the jitters

[MSKmonky]

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Any one ever get the "jitters" before entering a PMR residency... yknow, as in "what the heck am I getting myself into?"

In other words, have any of you ever had second thoughts? If you could do it all over again (and lets say you had amazing board scores and grades), would you make any changes or consider any other specialty?

What is the one thing about PMR that you don't like...?

 

[acolyte28]

One thing I don't like is going through stacks of progress notes, and in general, the length of time it takes to do just one admission. Fortunately I haven't done more than 2 in a day.

Well, I'm glad that at least with PM&R you don't have to worry about the next CP or COPD exacerbation waiting for you in the ER. 😀

 

[Ligament]

I'm glad that at least with PM&R you don't have to worry about the next CP or COPD exacerbation waiting for you in the ER. 😀

Nope, instead you get to worry about the next CP or COPD in the PT gym...seriously...😀

 

[Louisville04]

One thing I don't like is going through stacks of progress notes, and in general, the length of time it takes to do just one admission. Fortunately I haven't done more than 2 in a day.

Well, I'm glad that at least with PM&R you don't have to worry about the next CP or COPD exacerbation waiting for you in the ER. 😀

There were some patients that were in the hospital for a long time (> 4 weeks). Even though they clearly weren't rehab candidates, the intern/resident would order a pm&r consult. I think they just wanted our HPI for the discharge summary 🙄.

 

[Disciple]

No, I think they decided that the patient couldn't go straight home and wanted someone else to handle to the dispo.

 

[topwise]

Any one ever get the "jitters" before entering a PMR residency... yknow, as in "what the heck am I getting myself into?"

In other words, have any of you ever had second thoughts? If you could do it all over again (and lets say you had amazing board scores and grades), would you make any changes or consider any other specialty?

What is the one thing about PMR that you don't like...?

Every time I see an outpatient with chronic lower back AND neck pain, I think to myself, "What the heck did I get myself into?"

But despite some bad days, I'm pretty satisfied with my choice of specialty. No regrets thusfar from this PGY3. I'll get back to you on this in two years.

P.S. Most PM&R admits I've done in one day is 4.

 

[lobelsteve]

Every time I see an outpatient with chronic lower back AND neck pain, I think to myself, "What the heck did I get myself into?"

But despite some bad days, I'm pretty satisfied with my choice of specialty. No regrets thusfar from this PGY3. I'll get back to you on this in two years.

P.S. Most PM&R admits I've done in one day is 4.

Some of us love the outpatient neck and back pain patients.

Some of us have done 4 admissions before 9AM (acute hospital in same building- PMR consult fresh on chart is a great cheat sheet to an H&P), and took a 3 hour lunch to visit the outlying hospitals to get the last 3 admits done (orders faxed to the rehab floor and carried to work the next day, notes dictated from cell phone between hospitals). It takes a team approach.

7AM visit floors to get scoop on admits for the day- write orders and dictate.
9AM round on 15 patients and write notes.
11AM Team conference
12-3 Street racer/lunch/H&P machine
3PM Family conferences
4PM check labs, look in the gym, put out fires, go home
5PM damn drawbridges in Norfolk/Chesapeake got me again.

 

[rehab_sports_dr]

I think it is only healthy to constantly re-evaluate decisions, and think about what you like and dislike about your current job. Overall, though, I think the positives of PM+R outweigh the negatives.

The main negatives:
1. Nobody knows what a physiatrist is. I don't really consider this a negative. In my interactions with patients, it gives me an opportunity to explain my approach to patients, which I enjoy.
The one time it can be frustrating is when dealing with administrators. It is sometimes challenging to advocate for the needs of my patients and residents with people unfamiliar with our discipline. In the big picture, though, this is mostly an educational opportunity.

Other than that, there are no major negatives.

Main positives:
1. A better approach. I sincerely believe that the functional approach to patient care is the ideal model for the patients, and makes me feel incredibly satisfied on a nearly daily basis. It's the way that I would want to be treated as a patient, and I feel like physiatry is one of the few places medicine is practiced the way it should be.

 

[MSKmonky]

thanks for the replies. I honestly hate "the jitters" but they do occur.

My primary interest is in MSK and Pain medicine. Pain medicine especially has been getting hit by cuts as well as other fields trying to practice PAIN (I'm not talking about anesthesa because they are well qualified).

Just don't want to get into something that will face too many hardships in the future.