|Co-Treasurers||Vivienne Vinton & Lindsey Palm-Vlasak|
|Faculty Advisor||Dr. Jason Zaremski|
Welcome to the Physical Medicine and Rehabilitation Interest Group (PMRIG)!
We are excited to introduce the PMRIG, which was officially approved in early 2022! Our goal is ultimately to increase awareness of PM&R to medical students earlier on in their education to seriously consider this speciality as their career. PM&R is a smaller speciality (with only ~100 programs in the U.S.), but is rapidly growing and the need for physiatrists is increasing each year. Our official goals as listed in the constitution are below:
- To plan and implement learning opportunities in the field of PM&R through direct interaction with faculty, clinical experiences, research opportunities, outreach opportunities (such as sports event coverage and community engagement), and a myriad of seminars and discussions.
- To serve as a central resource for medical students and undergraduate pre-medical students in their endeavors to learn about PM&R, facilitate career, residency, and fellowship planning, and enable faculty mentorship.
- To facilitate programs to advance medical students’ knowledge, specifically during the Neuroscience and Musculoskeletal courses during the 2nd year of medical school as well as on clinical rotations during their 3rd and 4th years.
What exactly is PM&R?
A common line from MS1s and MS2s is “I have heard of PM&R, but honestly I have no idea what they actually do.” To be fair, it is a speciality that you will also have to explain to your friends and family who are not in medicine. Everyone knows what an orthopedic surgeon does. Everyone knows what a cardiologist does. Everyone certainly does not know what a physiatrist does. Often, you’ll hear “psychiatry?” or “so it’s similar to physical therapy?”.
The American Academy of PM&R describes the speciality as one who: “aims to enhance and restore functional ability and quality of life to those with physical impairments or disabilities affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons. Physiatrists utilize cutting-edge as well as time-tested treatments to maximize function and quality of life.”
To put it simply, physiatrists focus on improving function and quality of life for patients with new-found impairments. These impairments are widespread in the neuro and MSK realm, such as traumatic brain injury, spinal cord injury, new amputation, stroke, multiple sclerosis, spasticity, chronic pain, and much more. The emphasis on treating these impairments is multidisciplinary and multifactorial – physiatrists coordinate a team of physical therapists, occupational therapists, speech language pathologists, nurses, and more. The speciality is extremely collaborative both on the inpatient and outpatient sites.
Inpatient – Inpatient PM&R takes place at either a standalone rehabilitation hospital or a specific unit/floor of a main hospital. At UF, the UF Health Rehab Hospital is a standalone facility at 2708 SW Archer Rd, Gainesville, FL 32608. It is a 60-bed acute rehabilitation facility, in which patients are transferred here following a new aforementioned impairment (such as an amputation). Once they arrive, they undergo evaluations from the PM&R team and specialists (PT, OT, SLP), and a multidisciplinary treatment plan is elicited for them. This usually involves multiple times a day therapy to help them improve their function and adapt to their new limitations. Once these goals are met, they are discharged home or to a long-term rehabilitation facility.
Outpatient – Outpatient PM&R is vast. There is general outpatient PM&R services, focusing on follow-ups from their rehabilitation stay, as well as new-patient visits. There is also more subspeciality clinics, such as sports medicine, spinal cord injury, TBI/concussion, pediatric, spine/pain, EMG and more. Each of these clinics provide their own scope into the world of PM&R and have very different pathologies/treatments/procedures associated. For example, in sports medicine clinic, one may see an older patient who hurt their shoulder while gardening. They have tried physical therapy, topical and oral anti-inflammatory medications, with no relief. In clinic today, they receive a corticosteroid injection in their shoulder in attempt to relieve their pain, with scheduled follow-up.
Overall, there is excellent variety in PM&R. There is a mix of inpatient and outpatient as well as a many procedures (ultrasound-guided injections, fluoroscopic-guided injections, nerve ablations/blocks, botox injections, EMGs, etc.). The pathologies seen are vast and cover many neurological and musculoskeletal impairments. There is a variety of fellowship opportunities seen here.
Here are some helpful resources, as well as a roadmap based on medical school year.
- https://pmr.med.ufl.edu/ – UF’s PM&R department website. Great resource to see news, opportunities, and connect with faculty.
- https://www.aapmr.org/home – National PM&R association, tons of resources, research opportunities, networking, and conferences. Specific page for med students.
- https://www.physiatry.org/ – National PM&R association, tons of resources, research opportunities, networking, and conferences. Specific page for med students.
- http://www.pmrscholars.org/ – Hosts a virtual residency fair each year to specifically connect/learn about certain residency programs.
MS1 – Focus on doing well in classes, the transition to medical school is difficult! Attend PMRIG meetings and establish relationships with senior medical students. If possible, find a faculty mentor in PM&R that you can maybe begin research with or shadow when time permits. Consider MSRP with a PM&R physician or with Dr. Heather Vincent or Dr. Sibille. Other great opportunities for that summer:
- RREMS – basically MSRP but $4000 stipend with a PM&R mentor somewhere in the U.S. – great for networking, possibility of in-person or virtual depending on the mentor and project. Will make your app stand out for residency as it shows early interest in the speciality.
- MSSCE – basically a clinical MSRP – 4000$ stipend, program based on didactics, as well as inpatient and outpatient clinical experiences. Also shows early interest and gives you early clinical exposure to PM&R.
MS2 – MSK and neuro courses in the fall with some PM&R faculty exposure. Those courses should give you a good idea if this is the specialty for you. Would recommend trying to hop on a research project this year, or more likely may be finishing up MSRP abstracts/publications/etc. Pass Step 1!
MS3 – PM&R exposure during geriatrics week. PM&R 2 week elective during the elective time. Would recommend doing it and really establishing connections with some faculty, especially in your field of interest.
- Dr. Kevin Vincent and Dr. Jason Zaremski – Sports medicine
- Dr. Andrea Aguirre – Spinal Cord Injury
- Dr. Michael Sein and Dr. Shawn McGargill – Pain/interventional spine
- Dr. Carolyn Geis – Traumatic Brain Injury
- Dr. Andrew Dubin and Dr. Zarreii – Inpatient PM&R
- Dr. Estores – Integrative Medicine
- Dr. Ansoanuur – Pediatric PM&R
MS4 – Step 2 – with Step 1 being P/F now, doing well on Step 2 is very important. Although PM&R is not a speciality where you need exceptionally high scores, it would benefit you greatly by scoring well. The average Step 2 score currently is 237.4 (see more stats here).
- For scheduling 4th year – definitely will want to do the 4 week PM&R elective. Consider doing the 2 week sports med elective or the 2 week comprehensive spine elective depending on what your interests are. Consider if you want to do away rotations (not needed for PM&R, but may be helpful if you have specific program or location desires).
- Application season! Secure letter of recommendation writers (consider that you’ll also have to apply for preliminary and transitional years, as many programs are 3 year programs that require an intern year completed separately). For that reason, definitely will want 1-2 internal medicine letter writters.
- Definitely have research experience by now and some meaningful activities that show early interest in PM&R/adaptive sports/amputee advocacy/teamwork/etc.
- Then interviews/match day/graduation! More specific advice will be covered in post-match day panels with newly matched MS4s!