Physical Medicine & Rehabilitation
Student Interest Group

Boston University School Of Medicine

Frequently Asked Questions

Q: What is Physical Medicine & Rehabilitation or Physiatry?
(answer adapted from the aapmr website)
A: PM&R or physiatry is the branch of medicine that emphasizes the prevention, diagnosis, treatment and rehabilitation of disorders, particularly those of the neuromusculoskeletal, cardiovascular, and pulmonary systems, that may produce temporary or permanent impairment. Physiatry is unique among medical fields in that its area of expertise is the functioning of the whole patient, as compared with a focus on an organ system or systems.
Physiatrists also attend specifically to physiologic adaptation to disability and to preventing complications or deterioration secondary to disabling conditions. The goal of the physiatrist is to provide medical care to patients with pain, weakness, numbness, and loss of function so that they can maximize their physical, psychological, social, and vocational potential.

Q: How does one become a PM&R specialist?
A: 4 years of Medical School (or Osteopathic Medicine)
    1 year of internship (Internal Medicine or Surgery, or a Transitional Year)
    3 years of PM&R
    (followed by optional Fellowship training 1-2 years)

Some programs offer "categorical" positions, i.e. internship and PM&R training at the same institution.  For most programs, however, during your senior (BUSM IV) year you will apply for PM&R residency and Internship placement concurrently, but at different institutions. 

Q: Is there potential for sub-specialty training?
A: Six formal sub-specializations (Fellowship training) are currently recognized by the field in the United States

Many also subspecialize in areas of amputee care, musculoskeletal medicine, electrodiagnostics, traumatic brain injury (TBI), and cardiopulmonary rehabilitation.

Q: How is the lifestyle?
A: PM&R is considered a "lifestyle" specialty!
Practice varies depending on subspecialty: from Inpatient (e.g. taking care of Spinal Cord Injury/Traumatic Brain Injury patients in subacute settings) with an outpatient clinic component for follow-up, to outpatient privately owned practice (e.g. Sports Medicine/ Musculoskeletal medicine), or as member of a larger (multi-specialty) practice group/rehab center.  Depending on the setting, rehab facility, etc, Call is usually infrequent, and in general physiatrists are in high demand.
According to the AAMC, The annual salary for physiatrists ranges from $173,000 to $312,010 (2007 estimates).  According to MDsalaries.blogspot.com, here are some income snapshots across sample cities: Houston, TX: $202,000/- Los Angeles, CA: $220,000/- Miami, FL: $195,000/- New York, NY: $230,000/- Seattle, WA: $215,000/- with a National Average of $192,000/-
Anecdotal, but verified, accounts of particular settings and sub-specialties (e.g. private-practice pain clinic) have reported incomes as high as $800,000 (an extreme outlier).

Q: Physician satisfaction / who gravitates toward PM&R?
A: Physiatrists are among the most contented and satisfied practitioners in medicine.  People gravitate to PM&R for many different reasons.  Typically they possess a confluence of the following intellectual and emotional traits:
Keen interest in anatomy (musculoskeletal anatomy/neuroanatomy and pathophysiology of these systems), good spatial and kinesthetic sense, excellent communication skills (to educate patients), highly creative, with a profound emotional intelligence and depth, willingness and ability to establish good rapport and trusting relationships with patients enduringly, exceptional ability to work well with others. 
Some of the ailments we deal with are temporary, and there is mutual appreciation of a rapid recovery by patient and physician alike.  A lot of the conditions we deal with, however, are chronic disabilities in which progress may be slow and ultimate goals of complete recovery (currently) unattainable.  An appreciation of the complete person (limitations, abilities, hopes, dreams, fears, concerns, aspirations of patients and their families) is essential to the therapeutic contract and relationship.
You are sure to find physiatrists to be very intelligent, pleasant, personable and deeply caring people as colleagues.