Residency AFTER fellowship?!!

[Medman2737]

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Greetings to all,

First, a little about myself.

I'm 33 y/o, an IMG from Ross (decent student . . >83rd percentile on all three steps)

I've completed residency and I am board certified in Internal Medicine AND Occupational Medicine

I did my Primary Care Sports Fellowship at a very reputable program

I also have completed the Helms Acupuncture course and am also certified to do OMT (manipulation) despite the fact that I am NOT a D.O.

For the last 2 years, I've practicing as a non-operative sports physician in a local multi-specialty group and doing a fair amount of Sports medicine, lots of procedures (injections/OMT/acupuncture) and OccMed as well-mostly disability evaluation/injury care, and YES I AM HAPPY IN MY JOB.

I earn a salary just below 190K, with an awesome lifestyle (no call, 8-4pm, time for me, yadda, yadda, yadda)

Now that we are acquainted, I am GENUINELY interested in Physiatry, the more I read about the field and its subject matter , the more I believe I am a Physiatrist at heart.

My question is this:

Before I uproot the family (wife, 2 cats/1 dog), and give up my happy niche, do I have a realistic chance of securing a residency position?

What advice would you give someone in my position?

I believe that I would rather enjoy learning about this field, and appreciate any and all comments/suggestions no matter how discouraging.

Thanks to all, and I apologize for the long post.

-Dr. P

 

[Disciple]

Before I uproot the family (wife, 2 cats/1 dog), and give up my happy niche, do I have a realistic chance of securing a residency position?

I don't see why not.

The question is why? Your current job is strikingly similar to a desirable PM&R job.

Unless you're thinking of switching to an inpt type career?

 

[Medman2737]

Wow, 2 replies in 1 hour. Awesome guys . . . thank you!🙂

Well, the main reason is that we have an interventional spine/pain doctor in our group. He's a spine/pain specialist by way of anesthesia training, but that's neither here nor there.

It seems that whereas I have 4 or 5 "tools" in my "toolbox" for the variety of musculoskeletal injuries/complaints, he has 7 or 8 tools, as well as greater scope/understanding of spinal pathology and a greater array of treatment options to offer his patients-i.e. nerve blocks, epidural/facet injections, etc.

Plus, I just plain enjoy learning . . . and think it would broaden my understanding of musculoskeletal functioning/rehabilitation.

Hope this gives some insight into my warped psyche.

-Dr. P

 

[Disciple]

Maybe just do a Pain or Interventional Spine fellowship.

Another option (some would be against this, but, whatever) is to get mentoring/proctoring from your colleague and go to some cadaver workshops.

With your current expertise and what you already do in your day to day practice, an entire PM&R residency seems like overkill, just to add the procedures.

My concern is that you may end up in a program with little musculoskeletal training, and if your current job is the type of stuff you like to do, then you may be doing something you don't want to do for about 2.5/3 years.

 

[topwise]

I agree with Disciple. I think you've got to be out of your mind to do a whole PM&R residency. There are fellowships in Pain/Spine that are geared towards the knowledge you sound like you want to gain. While there are a good number of procedures in PM&R residency, at least half of residency is inpt rehab with no procedures at all (at least, none that would be relevant to your practice).

 

[DrJosephKim]

Sometimes it's really worth pursuing your dream. Of course, you'll probably know the answer very quickly by going to a few interviews and making several phone calls. Why not?

 

[RUOkie]

My 2 cents.
I think that all you need to do is an interventional fellowship, or if you are more interested in mechanics, just go to some courses in biomechanics. Many of those are taught by ortho anyway. Heck, join AAPMR, and go to some of the meetings. The only thing you would have difficulty doing in most communities at this point is EMG. While that may add to your income, 190K with those hours is pretty good. To make more, you will have to work more (the interventions and EMG do pay better than E&M). Most PM&R residencies are still inpatient weighted despite the fact that most of us have primarily office based practices. I think you will be wasting your time and earning potential.

 

[Ludicolo]

I agree with pursuing the interventional fellowship, if you are truly interested in expanding your armamentarium. And even if your current gig is good enough now, the skills and credentials you'll gain in fellowship will make you more marketable down the road if need be. I kinda like the suggestion for joining the AAPM&R. Doing another entire residency is just crazy talk.

A couple practical questions: to those in the know, how competitive would this non-traditional spine/pain fellowship candidate be? I personally think he’d be worth taking a chance on. And to the OP, would your group (and family) be supportive in losing you for a year while you pursue fellowship?

 

[lucyz02]

I am not sure on this but don't you have to be a PMR grad to do the AAPMR sport/spine fellowships??

 

[axm397]

At this time the AAPM&R membership is not open to non-physiatrists although there is an "academic" category for PhD researchers in PM&R...

 

[2006MD]

Greetings to all,

First, a little about myself.

I'm 33 y/o, an IMG from Ross (decent student . . >83rd percentile on all three steps)

I've completed residency and I am board certified in Internal Medicine AND Occupational Medicine

I did my Primary Care Sports Fellowship at a very reputable program

I also have completed the Helms Acupuncture course and am also certified to do OMT (manipulation) despite the fact that I am NOT a D.O.

For the last 2 years, I've practicing as a non-operative sports physician in a local multi-specialty group and doing a fair amount of Sports medicine, lots of procedures (injections/OMT/acupuncture) and OccMed as well-mostly disability evaluation/injury care, and YES I AM HAPPY IN MY JOB.

I earn a salary just below 190K, with an awesome lifestyle (no call, 8-4pm, time for me, yadda, yadda, yadda)

Now that we are acquainted, I am GENUINELY interested in Physiatry, the more I read about the field and its subject matter , the more I believe I am a Physiatrist at heart.

My question is this:

Before I uproot the family (wife, 2 cats/1 dog), and give up my happy niche, do I have a realistic chance of securing a residency position?

What advice would you give someone in my position?

I believe that I would rather enjoy learning about this field, and appreciate any and all comments/suggestions no matter how discouraging.

Thanks to all, and I apologize for the long post.

-Dr. P

I was wondering where in America do you practice? Sounds like you have a great gig.

 

[Hemisphere]

agreed redoing residency seems like going in the wrong direction for you since u wont even be in an outpatient clinic for months at a time and take a huge pay cut...

not sure he could jump into a spine fellowship without graduating from PM&R residency though, check with the fellowships... could try a sports med fellowship that includes some spinal procedures...

anesthesia pain fellowships, which are 'multidisciplinary' and might take neuro, psych, rehab, maybe IM too? think it's worth applying to scores in > 83% for all three steps seem competitive to me.

if fellowship dosen'st fly, as of now it seems there is no 'certification' for doing spinal procedures, taking interventional courses offered by aapmr or radiology departments rather than doing a whole fellowship might be the way to go as well as maybe combined with shadowing the guy in your practice a bit (sort of an informal fellowship?) then once you feel comformtable start doing some basic procedures on your own?

just some ideas...

 

[dc2md]

you CAN do sports/spine and even acgme-accredited pain fellowships without being pmr/neuro/anesth. we (LSU) had a family medicine fellow two years ago. don't know how she managed to pull that off (don't think she had any connections in the program).

i say, go start calling around some of the fellowships. remember, u don't need to have completed an interventional pain fellowship in order to do interventional pain procedures. the bread-and-butter lumbar procedures can be done right out of residency if u feel proficient enough. some jobs they advertise to us even offer "training" by the interventional pain guy/girl they already have in the group. go for that then medman.

and i'll echo the others in this thread - doing a full pm&r residency is lunacy