NRAI2001

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Hey guys,

What are the differences between sports medicine practice/fellowship of PMR trained docs vs FP/IM trained docs?

What are the strengths and roles of both? I know that PMR sports medicine is a difficult fellowship to get but what about FP/IM sports med?

Thanks
 

MedBronc23

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Hey guys,

What are the differences between sports medicine practice/fellowship of PMR trained docs vs FP/IM trained docs?

What are the strengths and roles of both? I know that PMR sports medicine is a difficult fellowship to get but what about FP/IM sports med?

Thanks
I asked this question earlier this year and got some great responses on this post refer to it: I asked because I plan to apply to PM&R based sports fellowships this coming fall and looking into some primary care fellowships.

http://mobile.studentdoctor.net/showthread.php?t=976575

One big difference I can tell you is there are 12 ACGME PM&R based sports fellowships of which Mayo, RIC/NW, Harvard/Spaulding, u of Washington, UC Davis, Stanford, MCW, Emory, MedStar/Georgetown/national rehab hospital have some of the more well known programs IMHO. Each of these varies in experience with amount of Sports coverage opportunities, sports/msk clinic, interventional spine/pain rotations electives, EMG, MSK US experiences, etc. You are eligible to take your sports med CAQ boards from these. However as you eluded it is more difficult to land one of these with each one having 1 spot usually.

There are also multiple non accredited sports and spine fellowships with focus mostly on i-spine/fluoroscopic guided and/or us guided interventions +/- more EMG exposure and sports coverage opportunities. You cannot say your sports medicine or pain medicine certified or boarded from these.

Then there are primary care fellowships that have PM&R tracks like Utah or JPS as examples within multiple fellow tracks for ER FP IM and sometimes peds. These often have EMG and spine intervention skills continuity built in for PM&R based fellows, plus usually good sports coverage opportunities.

Then there are primary care sports fellowships that have 1-2 spots and interview PM&R IM ED FP and sometimes Peds for there positions considering all applicants equally. U of Iowa, Michigan, and Florida are some places that come to mind, but there are many others. These usually have at least one Physiatrist associated with sports fellowship, hence why PM&R residents get a shot.

Then there are strict primary care only fellowships that only accept what they consider "true" Primary care disciplines including FP, IM, ED. These can take sports boards. Unfortunately there many of these types of fellowships, but gradually as PM&R shows what we can provide to sports care with our non-operative ortho, Neuro, and pain knowledge doors are opening up all the time. Many of these fellowships just dont have the ability for a PMR base fellow to continue their primary specialty based skills (EMG, NCS, P& O, disabled athletes, US, spine interventions, ect) or lack a physiatrist on staff for exposure to our discipline. It used to make me mad but now I realize I would not want to go somewhere where they did not know how to use me.

Needless to say I think PM&R training is best suited for non-operative sports medicine, especially since most of us take a year of IM or transitional year to get exposure with primary care needs (cardio pulm renal derm issues that often present in athletes) plus we have all our Neuro Urologic MSK Fuctional knowledge of which most sports injuries are non-operative MSK.

Hope this helps. r u med student or resident? PM me if more questions. Love the Cookie Monster avatar
 
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gman33

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How about the difference in practice of running an outpatient sports med or MSK clinic?

Sorry, I mean the difference in PM&R vs primary care + sports med fellowship.

I realize the base training is totally different. PM&R has was more training, but some of the stuff wouldn't apply as much (like the rehab part).
 

MedBronc23

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May 1, 2009
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How about the difference in practice of running an outpatient sports med or MSK clinic?

Sorry, I mean the difference in PM&R vs primary care + sports med fellowship.

I realize the base training is totally different. PM&R has was more training, but some of the stuff wouldn't apply as much (like the rehab part).
I think as a PM&R trained sports doc you will have more training in the scope of Neuro and MSK medicine including EMG, interventional spine therapeutics, bracing, orthotics, and exercise prescription. Also if you are fortunate enough more diagnostic and interventional MSK Ultrasound experience prior to sports fellowship or job.

Also, you will prescribe rehab and therapy for your patients. We assist many of our ortho colleagues with the right therapy interventions for post op return to sport.

FP Peds And IM probably have better experience with rashes infections and cardiac sports stuff...so that's the trade off. But we are better at caring for head injuries/concussions, peripheral nerve, soft tissue injuries, and spine injuries.

Remember that no one doc can only care for collegiate pro or even high school athletes. All team docs have practices taking care of the public using their skills from their primary speciality.