J501 Physical Medicine and Rehabilitation (Montefiore Medical Center/Burke Rehabilitation Hospital/Montefiore Medical Park/Beth Abraham Health Services)
This 4 week elective will introduce the student to the specialty of Physical Medicine and Rehabilitation (PMR) in inpatient acute, subacute and long-term care settings as well as in outpatient venues that span the full spectrum of physiatric specialty and subspecialty services. The student will have the opportunity to observe the planning and implementation of both physical medicine and rehabilitation care, including acute and subacute general rehabilitation, neuromusculoskeletal care, cardiac rehabilitation, and pediatric rehabilitation. The student will have opportunities to participate in diverse subspecialty services including electrodiagnosis, prosthetics, orthotics, spasticity management, spinal cord injury rehabilitation, wheelchair and durable medical equipment services, complementary and alternative medicine care, and interventional pain management.
1. Understand of role of Physical Medicine and Rehabilitation in different clinical settings
2. Differentiate the role of physiatrists and physical/occupation/speech language therapies
3. Identify common neuromusculoskeletal disorders and their management
4. Appreciate different physiatric interventions
The elective will be split between inpatient and outpatient rehabilitation. The student will spend two weeks on acute inpatient rehabilitation floors to participate in daily work and teaching rounds, as well as team conferences. Acute rehabilitation floors may include general rehabilitation, traumatic brain injury, spinal cord injury, and neurorehabilitation. The student will spend one whole week in the outpatient rehabilitation setting, and one week split between subacute rehabilitation and the outpatient setting. They assist in various physiatric procedures including joint and soft tissue injections, botulinum toxin injections, neurolytic blocks, myofascial manual medicine techniques and ultrasound or fluoroscopic guided procedures. The student will observe and participate in the interdisciplinary rehabilitation team process and become familiar with the treatment modalities employed by physical therapists, occupational therapists and speech and language pathologists. The roles of music and recreation therapies as well as rehabilitation social workers and vocational counselors will be addressed. The student will participate in the PMR residency didactic program, including journal clubs, lectures and all other educational presentations.
Method of student feedback and evaluation: An end of rotation evaluation will be compiled by the course director through input from the faculty with whom the student has rotated. A presentation topic will be provided at the beginning of the elective, which the student will present at the end of the elective.
Title: Physical Medicine and Rehabilitation
Author: Randall L. Braddom MD
Other Suggested Reading include:
Title: Physical Medicine and Rehabilitation Board Review
Author: Sara Cuccurullo MD
Title: Physical Medicine and Rehabilitation Pocketpedia
Author: Matthew Shatzer DO
Stephanie Rand, DO
Flora Tabaddor, MD
Modules: All except 1B
Maximum: 3 students
First day of elective students should report to Dr. Rand at Rehab Clinic, Ground Floor, North West Pavilion, 111 East 210th Street, Montefiore Medical Center-Moses. Detailed location and time schedule will be provided at or prior to the start of the elective.
J504 Introduction to Physical Medicine and Rehabilitation (Jacobi Medical Center)
A four-week introductory clerkship in PMR to provide exposure to the scope of services provided by the specialty. Students will have the opportunity to rotate in the various inpatient and outpatient settings at both Jacobi and North Central Bronx Hospital. The student will participate in the various clinics that include: Injection clinic, interventional procedures, Musculoskeletal clinics, electrodiagnostics, Back Clinic and orthotics and prosthetics. In addition, the student will be exposed to the inpatient rehab service and the management of an acute stroke patient, from the initial consult, to the admission to the rehab floor, to the team conference to discharge planning. Didactic on Shoulder examination, back examination and the evaluation of a stroke patient.
To evaluate the shoulder and the back and determine which patients are appropriate for interventional procedures and the techniques involved in the procedures. To evaluate the stroke patient for their physiatric need, expected functional outcomes and team conference leadership. Residents, fellows, and attendings provide small group interactive didactics, clinical guidance and supervision and daily feedback regarding clinical and presentation skills. At the end of the rotation there is one required 15-minute oral case presentation, based upon a diagnosis seen in the outpatient or inpatient setting.
1) To become familiar with the patient populations that physiatrists treat.
2) To understand the unique roles physiatrists play as medical specialists in the care of patients with musculoskeletal disorders
3) To understand the indications for referral of patients to physiatrists.
4) To become proficient in the examination of the shoulder and the back
Michelle Stern, MD