Physiatry

[Guest mandm]

hi guys:

 

Is anyone considering Physiatry in the CaRMs match this year? (RAK2005, I recall you mentioning it awhile back....)

 

Anyway, if there's anyone who has already matched to this discipline or is doing elective time, can you please give me the heads up in terms of competition for spots/ what programs are looking for in their candidates??!

 

Thanks!

 

M

[Guest jmh2005]

As a former OT, I thought about Physiatry, however, it's not going to be in the cards for me. A great lifestyle, not a killer residency (still 5 years), decent renumeration...however, despite this, often there is spot or two still left after the 1st match. Not alot of people, even those in my class don't know much about it!!

 

Each school has its' certain strengths, McMaster and U of T apparently have great programs..and if the Physicians at these schools are any indication, I think they would be great places to learn the art and science of Physiatry. Go for it! We need more! Best of luck!

[Guest RAK2005]

Actually, I had thought about it seriously a couple of years ago, especially since I am a former PT. But the same things I didn't like about PT exist in physiatry. I've decided to go into woodworking (read: Ortho).

[Guest macdaddyeh]

I'm *VERY* interested that this topic came up because I have thought a lot about physiatry (the little known specialty).

 

For example, I have done many a shadowing session with a friend of mine who is an OT. In fact, I have many friends who are OT's and are encouraging me to apply.

 

My most recent dilemma is the pros/cons list which is where any great decision-making starts.

 

So......my question to you specifically JMH is...What led you *out of* not necessarily *into* OT? I realize this is a public forum and I respect your privacy, so if you don't want to go into too much detail then don't.

 

But otherwise, could you please indulge me with some of the details of your life as a former OT??

 

Edited to add: How did you make the transition to meds and justify this transition to the adcom (if you feel comfortable answering)...

[Guest medicator007]

Well this may sound a little naive.... but could someone explain to me what exactly Physiatry is? Judging by the discussion I would presume some connection to the world of PT/OT, but would really be interested in hearing more about this apltly named "little known specialty".

 

Thanks,

Medicator

[Guest macdaddyeh]

Hi Medicator:

 

It is similarly named Physical Medicine or Rehabilitation medicine because it is a specialty that more or less deals with individuals who have mobility impairments etc. That wee explanation of course is a gross generalization and understatement so I encourage you to poke around on the web to learn more..

[Guest UWOMED2005]

I've looked quite a bit into Physiatry having some interest in that particular specialty. Great lifestyle and actually good renumeration despite OMA figures: It's one the worst specialties for OHIP billings, but most physiatrists supplement with insurance work which can be lucrative. Rumour is one of the London physiatrists pulls in around $600k doing a lot of insurance work.

 

That's one of the big downsides though - insurance work. Many (future) docs hate this stuff, and there's potential for dirtiness.

 

Physiatry is rather peculiar in its scope of practice. It's actually one of the oldest specialties, being acredited in the 1940s. . . actually, the year before neurology was accredited, if my sources are correct. But it's not really a unified specialty - physiatrists do work in everything from pain management, to sports injuries, to spinal cord injuries, to prosthetics to insurance assessments. As one physiatrist put it, they are the pain and disability experts.

 

I've heard good things about the programs at Mac, U of T and U of O. Ironically, UWO has one of the better academic departments (lots of research here) but no residency program, having canned back when they were shrinking med school programs. My understanding though is that we are trying to start a program for the class of 2005 or 2006, if they are expanding residency spots at UWO as ?anticipated?

[Guest RAK2005]

Hey, there is a couple here in Kingston that do the insurance assessment, expert witness thing. One guy I spoke to mentioned that he does 4 days a week in the hospital, and one full day doing insurance/legal work. I didn't have the courage to ask him what the nets him though.

 

Interestingly, there are lots of subspecialty areas in PM&R. For example, a number of them run sports medicine clinics (usually with an orthopod or ortho consult, PT handy), do EMG studies, use alternative therapies, and geriatrics to name just a few.

 

The only way you'll know if you like it is to get on the ward and spend time with them I guess.

[Guest jmh2005]

Great discussion...

 

Macdaddeh...I practiced OT for 3 years and needed a change because I wanted to provide more to my patients. I worked in rheumatology (as well as several other areas) prior to my switch and was always being asked for advice I simply was not qualified to give. I got frustrated with the lack of knowledge and respect my profession seemed to have. The other major reason for the switch was that fact that I want to work with people BEFORE they get sick, disabled, injured...clearly I was not seeing any patient for proactive/preventative types of things.

 

Physiatry is a great speciality however, for the reasons I mentioned above. You can do so many different things...EMG testing clinics, in-patient rehab, sports medicine, seating (wheelchair) clinics, orthotics clinics, insurance/disability ax, neuro/msk referrals....I still find that as a Physiatrist, you can't necessarily solely help your patients...you are limited in some ways, because you need to rely on your allied health care professionals to do their part too in many cases, OT, PT, SLP (not always I realize, but enough). When I was an OT, I needed to rely on the physician to sign off on my wheelchair prescriptions, orthoses, etc...you each need each other, which I don't necessarily like.

 

If you have any further questions, I'd be more than happy to answer them personally via email if you drop your email address.

 

Take care,

J

[Guest macdaddyeh]

Hi again JMH2005:

 

Thank you for your succinct and insightful reply. I have pondered applying to OT for quite some time. I have a number of friends who just can't say enough about it; two of them work in California and get paid a killing and work in some very innovative ares of OT.

 

That said, I think you have warned fellow readers before that if one has one's heart set on medicine it is best to pursue that avenue because of the difficulty associated with justifying the change of mind etc.

 

Do you concur? Any final advice?

 

PS. I really don't feel comfortable giving out my email address. Long story, but I had a very strange and negative experience when an old acquaintance of mind turned on me and did some strange and nasty things via email. Strange but true..... Hence, we'll have to stick to this forum, but thanks for the offer.

 

PPS. Purely out of interest sake, have you decided on a specialty?

[Guest jmh2005]

Macdaddeh...you have a good memory, I do believe that you should go for what you really, really want because otherwise, you may never be truly satisfied and always wonder whether you could have had what your heart really desired...(just my two cents on that one)..just go for it...don't let one round get you off track...it sometimes takes perserverence!!!

 

OT practice in Canada/Ontario is VERY different than that in the US, I can't stress that enough. Pay scales are very different, the work is quite different as well... and in fact OTs are quite highly regarded professionals (compared to MY experiences here in Ontario...)...Some work done by OTs is very interesting, challenging and rewarding, but as with everything else there is a lot that is none of the above! Having met with several of my former classmates just this weekend, many were wondering what their '2nd career' would entail in the future...not necessarily going back to school (some are pondering this route), but what other things can they do with their education/experiences but not practice 'OT' per se...

 

As for me, I'm planning on doing Family Medicine and the extra year of Emergency Medicine as of now...that's what I went in with thinking, and day-by-day I'm realizing that is definately what is best suited for me!

 

Take care,

J