CAREERS IN MEDICINE: PHYSICAL MEDICINE AND REHABILITATION
If you have decided you want to be a physician, and you’re considering medical specialties down the road, take a look at this one: physical medicine and rehabilitation (PM&R). A doctor of PM&R, which is also known as physiatry, is called a physiatrist. Physiatrists are experts in the diagnosis, prognosis, and treatment of disorders of the musculoskeletal system. This system includes the bones that support the body, the muscles that move the body, and the connections between them. Physiatry also concerns the parts of the nervous system that control body movements and register pain.
WHAT DO PHYSIATRISTS DO?
Physiatrists treat conditions affecting the brain, bones, joints, ligaments, muscles, nerves, spinal cord, and tendons. They are experts in the treatment of pain, correcting mobility limitations, and restoring functionality. These problems may result from chronic conditions, disability, illness, injury, or surgery. Physiatrists treat such conditions as carpal tunnel syndrome, chronic back pain, stress fractures, and tendonitis, as well as physical problems related to aging or growing.
Physiatrists diagnose patients through physical examinations and medical history reviews, and then order and analyze tests to develop or confirm diagnoses. Magnetic resonance imaging (MRI) and X-ray examinations enable the physiatrist to see inside the body. Other tests include electromyography (muscle conduction) and nerve conduction studies.
Physiatrists treat patients through active physical therapy exercises designed to heal and strengthen the body. They also use such passive physical therapies as the application of heat, ice, massage, and pressure to various parts of the body. Physiatrists prescribe or recommend these therapies, but they are usually performed by massage, occupational, and physical therapists.
Physiatrists also use medication to control pain and enable patients to participate in rehabilitation exercises and everyday life activities. Pain-killing medications range from prescription pills and joint blocks to injections and epidurals. Physiatrists also prescribe braces, orthotics, and other assistive devices and wearable supports.
HOW TO BECOME A PHYSIATRIST
To be a physiatrist, you must first become a physician by graduating from an accredited medical school—such as American University of the Caribbean School of Medicine* (AUC). The path to a medical degree at AUC, which is located on the Caribbean island of St. Maarten, is the same as at United States-based schools: two years of medical science classes and two years of hands-on clinical training. For AUC students, the medical sciences curriculum is completed at the St. Maarten campus; the clinical training can be completed at affiliated teaching hospitals in the United States or in the United Kingdom.
AUC also partners with the University of Central Lancashire (UCLan) in the United Kingdom for a “UK-track” option. The first two years at UCLan focus on studying the medical sciences. Upon completion, students receive a Post Graduate Diploma in International Medical Sciences, which AUC recognizes as equivalent to its own medical sciences curriculum. During the final two years, students can then complete clinical training across AUC’s network of affiliated teaching hospitals.
During clinical training, AUC students complete core rotations in internal medicine, surgery, pediatrics, family medicine, obstetrics/ gynecology, and psychiatry. Each individual student, then, selects from among dozens of specialty elective clerkships to fulfill their remaining clinical requirements.
During the fourth and final year of medical school, students prepare for the next phase of their medical education: residency. At AUC, the Office of Career Advisement (OCA) can help students determine which residency specialty—such as physical medicine and rehabilitation—suits them best. The OCA then helps students navigate the National Resident Matching Program® (NRMP®)—a placement system which medical students who wish to become licensed in the United States use to “match” with a medical residency. A PM&R residency typically runs four years, beginning with a transition year of internal medicine.
In 2021, AUC had a first-time residency attainment rate of 92 percent for 2020-2021 graduates—on par with the overall match rate (92.8 percent) for medical schools in the United States. In recent years, AUC MD’s have matched with transitional internal medicine residency programs at Michigan State College of Human Medicine; Piedmont Macon in Georgia; St. Petersburg General Hospital in Florida; and Weiss Memorial Hospital in Illinois.
After completing physical medicine and rehabilitation training, a physiatrist may be certified by the American Board of Physical Medicine and Rehabilitation (ABPMR). Many board-certified PM&R doctors are members of the American Academy of Physical Medicine and Rehabilitation (AAPM&R). With additional training, doctors may subspecialize in a specific area of physical medicine and rehabilitation. These subspecialties include:
- Brain Injury Medicine
- Hospice & Palliative Medicine
- Neuromuscular Medicine
- Pain Medicine
- Pediatric Rehabilitation Medicine
- Spinal Cord Injury Medicine
- Sports Medicine
MEET A PHYSIATRIST
Brandon Snead, MD, a 2009 AUC graduate, is the medical director at Nevada Sports and Spine in Las Vegas. We asked Dr. Snead to describe the role of a physiatrist.
Q: Why did you decide to go into your specialty?
A: I chose Physical Medicine & Rehabilitation/ Sports Medicine because I love working with patients with significant impairments such as amputation, spinal cord injury and traumatic brain injury. It is rewarding to help them become more independent and to accomplish their goals. I feel the same way in rehabbing sports injuries to get athletes back onto the field.
Q: Any advice to medical students considering the specialty?
A: Definitely set up a clinical rotation to get first-hand experience. You can also shadow a PM&R physician prior to starting clinicals or if you have a week or two of break.
Q: What’s the most rewarding part of your job?
A: Patients giving feedback and thanks for helping them get back in the game or back to their lives.
If you want to become a doctor, and a career as a physiatrist appeals to you, learn more about the AUC MD Program and investigate the Office of Career Advisement. When you’re ready, take the next step on your path to a specialization in physical medicine and rehabilitation: apply for admission to American University of the Caribbean School of Medicine.
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*American University of the Caribbean School of Medicine is accredited by the Accreditation Commission on Colleges of Medicine (ACCM, www.accredmed.org), which is the accreditor used by the country of St. Maarten.