Tuesday, July 31, 2012

Why I (Almost) Didn't Do PM&R

I've been doing this series for a while and somebody requested I do one for PM&R. Considering I did PM&R, it's hard to write a post about why I didn't do it. But then again, I matched in another field initially, so I could explain my original thinking process.

I did a rotation in PM&R during October of my fourth year, which was just a little too late. I liked it a lot. I liked the pace, I liked the types of patients, I liked the procedures, and I thought all the attendings were really nice and laid back. I noticed the residents got to go home when they were on call and worked very reasonable hours.

Again, it was mostly about location for me. There was only ONE PM&R program in the area where I wanted to live to be near my husband, so that limited my choices significantly. And even if I matched at that program, I was worried about finding a prelim spot in that region. But here are a few other reasons why I initially decided against PM&R. I am basing this on an actual pro/con list that I made during my fourth year:

1) Can be kind of boring, at least on the inpatient side. On inpatient rehab, things move slowly and there's a lot of documentation involved. There's no adrenaline rush, even compared with internal medicine.

2) Fewer opportunities for specialization. I wrote this, but it actually isn't true. Physiatrists can specialize in brain injury, spinal cord injury, stroke, pain medicine, pediatrics, electrophysiology, sports medicine.

3) Longer residency than internal medicine. Apparently, I didn't want to be in residency one extra second.

4) Jobs limited to urban areas. I'm not sure if this is exactly true, but I'd definitely say the job options for PM&R are limited compared with internal medicine.

5) No minions. When you're a medicine resident, you get interns to help you. When you're a PM&R resident, you don't. I liked the idea of having minions. Then again, when I was a PM&R resident, there was actually a really good support staff that made the need for minions less. Like instead of making my intern figure out how to get the patient off our service, we'd have a case manager who would do it.

6) Not as respected. Within the medical profession, it's definitely true that a lot of people don't respect physiatrists. And outside the medical profession, a lot of people don't know what we do. And vice versa.

Ultimately, looking through my list, a lot of the reasons I didn't want to do PM&R weren't really all that accurate. Mostly, it was about location and the fact that I did my rotation much too late.


  1. Interesting. Why don't you think people don't respect physiatrists btw? I think I'm about to take a job as a PA in PM&R...might be a good gig but I can't tell just yet.

    1. I'm wondering the same. I'm actually a PA back in school premed and strongly considering PM&R.

      Fizzy- do you still think other medical professionals do not respect physiatrists?

    2. I think it's partially because they don't understand what we do, and that inpatient rehab is seen as a bit of a dumping ground for acute hospitals. Also, a lot of rehab interventions don't have rigorous studies supporting them, so some docs may regard it as quackery.

    3. HI- I am a PA who accepted a position in PM&R- any insight on what it will be like, procedures, job duties, etc...

  2. Yes. your insights may at some point true but of course not absolute. It's a fact that many people don't know about PM&R and practitioners on that field might not gain enough respect as much as Internal Medicine practitioners have. Physiatrist may not have interns to aid them since they are only few. But what I see in this practice is, the lesser they are, the more they are needed in the society. Think about your purpose and how essential professionals like you in the field. You maybe the reason of people's big smile.

  3. Hi Dr. Fizzy/ McFizzy! I love reading your blog to relieve my med school anxiety :)

    I have a question about prelim year. How intensive is it to get into a prelim or transitional spot, especially if you're concerned about geography? Is it a real deterrent from applying to PM&R residency? I am trying to go back to the east coast after Med School..is it possible to coordinate both PM&R residency and prelim year on the same side of the country or is just wherever I find an open spot for that year? Sorry, I just don't know much about the process for PM&R residency since it's conventional compared to other specialties.