Medical Students: Prioritize Your Personal Statement When Applying to PM&R Residency Programs
We recognize that these are unprecedented times full of new challenges. Given that medical student rotations have been impacted by COVID-19, we spoke to PM&R residency program directors and they understand that not all well-qualified applicants will have the opportunity to do a PM&R rotation. You may be concerned about what this means when you apply for residency programs.
In the past, your rotation experience and letters of recommendation have been highly valued. While those remain important components of your application, residency programs will also heavily consider other aspects including your personal statement. Your personal statement is your opportunity to shine and the key to telling your story. It gives you the chance to express your interest in PM&R and particular residency programs as well as your specific interests and career goals. You'll find additional suggestions on crafting your statement in this section.
FIRST YEAR MEDICAL STUDENTS
The first year of medical school is very exciting but can be overwhelming. Your primary focus should be acclimating to your new environment and discovering how you learn best. Medical school is different from college and other graduate programs primarily due to the volume of material in a short amount of time. You should remain open-minded to new study strategies, but ultimately go with what works best for you!
HOW TO GAIN EARLY EXPOSURE TO THE FIELD OF PM&R:
- Contact a physiatrist that is affiliated with your school and try to set up shadowing opportunities.
- Get involved (or even run!) your medical school's PM&R interest group.
- If there is no physiatrist affiliated with your school, contact the American Academy of Physical Medicine and Rehabilitation (AAPM&R) and review its Frequently Asked Questions. This document has been created from actual medical student inquiries and can be one of your best resources!
- Join AAPM&R for FREE! Yes, it is free to be a member as a student. Click here to complete an application today.
- Using the AAPM&R search engine, you can find a physiatrist in your area to reach out to for additional shadowing opportunities.
- Consider keeping a journal while in medical school to document and reflect on your experience and to record stories that might be useful in your personal statement when you apply for residency positions.
The summers in medical school are a time for rest and relaxation after a tough year! It is also a perfect time to gain more experience in the field. You should try to secure something in late winter/early spring (it's never too early to start!). Some ways to learn about such opportunities are through interest groups and recommendations from second through fourth year medical students. Some ideas include:
PAID SUMMER EXTERNSHIPS
Some PM&R physicians offer summer externships that provide a mixture of research and clinical experiences.
- Check with your PM&R department to see if there are any summer research opportunities. Don't worry if your school does not have a PM&R Department, as there is likely related research in another field that would be valuable. Check your departments of neurology, neurosurgery, orthopedics, pediatrics, and internal medicine (e.g., rheumatology, geriatric medicine) for possible research opportunities.
- The Association of Academic Physiatrists (AAP) offers the Rehabilitation Research Experience for Medical Students (RREMS) program. This program allows first-year medical students to experience research within the specialty through an 8-week summer elective.
- If you will be spending your summer near a PM&R residency program, contact the Program Director to see if there are any opportunities for you to participate.
Another fun way to gain exposure to the field of physiatry is through summer camps or community outreach programs.
Some examples include:
- Schwab Rehabilitation Hospital in Chicago, IL hosts Camp Schwab every August and accepts enthusiastic volunteers.
- Texas Scottish Rite in Dallas, TX hosts many camps for children with various disabilities throughout the year.
- Peak Potential (founded by pediatric physiatrist JenFu Cheng, MD, FAAPMR at Children’s Specialized in NJ) helps children with disabilities rock climb and reach new heights at the NJ Rock Gym (various locations in NJ including Princeton and Fairfield).
- Get involved with organizations in your area such as Adaptive Adventures, an organization which works with people with physical disabilities.
- There are also local and national adaptive sports organizations which you can get involved in such as the Special Olympics.
- If your medical school has a PM&R department, contact them to see if you would be able to set up a shadowing opportunity with the Department (oftentimes, you can combine this with research).
- If your medical school does not have a PM&R department, contact the Academy to help locate physiatrists and try to set up shadowing opportunities. You may also try contacting PM&R programs in your area as well.
- Try to set up opportunities in a variety of settings (e.g., inpatient, outpatient, electromyography/nerve conduction studies, interventional spine, sports medicine, pediatrics, spinal cord injury, brain injury, joint injuries and amputee management).
- Clinical rotations for the first-year medical student should focus on getting to know the field and if it is a good fit for you.
SECOND-YEAR MEDICAL STUDENTS
Doing well on the USMLE/COMLEX exams will only strengthen your application, and these scores are becoming more important as PM&R has become more competitive over the past few years (especially with the more competitive programs) Click here to see the most recent reports compiled by the NRMP regarding Match results.
At the end of second year, medical students should understand:
- Basic musculoskeletal and neuroanatomy
- Elements of a history and physical
- How to perform a basic musculoskeletal and neurologic exam
THIRD-YEAR MEDICAL STUDENTS
Finally, you have reached the clinical portion of your training—get excited! Every school has a set core curriculum for mandatory rotations. However, there is some variability in terms of duration of rotations and/or possible electives that students are offered. If you have elective time during your third year, this is a great time to gain some exposure to the field of PM&R as you go through your core rotations.
Between your third and fourth year, it is also highly advisable to undertake a clerkship in PM&R. Please find below a list of these provided by the Association of Academic Physiatrists (AAP) by clicking here. This will give you the greatest exposure to the field of physiatry and put you in the most optimal position when it comes to residency interview season.
It's also helpful to attend the Medical Student Program at the AAPM&R Annual Assembly. It's complimentary for AAPM&R medical student members!
Most away rotations at other institutions require third- and fourth-year medical students go through the VSAS application/website, which usually has a list of away rotations by specialty that are accepting students that year (once logged in, go to the “Electives” tab and select “Physical Medicine and Rehabilitation” from the “Specialty” pull-down menu). Your medical school may need to provide you with further information on how to register and log into VSAS. You should start to do this in the middle of second year as there are limited spots depending on the program. If you do not find a program on VSAS, you can always reach out to a specific PM&R Department directly through their website and inquire about opportunities for medical students.
If you are not able to do an in-person rotation due to the COVID-19 pandemic, see if the PM&R Department offers virtual opportunities. Many programs allow medical students to attend didactics virtually, which is a great way to network, interact with residents/faculty and learn about physiatry!
Try to keep track of interesting PM&R cases to talk about in your personal statement and in interviews.
PM&R Knowledge NOW® is also a resource available to medical professionals that provides information on common PM&R related topics (like UpToDate but for PM&R topics, many of which are not covered on UpToDate).
When you are doing rotations in other specialties, try to think about these PM&R-related objectives which you will commonly see in our field:
- Understand diagnosis and treatment of chronic pain problems
- Learn to assess airway and pharmacologic considerations perioperatively
- Learn EKG interpretation (as a resident, this is critical for inpatient rehab!)
- Consider indications, benefits and goals of cardiac rehabilitation
- Management of common cardiac issues (e.g. heart failure, hypertension)
Critical Care Medicine
- Learn about critical illness polyneuropathy and myopathy
- Learn about tracheostomy and ventilator management
- Learn how to obtain access (peripheral IVs, IOs)
- Learn about fluid management
- Learn about wound care management
- Learn about diabetes management and understand how it can lead to complications such as vascular disease, neuropathy, chronic wounds, amputation, and other impairments
- Learn about management of primary care medical issues for adults and pediatrics, preventative screening, routine follow-up, or other common medical needs. Can be helpful to gain some phlebotomy experience for your inpatient rehab rotations
- Learn about sports medicine/musculoskeletal management, pain management, how various medical conditions can lead to impairment/disability
- Learn about what qualifies a patient to be on disability
Gastroenterology / General surgery
- Learn the indications, risks, contraindications and management of percutaneous endoscopic gastrostomy (PEG) tubes
- Learn about stoma management
- Learn about assessment of nutritional status
- Learn about transplant hepatology
- Investigation and management of more common conditions such as diarrhea and constipation
Hematology / Oncology
- Learn about late effects of chemotherapy, infectious complications
- Understand how to investigate causes of anemia
- Learn about anti-coagulation, as well as duration of treatment for DVTs, PEs and strokes
- Learn about treatment of common infectious diseases (e.g. urinary tract infections, pneumonia, infectious diarrhea) and consider how they might present and be treated in a less common population (e.g. spinal cord injury, traumatic brain injury, stroke, post- operative joint replacements, etc.)
- Learn about infectious issuesin transplant/immunocompromised patients
- Learn about common genetic disorders that might present in a pediatric PM&R practice such as Down Syndrome, Cystic Fibrosis, the Muscular Dystrophies, Fragile X and Spinal Muscular Atrophy
- Learn about kidney transplant, dialysis indications
- Understand the indications and considerations for fistula care
- Learn management of acute kidney injuries
- Learn electrolyte management
- Become proficient at your neurologic exam
- Learn management and complications of acute stroke, Guillain-Barre Syndrome, Multiple Sclerosis, ALS, myasthenia gravis, Lambert-Eaton, Parkinson’s Disease
- If possible, gain exposure to electromyography/nerve conduction studies
- Learn management of common medical issues in neuro patients (e.g. hyponatremia, hypertension)
- Learn from various therapists (physical therapists, occupational therapists, speech language pathologists) on inpatient and outpatient rotations
- Learn to interpret imaging and how they correlate to physical exam findings, treatment, and functional prognosis
- Learn the indications and surgical management for acquired brain trauma, spinal cord/column injury, vertebral disk herniation, central nervous system tumors, and spasticity
- Learn to interpret imaging and how they correlate to physical exam findings, treatment and functional prognosis
- Learn musculoskeletal anatomy and physical exam techniques
- Learn indications for surgical and non-surgical management of common musculoskeletal injuries
- Learn basic peripheral joint injections
- Learn to interpret imaging and how they correlate to physical exam findings, treatment and functional prognosis
- Learn basic splint management, staple and suture placement and removal
- Understand the mechanics of swallowing
- Learn the indications for a tracheostomy, as well as management and risks
- Learn how to change/manage a trach and decannulate
- Learn from respiratory therapists and speech language pathologists
- Learn normal and abnormal development
- Management of chronic medical conditions including cerebral palsy, muscular dystrophy, spina bifida and scoliosis, and how they relate to function
- Learn pulmonary rehabilitation, pulmonary toilet
- Practice reading chest x-rays
- Learn about addiction, substance abuse, post-traumatic stress disorder (PTSD), delirium vs. dementia, pharmacologic treatment for insomnia, agitation, and anxiety and how to assess for capacity to make medical decisions
- Learn indications for imaging for neurological and musculoskeletal conditions
- Learn radiographic anatomy and interpretation
- Learn medical management for chronic rheumatological conditions.
- Learn basic peripheral joint injections or aspirations
- Gain exposure to various surgical areas including Cardiothoracic, Vascular, Plastic, Transplant, Surgical Oncology, Trauma, Burn, Oral and Maxillofacial, Orthopedic, Podiatric surgery
- Learn about many surgical procedures and what they entail, as well as how they may impact function post-operatively
- Learn to order appropriate urologic studies, supplies and medications for patients with neurogenic bladder due to spinal cord injury, stroke, brain injury and other neurologic disorders
- Gain skills in catheter placement and learn about the different catheters that are available to patients
- Learn about various procedures available to patients with bladder/urologic issues
- Disaster Medicine, Medical Ethics, Biomedical Engineering, Hospice and Palliative Care, Pain Management, Sports Medicine, Diving Medicine
FOURTH-YEAR MEDICAL STUDENTS
Almost there! Your fourth year is another exciting and pivotal point in your medical training. More reason for you to have a game plan and stay organized! There are many things that you need to keep track of as you transition from third year to fourth year. Some things that you want to keep in mind as you plan your fourth year (make sure to also check out the Step-by-Step Guide to Applying for PM&R Residency page):
AAPM&R MEDICAL STUDENT PROGRAM
Attend the Medical Student Program at the AAPM&R Annual Assembly. It's complimentary for AAPM&R medical student members! Gives you an opportunity to speak directly with a number of PM&R programs right around the start of interview season. Can help put a face to your application!
Starting EARLY is always a good step. Aim to submit your applications through ERAS as close to the opening date for applications as possible. Some programs fill up their interview spots early so the earlier the better.
PERSONAL STATEMENT TIPS:
- Writing a good personal statement does take a lot of time and self-reflection.
- Have others proofread your personal statement and allow them enough time to do so. It can be helpful to have a physiatrist look over your personal statement.
- Your personal statement is a very important part of the interview process as it is your opportunity to set yourself apart from others.
- There are many opinions about what elements make a good personal statement.
- Being too conservative can be just as risky as being too bold.
- Avoid colloquial language.
- The opening sentence is the most important line in the personal statement. It should invite the reader to keep reading.
- Draw on personal and/or patient experiences to help relay why you want to go into PM&R. You could refer to the journal you kept throughout medical school for ideas and stories.
- Include why you think that you would be a good physiatrist.
- Discuss your interests and career goals.
- Highlight what makes you different and why you will be a valuable asset to a program.
- Can consider tailoring the statement to specific programs.
- Make sure that your grammar and content flows for easy reading.
- Finish with a strong closing paragraph.
- Have multiple people (faculty, friends, family, etc.) provide you feedback and criticism on your personal statement. A good piece of writing always benefits from multiple drafts.
- Try to be concise and keep to 1 page. ERAS applications are long enough!
LETTERS OF RECOMMENDATION
- Most programs require 3 letters of recommendation for residency.
- A letter from a physiatrist is not a requirement at all residency programs but it is HIGHLY advised, especially if your medical school has opportunities for you to rotate in PM&R. PM&R letters of recommendation are also becoming more important as the specialty becomes more competitive and most applicants provide at least 1-2 letters of recommendation from PM&R faculty.
- Most PM&R programs require a preliminary year (intern year), most commonly in Internal Medicine or Surgery. It is strongly advised that you get a letter of recommendation from either Internal Medicine or Surgery, depending on which respective intern specialty you apply for. Please note that some Internal Medicine preliminary year programs may require up to 4 letters of recommendation (this usually includes the Internal Medicine departmental letter, which is a general letter your medical school’s Internal Medicine Department should be writing for every medical student applying for an Internal Medicine prelim year). Most preliminary programs accept (and sometimes even expect) the PM&R letters of recommendation you are already using for your PM&R program applications.
- Your medical school will give you guidance on how to ask for and obtain your letters of recommendation.
- Choose letter writers that you know will write strong letters of recommendation. You can seek out advice from senior medical students and residents.
- Make sure you provide your letter writers with plenty of time to write your letter as well as an updated CV and personal statement.
- Stay in regular communication with your letter writers to make sure they send their letters to ERAS at the appropriate time. You don't want your file to be incomplete due to pending letters.
SCHEDULING STEP 2 OF USMLE/COMLEX
Remember to schedule your Step 2 Exam during a time when you can study. Studying and taking Step 2 may be difficult if you are on a busy rotation and/or PM&R audition rotation. However, also keep in mind not to take it too late in the year if you think that your Step 2 scores are vital to your application (more PM&R programs now prefer your Step 2 scores prior to offering interviews, but it is not always necessary)
ELECTRONIC RESIDENCY APPLICATION SERVICE (ERAS)
- Both allopathic and osteopathic residency programs use ERAS. The application service typically starts on July 1 of your fourth year. For a complete timeline, please check the ERAS website.
- The opening date for your ERAS application to be sent to the programs of your choice is typically on September 15 (please check the ERAS website and timeline to verify this as the ERAS timeline sometimes changes year to year).
- Read your ERAS application over several times before submitting to ensure no errors in your application! Consider having a classmate review your application since they are familiar with the software and you can return the favor!
- Conduct mock interviews with classmates and faculty.
- Wear professional attire.
- Do your research on the program/interviewers before the interview day.
- Stay engaged and focused throughout the interview day. Be polite and cordial to everyone you meet throughout the day. Remember the entire day is an interview, even during lunch and breaks!
- If virtual for 2021-2022 season, ensure a good interview setup with optimal lighting, minimal distractions, quiet setting and stable internet connection. Some medical schools provide their students with areas on campus to conduct virtual interviews. Practice over Zoom with friends to ensure appropriate eye contact and mannerisms. Virtual interviews are very different from in-person interviews!
- Smile, smile, smile 😊
Physical medicine and rehabilitation is an amazing and exciting field! The depth and breadth of our knowledge is one of our greatest strengths. Take advantage of every rotation to think “like a physiatrist” (e.g., think about the effect of medical conditions on function and how patients may be able to return to or maximize their functional levels). Our field applies to every medical specialty and patient population and there are numerous opportunities to tailor your future practice to your interest.
Good luck! 2020-2021 Physiatrist in Training (PHiT) Council