/r/pmr

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Physical Medicine & Rehabilitation (PM&R) News, Articles, and Discussions.

Posting Criteria

Anything that relates to PM&R is welcome, so long as it follows the following guidelines:

  • Personal medical advice: Inappropriate and will be removed promptly.

  • Scientific posts: Please provide links to PubMed or the journal article web page

PM&R

PM&R, or physiatry, is a medical subspecialty that "enhance and restore functional ability and quality of life to those with physical impairments or disabilities":

/r/medicine

Inpatient PM&R is multi-disciplinary. Major diagnoses include traumatic brain injury, spinal cord injury, and stroke. We work with:

/r/neuropsychology

/r/nursing

/r/rehabtherapy

/r/neuro

... and of course our surgical colleagues, Orthopaedics and Neurosurgery.

Outpatient PM&R surrounds follow-up of our inpatient population, as well as pain, spine, and sports medicine:

/r/painmed

/r/sportsmed

/r/pmr

2,690 Subscribers

3

Compensation/job opportunities for cardiac/pulm/cancer rehab?

Title, i dont have free access to some of the resources that may list these figures. What can someone expect after fellowship training in these specialties? Would dual training in cardiac and pulm rehab be beneficial at all? And lastly, is there any opportunities to open up your own practice in any of these?

2 Comments
2024/04/24
20:26 UTC

8

Pain medicine rotation

I am set to do a 2 week pain medicine rotation at the VA affiliated with my school before Eras submission. I was considering asking for an LOR since it’s mostly PM&R trained pain med docs and I already have a general PM&R letter. However recently I’ve seen talk about wanting to pain med is a new “red flag” withing PM&R. I do not want to do pain medicine and was just trying to fill my schedule with PM&R related electives. There won’t be anything on my app talking about interest or desire to do pain other than this rotation being on my transcript and possibly an LOR. What do you guys think? Would I be better off asking for a general IM/FM letter or is it really not that much of a red flag?

6 Comments
2024/04/23
17:45 UTC

3

Billing Company

I'm transitioning to an independent contractor role next year and need advice on choosing a billing company. Do you guys have any recommendations or tips on how to find a good one?

1 Comment
2024/04/19
14:26 UTC

4

Using percutaneous tenotomy devices to remove scar tissue - opinions?

I am familiar with the use of these devices to remove scar tissue from tendons, thereby hopefully promoting healing. But I have always wondered whether they could be used to just generally remove scar tissue in areas with significant adhesions (for ex. the hamstrings, post surgical, etc). Disclaimer, I have never actually operated a Tenex device, so I could be missing something here... but theoretically, it seems like a better option to remove scar tissue with a minimally invasive method like this than perform an open scar tissue resection, in which it tends to reform. Any insights on this? Perhaps as an adjunct to a scar tissue hydrodissection, when there is an exceptional amount of scarring? (NOTE: I am not referring to nerve hydrodissection, just scar tissue hydrodissection. I understand that using a tenex device in close proximity to nerves would be risky)

1 Comment
2024/04/19
14:06 UTC

10

PM&R Away Spreadsheet

Someone made a spreadsheet to keep track of aways if you are interested! https://docs.google.com/spreadsheets/d/1f55DKSzp-Jzk20Qbhm9jSlJy2YqhEpO4XVr8YwXs_k0/edit?usp=sharing

0 Comments
2024/04/19
00:35 UTC

8

Screwed by home program

My home program somehow cannot accommodate all the students applying PM&R who want to rotate before ERAS. Is it going to look like a red flag to other programs that I didn’t rotate at my home program and do not have a letter from them? Also, I can’t leave the area for an away rotation due to family responsibilities so I was looking for advice about getting a PM&R letter before ERAS. There’s a new residency program which just got accredited this past year and will not have residents yet but is on VSLO and it is an hour and 15 min drive away, is this worth it? Other option is my school does allow custom rotations but I would have to reach out to local docs in other hospital systems/private clinics and find one willing to take me. Any advice is appreciated!

16 Comments
2024/04/18
20:50 UTC

5

Job opportunities for people interested in PMR

Hey everyone,

Im in my mid 20s and have been interested in PM&R for a long time. I've been weighing the option of going to medical school for a long time, and I was wondering if it was common to have scribes/medical assistants/etc. in rehab units or in PMR focused work environments. I would love to get some more experience and perspective before applying, so I was curious about if these types of jobs were out there.

4 Comments
2024/04/18
00:06 UTC

4

ACGME Pain vs NASS at the VA

I have seen a few threads about this but wanted to bring it back for discussion in the hopes that someone could shed some light.

TL;DR: Can NASS fellowship docs do pain jobs at the VA or is everyone doing it ACGME pain? I spoke to two ACGME pain docs at VA’s with residency programs and they both said it depends from VA to VA, So I wanted some clarification.

CONTEXT: I did a scholarship through the VA for medical school payment and have to work there for 6 years after residency (18 months per year of tuition paid for) and after a Quick Look at job openings for VA pain jobs, they all require ACGME pain medicine certification.

3 Comments
2024/04/16
23:49 UTC

10

Specialty Financial Outlook

From a purely financial perspective, what subspecialty within the field is the most promising given changes in reimbursement and supply/demand (general PMR included)? PGY 0 looking for career advice.

11 Comments
2024/04/16
15:56 UTC

2

UK to Canada PMR

Hi all, my question is can a UK based rehabilitation medicine consultant practice PMR in Canada (once usual IMG entrance exams complete of course). Grateful for any advice or suggestions?

1 Comment
2024/04/16
09:50 UTC

3

Clinical privileges question

I left my job recently (private practice set up) and my clinical privileges at a hospital (no direct clinical role there-- just mainly for insurance purposes) was automatically suspended due to my malpractice insurance ending for that practice.

I was left with the option to either resign my privileges (would have to reapply for privileges if I need it again in the future) or keep it suspended until a new COI for my malpractice insurance was submitted.

I will be starting work again with another employer in a few months and was wondering if there were any negative impact if I was to keep it suspended until I give them a new one. I ask this because I know on some applications for insurance panels/ASCs, they ask if you ever had your privileges suspended.

Has anyone dealt with this before?

1 Comment
2024/04/15
04:55 UTC

2

Research

Hi guys, I am an IMG, living and working in ME. Currently preparing for the USMLE Steps, so I can finally try and get back into my true passion, PMR.

For almost two years, I worked as a high school teacher at a magnet medical hs, teaching basic pmr subjects, fundamentals of kinesytherapy and massage (as licensed doctors of medicine, we are the only personal that could teach medical subjects). I have worked as a paramedic for 6 months as well before moving to the States.

I miss PMR awfully and am actually excited about starting studying again, for the first time in my life 😂

Would really like to start/be a part of some research material before I get into the dedicated Usmle prep. Please hit me up if you need a team member or a helping hand!

0 Comments
2024/04/12
20:21 UTC

13

PM&R Residency Programs with strong Sports Med curriculum

Hey yall, I'm a third year and working on making my program list and wanted to see if anyone has a list of programs/any other Reddit threads that highlight programs with strong sports med presence.

20 Comments
2024/04/11
23:51 UTC

10

Sports and spine fellowship that actually has sports training?

Does anyone know which of the sports and spine fellowships actually include training in sports and aren’t just essentially interventional pain training? Thanks!

3 Comments
2024/04/08
11:05 UTC

7

Seeking advice - Fellowships, Boards, Research

Hi all! I am a 4th year DO student who just matched PM&R. I'm really excited about this next step in training. I do have a few questions and would appreciate any input.

- What made you decide to or not to pursue fellowship?

- For those who decided to pursue fellowship, what were some things you did to decide which subspecialty to go into?

- I did not do too well on Step 2. What are your thoughts on taking Step 3 as a DO to improve chances of matching into fellowship?

- I've participated in research at an outside institution during medical school. The residency program that I will be training at does not seem to have a huge emphasis on research. Would it be appropriate to find research opportunities at other institutions, or would there be some (legal?) conflict since I am now a paid employee at my residency program?

- Are there any other advice you can share for those of us who just match into PM&R?

Thank you!

6 Comments
2024/04/08
03:24 UTC

10

Sports PM&R

Can someone explain the difference between sports medicine for ortho, PM&r, and family med? I know ortho vs the other two are surgical vs nonsurgical, but what else is there? I’m an incoming M1 interested in PM&R but don’t know a ton about it. Thank you!

11 Comments
2024/04/01
17:31 UTC

4

Transitional Year Electives Suggestions

Hello! I am an incoming PGY-1 working on a list of electives (we get 6) for the PC so she can start working on everybody's schedules. I was wondering if anybody had suggestions on rotations they thought were really helpful or wish they did before starting at their advanced program. I also talked about it with my TY PD and she gave some suggestions as well. Currently, I am thinking rheumatology, neurology, wound care, and radiology.

The list also includes: anesthesia, critical care, derm, endo, GI, gen surg, infectious disease, nephro, ortho, peds, PM&R, pulm, and sports medicine.

1 Comment
2024/04/01
05:07 UTC

7

Categorical vs. Advance

Dumb question but is there a difference in match success rate between applying to a categorical program vs. advance + prelim year separately?

I feel like you would have higher chances applying to just the advance program at an institution vs it’s categorical program as there are less people applying.

sincerely, someone who will do anything to match

8 Comments
2024/03/31
21:31 UTC

33

General Physiatry Compensation

Inspired by the post from a couple weeks ago asking about lifestyle/pay of spine/pain specialists. What sort of offers are current or soon-to-be attendings seeing for general physiatry? Inclusion of schedule, location, and benefits would be appreciated!

8 Comments
2024/03/30
21:28 UTC

3

Pre-med student interested in PM&R

Hey guys, hope y’all are doing well.

I’m currently a second year college student; I’ve been interested in PM&R before even applying to college, that said I recently shadowed some Physiatrists and absolutely love their work.

What can I do to get more involved with the specialty throughout these premed years? Research, volunteering, etc…

If you guys have any recommendations/resources that you’d like to share, I’ll greatly appreciate it!

(English is not my first language, sorry if I misspelled something)

1 Comment
2024/03/29
23:54 UTC

3

Incoming M1- looking to get a head start!

Hello! I saw somewhere thwt the match rate for PMR is 51% which is terrifying!!

Up til now, much of my focus has been neuro based (neurosurgical case report from a summer internship, neuro pub from a year spent as crc in cognitive neurology/Alzheimer’s lab). Im starting to realize thwt I want to pivot to PMR- it seems like a lot of my neuro knowldge would apply and a lot of similar conditions would come through my practice….

It seems like PMR is more procedural than neurology, but less than neurosurgery and much better lifestyle! I also realized thwt I dont love the idea of every single stroke emergency entering the hospital being my responsibility for 4 years during neuro residency lol… but it seems like everyone else is also realizing this and PMR seems to be getting really competitive.

I plan to get involved in research as a med student, maybe something in MS or other neuro conditions from a PMR pov to solidify this transition… I saw people recommending interest groups or sports medicine type of activities, but that sports based side of it doesn’t really seem to make as much sense for my narrative and background.

Anyone have any other recommendations for how I can build a strong PMR CV with this sort of neuro background? Anyone else approach this specialty from a similar angle? Any advice appreciated!!

10 Comments
2024/03/29
17:01 UTC

0

Any ideas on best electives rotation

Hello ,

So am a final year medical student ,and now am going into my internship year.

As I have 3 months of electives I wanted to Take all of them in sport medicine field ( orthopedic , PM&R , FM ).

The thing is my electives are in 2024 December and January and February of 2025.

I wanted the best hospitals worldwide who accept electives as international medical students and have sub specialty in sport medicine

I dont think I would be able to get the Usmle step 1 or 2 on time to get the elective in the US so I think that’s out of the way.

I saw some people recommend some Canadian programs but I wanted to see if any of you had any recommendations

Note* the hospital must be associated with a university as that is a requirement from my college internship unit

Thank you

5 Comments
2024/03/29
11:59 UTC

0

Any ideas on best electives rotation

Hello ,

So am a final year medical student ,and now am going into my internship year.

As I have 3 months of electives I wanted to Take all of them in sport medicine field ( orthopedic , PM&R , FM ).

The thing is my electives are in 2024 December and January and February of 2025.

I wanted the best hospitals worldwide who accept electives as international medical students and have sub specialty in sport medicine

I dont think I would be able to get the Usmle step 1 or 2 on time to get the elective in the US so I think that’s out of the way.

I saw some people recommend some Canadian programs but I wanted to see if any of you had any recommendations

Note* the hospital must be associated with a university as that is a requirement from my college internship unit

Thank you

0 Comments
2024/03/29
11:59 UTC

10

TY vs Prelim

Hi everyone! I was wondering if someone could explain to me the different pros/cons of these options within the context of PM&R? I have heard that TYs are more chill and flexible but that those coming from Prelims are more prepared? Not sure what everyone’s thoughts are but would love to learn more about these options. Thank you!

10 Comments
2024/03/28
20:18 UTC

0

Can A Physiatrist Become A Collegiate Sports Strength And Conditioning Coach

For reference I am in undergrad right now and very drawn to both exercise science and medicine. Hope to pursue PMR one day and can definitely see myself doing something in the realm of sports medicine like being a team doc, but I’m wondering if being a physiatrist would also make you qualified for a strength and conditioning coach role. I know this isn’t something many physiatrists would even consider haha but I’m simply curious

11 Comments
2024/03/25
21:52 UTC

12

any help would be great

didnt match into PM&R but matched in a 3 yr IM program. I have seen people switch out of residencies by reapplying in their intern year. How/when do i tell my current PD that I want to switch out/apply into PM&R?

Any advice on what I can do in the interim to help improve my application? I'd appreciate any mentorship possible

12 Comments
2024/03/25
14:02 UTC

16

Basic resources about PM&R for an interested med student

Hello everyone, so basically I’m a med student interested in PM&R and wanted to read more about it. So is there a basic/beginner type book or other kind of resource you recommend?

5 Comments
2024/03/23
09:39 UTC

18

PM&R Attending lifestyle/pay

Can someone give accurate numbers on how much physiatrists earn annually?

Looking for numbers on big city, working 40-50 hour weeks doing outpatient interventional spine and pain. I know this may be an annoying question but I’m trying to get more information before my 4th year of med school.

Thanks!

10 Comments
2024/03/22
23:05 UTC

13

How much does EMG work pay?

I’m a pgy4 about to graduate Wondering how much Emg work pays I’m talking maybe doing one whole day a week vs a half day how much can I expect to earn from each and total per year

Thanks y’all

14 Comments
2024/03/21
04:36 UTC

13

Scope creep in PM&R ?

Are there any fears on other specialities, physio or other therapists taking the role of the physiatrist and doing injections, like in other countries?

Genuine question Thanks

6 Comments
2024/03/20
20:01 UTC

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