1) Welcome to the Team
Medicine is a team sport and no specialty exemplifies that better than PM&R. Most interventions require follow-up or coordination with another healthcare providers, most commonly physiotherapists and occupational therapists. I was also impressed by the close interaction with prosthetic device manufacturers - who are typically privately-funded - in the management of patients with amputations, an obvious advantage for individuals whose lives are greatly affected by the nature and quality of their prostheses. It was also interesting to see the connections with other physicians. The PM&R physicians I worked with had a lot of their work referred to them by specialists, rather than by family physicians. This represents a somewhat unique position in medicine; while most specialists see a fair amount of their patients due to referrals from family physicians, community pediatricians, or emergency physicians, a large portion of rehabilitation work comes from neurologists or surgeons. Part of this disparity may have been due to being in an academic centre rather than general community practice, but even then, most of the academic physicians I worked with in the past nevertheless had their patients largely come from primary care physician referrals. Overall, this need to work with other providers meant a focus on communication and integration of service delivery. While there were still some hiccups, it was a refreshing attitude to see in medicine which so often has difficulties working together effectively.
2) I Forgot Stuff... Lots of Stuff
We learn about MSK problems and anatomy in 2nd year at my school. Shortly after, we learn Neurological program and anatomy. It's not hard to go through most of 3rd and 4th year using very little of that knowledge - of the core rotations, only Family and Emerg really draw on it to any real degree. As a result, my knowledge of these subjects has definitely... atrophied. I chose this rotation in part because I was fully aware of my ignorance on these subjects, particularly with respect to my neurology skills, but those first few days hit me hard - I have some studying to do before medical school is over!
3) Competitive
This specialty is going to be competitive this year, I have little doubt of that. It's a small field, with only 30 spots (almost entirely CMG spots) across the country, with no program having more than 3 spots per yet. Interest in the field is undoubtedly higher than that, significantly so. It's hard not to see why - it's a specialized field with a clear role and positive, observable impacts on patients; it has good hours, decent pay, open job market that's likely to expand; and a reasonable variety of clinical presentations and conditions with many opportunities for specialization. Somehow this specialty managed to fly under the radar for a long time. That's no longer the case - the match rate in PM&R took a steep drop last year and I expect this coming year will be no different.
4) Happiness Test
The best advice I got through my medical training is to go where the happy people are. PM&R docs seem pretty happy. They also seemed to maintain empathy better than most other groups of physicians I've met, and albeit with the odd exception, they seemed more grounded than most doctors I've met. Maybe it's their relatively lighter workloads and longer appointments with each patient. Maybe it's because they work with so many non-physicians on a regular basis. Maybe it's because their work is more oriented towards improving functional status than on treating illness. Whatever the reason, despite having zero interest in PM&R, in addition to little ability in the field, I thoroughly enjoyed my time on this rotation.
This specialty is going to be competitive this year, I have little doubt of that. It's a small field, with only 30 spots (almost entirely CMG spots) across the country, with no program having more than 3 spots per yet. Interest in the field is undoubtedly higher than that, significantly so. It's hard not to see why - it's a specialized field with a clear role and positive, observable impacts on patients; it has good hours, decent pay, open job market that's likely to expand; and a reasonable variety of clinical presentations and conditions with many opportunities for specialization. Somehow this specialty managed to fly under the radar for a long time. That's no longer the case - the match rate in PM&R took a steep drop last year and I expect this coming year will be no different.
4) Happiness Test
The best advice I got through my medical training is to go where the happy people are. PM&R docs seem pretty happy. They also seemed to maintain empathy better than most other groups of physicians I've met, and albeit with the odd exception, they seemed more grounded than most doctors I've met. Maybe it's their relatively lighter workloads and longer appointments with each patient. Maybe it's because they work with so many non-physicians on a regular basis. Maybe it's because their work is more oriented towards improving functional status than on treating illness. Whatever the reason, despite having zero interest in PM&R, in addition to little ability in the field, I thoroughly enjoyed my time on this rotation.
No comments:
Post a Comment