I like neuro

[Dr. Bruce Banner]

I like neurology better

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[Gauss]

not sure what specialties you are considering. PM&R is very broad so each area has good and bad qualities - neuro/neuromuscular, EMG, pain, sports/MSK, inpatient, peds, SCI, TBI ....

 

[j4pac]

I understand it is very broad, I'm just curious to what people find to be the worst part in their OWN subspecialty within PM&R, be it pain, sports, inpatient, etc.

I love PM&R, but it’s not for everyone. And often the negatives are similar to the positives and it really depends on your perspective. PM&R handles folks in depressing situations, whether it’s a catastrophic injury (amputation, SCI, brain injury), a horrible medical problem (stroke, Neuro degenerative disease, etc), and folks in chronic pain. Because of this you have to at least respect the psychosocial side of the problem. Helping these types of patients can be very rewarding but can also wear you down emotionally. Sports is probably the subspecialty most protected from this...but many jobs require you to work without pay to cover sports.

 

[DMBandFan86]

in the inpatient-rehab setting you will see many people who have been in the hospital for a very long time. Many are adjusting to new disabilities or have ongoing medical issues that they look at you to help them with. So I agree the psychological aspect can be both challenging and demanding.

TBI populations also take a lot of time and tend to come attached with a lot of family/personal drama that the PM&R physician will deal with.

depending on where you work, home-call and weekend-call can be more frequent than other specialities.

 

[PMR2008]

PM&R is many things. You can chose to focus on pediatric, geriatric, palliative, neuromuscular medicine, sports medicine, pain medicine, interventional pain medicine, inpatient, consultant, outpatient general MSK, occupational med, performance arts, functional medicine, academic, medico legal, industry etc. You can not do it all but you can pick a few from the above. All of them have different pros and cons. If anything the worst part of Physiatry is that most patients and docs don't know what we do. Also financially it is hard to make the same money as Rad Onc or surgery but a the same time and hours are better than surgery and risk is lower than other specialties.

 

[Tigerhawk77]

How does one make inroads to industry?

 

[DMBandFan86]

How does one make inroads to industry?

huh, what now

 

[Tigerhawk77]

From earlier post “You can chose to focus on pediatric, geriatric, palliative, neuromuscular medicine, sports medicine, pain medicine, interventional pain medicine, inpatient, consultant, outpatient general MSK, occupational med, performance arts, functional medicine, academic, medico legal, industry etc.” I’m curious how to get established in industry.

 

[PMR2008]

No idea. I am guessing getting a higher degree at a institution like Stanford or Harvard would open doors. Getting into industry is all about who you know.

 

[bizdr]

Hi all, I'm still stuck choosing between several specialties, and my mentor asked me to reach out and ask other people in their respective specialties what the worst parts of their specialities are. PM&R is one of the specialties I am considering and I am just wondering if physiatry resident or attending can shed like on what the worst parts are about the specialty BESIDES all the paperwork and documenting (because every specialty has that in common). Thanks!

PM&R is very different than many specialties, because you are often seeing patients long after their initial diagnosis and treatment has been made. So the kind of medicine you practice can seem very different that what you have done in your rotations and intern year. I found this to be a bit depressing when I started my residency. But eventually you can specialize in something like sports or pain medicine, and see more acute cases. That's what I did.

 

[j4pac]

PM&R is very different than many specialties, because you are often seeing patients long after their initial diagnosis and treatment has been made. So the kind of medicine you practice can seem very different that what you have done in your rotations and intern year. I found this to be a bit depressing when I started my residency. But eventually you can specialize in something like sports or pain medicine, and see more acute cases. That's what I did.

I really think it depends on your perception. In a prior life I treated almost nothing but acute injuries, and I did enjoy it...but the truth is that much of our acute management in PM&R are interventions that often unnecessary because if given enough time the significant majority get better on their own. Chronic pain complaints are tough because they have already declared themselves as conditions unlikely to improve without your intervention. So the upside is that you get the chance to help people truly in need of a medical professional with expertise of a treating MSK. The downside is that there is often lots of psych, there are often slow improvements or maintanence of symptoms, and it could wear on you as a physician if it’s dinething you don’t like. Again...it’s all about perspective.

 

[bizdr]

I really think it depends on your perception. In a prior life I treated almost nothing but acute injuries, and I did enjoy it...but the truth is that much of our acute management in PM&R are interventions that often unnecessary because if given enough time the significant majority get better on their own. Chronic pain complaints are tough because they have already declared themselves as conditions unlikely to improve without your intervention. So the upside is that you get the chance to help people truly in need of a medical professional with expertise of a treating MSK. The downside is that there is often lots of psych, there are often slow improvements or maintanence of symptoms, and it could wear on you as a physician if it’s dinething you don’t like. Again...it’s all about perspective.

I agree, and I found what I liked. I just remember when I started, coming out of a Medicine intern year, and was doing floors. It felt a bit depressing seeing patients who are coming from acute hospitals, and writing PT/OT orders.

 

[OutofNetwork]

No regrets about training in PM&R. With that said...

A frustrating part of this field is the constant marketing/explaining I have to do for people not familiar with the field or are associated with non-academic facilities (often times they don't have a PM&R department).