Question for drusso, ligament, et al.

[Cougarblue]

Can any of you give me insight into pediatric physiatry? I have taken a look at U of Cinncinnati and U of Colorado's combined program websites, but I didn't find them particularly useful in terms of exactly what type of patients they treat, where their alumni practice, what type of procedures they do, etc. Physiatry, hands down, seems to be the best fit for me amongst the specialties which I have encountered to date. In trying to learn more about the field, I volunteered at Kluge Children's Rehabilitation Hospital this year, and have loved it. The thing which confuses me here is that Kluge isn't run by rehab. It is run by developmental pediatrics. PM&R consults, but doesn't manage patient care. An attending, which I have spoken to several times, is trying to convince me that I should pursue pediatric development or pediatric neuro. I would appreciate any info. as to how things are run in your programs, what the prospects are for pediatric physiatry, and your general thoughts on pediatric PM&R as a specialty. Thanks!

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[Ligament]

Peds PM&R is VERY depressing. about as bad as peds onc.

Those who do it, though, are SAINTS.

sorry thats not too helpful really!
ligament

 

[bobatea]

don't know much about peds pm&r....I do know that it seems to be a less-emphasized area of physiatry (compared with tbi, sci, pain, msk, etc.) Some programs I interviewed at this year even stressed their lack of emphasis on peds pmr (ie, if you want to do it, best not come to our program, as we spend more time on the other areas).

That being said, some programs that I encountered that seemed to have good peds areas, or at least functional childrens hospitals, included UCDavis (beautiful Shriner's Hospital on their campus) and EVMS (has nice children's hospital on their campus).

 

[axm397]

UPenn has CHOP.

 

[drusso]

I'm actually doing my pediatric PM&R rotation right now. It can be depressing---neonatal strokes, hypoxic-ischemic encephalopathy, very bad and incurable genetic disorders---but it also has some wonderful moments because kids bounce back from injuries much better than adults.

Pedi PM&R is an extremely YOUNG field. Sub-specialty certification was just started in 1999. Like most things in PM&R, many of the pioneers in the field came from different specialties--pedi neurology, developmental pediatrics, orthopedics, etc. You will need to find some pediatric physiatrists who can mentor you and answer questions.

Here's a download for more info: I think your desire to pursue pedi PM&R is fantastic. With the field being so young you might be perceived as more "credible" if you did a combined pediatrics-PM&R program. Hopefully in 20 years the field will be better recognized for its role in restoring health and function to children with injuries and disabilities.

http://www.abpmr.org/downloads/applications/docs/prm_booklet.pdf

 

[Cougarblue]

Thanks for the posts so far. The info is much appreciated.

 

[drvlad2004]

Cougarblue,

If you decide to go for peds-PM&R dual certification, you will immediately stand out in terms of you credibility. Many hospitals, especially rehab hospitals, will be knocking on your door. Axm mentioned CHOP, which is arguably the best peds hospital in the world (if not the most beautiful facility!). However, CHOP does not have a peds fellowship, despite having a very strong peds-pm&r department. I would also check out Jefferson and Temple, both which have a peds-PM&R residency program.

You should also look into PM&R programs that also have peds fellowship, such as UTHSCSA, U of M, MCV, Baylor, and UC Davis (Shriners).

 

[Naraku]

There are 4-6 programs in the country that offer combined (5 year) programs in peds/PM&R. Aside from U. of Cinncinnati and U. of Colorado, Temple and Thomas Jefferson also have combined programs.

Peds rehab can be depressing... but it can also be as inspiring and uplifting as, well, any branch of medicine. I spent some time at the Children's Seashore House (part of CHOP, but Temple and Jeff residents rotate through there also), and I loved it. It's interesting stuff, you can really make a difference in quality of life, and there's a huge need for it right now. I mentioned my interest in pediatric rehab in my personal statement, and all of the programs jumped on it... everyone I interviewed with was very enthusiastic about the field and made sure to emphasize how much they need qualified people.

I interviewed for the combined programs at Temple and Thomas Jefferson... here are a few quick thoughts.

Temple:
Great program, with a lot of great attendings. My only problem was with the pediatric side, which is done through Albert Einstein Medical Center (Philly, not NYC). I really wasn't crazy about Einstein. They recently closed their inpatient pediatric floor, so they're sending their residents over to St. Chris for all of those rotations, along with a good part of their subspeciality rotations. This didn't bother me that much at first, but as time went by and I interviewed at other programs, it started to really nag at me. Granted, St. Chris is a great hospital... but a recent graduate told me that the Einstein residents were treated like second class citizens over there. Also, there were a lot of rumors going around on the pediatric interview trail about Einstein... no one thought that they were even interviewing this year.

Thomas Jefferson:
Nice program, and I loved the residents, but I wasn't blown away by them. duPont, however, is fantastic for pediatrics... it's a great children's hospital, and I really loved everyone there.

If I could have combined Temple and duPont, I'd have done backflips for joy... but in the end, I didn't like Einstein or Jeff enough to rank either of them, and I ended up just ranking pediatric programs. (I spent my whole peds rehab rotation whining about how I wanted to do a pediatric residency first and a rehab fellowship after that, if such things existed... and I eventually listened to what I was saying.) If I have to go back and do another residency, I will... or I may just go into neuro or development, as there's lots of need, and lots of overlap. We'll see.

Anyway... if you want to do a rotation, I can't recommend CHOP enough. It's a great hospital, and I can't say enough good things about the attendings. (Except that they forgot to circle my grade on my evaluation form, and I'm having trouble getting in touch with them... but, other than that, no complaints.) Also consider peds rehab fellowships (I know that Kessler has a very nice one), but make sure you get a good grounding in pediatrics at some point... it'll make call much easier.

Oh, yeah- one more thing. Starting this year, they're changing the requirements... in order to sit for the Pediatric Rehab boards, you'll have to do an extra fellowship/research year after a 5 year combined program or a two year fellowship after a 4 year PM&R program. Up through this year, you could just sit for the boards right out of the combined program. In the end, you won't save any time with the combined program... but you'll be much more comfortable with pediatric issues.

Good luck!