Regardless of pay and lifestyle; what do you love about PMR?

[azcomdiddy]

Let me start by saying this is not a veiled attempt to insult physiatry. Originally, I was considering ENT but I'm interested in learning more about physiatry. I won't lie; the lifestyle and compensation is great. Also, I have noticed the physiatrists seem to be one of the happiest groups of physicians I have met. Obviously, I will learn more when I do my elective rotations. I have done a search for this topic and it hasn't been answered to any great detail. This isn't the fault of the physiatrists on this page. Rather, those threads were hijacked by trolls who sought to put the profession down. The physiatrists and moderators were then forced to being put on the defensive as opposed to being allowed to answer the question. I'm assuming most of those trolls have been dealt with so I can ask this question all over again.

Regardless of pay and lifestyle, what draws you to the field? I have been told it is incredibly boring but those are comments made by non-physiatrists. And I have a feeling they are making assumptions about the field based on their perceptions of it. But thousands of physiatrists couldn't be happy if their job duties were boring? So, to those physiatrists and physiatry residents, what do you feel are the more exciting aspects of your field?

Let me also say that one reason why I have shyed away from surgery is because of the lack of patient contact. What is the level of patient contact in physiatry as far as consulting with your patients directly? This is something I'm looking for. I realize I don't have a surgeon's personality because patient contact isn't something like to avoid. I actually enjoyed interacting with patients...even the bad ones. That being said, do you feel a sense of personal gratification at the end of the day as a physiatrist? I'm genuinely interested in this field. Is it exciting? Also, I only want to know the positives about the field. I'm aware of the perceived negatives so we don't need to go there. Just let me know why you love your field.

Thank you for your time.

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[theD.O.C.]

Well;

Sorry you had to experience a little ugliness on the board in the last PMNR thread. It wasn't about the money question, it's just that some folks just can't get a clue (read the stickies esp when referred to them).

So onto your question: What do I like about PM&R.
1. Controlled lifestyle: You can very easily be mostly outpatient (gen rehab, MSK, Pain) or EMG based. This leads to more predictable patient encounters and less (or no) overnight call.

2. Longitudinal care of patients: You get to see them just as they finish acute care (med/surg), help them ready to go home and function in their activities of daily living, and in follow up as they are living their own lives. I think it's rewarding to help people get on with their lives after a life altering experience. I'm strange that way I guess. I tend be a root for the underdog person.

3. New field: PM&R is relatively new. That means you ,even as a new guy, can help define the field and how people view it. There's alot of places where our expertise can be a great help, and it's up to us to find our niche.

4. Research: There are many interesting topics that are unexplored in the field of rehab and everyone in academic PM&R is very welcoming to new young investigators.

5. Muskuloskeletal and biomechanics: I am interested in how things move, how movement can be altered by pathology, and how this alteration can cause more pain or dysfunction. It's all very technical and applied anatomy.

6. Motivated patients: Alot of our patients want to get better so that they can care for themselves, return to their sport, etc etc. Of course this is a generality and there are lots of folks you can't help or that are just in love with their pathology (such as some chronic pain patients, but you only wanted to hear about positives)

Well I hope this helps. One more thing,I think it's wonderful that you are doing a rotation in PM&R and that you're asking about how people perceive themselves in their field.

 

[bustbones26]

It offers a little bit of everything: Neuro, musculoskeletal, and general medicine. Its a nice combo. Also, if you are a DO, it is a great opportunity put your OMT skills to work.

Lifestyle is certainly an attractive feature of the field, but as I have pointed out on past post, not the best reason to choose PM&R.

 

[azcomdiddy]

It offers a little bit of everything: Neuro, musculoskeletal, and general medicine. Its a nice combo. Also, if you are a DO, it is a great opportunity put your OMT skills to work.

Lifestyle is certainly an attractive feature of the field, but as I have pointed out on past post, not the best reason to choose PM&R.

Lifestyle is appealing but I would never choose PM&R based on lifestyle alone. If I wanted that, I would go into Anesthesiology, radiology, family medicine, psychiatry etc.

To me, the nature of the work is the most important. You have to be able to emjoy most of the aspects of your job.

Still, I'm suprised, I only received two responses on this question. you would think people would love to boast about the positives aspects of their job duties.

 

[prefontaine]

How do you define 'relatively new'?

It is been an ABMS specialty since 1948 and has been a part of the US's oldest medical school since the 19th century.

IMO, emergency medicine and family practice are 'relatively new', but not PM&R.

Well;

Sorry you had to experience a little ugliness on the board in the last PMNR thread. It wasn't about the money question, it's just that some folks just can't get a clue (read the stickies esp when referred to them).

So onto your question: What do I like about PM&R.
1. Controlled lifestyle: You can very easily be mostly outpatient (gen rehab, MSK, Pain) or EMG based. This leads to more predictable patient encounters and less (or no) overnight call.

2. Longitudinal care of patients: You get to see them just as they finish acute care (med/surg), help them ready to go home and function in their activities of daily living, and in follow up as they are living their own lives. I think it's rewarding to help people get on with their lives after a life altering experience. I'm strange that way I guess. I tend be a root for the underdog person.

3. New field: PM&R is relatively new. That means you ,even as a new guy, can help define the field and how people view it. There's alot of places where our expertise can be a great help, and it's up to us to find our niche.

4. Research: There are many interesting topics that are unexplored in the field of rehab and everyone in academic PM&R is very welcoming to new young investigators.

5. Muskuloskeletal and biomechanics: I am interested in how things move, how movement can be altered by pathology, and how this alteration can cause more pain or dysfunction. It's all very technical and applied anatomy.

6. Motivated patients: Alot of our patients want to get better so that they can care for themselves, return to their sport, etc etc. Of course this is a generality and there are lots of folks you can't help or that are just in love with their pathology (such as some chronic pain patients, but you only wanted to hear about positives)

Well I hope this helps. One more thing,I think it's wonderful that you are doing a rotation in PM&R and that you're asking about how people perceive themselves in their field.

 

[novacek88]

This might tick a lot of people off but I think lifestyle and money are the two main reasons why people do PM&R. This is why people can't elaborate upon it to a great extent like other fields. I think it is a lot like anesthesiology. No one was interested in gas when it didn't pay well. I don't think most people would go into PM&R if it didn't have those intagibles. PM&R is a relatively easy position to match compared to other fields. Usualy, a lifestyle field that pays well is nearly impossible to match, but PM&R, pathology and anesthesiology defy these factors. And the reason is because people find them it to be deathly boring. If PM&R was interesting, it would be much tougher to match into these fields.

 

[normalforce]

This might tick a lot of people off but I think lifestyle and money are the two main reasons why people do PM&R. This is why people can't elaborate upon it to a great extent like other fields. I think it is a lot like anesthesiology. No one was interested in gas when it didn't pay well. I don't think most people would go into PM&R if it didn't have those intagibles. PM&R is a relatively easy position to match compared to other fields. Usualy, a lifestyle field that pays well is nearly impossible to match, but PM&R, pathology and anesthesiology defy these factors. And the reason is because people find them it to be deathly boring. If PM&R was interesting, it would be much tougher to match into these fields.

Come on. You think radiology and derm are MORE interesting than PM&R. In one day I did an EMG, SI joint injection, dx a possible cauda equina, dx a meniscal tear, and performed a valid IME (all with an attending b/c I am an MSIV). I have done rads and two weeks of derm, and was WAY more bored. My scores and CV are competitive enough to match to both, trust me. People should pick a specialty based on their interest. I love PM&R and musculoskeletal med. That's me. I think the % of people going into rads,derm,optho because of the lifestyle and money is prob the same % as people going into PM&R for the lifestyle and money... some people do, but I do not think that the # or % of people increase in PM&R.

NF

 

[theD.O.C.]

How do you define 'relatively new'?

It is been an ABMS specialty since 1948 and has been a part of the US's oldest medical school since the 19th century.

IMO, emergency medicine and family practice are 'relatively new', but not PM&R.

Hi there;

I guess I should have made myself clear. PM&R as a distinct discipline in medicine is new compared with Internal Medicine and Surgery. The reason why I think this is relevant is that (from what I have seen) there is less of an orthodoxy in PM&R. Thus, as a PM&R doc in training I don't feel like I am being pushed down some pre-defined career path just because everyone else has gone down it before. The field has been very accepting and encouraging of individuals with very diverse career goals. I have met people in this field with such diverse goals/careers as olympic sports team doctors to basic science researchers all of which are 'rehab docs' and all of which are respected for the variety they bring into the field. I meant new as a good thing.

PS Normalforce, it sounds like you're having a really great rotation in PM&R! Where are you doing it?

 

[chauffeur]

i'm going into pmnr for the previously stated reasons: diversity of procedures, continuity of patient care, patient care satisfaction, interest in neuro and ortho, patient contact, ability to define your role within a specialty with very different subspecialties

after asking all of my classmates going into Derm and Radiology, the response was clearly lifestyle and money. as DOC said, most people weren't interested in GI until the pay went up.

 

[BrooklynDO]

OP : sometimes not many more than a few people answer because someone already said it.

In my case, ive always been fascinated with biomechanics and pain/injury and healing. I came into medicine from a martial arts background, which often involves knowing how to prevent pain as well as cause it.

anyway i thought i wanted to do Sports med or ortho... until by accident i ran across the AAPMR site and was basically like : OMG, THAT's what ive been thinking about when i wanted to do sports med (this was undergrad)
Also, as a future DO, i think its right up my alley, from what ive seen hanging out with the rehab guys in the hospital, the background knowledge is very similar.
~Brooklyn
PMR wannabe

 

[novacek88]

Come on. You think radiology and derm are MORE interesting than PM&R. In one day I did an EMG, SI joint injection, dx a possible cauda equina, dx a meniscal tear, and performed a valid IME (all with an attending b/c I am an MSIV). I have done rads and two weeks of derm, and was WAY more bored. My scores and CV are competitive enough to match to both, trust me. People should pick a specialty based on their interest. I love PM&R and musculoskeletal med. That's me. I think the % of people going into rads,derm,optho because of the lifestyle and money is prob the same % as people going into PM&R for the lifestyle and money... some people do, but I do not think that the # or % of people increase in PM&R.

NF

That's fine but you still haven't explained why PM&R is so much easier to match into than Rads and Derm. The pay and lifestyle of derm and rads is comparable to PM&R but PM&R is a lot easier to match into...a LOT easier.

 

[prefontaine]

...prestige and it is a lesser known specialty.



QUOTE=novacek88]That's fine but you still haven't explained why PM&R is so much easier to match into than Rads and Derm. The pay and lifestyle of derm and rads is comparable to PM&R but PM&R is a lot easier to match into...a LOT easier.[/QUOTE]

 

[novacek88]

...prestige and it is a lesser known specialty.



QUOTE=novacek88]That's fine but you still haven't explained why PM&R is so much easier to match into than Rads and Derm. The pay and lifestyle of derm and rads is comparable to PM&R but PM&R is a lot easier to match into...a LOT easier.

Well, first I have to offer an apology. I don't mean to criticize PM&R. For some people, it is an amazing field. I'm interested in pediatrics which is far less competitive and popular than PM&R. You couldn't pay most people to do peds these days. But for the sake of argument, I still disagree with you. I think dermatology is more popular because it is more hands on. There is more direct patient interaction in derm. Also, the appeal of doing cosmetic procedures and the prospect of Mohs surgery makes the field very attractive. I think radiology is more attractive because it is an intellectually stimulating field despite the lack of procedures in diagnostic. I don't know that PM&R is less known to medical students. Medical students do their homework when it comes to fields especially lifestyle fields. If a specialty pays well and offers great hours, medica students will know about it. I agree that derm is definitely more prestigious but I'm not so sure radiology is. 10 years ago, rads was not competitive at all. In fact radiology was full of IMG's because no one wanted to do it. Then when the lifestyle issue became important and people realized they could make a lot of money in rads, people fled to that specialty. I think the only reason why people have not done the same with PM&R is because most find it be much more boring than anesthesiology, rads and derm.

 

[normalforce]

Have you done a PM&R rotation?

Well, first I have to offer an apology. I don't mean to criticize PM&R. For some people, it is an amazing field. I'm interested in pediatrics which is far less competitive and popular than PM&R. You couldn't pay most people to do peds these days. But for the sake of argument, I still disagree with you. I think dermatology is more popular because it is more hands on. There is more direct patient interaction in derm. Also, the appeal of doing cosmetic procedures and the prospect of Mohs surgery makes the field very attractive. I think radiology is more attractive because it is an intellectually stimulating field despite the lack of procedures in diagnostic. I don't know that PM&R is less known to medical students. Medical students do their homework when it comes to fields especially lifestyle fields. If a specialty pays well and offers great hours, medica students will know about it. I agree that derm is definitely more prestigious but I'm not so sure radiology is. 10 years ago, rads was not competitive at all. In fact radiology was full of IMG's because no one wanted to do it. Then when the lifestyle issue became important and people realized they could make a lot of money in rads, people fled to that specialty. I think the only reason why people have not done the same with PM&R is because most find it be much more boring than anesthesiology, rads and derm.

 

[chauffeur]

That's fine but you still haven't explained why PM&R is so much easier to match into than Rads and Derm. The pay and lifestyle of derm and rads is comparable to PM&R but PM&R is a lot easier to match into...a LOT easier.

i go to a school with a solid PMNR program and my classmates still don't know much about it. we have a mandatory 4th year block, but people have applied by then. most students think that PMNR is just sending a patient to physical therapy.

also, if you match into derm spot people will say, wow, he/she's smart and had solid board scores, that's impressive... i'm pretty sure people don't say that about matching in PMNR. the field is gaining recognition among med students and even doctors. i think it will become more competitive in time. it's not the nature of some med students to do something that isn't impressive to others.

 

[esposo]

most students think that PMNR is just sending a patient to physical therapy.

Forgive my ignorance, but yeah, I'm one of those guys who think that's all PM&R is. I just assumed all they do is consult with accident victims and send them to physical therapists. And I'm not the only one who thinks this. Nearly everyone I have spoken with thinks PM&R just gives order to PT's. The idea of just seding patients to physical therapists sounds boring. How is it different? Please educate me.

The other drawback to PM&R from what I have heard is that it is hard to find a job since a PM&R isn't a neatly defined and other docs can fulfill its duties like sports medicine family docs, orthopedic surgeons, physical therapists and even family practice docs. I take that back. You can find a job if you were willing to travel but supposedly, you can't find a job as physiatrist in just any city like you can with other fields. For example, a radiologist and an anesthesiologist can work anywhere they want. Please educate me

 

[drusso]

Read the FAQ's about PM&R on this site!

 

[klgsatx]

I know of some PM&R residents that were having a problem landing a FULL time position after their training...also I know that there was a PM&R residency in Tennessee that was closed....I also know that when a crisis arise here that PM&R residents can not handle it and always call for the Internal Medicine residents

 

[BrooklynDO]

I know of some PM&R residents that were having a problem landing a FULL time position after their training...also I know that there was a PM&R residency in Tennessee that was closed....I also know that when a crisis arise here that PM&R residents can not handle it and always call for the Internal Medicine residents

residencies open and close all the time in many fields, i bet there was one IM one that closed last year or this year somewhere as well...
also, youre equating the purpose of PM&R residency and the purpose of IM residency when you bring up the "crisis" question. IM cant really "handle" an SBO...IMHO that doesnt make them inferior to the surgery intern who can.
oh and im assuming youd also call an opho consult for eye trauma...not IM or gen surg?

if im wrong here, please correct me.
I just think its comparing apples to oranges

 

[AviatorDoc]

Having just finished a fantastic month at University of Utah PM&R, I have to say that I love the field. First off, let me say that no matter what the field, if I was working 18 hour days with q3 call & no weekends, I would hate it. Period. So lifestyle is a factor that I can never be honest about separating out.

HOWEVER... I love the field of PM&R. My rotation was an introduction to the field, meaning I did a week of musculoskeletal, a week of community pm&r, a week of TBI, and a week of childrens. Each provided their own level of intrigue, and the hardest decision for me will be deciding how I want to set up practice.

* Sports Medicine is fantastic, because most of the patients are young & motivated.

* Community PM&R is a lot of geriatrics. Most older folks s/p ortho surgery who are otherwise medically healthy make great patients. They're motivated, and generally don't complain too much.

* If you want to work with the really interesting cases, university-based PM&R is fantastic. We worked side-by-side with the trauma & neurosurg teams to develop a plan for the patients. We were consulted as experts by surgeons (who usually treat rads & anesthesia like crap).

* If you truly want to make a huge difference in someone's life, PM&R is a fantastic field. You can save someone's life in the ICU... but then what? PM&R makes a big difference in quality of life of a patient after discharge. (Does that mean ICU docs are more important? An ignorant man once told a cardiologist... "You don't do heart surgery? Oh, so you don't really save peoples' lives.")

* Most PM&R docs do not have the "god-complex". If you like working with colleagues who think they have divine powers and can treat staff like crap, you should not choose PM&R as a field. On a rehab floor, docs, nurses, therapists, dieticians, and pharmacists all play a crucial role, and contribute in their relative area of expertise.

* Children's rehab can be fascinating, frustrating, challenging, and rewarding. The saddest cases in all of medicine can be found in Children's rehab. The good news is that the bad news has already been given, and the PM&R docs' job is to give as much as possible back to the child. If you believe in such a thing, Children's rehab is a true vocation.


I hope this helps,
Aviatordoc

 

[theD.O.C.]

Having just finished a fantastic month at University of Utah PM&R, I have to say that I love the field. First off, let me say that no matter what the field, if I was working 18 hour days with q3 call & no weekends, I would hate it. Period. So lifestyle is a factor that I can never be honest about separating out.

HOWEVER... I love the field of PM&R. My rotation was an introduction to the field, meaning I did a week of musculoskeletal, a week of community pm&r, a week of TBI, and a week of childrens. Each provided their own level of intrigue, and the hardest decision for me will be deciding how I want to set up practice.

Aviatordoc

Awesome, that sounds great! I agree that the best things about the field are the variety, cooperativity, and the motivated patient. To anyone interested in the field, it would be great for you to do a rotation early in your 4th year. Plus, does Utah rock or what? Did you get up in the mountains?

 

[AviatorDoc]

Awesome, that sounds great! I agree that the best things about the field are the variety, cooperativity, and the motivated patient. To anyone interested in the field, it would be great for you to do a rotation early in your 4th year. Plus, does Utah rock or what? Did you get up in the mountains?

I did go hiking quite a bit. An attending took me on a rough 6 mile run w/ about a 600 ft elevation change. Later on, I did about 9 miles w/ 1500 ft change. Utah is an outdoor enthusiasts dream.