finishin up ms3, liked all my cores, ob & internal the most.
been reading about pmr and neurology a lot recently. gotta say they both sound pretty appealing and both seem to have some nice fellowship opportunities.
seems that anes to pain is an easier route than pmr (which is a better one than neuro), but what would the chances of your basic avg joe schmoe pmr resident getting into a pain fellowship?
thanks
The average joe schmoe pm&r resident is going to have a hard time for pain along with any average joe schmoe from anesthesia. It is up to you if you want to be average... what sets most people apart at the residency level is not intelligence, but work ethic and whether or not you are a team player.
In regards to neurology versus pm&r--pm&r residency is much more procedurally oriented than most realize--electrodiagnostics (EMGs), chemodenervation (Botox), peripheral joint injections, MSK ultrasound, fluoroguided injections (mostly neuraxial), cystometrograms, swallow studies, intrathecal pump management. Competence in electrodiagnostics and peripheral joint injections is standard after pm&r residency; the remaining procedures vary based on where you do residency.
Neurology residents usually have to do fellowships for any of the above--neuromuscular to learn electrodiagnostics; movement disorders/spasticity for chemodenervation; etc. Neurology does have a neurointerventional (ie. endovascular stenting) fellowship that is super-competitive, but definitely very procedurally oriented. EEGs and autonomic studies are also unique to neurology.
Neurology is more acute and cerebral--which may be a good match if you really liked medicine. Apart from MSK, most major diagnoses are already made by the time we get them in pm&r. Neurology also has the advantage of a clear scope of practice--as a medical student you know what you are getting into (along with your friends and family). PM&R is much more broad and, at least in my experience, takes until near the end of residency until you realize what you skill set exactly is. It is really neat when you finally figure it out--and you definitely think differently than any other specialty.
If you decide to check out PM&R, make sure you get a broad exposure--it is not all about inpatient rehab which is where a lot of medical students land on their rotations.
Like all seasoned posters say--pick what you like, and worry about fellowship later. Good luck and sorry about the tangential post.
