Joelseff Posted February 24, 2011 Share Posted February 24, 2011 I am close to accepting a Physiatry Job and I am a new grad. I want to know what the day-to-day is like and also any negative aspects of the specialty. I have extensive IM and Surgical Pre-PA experience but have never worked Ortho or Physiatry, can you recommend areas I need to Hone/develop and possible things to study? Thanks everyone! Link to comment Share on other sites More sharing options...
rcdavis Posted February 24, 2011 Share Posted February 24, 2011 Before they had a residency program, I moon-lit as the weekend in house for the Carolinas (Charlotte) institute of Rehabilitation. I would round on the 60-70 patients that they had as inpatients each day... divided into traumatic brain, stroke brain, and spinal cord sections(also infarct vs trauma). The physiatrists that I worked for , when I told them that I did not have a lot of brain or cns experience, told me what they principlally wanted me to do was manage those things that got the pt there: DM, HTN, ETOH/ drug abuse, liver dz, esrd, etc.. that they would handle the day to day rehab things. Hour for hour, except for a year and a half in CV and surgical ICU training, was the best learning experience I have had. learning curve was steep. But doable. Most of the stroke patients are vasculopaths... bruits galore, renal, hepatic, subclavain, carotid, (one occular!) and all have varying degrees of difficult to manage diseases. Of course, varying degrees of mobility leads to higher than usual incidences of pneumonia, stasis problems (clots, decubitii, atrophy, embolii), urosepsis from catheters, de-conditioning, etc. But excepting the trauma cords (which are usually spinal GSWs and MVAs) the vast majority are patients with the same problems that u would see in an IM clinic... only more so. Learn some of the types of cord injuries (frankel, brown sequard, anterior and central cord , etc) and sensory/motor deficits, the major deficits with areas of the brain injury (eg, what are the sensory changes in a pure thalmic cva), KNOW THE STAGES OF decubiti and wound ulcers. The rest: management of the lipidemias, the diabetes, the hypertensiion, the renal and liver, etc.. you should have enough of the basics. In 18 months, you will be studly, will be able to correlate a physical exam finding with the nerous system deficit (peripheral or central... and where), and will have a much better handle on what is a "serious" defect, or level of hypertension. You will also have a pretty good idea about physicial rehab and occupational rehab. And will have significantly better insight into peoples' inate character... and ability to handle devastation and seemingly insurmountable odds. (18 y/o with a t4...sex??). You will learn more PRACTICAL medicine and see more END STAGE disease in a year than you will see in your multispecialty clinic in 10 years. If you do get out of that business, you will never never ever regret it... there will be a capacity gleam in your eye that only trauma, and ICU or heart surgery PAs have... your inate level of insecurity and fears of bad things will be lowered immensely. This is a good decision. Now that you have made it, make the most of it. Start studying with any book of clinical correlatibve neurology.. oh.. what a minute, there just happens to be a text of that name... :) good luck, future stud.. davis Link to comment Share on other sites More sharing options...
Joelseff Posted February 24, 2011 Author Share Posted February 24, 2011 Thanks davis! Invaluable info. I'd better get crackin on that learning curve! :D Link to comment Share on other sites More sharing options...
Hemegroup Posted August 4, 2011 Share Posted August 4, 2011 As his specialty changes to GI/Hepatology, I see ;) Link to comment Share on other sites More sharing options...
Guest TerryF Posted August 4, 2011 Share Posted August 4, 2011 I, too, am interested in the psychiatric field, especially eating disorders. Any ideas on approaching MDs about this and how to get it started? I appreciate the input. TerryF Link to comment Share on other sites More sharing options...
Hemegroup Posted August 5, 2011 Share Posted August 5, 2011 I, too, am interested in the psychiatric field, especially eating disorders. Any ideas on approaching MDs about this and how to get it started? I appreciate the input. TerryF Terry ... this thread is about Physiatry, not Psychiatry. Link to comment Share on other sites More sharing options...
Guest TerryF Posted August 5, 2011 Share Posted August 5, 2011 My pardon. I'm not the smartest kid on the block. ;-)) Link to comment Share on other sites More sharing options...
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