Sports Medicine (FM or PM&R?)

[AspiringPhys4]

Hi everybody,

Looking for some insight regarding the two most common pathways towards non-op Sports Med:
FM and PM&R.

- How would your practice differ?
- Compensation?
- Does one better train you for Sports Med?
- Any nuggets of wisdom regarding generic pro's and con's for either pathway would be appreciated!

Cheers!

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[galactus]

Hi everybody,

Looking for some insight regarding the two most common pathways towards non-op Sports Med:
FM and PM&R.

- How would your practice differ?
- Compensation?
- Does one better train you for Sports Med?
- Any nuggets of wisdom regarding generic pro's and con's for either pathway would be appreciated!

Cheers!

Doesn’t matter. We all take the same board exam for sports. FM is three years and PMR is 4. It also depends on what kind of sports medicine do you plan practicing. If you go the PMR route it’s mostly 99% MSK issues, which is fine. Our sports Medicine team where I work is made up of ortho, PMR, and FM who are board certified in sports and we all refer to each other depending on our strengths. I did FM because I enjoy the primary care side of things to take care of my athletes. I’m also the end stop for medical clearance for the teams I cover. Who else can clear an athlete to play after mono, or a partial lung collapse? Primary care sports!

 

[raptor5]

PM&R might yield training in interventional spine procedures and better procedural training with fluoro and US


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[galactus]

PM&R might yield training in interventional spine procedures and better procedural training with fluoro and US


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I'll agree with that. PMR residents will have exposure to these procedures during their residency, and depending on the sports medicine fellowship, may or may not have interventional spine or fluoro in their fellowship program (mine didn't). US is standard now in sports medicine fellowships, and with the rise of point of care ultrasound and ultrasound curriculum in medical schools, it'll become more common in FM residency too.

 

[raptor5]

If an applicant “knows” they want to do non-operative sports med then I would recommmend PM&R with or without the fellowship. Most our outpatient PM&Rs really see non fracture care sports med. plus interventional spine. PM&R can do interventional spine fellowship. It’s not an acgme fellowship but procedures include Flouro and ultrasound injections, kyphoplasty, MBB, RFA, discography, ESI, and discography/biacuplasty.

 

[galactus]

If an applicant “knows” they want to do non-operative sports med then I would recommmend PM&R with or without the fellowship. Most our outpatient PM&Rs really see non fracture care sports med. plus interventional spine. PM&R can do interventional spine fellowship. It’s not an acgme fellowship but procedures include Flouro and ultrasound injections, kyphoplasty, MBB, RFA, discography, ESI, and discography/biacuplasty.

I'm just playing devil's advocate here, I would also say that non-operative sports med goes beyond MSK/spine. High altitude training, nutrition, WADA/banned substances, doping, medical clearance to play, infectious outbreaks, wilderness medicine, sickle cell athletes, etc. I actually manage a fair amount of fracture care too. My passion is on the sidelines, not in an operative suite. I do training room clinic with my college and pro teams on a weekly basis, so I like developing that continuity as the team doc. To each their own!

In reality if you see yourself wanting to do all the fluoro/spine stuff as the above poster mentioned, I agree with going down the PMR route, and you don't necessarily need a fellowship for that. Everyone has a different path to go into sports medicine, so choose wisely!

 

[Firelambo]

I'm just playing devil's advocate here, I would also say that non-operative sports med goes beyond MSK/spine. High altitude training, nutrition, WADA/banned substances, doping, medical clearance to play, infectious outbreaks, wilderness medicine, sickle cell athletes, etc. I actually manage a fair amount of fracture care too. My passion is on the sidelines, not in an operative suite. I do training room clinic with my college and pro teams on a weekly basis, so I like developing that continuity as the team doc. To each their own!

In reality if you see yourself wanting to do all the fluoro/spine stuff as the above poster mentioned, I agree with going down the PMR route, and you don't necessarily need a fellowship for that. Everyone has a different path to go into sports medicine, so choose wisely!

As a FM sports medicine doc...what % of your day to day is MSK conditions/Primary care conditions/all the rest of the things you mentioned above? Do most FM sports medicine jobs require you to provide all the above or are there strictly MSK jobs available? Thanks!

 

[galactus]

As a FM sports medicine doc...what % of your day to day is MSK conditions/Primary care conditions/all the rest of the things you mentioned above? Do most FM sports medicine jobs require you to provide all the above or are there strictly MSK jobs available? Thanks!

My practice is about 40/40 primary care and sports medicine and 20% teaching med students/residents.

In regards to FM sports medicine jobs, it depends on the practice. I'm housed in the FM department, so which is why I still do a fair amount of primary care, but all the MSK/SM referrals are placed in house, and ortho triages any initial referrals to me as well. I know of other FM sports med individuals who do 100% MSK and work specifically in an ortho practice, however like I said before it's all about how one sees themselves in the sports medicine world.

 

[raptor5]

0% primary care. All MSK. 90% spine. I do 2-4 urgent care shifts per month on the side to keep up on my non-MSK skills and knowledge.


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[septoplasty]

I do 2-4 urgent care shifts per month on the side to keep up on my non-MSK skills and knowledge.

That's alot of spine, so are you doing FL as an FM doc? Not very common at all..

Also.. UC, imo, isn't a good way to keep up primary care skills, its just a bunch of blah

 

[Firelambo]

Thank you for both of your insights! Very helpful. I’ve noticed through browsing sports Med jobs that there’s way more primary care sports medicine jobs then PM&R jobs? A lot of these jobs posting are cookie cutter info so can’t really get an idea of exact job function. Do most primary care sport Med job want a combo of primary care and msk? Is the demand in the job market for having both or are there plenty of just MSK only jobs? Thanks