Previous pre-DPT now Pre-med with a career focused on PM&R.. Advise

[lee9786]

As I was doing prerequisites for applying to Physical Therapy programs, I felt more and more uneasy about how that field is going. Everything from the increasing educational requirement to the clinical doctorate not supported by many current PTs, the push for "direct access", the high student loan debt, and pressure on decreasing salaries. I was disillusioned by it all and withdrew applications to the programs thinking it just was not a good idea to get into that much debt for that job. The reason why is I didn't see it as an end point to my career. I believe I would have wanted more and felt the need to grow out of it.

I have always valued preventative health. My undergrad education is in Nutrition Science. I have a deep interest in exercise, therapy, and pain management. Like everyone else on here, I value really helping people in their predicament. In my disillusioned state, I fell back on my nutrition degree and have been working as a Food Service Director at nursing homes. I however just left that position to focus on going to med school.

I believe PM&R would allow me to take care of people without the scope of practice boundaries that Physical Therapy or Chiropractic has.

Any assistance is greatly appreciated. If you know of a colleges that I should look into that'd be greatly appreciated.

I am feeling very confident that this specialty is exactly what I would like to do and shoot for as a goal.

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[j4pac]

Many of the same concerns you have for PT are the same concerns for PM&R and medicine. The earning potential and scope of practice is greater, but so is the work and money you have to put into it. And getting into med school isn't exactly a slam dunk. Would you be happy in medicine if you DIDN'T match to PM&R and had to settle for primary care?

Find a job that you love and go for it. You can't predict the future of either specialty.

 

[RangerBob]

As j4pac mentions, there are drawbacks to medicine as well--mostly the time you need to put in, plus the cost to finance a medical education. I borrowed around $300k. Ouch. Plus when you add in my wife's debt, we I will not be living the "good life" for 15-20 years. But I have a job I love and find very rewarding, and the odds of getting laid off as a physician are extremely low (and the odds of not finding another job if you are are even lower), and I'll still have a solid middle-class take-home salary after taxes and loan payments, so it's still all good in my book. I never liked BMW's anyway... (OK, a manual 3 series is a ton of fun to drive, but I seriously do prefer my pick-up). I joke that I would've brought home the same salary had I gone on to be a park ranger or high school teacher (the other jobs I'd considered along with medicine).

I also agree with my college that going to medical school is a bad idea if your not ok with the prospect of not becoming a physiatrist. You have to want to be a physician first, physiatrist second. And you have to be ok with a "backup" specialty in the event you don't match into PM&R (which is possible given how small the field is, which makes it competitive). Fields like internal medicine, family medicine, pediatrics, psychiatry are all "backup" specialties in that they often have unfilled positions or a lot of positions that go to foreign-trained MD's that you would hopefully be preferred over. I would've been happy in psych or family medicine, but the honest truth is even if I wasn't I would have still had to choose one if I couldn't get into PM&R because I owed so much money that there was no other way for me to pay off my loans without going through residency and becoming a physician. (Though, running away to a non-extradition country with warm beaches did sound appealing...)

If you're ok with all of that, the first step is to start shadowing some physicians and physiatrists and get a sense for what the job is really like. Then you will need to go back and take the pre-medical courses (when I applied it was one year each of gen chem, o-chem, physics, bio, but now I think many schools require a semester of biochem and maybe other stuff too). You can do this through a formal post-bac program or even a community college, though the latter isn't the preferred way to do it, though I know a few who did.

If you have a "low" (for medicine) undergrad GPA, then you'll probably want to take extra courses to boost that up. That's hard to do with a whole undergrad-degree's worth of credits, but you need to show a sustained effort. My undergrad GPA of 3.45 would have been too low to be considered at most medical schools, but I did a formal post-bac and got a 3.9 there, so I showed a sustained upward trend. That still only brought my total GPA up to a 3.49 (I had enough credits that I graduated with a BA and BS though). A strong MCAT and really helped me, and you'll also want to do very well on it.

Unless you're in the SF Bay Area I can't really recommend any specific post-bac programs to apply to. If I were you I would also post your question on the pre-med and the post-bac forums to try and get some advice from people currently going through the process.

 

[deleted763299]

Disclaimer: I have had minimal exposure to PM&R during medical school. I will restrict my comments to a few things that you brought up about medicine in general.

the high student loan debt, and pressure on decreasing salaries.

Student loan debt is a huge problem if you want to go to med school. I owe $300k from med school alone. There is plenty of pressure pushing physician reimbursement down, and physician salaries could potentially decrease in the not-so-distant future.

I have always valued preventative health. My undergrad education is in Nutrition Science. I have a deep interest in exercise, therapy, and pain management.

Preventative healthcare is actually what the primary care specialties (family medicine, internal medicine, pediatrics) are all about. Strongly consider doing some shadowing in one or all of these specialties, in addition to shadowing a physiatrist. One of the things that pushed me personally away from the primary care specialties is that, generally speaking, patients aren't interested in changing their lifestyles. They would rather just take another pill.

I am feeling very confident that this specialty is exactly what I would like to do and shoot for as a goal.

I also second the advice that if it's "PM&R or bust", than don't go to medical school. There is no guarantee that you will match in your desired specialty, and have to be at peace with the fact that you may be forced to choose something else. In my graduating class from medical school, MOST people changed their minds at least once about which specialty they were going into. I personally changed my mind 4 times during 3rd year alone! If you do end up choosing to go to medical school, keep an open mind. You never know what specialty might surprise you.

 

[RUOkie]

OP: I agree with all of the previous replies. If I start with the premise that you will be successful in your med school applications, may I suggest to you that you look into alternative funding methods. Join the Indian Health Service or the military. Both of these Govt systems will pay for your education in exchange for 2 years service for each year of school. And the pay for both is only minimally less than civilian jobs with the same level of experience.

 

[sloh]

To add a different perspective, I discovered PM&R in college. PM&R was the reason I pursued medicine. It was one of the few specialties that was an amalgam of MSK, patient interaction, and lifestyle that really resonated with me.


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[lee9786]

I appreciate all the responses.

I got to admit that I find it a bit disheartening in the fact that one with a passion and goal set on a particular specialty wouldn't "match" (I have to research what that process is) to it. My assumption is that the matching is mostly likely another application process that's dependent upon another person's perspective that determines whether or not I would be accepted into the specialty's residency. I don't feel really good about ending up "settling" for a particular field of practice due to not getting in my primary goal. How could anyone be okay with that after all the time and effort you've put in? So I have a lot to learn yet regarding the whole process.

I understand people could change their minds after being exposed to different settings, but I have a problem with the idea that someone how I will be "forced" into doing something I don't want to do. It's things like that which make me feel that going the path toward Physician Assistant or Nurse Practitioner would be a better option for me.

 

[deleted763299]

Residency positions in the US are obtained through the National Resident Matching Program (NRMP). Their website is: http://www.nrmp.org and it has all the basic information about how the process works.

I highly recommend reviewing the match data in this particular document: http://www.nrmp.org/wp-content/uploads/2014/09/Charting-Outcomes-2014-Final.pdf

And here is a youtube video illustrating how the actual match algorithm works

 

[SSdoc33]

I appreciate all the responses.

I got to admit that I find it a bit disheartening in the fact that one with a passion and goal set on a particular specialty wouldn't "match" (I have to research what that process is) to it. My assumption is that the matching is mostly likely another application process that's dependent upon another person's perspective that determines whether or not I would be accepted into the specialty's residency. I don't feel really good about ending up "settling" for a particular field of practice due to not getting in my primary goal. How could anyone be okay with that after all the time and effort you've put in? So I have a lot to learn yet regarding the whole process.

I understand people could change their minds after being exposed to different settings, but I have a problem with the idea that someone how I will be "forced" into doing something I don't want to do. It's things like that which make me feel that going the path toward Physician Assistant or Nurse Practitioner would be a better option for me.

you will match somewhere in PMR. may be a piece of crap program, but you will match somewhere. the match shouldnt be a deal-breaker.

 

[lee9786]

I'm currently looking at applying this upcoming cycle to MD and/or DO programs. I'm reading about how MD programs generally match better to specialties so I'm wondering if I should be focusing on applying to MD schools, DO schools, or both.

I still haven't taken the MCAT yet so that will be a big factor. I just wonder if the grades are good enough. th eGPA is 3.62 cumulative but the last 60 credits is a 3.92 of heavily the physical sciences (took prereqs later). There's also been over five years of taking some of those science classes though. I don't know how much that will be looked at or not.

 

[RM38]

I would say both. If you can get into a US MD school go there as you will have more opportunities as far as research and being able to do rotations within your home department as most DO school's do not really have developed academic departments with the same level of advisement as the MD school's do. Also if you start med school and have a change in heart on your field of interest (>50% of med students do) you will probably be able to obtain some of the more competitive stuff like Urology, ENT, etc a little easier than you would at DO school. DO's have no issues matching pretty much anywhere in PM&R as long as you are a good applicant. My last choice would be to go an MD school in the Carribean as they are usually much more expensive than even private US schools (MD&DO), and some programs including mine do not considering interviewing them.