Day in the life of a PM&R resident?

[liger]

Hi! I'm a 3rd year med student trying to figure out what to do with my life. I just had a baby and am looking to do one of the shorter & easier residency programs but still do something that I like. I would like to work part-time and do something with kids with developmental problems & helping them to improve the quality of their lives. I am more interested in helping people who already have a diagnosis (vs. making the diagnosis). I have been thinking peds all the way but someone suggested I look into PM&R. I was wondering if you can work part-time doing PM&R and what the residency is like. It is a year longer than peds which is a bit of a worry but I heard that the hours are more reasonable so I could spend time with my child. I don't think I would have time to do a fellowship since I am already on the older side & want to be a mom first & foremost. Can you still work with kids without doing a pediatric fellowship? Thanks!

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[drusso]

I commend your interest in physiatry, but I lament your personal reasons for considering the field: Desiring part-time work, desiring a shorter/easier residency, desiring to work with patients who are already diagnosed instead of making the diagnosis.

In short, your interests and aims can be well-accomodated in PM&R. I'm just not sure that field itself can thrive and advance if it continues to attract the "ambivalently attached" to its ranks. You would never see this kind of question from a prospective neurosurgeon, orthopod, etc.

Some residents call applicants like you "Soccer Mom Physiatrists." It's not the most flattering of labels. If you choose to apply to PM&R programs, I would tone-down your avocational interests in the field and try to present yourself as a serious contender---someone deeply committed to the rehabilitation of children with developmental disabilities, someone with deep scholarly interests in the neurobiology of cognitive and motor skill acqusition, an individual with leadership qualities who can effectively advocate for children with disabilities...get the picture?

 

[SSdoc33]

the residency has shorter hours than peds. you probably can treat pediatric patients without a fellowship, but you really wont know what you are doing, at least for the first few years. pediatric physiatrists are in tremendously high demand, but the better jobs would go to fellowship trained individuals. you could find a part-time job, yes.

so, as i think most of us have learned, there's really no shortcut here. you are looking at 5 more years of full-time, relatively hard work. then, if you want a decent job with good pay, you will still be working hard.

if your ambition truly lies in being with your family, you may think about using your MD degree for other types of work -- industry, insurance, etc.

 

[PMR 4 MSK]

A day in the life of PM&R, as seen by surgery and IM residents:

8 am, hit the snooze button.
9 am, actually get up, get some coffee and watch TV, read the paper.
10 am, come in to hospital, grab some coffee, wait for attendings to arrive. Surf the internet while waiting.
11 am, start morning rounds.
11:15, finish morning rounds and start writing notes
11:30, finish notes and go to lunch
1:30 pm, return to rehab and kibbitz with the nurses and PTs for a while
2:00 pm, go see consults, write on every patient chart "Patient is appropriate for rehab, but not medically stable enough yet. Will reassess tomorrow." High-5 attendings after each daily delay in admitting.
3 pm, admit 1 patient, discharge 3. Cry about how overworked you are.
4 pm, leave for home, knowing you have no call.

 

[lobelsteve]

A day in the life of PM&R, as seen by surgery and IM residents:

8 am, hit the snooze button.
9 am, actually get up, get some coffee and watch TV, read the paper.
10 am, come in to hospital, grab some coffee, wait for attendings to arrive. Surf the internet while waiting.
11 am, start morning rounds.
11:15, finish morning rounds and start writing notes
11:30, finish notes and go to lunch
1:30 pm, return to rehab and kibbitz with the nurses and PTs for a while
2:00 pm, go see consults, write on every patient chart "Patient is appropriate for rehab, but not medically stable enough yet. Will reassess tomorrow." High-5 attendings after each daily delay in admitting.
3 pm, admit 1 patient, discharge 3. Cry about how overworked you are.
4 pm, leave for home, knowing you have no call.

Sounds like my residency, and thanks for leaving out the bit about what goes on in the call rooms. Although, I used to drive out to the surrounding hospitals while on consult service so I could bang out the orders ahead of transfer and dictate from my cellphone while driving home.

 

[Ludicolo]

Congrats on the baby.

If you like working with the developmentally disabled population, you will find a home in PM&R. Working part time as a peds physiatrist after residency is doable. And as been said, a peds rehab fellowship isn’t absolutely necessary, but it may open more doors down the road.

But to echo the concerns of drusso:

Can you name any decent residency program, in any specialty, that wants to hear that you would like to work less and not have to make diagnoses? If that comes across during your interview with me, I’ll wish you all the luck in the world but I’ll go ahead and rank somebody else.

Being a successful parent and being a successful resident/attending physician isn’t mutually exclusive. Many people have succeeded in both, in every specialty. Both however require a huge degree of commitment and hard work. Not necessarily the “shorter and easier” path, because nothing about medicine – or parenthood – is short and easy. But despite the effort (or perhaps because of it?), both can be extremely fulfilling, as long you enter into them for the right reasons.

...thanks for leaving out the bit about what goes on in the call rooms...

What goes on in the call rooms, stays in the call rooms.

 

[alparkeruab]

Can someone shed some real insight on a day in the life of a PM&R resident?

 

[topwise]

Can someone shed some real insight on a day in the life of a PM&R resident?

I think it's a hard question to answer because it varies vastly based on which program you're attending, and within a program, what rotation you're doing. Inpt vs. outpt is very different. And within that, our inpt or outpt rotations can be very different, based on what campus we're working in. I mean, if someone asked you what's a day in the life of a med student like, that would be a tough question to answer too.

The best I can say is that I wake up at a reasonable hour, go to work, then get home at a reasonable hour.

I think it's been said before that there's more to going into a field than just the hours. If the first question you have about a field is "what are the hours like" that's not a good sign. If the only reason you do PM&R is because you want a cush residency, you're not going to be happy. If you do what you love, the hours won't seem as bad. (My two cents, for what it's worth.)

 

[PMR 4 MSK]

Typical day for a PM&R resident is 8 am - 5 pm M-F. Some rotations are earlier and/or later. Call depends on residency, many are from home, larger programs are in-house. Outpt rotations vary similarly, but are even less time-intensive.

As an example, my SCI rotation was our hardest, 7 am - 5 pm, carrying 15 + pts on SCI rehab, and watching another dozen or so on neuro. Call was 24/7, except 1 weekend a month, this was for 3 months. We occasionally had a urology resident with us. They considered SCI to be their vacation rotation.

After residency, you can work as much or as little as you and your employer agree on. You'll do best in either a small hospital with a small rehab ward and just do inpt work, or work at an academic center with an agreement to work part time. Private outpt practice will not likely be for you, as you will be unlikely to meet your overhead working part time. Solo part time is not feasible.

Again, PM&R is less time-intensive than other residencies, but as above, unless you show a sincere interest in it, you'll be passed on.

 

[Finally M3]

A day in the life of PM&R, as seen by surgery and IM residents:

8 am, hit the snooze button.
9 am, actually get up, get some coffee and watch TV, read the paper.
10 am, come in to hospital, grab some coffee, wait for attendings to arrive. Surf the internet while waiting.
11 am, start morning rounds.
11:15, finish morning rounds and start writing notes
11:30, finish notes and go to lunch
1:30 pm, return to rehab and kibbitz with the nurses and PTs for a while
2:00 pm, go see consults, write on every patient chart "Patient is appropriate for rehab, but not medically stable enough yet. Will reassess tomorrow." High-5 attendings after each daily delay in admitting.
3 pm, admit 1 patient, discharge 3. Cry about how overworked you are.
4 pm, leave for home, knowing you have no call.

To OP; you can look into Cinci's combined peds/pmr residency

 

[lobelsteve]

Can someone shed some real insight on a day in the life of a PM&R resident?

I was being honest and sincere where I trained. I did not put in extra effort as it would not be rewarded. I managed to get a Pain Fellowship slot and the est has turned out well.

 

[alparkeruab]

Typical day for a PM&R resident is 8 am - 5 pm M-F. Some rotations are earlier and/or later. Call depends on residency, many are from home, larger programs are in-house. Outpt rotations vary similarly, but are even less time-intensive.

As an example, my SCI rotation was our hardest, 7 am - 5 pm, carrying 15 + pts on SCI rehab, and watching another dozen or so on neuro. Call was 24/7, except 1 weekend a month, this was for 3 months. We occasionally had a urology resident with us. They considered SCI to be their vacation rotation.

After residency, you can work as much or as little as you and your employer agree on. You'll do best in either a small hospital with a small rehab ward and just do inpt work, or work at an academic center with an agreement to work part time. Private outpt practice will not likely be for you, as you will be unlikely to meet your overhead working part time. Solo part time is not feasible.

Again, PM&R is less time-intensive than other residencies, but as above, unless you show a sincere interest in it, you'll be passed on.

Thanks for the reply. Does anyone else have any other info, or is this pretty standard across most residency programs?

 

[lowbudget]

What's the difference between Peds PM&R and Developmental Peds? Is it the focus on neuroMSK in PM&R vs. biopsychosocial in Dev Ped?

http://aap.org/family/WhatisDevBehPeds.pdf

 

[PMR 4 MSK]

What's the difference between Peds PM&R and Developmental Peds? Is it the focus on neuroMSK in PM&R vs. biopsychosocial in Dev Ped?

http://aap.org/family/WhatisDevBehPeds.pdf

This is an example of convergent evolution in medicine.

I can't speak for the Dev Peds, but from PM&R, we would be more likely to see pts with CP, MD, TBI, SCI, and concentrate on their mobility issues, looking for ways to improve or adapt to the physical disabilities. We can also do more interventional techniques such as for spasticity, but Dev Peds might learn that as well.

Developmental Peds sounds like a very interesting, likely newer, subspecialty of Peds. I've never actually enountered anyone who does this. I can see the two fields working well together.

PM&R usually is not going to be seeing pts for things like ADHD, dyslexia, conduct DO, etc.

 

[JerseyTomato]

I spent 2 weeks on a Dev Peds rotation as a 4th year med student. While I admittedly did not get a complete picture of the specialty, my observations were that the physicians I worked with spent the majority of their time diagnosing and treating children with autism spectrum disorders and ADHD.

They also participated in the hospital's CP clinic along with physiatry. The dev peds docs would focus on psychosocial issues and making sure the child's needs were being met in terms of optimal development while the physiatrists focused on spasticity issues.