The following is one resident’s advice on how to start a PM&R interest group at your institution.
After completing my surgical clerkship I realized my passion for surgery wasn’t as strong as I thought it would be, and I began restructuring my career goals in order to find my niche in medicine.
Frustrated, I lamented that I was going to have to settle on a career that I wasn't very passionate about. Then a close friend of mine asked if I had ever heard about physical medicine and rehabilitation. I hadn’t, but after spending a few nights reading about the specialty on the Internet and in the student bookstore, I was convinced that I had found the perfect fit for me. PM&R was my diamond in the rough. It was the career that I had been searching for.
I was fortunate to have an established PM&R residency program at the University of Virginia (UVA) to help guide me in the right direction. However, I was discouraged that I had never even heard about the specialty until the end of my third year of medical school. Lack of visibility is a problem inherent to many PM&R programs. Few medical schools have required PM&R rotations, and most students interested in the field don't rotate in PM&R until their 4th year electives. Many PM&R departments, clinics, and inpatient services are located at outside facilities (including UVA) that medical students don’t often get a chance to see. This lack of visibility was unacceptable to me, and I wanted to make sure that future medical students at UVA had the opportunity to learn about the specialty earlier in medical school.
As a fourth year med student, my solution was to generate interest in rehabilitation medicine by starting a student-run PM&R club geared toward first and second year medical students. At our meetings, UVA PM&R faculty gave lectures on musculoskeletal topics that paralleled the first year anatomy course. In addition, some attendings spoke about what their clinical practices were like, and residents sometimes came lent their perspectives on why they chose PM&R as a career.
The first year as an organized club was a huge success. We established a shadowing program in our department for first- and second-year medical students. Several club members who were interested in sports medicine were able to volunteer in the medical tents at local road races, including the Charlottesville marathon and half marathon (the medical director is a PM&R attending). One student even pursued PM&R-supported research in UVA’s gait and motion analysis laboratory. Most importantly though, many medical students who were not in the club heard about PM&R from their peers, and they learned that our field provides a wonderfully unique service to patients with disability, pain, and loss of function.
Over the last three years, the club has served as an important line of communication between medical students and PM&R residents and faculty at the University of Virginia. More students rotate through our clinics and inpatient services, and I believe increased exposure of physiatry (from the club) has had a large impact on the career choices of several UVA medical students. Since the club began in August 2004, nine UVA students have pursued a residency in PM&R. Prior to that, only five UVA students pursued rehab residencies in the previous decade.
Honestly, I'm not at all surprised by the instant success of the club and subsequent rise in popularity of PM&R at UVA. I believe that exposure to PM&R is ideal during the first and second year of medical school. Our knowledge of muscle, bone, and nervous system anatomy; our unique multidisciplinary approach to patient care; and our focus on restoring function make physiatrists valuable mentors to first and second year med students. We should be focusing efforts on educating this group of medical students and not just waiting for them to figure out who we are by the time 3rd and 4th year roll around.
So how can you help create more awareness of PM&R at your institution? First become familiar with the AAPMR Web site so that you can direct interested students toward valuable resources. There is a whole section devoted to medical students that explains what physiatry is and what a PM&R residency is like. In addition, there are links that provide a list of residency programs with contact information, and there are links to other important Web sites including the Association of Academic Physiatrists. Furthermore, there is a link to the medical student mentorship program that allows students to converse with PM&R residents at different programs. Consider signing up as a mentor yourself. Also, encourage any student who is really interested in PM&R to consider attending this year's Annual Assembly in Boston. There will even be a program just for medical students in which Academy leaders and residents will share their experiences and answer questions about PM&R. This program was extremely popular two years ago in Philadelphia and attracted over 160 medical students. Finally, take advantage of your time spent with medical students who rotate through your clinics and inpatient services. Usually we only have two weeks or less to get to know individual students, teach them the basics of our field, and at the same time foster interest in PM&R. This is the most critical time to make a lasting impression on students who are considering a career in physiatry vs. another specialty.
Michael S. Cicchetti, MD
PGY2 – University of Virginia School of Medicine