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PMR & Sports medicine

Discussion in 'PM&R' started by PMRsports, Dec 29, 2008.

  1. PMRsports

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    I've spent a decent amount of time sifting through the forums here and elsewhere on the internet looking into PMR but I was wondering if someone could give me more of a direct answer on some things. Unfortunately my medical institution does not have PMR and there are very few who practice in town that are hard to get ahold of.

    I was wondering what options/role PMR plays in sports medicine. It seems from talking to people that Ortho are the main people that get into sports med but I know you can also do it through Family and Emergency. Are there different roles/opportunities depending on what your residency was in? Is it still possible to be a team doctor for major university, pro, or semi-pro team as a PMR doc?

    A step further than that, what are some programs I should look at for residency if my final goal is to do sports medicine and what are some of the best sports medicine fellowships? And what is the job outlook for PMR in sports medicine?

    Since my institution does not have PMR, I will likely need to do 1-2 away rotations in PMR, are there any suggestions of places that are good/willing to do 4th year rotations that people recommend?

    Finally, I'm not completely up on all the accrediting stuff and I saw somewhere some of the PMR sports fellowships are not ACGME? certified but it looks like PMR may also be able to get into the family med and emergency med sports fellowships? Any elaboration on this would be great!

    Thanks for any of the questions you can answer and try to get me a better understanding of the field and where I could take it!

    Have a great New Year everyone
     
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  3. rehab_sports_dr

    7+ Year Member

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    I'll throw in my 2 cents, but it would be great to get feedback from other people on this topic as well

    > I was wondering what options/role PMR plays in sports medicine. It seems from talking to people that Ortho are the main people that get into sports med but I know you can also do it through Family and Emergency

    There is a clear demarcation between Orthopedic surgery and everybody else. Ortho can do surgery, no one else can (unless, I suppose, you count podiatry. No other MD/DO specialty can do surgery)

    the primary care sports medicine specialties are Family Med (this is the largest contigency. That is largely because there are also far more family med docs than otehr specialties), PMR, peds, IM, ER

    all of these specialties can sit for board exam given by the ACGME. PM&R only recently was approved for this (it's a long political story- we were given that option when the board for sports medicine was founded, and (unwisely) turned that option down, with the thinking that it is so core to what we do that we didn't need a second board exam), so we are newer in the process of applying for the board than other specialties.

    > Are there different roles/opportunities depending on what your residency was in?

    Yes. This is true for the other specialties as well.

    I've always felt that my PMR training has been outstanding for sports medicine. As a resident, I covered far more athletic events, pre-participation physicals, etc, than my colleagues in other specialties (including ortho). It also became apparent to me when I attended national meetings that my exposure to a complete MSK exam, along with complications like head and spine injuries made me more ready to see athletes than physicians in other areas

    I am in a fortunate environment now where I work closely with some outstanding family med trained sports medicine docs, as well as ortho docs. I feel like the additional skill sets I have in spine and nerve (particularly spine injections and EMGs) does help me in defining a niche.

    > Is it still possible to be a team doctor for major university, pro, or semi-pro team as a PMR doc?

    Yes. The most famous example is Stan Herring at the U of Washington, who is the head team physician for the Seattle Seahawks.

    There are LOTS of PM&R docs who are team doctors for major Division I schools, to many to list really. Just a few examples, though:

    Mike Fredericson- Stanford
    Stu Willick- Utah
    William Micheo- Puerto Rico (I think he is the head physician for the Puerto Rican Olympic team)

    Another very common scenario is for physiatrists is to have some sideline coverage for major pro or college teams in the area, and then also serve as a consultant for the other sports docs in the area. That is what I tend to do- be a go to guy for spine and nerve issues in athletes, and then cover endurance athletes and weekend warriors in clinic, or serve as a second opinion for sports case from colleagues in other specialties. most of the pro athletes I have seen have been in this context

    Other ways that PMR gets involved in sports is as athletic director or consultant for major sports events. I know several physiatrists who are the race directors for the major marathon in their city, or who are the head team physician for events on the pro tennis or golf tours.

    > A step further than that, what are some programs I should look at for residency if my final goal is to do sports medicine and what are some of the best sports medicine fellowships?

    I am biased, but I think Pitt should be very high on the list of anyone interested in sports medicine. I think other programs (by no means an exhaustive list) would include Mayo, U of Washington-Seattle, RIC, Kessler, Utah, Virginia, Colorado

    > And what is the job outlook for PMR in sports medicine?

    I think very good. I've had two job searches since residency, and both times my sports medicine skill set helped me in seeking a job

    > Finally, I'm not completely up on all the accrediting stuff and I saw somewhere some of the PMR sports fellowships are not ACGME? certified but it looks like PMR may also be able to get into the family med and emergency med sports fellowships? Any elaboration on this would be great!

    This is true. This is in part an artifact of PMR only recently being able to sit for the sports board. Sports Fellowships are trying to figure out how to best utilize the skills and knowledge of PMR/

    Hope that helps.
     
  4. PMR 4 MSK

    PMR 4 MSK Large Member
    SDN Advisor 5+ Year Member

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    I do sports med about 10 - 20 percent of my clinic. I am a team doc for minor league baseball and hockey teams. We also have an FP and 4 orthos who do sports med. The advantage you will have over FP is MSK knowledge and training in EMG and injections. Good ortho's will have you do as much of the non-operative care as you can, leaving them more time for surgical cases.

    Just keep in mind that teams rarely pay you for your time on the sidelines. You only get paid when you see them in the clinic.
     

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