Van Winkle Phenomenon." The field has been slowly trending toward an outpatient procedurally oriented specialty with a limited inpatient consultation role akin to dermatology for some time now, but many are oblivious to this. Ironically, this is where the field has its roots on the "physical medicine" side of things---or as I like to say "left of the ampersand."

Interestingly, many of the latest physiatric advances are not coming out of academic centers, but are championed by high energy private practice individuals with limited academic roles and affiliations. Our specialty also has a very different shape and form in Europe where a distinction is drawn between "orthopedic surgery" and "orthopedic medicine" the latter resembling outpatient musculoskeletal medicine in the USA. It still boggles me that we have a health care system that preferentially refers patients for evaluation of musculoskeletal complaints to a surgeon! Remind me to call the neurosurgeon the next time I have a headache or the cardiothoracic surgeon the next time I have chest pain...

--DR

 

[paz5559]

Excellent point Stinky. The future of physiatrists(MD and DO) in rehab medicine depends on our ability to integrate and earn the respect of physicians in other specialties and attracting top MD/DO students, just as derm and optho, two other lifestyle specialties have managed to do. What does it say about how we are perceived as a specialty when ours is a specialty in which a significant number of rehab chairmen are not even physiatrists, eg LIJ (neuro), Col/Cornell(neuro with neurorehab fellowship), Jamaica Hospital(PhD in psychology), Yale(ortho) and NYH of Queens(ortho).

As an expatriot NY'er, I feel the need to point out that, just because a phenomenon is happening regionally in NY does not mean it happens everywhere (please note all of the hospitals you menitioned are tri-state references). Also, just for your own edification, NO non-New Yorker cares what happens in Jamaica or NY Hospital -Queens Division, as almost no one knows they exist. Heck, I am guessing half the country wouldn't know ANY of the outer buroughs existed, were it not for Archie Bunker, Saturday Night Fever, Yankee Stadium, or old Brooklyn Dodger references.

Second, it hardly seems odd to me that of the 2-3 thousand hospitals nationally, rehab chairs are not all rehab docs - gotta remember the numbers here - there are somewhere between 6500-7500 rehab docs in the NATION. How many of them want to go academic? How many of them are inpatient specialists? How many of them are QUALIFIED to head up departments? Do you really believe there are between 3000 qualified, interested, appropriately trained PM&R docs to head up those departments?

 

[rehabmd]

Paz, If you want another more substantive examples, I forgot to mention that for before Columbia merged with Cornell, the chairman of Cornell rehab was orthopedics. Also, Burke REHAB Hospital in Westchester, which is where most chairmen and VIPs in NYC go for inpatient rehab, has no physiatrists on staff. My point is there are great rehab job opportunities that we are losing because of our perception as a specialty. The reason it is important to us that the smaller hospitals do not bother to hire rehab chairmen is because it is precisely those smaller hospitals where the desirable outpatient jobs are. After graduation from residency, junior attendings hired to develop an outpatient practice do not want to be writing 100 notes per day every fourth weekend covering acutely ill patients on the inpatient unit- Since that's the only way the rehab chairs will hire them-that's how most good graduating residents are lost. THe smaller hospitals are the only way out to keep an academic affiliation without the general inpatient scut work. It is ironic, but there are usually more US grads who work as attendings in the affiliate rehab sites than at the main academic hospital sites bc of such quality of life issues. (For example, NYHQueens is(?was) a Cornell affiliate and Jamaica an Einstein affiliate.) If you love seeing outpatients, and want to publish papers, there is little time to do that if you are seeing outpatients all week to pay off your salary(since non interventional outpatient rehab generates alot less revenue for the rehab dept) and then writing a 100 notes per day on weekends that is not contributing to your choice of career development. If you are an outpatient medicine or peds attending at an academic medical center, there is usually more freedom than in rehab to not do inpatient coverage as well. Thats why med and peds depts at large prestigious medical centers still are able to recruit their own residents as junior attendings.

 

[rehab_sports_dr]

> Since coming to Spaulding, my respect for Kessler has only increased because two of our best attending are graduates (Dr. O'Connor and Dr. Krivickas). I believe they produce some of the top graduates in the country and they have amazing faculty members there. I hardly ever get into debates as to which programs are the 'best', but I think it's unfair to say that we aren't in the same league as Kessler.

I'll echo these thoughts. I am currently a resident at Kessler, and would still rank them as my #1 choice. That said, I was very impressed with Spaulding when I applied, ranked them high, and would still do so.

In my opinion, there are 3 great programs in the northeast- Kessler, Spaulding, and Thomas Jefferson. I believe that Mount Sinai has the potential to be in the same tier, but it is not there yet.

> I think it's fair to say that Kessler has a better overall program and reputation within PM&R than we do, but I don't think this has necessarily translated into attracting better medical students, getting better job offers, being offered better fellowships, and retaining graduating residents. In these areas, I think we do just as well as any of the other 'top' programs.[/QUOTE]

I love Kessler, and I have nothing but great things to say about my experience here. But I don't think Spaulding has anything to apologize for. They are a terrific program, and I think that the overall quality of the programs are similar. But they are very different in how the residencies are organized, so I would advise serious candidates to apply to both to make the appropriate comparisons.