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pmr vs internal med

Discussion in 'PM&R' started by blaire003, Apr 29, 2007.

  1. blaire003

    blaire003 New Member
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    Help! I'm an MS3 who has until been now been considering internal medicine with future plans to specialize in infectious disease. I've always had a strong interest in public health in underserved communities and international medicine and internal med seems like the obvious choice to pursue these interests. However, I wasn't exactly thrilled with my internal med clerkship- I liked taking care of patients with chronic problems in a non-surgical setting, but I just hated the endless list of problems that came in with. And plus the feeling that you have to know everything about everything. I honestly thought, if this is what my life for the next three years will be like that I would be pretty miserable doing internal med. So lately I have been talking to other students and residents about PM&R and it seems like it everyone who does it has been really happy with their choice. I like the fact that PM&R incorporates a little bit of everything, including neurology, ortho, and anesthesia. I will be doing a rotation in July to rule in/out PM&R. However, my question is: is PM&R a field where I would still be able to puruse my interests in international/public health? I know it is not exactly a typical primary care field, but I am feeling very conflicted over my interests in public health and my desire to actually puruse a primary care field such as internal med. Any advice or input would be appreciated!! Thanks. :)
     
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  3. drusso

    Physician Moderator Emeritus Lifetime Donor Classifieds Approved 10+ Year Member

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    Blaire,

    You can absolutely pursue international health issues from a physiatry training background. Disability issues are huge world-wide. Most Third World countries don't even approach the level of development and sophistication with respect to disability and chronic disease management compared to Western countries. Moreover, in under-developed countries, spinal cord injuries, brain injuries, and the like are pretty much still a "death sentence" because patients don't receive coordinated care and follow-up.

    You can contact the Academy of PM&R for contacts or resources in the areas of international PM&R. This is really a new and emerging field. Another group to contact is the Center for International Rehabilitation Research Information and Exchange.

    http://cirrie.buffalo.edu/index.html

    Keep your eyes and ears open about other opportunities when you do your PM&R rotation. This fall, the Academy of PM&R will likely repeat a special program for medical students at its annual assembly in Boston. If you can attend, you can certainly network and meet many in the field with similar interests.
     
  4. axm397

    axm397 SDN Moderator
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    A few things I know:

    I have a classmate who is interested in public health and working in the government - she is hoping to score a robert wood johnson fellowship or do a residency in preventive health on top of her PM&R training.

    We also just had grand rounds at RIC where one of our physicians went w Dr. Delateur(sp) from Hopkins to Tanzania to teach at a medical school. The team consisted of 2 PM&R physicians, 1 anesthesiologist, and 1 neuroscience professor who is also a physician.

    Dr. Andrew Haig at U Mich is very much interested in international health and he is the chair of the Special Interest Group for international rehabilitation in the AAPM&R.

    Try checking the ISPRM (international society of physical and rehabilitation medicine) http://www.isprm.org

    I think you will be able to find a way to incorporate your interests with a training in PM&R but you will need to be innovative and find contacts, etc. I don't think there's one "track" for people like you. There are many people in PM&R who hold MPH degrees and it might be of use for you to try to find some of them.

    Hope this helps.
     
  5. carn311

    carn311 Dead tired.
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    Could someone give some examples of tasks a PM&R physician would perform on a mission trip?
     
  6. axm397

    axm397 SDN Moderator
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    As physicians, can do basic internal medicine stuff. (we all did internship and most places that need mission trips do not have advanced medical equipment so would be doing real basic first aid stuff anyways)

    PM&R specific stuff: evaluating need for prosthetics/orthotics
    post-amputation care
    post-polio syndrome
    wound care/prevention of pressure sores

    teaching medical students and physicians about how to care for disabled population.

    etc. etc.

    I'm obviously NOT an expert in this topic so anyone with exposure/experience, feel free to jump in!
     
  7. Nico47

    Nico47 New Member
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    Blaire003,

    I can’t offer much in terms of explaining how PM&R can be used in the public health arena after residency because I haven’t even started my intern year yet. But I share a VERY similar history with you concerning the leap from internal medicine to PM&R.

    When as an M4 I finally decided to apply for PM&R there was still a part of me that worried I wouldn’t be able to give back to needy communities, but looking back I see what irony that sort of mentality was! While I signing up for a Family elective entitled “Serving the Underserved” the coordinator said he was surprised that I was the second future physiatrist to show interest (I wasn’t sure what to make of that). Later, as part of the experience, I helped out at a homeless shelter clinic. I was concerned that being there and doing traditional primary care activities would give me feelings of regret about my career choice but, as it turned out, all of my patients were PM&R cases! One was a Polish immigrant who literally and figuratively couldn’t get back on his feet because of a work-related injury; another patient was a diabetic amputee with several compression sores. The preceptor was very thankful I had done rotations in PM&R and could be there that day to help out. During my spinal cord elective, I went on trips with a nurse to patients’ homes and again saw first hand how needed physiatrist are in taking care of people at the primary care level. TBI, amputees, SCI victims and many more patients who fall under the umbrella of PM&R are truly the forgotten members of society. I was told that even when SCI patients see their PCP, because of physical constraints, most of their physicians listen to their heart, anterior lung fields and that’s about it.
    So is there a need for PM&R in the public health domain? Most definitely! The need grows more every day. The exciting part has to do with something you touched upon, that physiatry incorporates different facets of medicine to treat the whole person. In that way, you can make this burgeoning field into whatever you want it to be. Good luck with your career decision process and PM me if I can help in any way. :)
     
  8. euroboy98

    euroboy98 Junior Member
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    They say than an image speaks more than 1000 words; here's one example:

    http://www.who.int/features/2005/disability/en/

    Then click on the link: Health and disability photo gallery

    There are some great pictures about this thread's topic.
    I am also very interested in the international impact of PM&R and look forward to "spreading the word" of the field in that sense; I also hope to do a rotation abroad in a place where I could help out the most.
     

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