I am just looking for information and then I would try and make that decision. Are their fellowships/internships for PM R? I have noticed there are for Family Practice doctors. Also I saw that some Emergency Medicine residents went to do a fellowships in sports medicine. So I am just wondering who is the most useful for non operative care in sports medicine? I know there isn't a right answer but there must some opinions on advs and disadvs that i would like to hear.
basic vocabulary:
internship = first year of residency after medical school.
Residency = the years spent training in a primary specialty.
Fellowship = done after residency to gain additional training in a specialty.
So in terms of
residency:
Family med is 3 years - mostly spent doing outpatient primary care stuff. If you go via family med, you will know your cardiology and pulmonary stuff well. In addition, you will be comfortable with peds and adults.
PM&R is 4 years including one year of intern year in IM, Family Med, Peds, Surg, transitional, etc. PM&R will teach you good MSK/neuro anatomy, physical exam, and diagnostic skills - and most residencies will give you plenty of opportunities doing peripheral joint injections, EMG/NCS, quick scan of initial radiological studies, and some basic rehabilitation of athletes.
ER is 4 years and you will learn your emergency management stuff - suturing, codes, airway management, etc. And also be able to do a quick initial read of radiological studies.
Pediatrics is 3 years - obviously, you will be comfortable treating kids.
Internal medicine is 3 years - you will spend a good amount of time doing inpatient medicine in addition to outpatient time doing primary care stuff. You will be really good at our cardiology and other basic internal medicine stuff.
Fellowship is available to all the above specialties - and are usually 1 year. PM&R is what I know best - so if you go from a PM&R background, you can do a fellowship in musculoskeletal, sports, spine, pain, or combination of the above. In 2006, we were granted the ability to become "board certified" in sports medicine (sit for the sports medicine boards) - either via grandfathering in or doing a fellowship. Currently, there are no ACGME accredited sports medicine fellowships but I'm sure there will be some by the time you are looking for a fellowship.
"On September 19, 2006, the American Board of Medicine Specialties (ABMS) approved the American Board of Physical Medicine and Rehabilitation (ABPMR) application to join with four other ABMS Boards to grant Sports Medicine subspecialty certification. The other ABMS Boards are the American Board of Family Medicine (ABFM), the American Board of Internal Medicine (ABIM), the American Board of Pediatrics (ABPeds), and the American Board of Emergency Medicine (ABEM)."
Many physiatrists (doctors who specialize in PM&R) enter group practices with orthopedic surgeons and generally have a good relationship with them - not only because we provide good non-operative care of their patients but also because we bring income generating procedures such as EMG/NCS, peripheral joint injections, and epidural steroid injections - AND we work well with therapists and athletic trainers.
You can get to sports medicine whatever way you want. Becoming a team physician sounds cool but most team docs I've met have been at academic medical centers because being a team doc doesn't pay well and has huge malpractice risk bc professional athletes are worth millions.
As a pre-med, you should keep your options open and try to get into the best medical school you can for you. Go through your rotations, then decide what you want. Looking at job listings for sports medicine docs seem premature and probably not the best way to figure out what you want to do with your life since even if you are applying to med schools this year - you are still a good 9-10 years away from looking for a job and by then, the market will be different.
