Training to be a Physiatrist (and Beyond)
I wrote some basic information about Rehabilitation Medicine in the first post for this category. You can read that here to refresh your memory.
Specialty training in Rehabilitation Medicine occurs in residency (side note: it’s called “residency” because in the past, graduate medical education required the trainees to live in the hospital – thus they were called “residents” or “house staff”). In the Philippines, residency training in Rehabilitation Medicine starts after completing internship, and lasts a total of three years. The American model has one year of internship as a foundation year (post-graduate year 1, or PGY-1), followed by three years of Physical Medicine & Rehabilitation (PGY-2 through 4). As I’ve written previously, the resident is well-equipped to start practicing right out of residency. However, some people opt to spend extra time concentrating on one area of expertise – this further training is called fellowship. Fellowship is generally 1 year in duration, except for Pediatric Rehabilitation which lasts 2 years. A few physiatrists choose to do more than one fellowship; for example, pediatric rehabilitation with a second fellowship in palliative care, or traumatic brain injury and spinal cord injury.
Fellowships are available in spinal cord injury, traumatic brain injury, electrodiagnostics/neuromuscular disease, sports medicine, pediatric rehabilitation, pain medicine, interventional spine medicine, cancer rehabilitation, performing arts medicine and Parkinson’s disease and movement disorders, and palliative care. There are also fellowships that combine some of these fields – for instance, sports + spine, or spine + electrodiagnostics. Some fellowships are not exclusive to physiatrists, so the fellowship applicant may have to compete with other specialties – for example, sports medicine, palliative care and integrative medicine are fellowship programs open to (or even primarily for) physicians from other specialties.
As medicine in general is an ever-changing field, physiatrists have to keep up with new developments. Continuing medical education takes the form of national and international conferences, short courses on certain topics (for example, musculoskeletal ultrasound or spasticity management), reading journal literature and the like. While online courses have been around for a while, the pandemic has accelerated the speed at which remote learning has been developed. This certainly has facilitated a greater exchange of ideas and I suspect remote learning as an option (in addition to in-person learning) will be here to stay.
