PM&R and Neuromuscular Fellowships?

[JBM16BYU]

As background, I'm a current preliminary medicine intern who has already matched into PM&R and will be matriculating July 2020. I'm curious about the world of neuromuscular medicine in regards to PM&R. I saw that many neuromuscular fellowships do offer positions for PM&R, but I still have some questions:
(1) Would a neurology-trained neuromuscular specialist vs. PM&R-trained neuromuscular specialist practice in pretty similar ways?
(2) What kind of procedures do PM&R-trained neuromuscular specialists perform?
(3) What kind of practice setting would you be in if a PM&R-trained neuromuscular specialist?
(4) Some neuromuscular fellowships specifically mention that they accept PM&R residents, while others do not specify. Is it safe to assume that only ones that specifically mention PM&R are the ones who do, or do you stand a chance at one that doesn't specifically say it?
(5) How sought after are neuromuscular fellowships right now?
(6) Neuromuscular ultrasound vs. MSK ultrasound. Obviously one has the word "neuro" in it, but are there benefits in being certified in both?
(7) Anybody ever combo a neuromuscular fellowship with another type of fellowship for their practice? If so, what worked well together?

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[TheGreatestTrochanter]

As background I am not NM trained, nor planning on doing so but nobody is biting on this question, and I have worked with a couple fairly closely (both Neuro and PMR trained). This may be different at other institutions but this is what I have seen:

1) Typically Neuro-trained NM is more involved in the diagnosing of NM conditions with genetic and lab testing. Both PM&R and Neuro will be involved with EMG testing for these conditions. PMR is very involved in symptom management of people with NM conditions (SMA, CMT, Muscular DYstrophies, etc), and ensuring they get care with the appropriate providers such as pulm, ophtho and cards as needed based on their condition. Also doing general PMR stuff like helping with adaptive equipiment. I haven't seen neuro do this as much.
2) More advanced EMGs such as single-fiber. They also might get more challenging EMGs to rule out ALS as other providers might feel uncomfortable doing this. Some may do muscle biopsies but this is happening less and less.
3) Academic for sure.
4) NO clue
5) I haven't met anyone thinking of going into this, but not sure.
6)I don't think ultrasound is typically a large part of NM fellowship training but I could be wrong.
7) Neuromuscular is a pretty niche field with a very specific population of patients, so I am not sure of the advantage of this.

Take this for what its worth, this is just what I have seen.

 

[JBM16BYU]

As background I am not NM trained, nor planning on doing so but nobody is biting on this question, and I have worked with a couple fairly closely (both Neuro and PMR trained). This may be different at other institutions but this is what I have seen:

1) Typically Neuro-trained NM is more involved in the diagnosing of NM conditions with genetic and lab testing. Both PM&R and Neuro will be involved with EMG testing for these conditions. PMR is very involved in symptom management of people with NM conditions (SMA, CMT, Muscular DYstrophies, etc), and ensuring they get care with the appropriate providers such as pulm, ophtho and cards as needed based on their condition. Also doing general PMR stuff like helping with adaptive equipiment. I haven't seen neuro do this as much.
2) More advanced EMGs such as single-fiber. They also might get more challenging EMGs to rule out ALS as other providers might feel uncomfortable doing this. Some may do muscle biopsies but this is happening less and less.
3) Academic for sure.
4) NO clue
5) I haven't met anyone thinking of going into this, but not sure.
6)I don't think ultrasound is typically a large part of NM fellowship training but I could be wrong.
7) Neuromuscular is a pretty niche field with a very specific population of patients, so I am not sure of the advantage of this.

Take this for what its worth, this is just what I have seen.

Thank you for your reply to this. I appreciate you taking the time to answer.