How much manual dexterity is required for PM&R

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Brain Stem

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Hi:
I'm highly interested in PM&R and would want a field where I can work past 65. While I have probably reasonable manual dexterity right now, I might not when I'm in my 60s.

How much manual dexterity/fine motor skills is required to perform basic tasks/procedures, and how much do you need for the more advanced procedures? Is there a "test" I can perform on myself to see if I have what it takes?

So when I lose some of my manual dexterity due to old age, will I still be able to work as a PM&R physician?

I wasn't able to find a thread on this. If this question has been answered before, I apologize and please point me in the right direction.

Thanks

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Umm on of my attendings is well into her 70's but she is a generalist and does not perform any procedures including EMGs. For her it's a part time gig to maintain her lifestyle ing he upper east side... As long as you can write notes you can practice PM&R
 
this is one of the dumbest questions I've read in a while
 
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I've rounded with one paraplegic and another elderly disabled attending. You should be fine.
 
this is one of the dumbest questions I've read in a while

How is it is a dumb question? This is exactly the kind of thing that medical candidates should be thinking about, rather than their usual, poorly thought out line of thinking for career planning (going by salary surveys, or exciting experiences they had on short rotations, etc.)

Anyway, if you do interventional spine a lot of manual dexterity is definitely needed. If you do joint injections, botox, and trigger points, a moderate amount of dexterity is needed. Doing EMG's mostly requires a strong back, as there's no good posture while you're doing them.

Most types of inpatient PM&R, however, do not require manual dexterity at all, except the ability to do basic neurologic and general physical exam, and the ability to type ones notes on a computer. If you have a condition or reason to believe that physically you will decline in the future, then inpatient PM&R is definitely a very viable and safe career choice. You will probably maintain an outpatient clinic a few half days a week, but procedures may be quite limited and can be passed on to other partners (who will be more than happy to do them).
 
How is it is a dumb question? This is exactly the kind of thing that medical candidates should be thinking about, rather than their usual, poorly thought out line of thinking for career planning (going by salary surveys, or exciting experiences they had on short rotations, etc.)

Seriously? For 8 years or more of school, 4 years residency, maybe 1 year fellowship, .... You would choose a field based on manual dexterity in your old age? When your patients ask you why you chose PM&R you say I want to use my hands in my 60's?? You think patients want to see a narcissistic, self centered twit that only cares about their hands when they get old? You really think they won't pick up on that? You think I'd recommend any patients to you or even refer them your way? You go home at night and feel good about your workday because your hands are spared? You're gonna put in 60-80 hours a week for the love of your hands???
it's a bizarre thought process by someone of questionable intelligence that I would never allow into residency in the first place.
so yes it's a dumb question and I'm calling them out on it.
If the question is, I'm disabled with limited use of my hands, can I do PM&R? that's entirely different. But that wasn't the question
 
I know a dentist who had to retire early due to arthritis (which was completely unforeseen). Diminished dexterity may be hard to imagine when you're younger and healthy but I think it demonstrates foresight to ask about the potential for longevity in your career if one wants to practice beyond the late 60's; as doctors should know, health doesn't last forever. I can't believe you would make the jump to calling someone a "narcissistic self-centered twit" for asking about this :confused:. And the OP makes no indication that this is their main criterion for choosing a career so I doubt this is what they would tell people when they ask "why PM&R?"
 
I know a dentist who had to retire early due to arthritis (which was completely unforeseen). Diminished dexterity may be hard to imagine when you're younger and healthy but I think it demonstrates foresight to ask about the potential for longevity in your career if one wants to practice beyond the late 60's; as doctors should know, health doesn't last forever. I can't believe you would make the jump to calling someone a "narcissistic self-centered twit" for asking about this :confused:. And the OP makes no indication that this is their main criterion for choosing a career so I doubt this is what they would tell people when they ask "why PM&R?"

And I have treated dozens of docs, nurses, lawyers, professionals that had strokes, spinal cord injuries, cancer, amputations, traumatic brain injuries, and many other tragedies. Their lives and careers changed far more than you can imagine. Age related dexterity loss is the LEAST of your worries.
How long have you been in practice? Your single example shows a very limited depth to your career.
 
You might as well ask "how dumb can I be and still be a lawyer?"
 
Seriously? For 8 years or more of school, 4 years residency, maybe 1 year fellowship, .... You would choose a field based on manual dexterity in your old age? When your patients ask you why you chose PM&R you say I want to use my hands in my 60's?? You think patients want to see a narcissistic, self centered twit that only cares about their hands when they get old? You really think they won't pick up on that? You think I'd recommend any patients to you or even refer them your way? You go home at night and feel good about your workday because your hands are spared? You're gonna put in 60-80 hours a week for the love of your hands???
it's a bizarre thought process by someone of questionable intelligence that I would never allow into residency in the first place.
so yes it's a dumb question and I'm calling them out on it.
If the question is, I'm disabled with limited use of my hands, can I do PM&R? that's entirely different. But that wasn't the question

Actually, Gauss, I believe you did not interpret my question as the way I intended it. Allow me to explain.

1. PM&R deals with issues similar to my current career, which I do not want to go into detail because I want to stay anonymous. That is my reason for considering PM&R seriously in the first place.
2. In addition, I do have a medical situation in which I'm concerned about loss of manual dexterity, but again, I did not want to disclose that because it is medical in nature. I simply want to make sure I will be able to function in the field, given my limitations, when I get old.
3. Working past 65 is also a concern for me because I'm significantly old than the average medical student. I want to at least make sure I have enough time to pay off my debts and have some retirement savings.

If I find the degree of fine motor skills required are beyond my abilities, I will have to rule this field out. I want to thank everyone else for taking the time to answer my question.

And Gauss, I want to thank you for your honest reaction, as that is teaching me to phrase my questions more carefully in the future so I can avoid misinterpretation.
 
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Actually, Gauss, I believe you did not interpret my question as the way I intended it. Allow me to explain.

1. PM&R deals with issues similar to my current career, which I do not want to go into detail because I want to stay anonymous. That is my reason for considering PM&R seriously in the first place.
2. In addition, I do have a medical situation in which I'm concerned about loss of manual dexterity, but again, I did not want to disclose that because it is medical in nature. I simply want to make sure I will be able to function in the field, given my limitations, when I get old.
3. Working past 65 is also a concern for me because I'm significantly old than the average medical student. I want to at least make sure I have enough time to pay off my debts and have some retirement savings.

If I find the degree of fine motor skills required are beyond my abilities, I will have to rule this field out. I want to thank everyone else for taking the time to answer my question.

And Gauss, I want to thank you for your honest reaction, as that is teaching me to phrase my questions more carefully in the future so I can avoid misinterpretation.

you will be one hell of a doc, brain stem.

seriously

:thumbup:
 
Gauss probably feels like a complete ***** right now.
 
Gauss probably feels like a complete ***** right now.

Not at all, in fact I stated that the question was not phrased in a way indicating there may be any pre-existing condition. Vague questions will get misinterpreted. So the op learned how to phrase questions correctly.
And in my department and sports practice, the unfortunate truth is we wouldn't be able to accommodate anyone that couldn't keep up due to hand limitations. So if that was what you wanted to do, if you got through residency, you would have difficulty finding a job
 
And in my department and sports practice, the unfortunate truth is we wouldn't be able to accommodate anyone that couldn't keep up due to hand limitations. So if that was what you wanted to do, if you got through residency, you would have difficulty finding a job

Thanks Gauss for finally answering the question - even if it took you a few times of being overly attackive or defensive.

Brain Stem - I'm sorry your first post got a "dumb question" response. I'm sure you've seen this already if you've looked at many of these student doctor threads, but sometimes people here forget that there is a lot of us posting because we're truly trying to better ourselves and others - and make educated decisions about our future. There are those occasional unhelpful replies, but overall this has been a great resource for me and I hope it will continue to be one for you! :)
 
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I agree with the others that if you're concerned about loss of manual dexterity later in life, many outpatient subspecialties of PM&R will be more difficult--some injections require a lot of manual dexterity and EMG/NCS's require a fair amount I suppose. But the bread & butter injections done in the clinic that I've done/observed don't require a whole lot of dexterity, relative to the ones done under flouro in the OR or any surgical procedure. So I think general outpatient PM&R would still be very doable, assuming you could still do a physical exam.

I've only done ~3 months total of PM&R rotations, but as others mentioned, inpatient rehab doesn't seem to require any more manual dexterity than medicine or neurology. Actually it's probably less because you wouldn't be placing lines or doing any LPs.

The only specialties I can think of that require less dexterity than inpt rehab would be psychiatry and diagnostic radiology, and maybe pathology, depending on what you do (autopsies seem rather crude, but I think they still require a lot of dexterity).

As another poster mentioned, typing is probably the most difficult thing you'd be doing in terms of fine-finger dexterity for inpatient rehab.
 
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