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Introduction to Physical Medicine and Rehabilitation

UNC School of Medicine
Department of Physical Medicine and Rehabilitation
A Fourth Year Medical Student Clerkship in Physical Medicine and Rehabilitation

PMED 401: Introduction to Physical Medicine and Rehabilitation

Welcome to the Physical Medicine and Rehabilitation Department at UNC School of Medicine. During your rotation, you will work with our physiatrists in many different inpatient and outpatient settings as part of a multidisciplinary team that work with the patient and their family to achieve maximal development or restoration of physical, psychological, social, occupational and vocational functions in persons with disabilities. Physiatrists, or rehabilitation physicians, diagnose and treat neurological, musculoskeletal, and other organ system impairments, and manage treatment of patients with long-term disabling conditions. The three major areas of medical care include:

1. Diagnosis and treatment of musculoskeletal injuries and pain syndrome. These include sports and/or work injuries to degenerative conditions as common as arthritis or low back pain.

2. Electrodiagnostic medicine. Physical Medicine & Rehabilitation is the only specialty of medicine in which training in electromyography (EMG) and nerve conduction studies is required during residency. These procedures are used for evaluation of various neurologic disorders.

3. Rehabilitation of patients with severe impairments. The physiatrist directs a comprehensive rehabilitation team of professionals that may include physical therapists, occupational therapists, recreational therapists, rehabilitation nurses, psychologists, social workers, speech-language pathologists and others. Physiatrists treat neurologic rehabilitation conditions including stroke, brain injury, and spinal cord injury. Many other disabling conditions such as amputations, multiple trauma, burns and sports injuries are treated as well. Board certification in Physical Medicine and Rehabilitation requires both written and oral examinations by the American Board of Physical Medicine and Rehabilitation, which also provides subspecialty certification in Hospice and Palliative Medicine, Neuromuscular Medicine, Pain Medicine, Pediatric Rehabilitation Medicine, Spinal Cord Injury Medicine, and Sports Medicine. American Board of Physical Medicine and Rehabilitation (https://www.abpmr.org) Association of Academic Physiatrists (http://www.physiatry.org) American Academy of Physical Medicine and Rehabilitation (http://www.aapmr.org)

Course Director: Dr. Lee Shuping, Director of Medical Student Education

Clerkship Information:

UNC Medical Students (https://www.med.unc.edu/md/curriculum/tec-curriculum-information/individualization-phase/scheduling/)

Visiting Medical Students (https://www.med.unc.edu/ome/studentaffairs/visiting-student-program/)

1. Overview
Each rotation is 4 weeks and divided into 2 weeks of inpatient rehabilitation and 2 weeks of outpatient clinics.
Inpatient
Time: daily rounds per attending schedule, typically at 0800 hrs with the exception of
Tuesday morning and Friday morning care conferences. Days typically end by 1700 hrs and
there are no on-call or weekend responsibilities.
Attendings: Baratta, Cleveland, Than
Outpatient
Time: Varies by clinic. Students are encouraged to identify a primary outpatient attending
to facilitate the evaluation process. Clinics typically start at 0800 hrs and end by 1700 hrs.
Some clinics require using the shuttle bus system or private automobiles so plan
accordingly. There are no weekend or after-hours clinics.
Attendings: Alexander, Cleveland, Rauch, Than

2. Educational experiences
There is a weekly PMR lecture series on Wednesdays, 1000-1200 hrs in Conference Room A, 7th Floor, N.C. Memorial Hospital as well as regularly scheduled journal club and Grand Rounds. Additionally, there will be selected journal articles in your packet that you will be expected to read.

3. Grading
Students will be evaluated by observation of clinical faculty and chief residents and based on participation and presentations on rounds and to the outpatient clinical preceptors, patient care documentation, and presentation and participation in the PM&R lecture series. Additionally, students will have to present on a PM&R topic of choice and present it to the attending and residents on the rotation. Students will also be evaluated on how to perform a complete musculoskeletal and neurological exam.

4. Absence Policy
Students are required to email the Residency Coordinator, Chief Resident, and Dr. Shuping with the dates that they will be away. Students on a 2-week rotation (10 days) are allowed to miss one day, students on a 4-week rotation may miss up to 2 days with permission. Exceptions can be made for major illness and/or residency interviews.