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PM&R Resident E-Newsletter

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December 2016

From Your Resident Physician Council (RPC)

A Letter from the President

G. Sunny Sharma, MD
VA Greater Los Angeles/University of California, Los Angeles
PGY3

AAPM&R’s 2016 Annual Assembly, held October 20-23, was a highly successful and fun gathering of physiatrists and residents in New Orleans. With the theme of Moving Physiatry Forward, the Assembly offered exceptional speakers, hands-on workshops, and networking events, including our spirited resident quiz bowl! Attendance was outstanding with more than 3,000 from around the world, including 600+ residents—the largest gathering of residents in the country.

On Wednesday, early attendees were able to visit the career-focused sessions, “You Are Here: Creating Your Path in the PM&R Specialty” and “You Get What You Negotiate—Contracting for PM&R Physicians.” Guest speakers provided expert advice on job search information to help guide resident physicians in both creating their own path and preparing for physiatric practice. This was followed by the interactive Job Fair, where residents and fellows met with an extensive range of recruiters, potential employers, and fellowship programs from more than 100 institutions across the country—the largest PM&R Job Fair in the country.

The Resident Physician Council (RPC) leadership met on Thursday to review the past year and welcome incoming leadership. The RPC leadership also reviewed plans for the upcoming year, including resident member benefits, recruitment of resident and medical student members, Visioning PM&R Bold, and the Physiatry is More Than initiative.

The Annual Assembly officially started on Thursday with AAPM&R’s President Dr. Gregory Worsowicz kicking off the Physiatry is More Than initiative. Another highlight was the resident-focused lectures, starting with sessions on spinal interventions and practice management pearls for the trainee in musculoskeletal and sports medicine. This was followed by the inaugural AAPM&R Resident Quiz Bowl, where the MetroHealth Rehabilitation Institute of Ohio/Case Western Reserve University School of Medicine program was crowned the champion. Congrats to Benjamin Kaplan, MD, MS; Daniel Painter, MD; and Jason Dancy, MD!

Early risers took part in a beautiful Friday morning run during the Foundation for PM&R 5K Run/Walk & Roll. Friday’s program featured Dr. Bennet Omalu, a ground-breaking forensic pathologist and the inspiration for the movie Concussion, who discussed chronic traumatic encephalopathy (CTE) and his history-making work to bring awareness to this disease. Dr. Omalu’s plenary shed new light and provided first-hand insight on this important topic as he reminded the audience to… “Don’t Break the Rules. Change the Game!” In addition to educational sessions, Friday included the fun wheelchair basketball tournament.

The RPC Board held the Resident Town Hall on Friday evening, providing a forum for residents to learn about RPC activities over the past year and to ask questions or offer suggestions for the upcoming year. Small group sessions were also held to provide resident feedback on Visioning PM&R Bold. Following the Town Hall, the RPC leadership met with other residents at the Residents’ Reception while enjoying appetizers and refreshments. Members then had the opportunity to participate in an exciting second line parade through the streets of New Orleans and attend a one-of-a-kind President’s Reception at the National World War II Museum.

The Annual Assembly was a huge success and we look forward to seeing you next year in Denver, Colorado, October 12-15, 2017. Be sure to mark your calendars for the largest gathering of PM&R residents in the country! Highlights will include innovative educational sessions, networking opportunities, Job Fair, learning labs, and hands-on activities. Residents should also consider arriving in Denver a day early on October 11 for career-planning sessions and the Job Fair. We look forward to seeing you there!

Minimizing Adaptive Equipment to Maximize Independence: Therapeutic Fly Fishing and the Art of Tenkara

P. Bobby Katta, JD, DO
University of Kentucky Medical Center
PGY3

"Fishing is the chance to wash one's soul with pure air. It brings meekness and inspiration, reduces our egoism, soothes our troubles, and shames our wickedness. It is discipline in the equality of men—for all men are equal before fish."—Herber Hoover

The soundtrack of a late fall morning plays as the sun peaks over the mountains in the distance, lighting the leaves in an inferno of orange and yellow. Exhaled breath condenses as it meets crisp, clear country air. Anglers from near and far stand along the shoreline to pay homage to fish and nature. The stunning scene unfolding in the shadow of the Daniel Boone National Forest is typical of any October morning in Kentucky.

It was in this majestic, yet serene setting that residents of the University of Kentucky Physical Medicine and Rehabilitation program joined members of Trout Unlimited-Bluegrass Chapter and Easter Seals of Cardinal Hill Rehabilitation Hospital in Lexington to host Kentucky’s first adaptive fly fishing event. This event was spearheaded by Dr. Robert Worthing, MD, associate professor at UK PM&R, amputation rehabilitation director of the Lexington VA Medical Center, and co-founder and instructor at TROutreach Guides LLC. TROutreach stands for Tenkara Recreational Outreach. The co-founders of this unique organization identified that adaptive equipment and cumbersome fishing gear limited a disabled person’s ability to fish. The organization formed around the belief that disabled men and women could maximize their independence by using the bare minimum of adaptive equipment and lightweight fishing gear. The organization sought to teach fly fishing techniques that would give the disabled angler a lifetime of enjoyment on the water.

The day began with a safety training session in handicap-accessible classrooms provided by the Wolf Creek National Fish Hatchery and Visitor’s Center. Disabled participants came from far and wide, some traveling great distances for this unique opportunity. The excitement in the room was palpable. During the morning briefing, participants, instructors, UK PM&R residents and Trout Unlimited members broke out and formed small groups. Naturally, some friendly competition began to develop between the groups, lending to the success of the event.

After safety training concluded, Dr. Worthing introduced the participants to Tenkara, a Japanese form of fly fishing that relies merely on rod, fishing line, and fly. This ancient art has gained significant popularity in the United States for its simplicity and effectiveness at catching fish. Tenkara requires subtle movement and minimal power to cast, making it highly efficient and effective. The rods that are used typically weigh ounces, and are very easy to handle. There is no reel for the operator to manipulate. Most importantly, the dynamics of the rod allow for the efficient transfer of energy to the line with minimal effort. The simplicity, efficiency, and elegance of Tenkara is well suited for spinal cord injured patients, amputees, patients with cerebral palsy, and multiple sclerosis. During the session, Tenkara rods were handed out, and instructors and residents worked with participants to modify the rods to accommodate for the impairments of the participant.

On the shoreline, basic instructions were given and then the teams were set loose. As the day progressed, and techniques improved, disabled participants began to rack up some serious numbers. By the end of the day, each participant had caught multiple fish. One participant even hauled in an enormous 19-inch rainbow trout. As a testament to the effectiveness of Tenkara, the disabled participants out fished every other able-bodied fisherman on the river that day. Everyone involved agreed that the adaptive fly fishing event was a resounding success. In fact, the event received such positive feedback from organizers, volunteers, and participants that Easter Seals committed to making adaptive fly fishing a quarterly event.

Importance of Resident Advocacy

John S. Georgy, MD, MBA
Montefiore Medical Center/Albert Einstein College of Medicine
PGY3

Supporting Authors: Naheed Van de Walle, MD and Michelle A. Stern, MD

As physicians, we often hear of health policy and think that it’s best left for politicians as we went into medicine for patient care. However, being a part of the NY Society of PM&R and getting the opportunity to attend MSSNY (Medical Society of the State of New York) Advocacy Day in Albany, NY as a member of the NYSPMR legislative delegation, to talk about the effects of current policy on physicians with our congressmen and their health policy legislative directors was an eye-opening experience that dispelled my misconceptions. Health policy affects each and every one of us whether we are practicing physiatrists, subspecialists, medical students or residents, like myself.  

As residents, teaching patients is just one facet of an important role we are learning to play as patient advocates. As an advocate for the patient, the concerns and best interests of the patient are at the core of all decisions and interactions. While most physicians and specialists advocate for their patients, the role of advocacy in PM&R is even more pronounced. Gaining an understanding of the policies around you in our field can influence policy changes at the community, state, and federal levels to assure all patients are best served¬. As physicians, we have the unique opportunity to share our expertise, advocate for our patients, our field, and educate our lawmakers. It is important to share your voice, contact your representative, and/or lobby on legislation that affects our field, our patients, and the care we provide. Every day there are rules, regulations, laws, and programs that are being implemented and/or changed by government entities that effect the practice of not only PM&R but the entire field of medicine. Through advocacy, a physician’s rights and needs are expressed and represented. By advocating for what is and/or not an appropriate course of action, a physician serves as the expert and provides insight that would otherwise not be considered. Since we are the new generation of physicians to influence the future of health care, we need to protect the rights and interests of the patients where they cannot protect their own. Current health care policy has the potential to drastically alter our ability to provide comprehensive clinical care as physicians. Whether you are a medical student concerned about matching into a funded post-graduate training spot, a medical resident wavering in your interest in primary care due to reimbursement or a practicing physician concerned about your future earning potential, health care policy directly impacts you.

Attending MSSNY Day was a wonderful experience that helped further my understanding of health policy and gave me an opportunity to give a personal perspective as a resident physician to our lawmakers on key health issues that will affect my future and the patients I will provide care for. I look forward to contributing to the process again next year with the New York delegation. The feedback we received from our representatives and their legislative directors was very positive and they seemed to appreciate and respond well to stories of our patients and personal challenges we may face as providers due to current policies. They hope to work with us to address these critical issues. We need to continue this work in our local communities and strive to be a part of the change we hope to see in health care. We hope that you will consider becoming involved in your state’s society to advocate for PM&R and to keep informed of the latest updates affecting current policies, and will continue supporting the mission of enhancing the quality and effectiveness of health care by fostering excellence and professionalism in the practice of physiatry.

“Never doubt that a small group of thoughtful committed citizens can change the world; indeed, it’s the only thing that ever has.”—Margaret Mead.

P.S. Be sure to browse your December/January issue of The Physiatrist to learn more about the importance of advocacy and read a few interviews!


Top Stories You Need to Know 


Save the Date for #AAPMR2017

A big thank you to our 3,000+ attendees who came to New Orleans for the 2016 Annual Assembly! From Dr. Gregory Worsowicz’s opening Presidential Address to the interactive Learning Lab, exciting Second Line Parade to the President’s Reception, celebrating Physiatry Day on Saturday, the Interactive Arcade, and valuable educational sessions throughout, the meeting was a huge success.

We connected with your resident peers while in New Orleans. Watch what they have to say about attending the Annual Assembly:

Mark your calendar for next year! We’re meeting in Denver, Colorado, October 12-15, 2017, and we have so many fun activities planned, including a brewery tour at Wynkoop Brewing, the first brewery established in Denver. We'll have live entertainment, brewery tours, pool tables, shuffleboard, and more! Stay tuned for details.

P.S. Save the date for the largest PM&R Job Fair in the country—October 11, 2017 at the Colorado Convention Center.

SAE-R Study Tools from Your Academy

The AAPM&R self-assessment examination for residents (SAE-R) takes place January 2017 and consists of 150 multiple-choice questions. Are you prepared?

Your Academy has several online resources to help you study. Many of these resources are available on mē® at a discounted rate for residents.

  • Abridged SAE-Rs: Each abridged SAE-R provides a taste of what to expect with January’s exam by featuring questions covering 10-12 clinical areas of PM&R.
  • Self-Assessment Examinations for Practitioners (SAE-Ps): SAE-Ps are a great way to zone in on 1 clinical area and evaluate your knowledge. Plus, some include review articles.
  • Certification Exam Prep Qbank: This online exam study tool covers the 12 PM&R core topics of the specialty through 800+ questions. The Qbank provides immediate feedback with comprehensive commentary and references, and you’ll have access to this resource for 2 years.

Engage With Your Peers on PhyzForum

PhyzForum is your community to discuss and engage with your peers. Upload your profile picture, update your contact information, and add colleagues and friends to your contact list. PhyzForum is your destination to receive insights and ideas from your fellow physiatrists—log in and post a discussion to get started!

Become Tomorrow’s Rehabilitation Researcher! Join the Rehabilitation Medicine Scientist Training Program

The Rehabilitation Medicine Scientist Training Program (RMSTP) provides research training, mentorship, and career development support for those physiatrists committed to developing productive careers in academic medicine and research. The ultimate aim of the RMSTP is to increase the number of rigorously-trained, extramurally-competitive, and scientifically-productive faculty members in physical medicine and rehabilitation departments, who can contribute to the continued development of physiatric research specifically and rehabilitation science in general. Learn more about the program here.

Resources for You

What’s Coming Next
Look for the next issue of the PM&R Resident in your email inbox in February.

Want more resident-specific content before then? to get additional articles written by your peers right in your news feed.

Missed the last issue? Check it out on the Academy’s website.