Spinal Cord Injury Fellowships

[Discount]

Anybody applying to SCI medicine fellowships?

It seems that it is not a popular field for PM&R grads. Just wondering what the scoop is with SCI programs. There seems to be a lot of these programs around... i think over 17 ACGME accredited programs.

Anybody know which one is considered "better" or "top." I guess Kessler, RIC, and U of Washington will be on the top list. Anybody have any good thoughts regarding this matter?

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[Stinky T]

Most of the residents these days seem to be interested in an outpatient musculoskeletal practice or interventional pain management.

 

[fozzy40]

Is it necessary to have a spinal cord injury fellowship to treat SCI pts in an academic setting? Has anyone felt that having an SCI fellowship might "type cast" a physiatrist if they want to practice as a generalist again?

Thanks

fozzy40

 

[dc2md]

Is it necessary to have a spinal cord injury fellowship to treat SCI pts in an academic setting? Has anyone felt that having an SCI fellowship might "type cast" a physiatrist if they want to practice as a generalist again?

I don't think anyone would know about the SCI diplomate unless you told them. Patient's definitely wouldn't know. So if the hoops to practice inpt rehab get to be too much one day, and you go back to general outpt PMR, I don't think anyone would care...unless maybe you're rusty with outpt msk by then. Is that what you're asking?

And besides our chairman, I don't know anyone else that treats SCI at our program, or anywhere in New Orleans that has a SCI diplomate. So no, it's not required in the academic setting...but I'm sure highly suggested

 

[axm397]

I don't think anyone would know about the SCI diplomate unless you told them. Patient's definitely wouldn't know. So if the hoops to practice inpt rehab get to be too much one day, and you go back to general outpt PMR, I don't think anyone would care...unless maybe you're rusty with outpt msk by then. Is that what you're asking?

And besides our chairman, I don't know anyone else that treats SCI at our program, or anywhere in New Orleans that has a SCI diplomate. So no, it's not required in the academic setting...but I'm sure highly suggested

depends on chair of program (and whoever else does the hiring) and how competitive the location/position is - if u r trying to go or stay somewhere saturated, the fellowship training will help your application over someone who may not have that training. SCI academic positions are few and far between because it is such a nice cush position no one wants to give it up! Seriously, have you ever met a crabby mean SCI attending?

 

[RUOkie]

Is it necessary to have a spinal cord injury fellowship to treat SCI pts in an academic setting? Has anyone felt that having an SCI fellowship might "type cast" a physiatrist if they want to practice as a generalist again?

Thanks

fozzy40

Having the fellowship will do nothing but help you. You can always go back. If you ever want to work at a model systems, you are going to want the subspecialty training. You can't grandfather in anymore, so if that is your goal, do the fellowship. They are NOT that competative. If you train at RIC, TIRR, Kessler, the fellowship may be redundant, but it allows you to sit for the boards!

I don't think anyone would know about the SCI diplomate unless you told them. Patient's definitely wouldn't know. So if the hoops to practice inpt rehab get to be too much one day, and you go back to general outpt PMR, I don't think anyone would care...unless maybe you're rusty with outpt msk by then. Is that what you're asking?

And besides our chairman, I don't know anyone else that treats SCI at our program, or anywhere in New Orleans that has a SCI diplomate. So no, it's not required in the academic setting...but I'm sure highly suggested

NOLA does not have a model systems. Dr. Glynn has such experience in SCI that he could have sat for the subspecialty boards if he wanted to (I'm surprised he didn't) by grandfathering.


All in all, I would suggest doing the fellowship if you LOVE SCI. If you want to be a generalist and see some SCI, don't bother. I could have grandfathered, and never bothered to take the test. I see some SCI in my rural practice. The thing is, I do it as a service, not because it is the focus of my practice.

 

[RUOkie]

Seriously, have you ever met a crabby mean SCI attending?

Yes I have. But the person was a crabby mean person!

 

[fozzy40]

Thanks for the advice. Other question for you all...

If I were a generalist trying to work as an inpatient at an academic center, how can I make myself marketable?

 

[PMR 4 MSK]

Thanks for the advice. Other question for you all...

If I were a generalist trying to work as an inpatient at an academic center, how can I make myself marketable?

Hang out every day in the Doctor's lounge/cafeteria if you have one.

Get to know the people at the hospitals truely responsible for pt disposition at discharge - social workers, ortho nurses and PAs, discharge planners, etc. They like you and you'll get all the referrals you can handle.

Do a Grand Rounds talk on any rehab issue.

 

[axm397]

I would say pick a niche that is not being fulfilled - then become an "expert" in it. More ambitious would be - do some research, get a grant. If you are definitely set in academics - can look into K-12 and other programs like that.

Talk to other attendings at that academic center and find out what the most common gripe is about and see if that is something you can help improve. So if no one wants to go over to day rehab, and that is something you wouldn't mind, sign up for it. if the residents are not getting the EMG numbers they need, look for referral opportunities and market yourself as the new EMG attending. It's really a matter of finding out the needs they may not even know they have - and tailoring yourself to that.

 

[Ludicolo]

Thanks for the advice. Other question for you all...

If I were a generalist trying to work as an inpatient at an academic center, how can I make myself marketable?

Be visible, be approachable, and be available.

I started out by doing a couple extra months of inpatient consults in order to build up my visibility/reputation/practice. That’ll keep you busy while you get started, and I’m fairly certain your colleagues will appreciate not having to do consults for a while. When you do get referrals, pick up the phone and talk to your sources. Keep them in the loop regarding the rehab plans, and thank them for their business. Show up to any weekly ortho or neuro conferences. Giving Grand Rounds is another good suggestion. As axm said - eventually establishing a comfortable niche is key. If you identify a demand, and you meet that demand well, the marketing will take care of itself.

It’s hard to balance at first – you have openings so you are willing to see anything and everything. But be careful, you don’t want to quickly become the expert in inpatient fibromyalgia or something like that. Or maybe you do, in which case more power to you…

 

[fozzy40]

Thanks for the advice!

 

[fozzy40]

Anyone on SDN applying for a spinal cord injury fellowship this year?

 

[njdevil]

SCI is a bread and butter inpatient rehabilitation field. People who practice SCI know what residencies train in this discipline well, actually the main SCI researchers all know each other because it is such a niche field. Residencies with rotations of cauda/conus and para's are not going to provide enough training for you to practice the entire breadth of an SCI job.

People hiring a clinician already know which programs are strong in SCI and the fellowship is +/-. If you trained at a program not known to be strong in SCI, doing the fellowship will certainly add to your CV. I have seen several physicans graduate from sci strong residencies and go right into an academic setting and take over an SCI program.

If you or the job is research oriented, its going to depend on your entire body or work, the fellowship will provide valuable skills that are not always built into residency training. If you are a new graduate, you will always need mentorship in starting a research career whether or not felllowship trained.