Physical Medicine and Rehabilitation

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This elective is for third- and fourth-year medical students interested in gaining experience in the field of Adult and Pediatric Physical Medicine and Rehabilitation (PM&R), improving diagnostic skills related to the complications of disability, and improving neurologic and musculoskeletal examination skills.

To apply to these electives, Penn State College of Medicine students should use OASIS (Link only works on Penn State College of Medicine network).

Chair and Program Director: David Gater Jr., MD, PhD, MS
Medical Student Clerkship Director: Sharon David, MD
Education and Residency Program Coordinator: Michelle Osterlund

Penn State Milton S. Hershey Medical Center
500 University Drive, HP28
P.O. Box 850
Hershey, PA 17033
Phone: 717-531-0003 ext. 282045
Fax: 717-566-8202
Email: mosterlund@pennstatehealth.psu.edu

PMR 730: Physical Medicine and Rehabilitation elective

Credit: 1 elective for medical school
Prerequisite: Successful completion of the second year of medical school

General information

The Physical Medicine and Rehabilitation elective provides basic training in PM&R evaluations with a strong focus on neurologic and musculoskeletal rehabilitation. The elective exposes the medical student to the broad field of PM&R including sports injuries, congenital and acquired disabilities, complications of disability, and the restoration and maintenance of function. Time will be spent on the rehabilitation consult service, the inpatient rehabilitation service, and in the various outpatient clinics. The student will be exposed to therapies, medications and procedures typically used in PM&R practice.

Topics

Topics included for this rotation will include the general role of a physiatrist and the staff, the work in the interdisciplinary teams, evaluation of function, description of functional loss, and treatment of physical dysfunction. The rotation can be tailored to some extent depending on the availability of diagnoses that match the students interest.

The following are the objectives of the course. By the end of the four-week elective, the medical student will be able to:

  1. Describe the role of Physical Medicine and Rehabilitation specialists in the evaluation for patients diagnosed with a variety of conditions, including but not limited to stroke, spinal cord injury, traumatic brain injury, amputations, multi-trauma, cerebral palsy and spina bifida.
  2. Reproducibly describe and demonstrate the evaluation of function through a comprehensive musculoskeletal and neurological examination as indicated within the musculoskeletal and neurological examination checklist, including the neurologic classification of spinal cord injury.
  3. Describe the impact of impaired function on health and disease.
  4. Detail a prescription for treatment of physical dysfunction including therapies, modalities, medications, durable medical equipment and interventional procedures.
  5. Relate a topic of interest that pertains to Physical Medicine and Rehabilitation to the faculty and staff in a presentation format.

Course Description

The medical students will participate in PM&R evaluations, care for patients on the inpatient rehabilitation service and management of patients within the outpatient clinics.

The elective will allow the student to improve his or her physical examination and diagnostic skills through clinical observation, practice and feedback provided by the attending physicians. They will participate in team management and team building at various points in the rotation.

The student will be exposed to:

  1. Physical, occupational and speech language therapies
  2. Medications specific to stroke, spinal cord injury and traumatic brain injury recovery
  3. Procedures typically used in PM&R practice such as electromyography, Botox type A injections, joint corticosteroid injections, joint aspirations and trigger/tender point injections
  4. An interactive disability day where students experience life in a wheelchair for one day of the elective

Didactics will be given weekly on core subjects within the PM&R topics of:

  • Stroke
  • Spinal cord injury
  • Traumatic brain injury
  • Cerebral palsy
  • Spina bifida

Pertinent readings will be provided on the first day of the elective.

Faculty Members

  • Sharon David, MD, Department of Physical Medicine and Rehabilitation
  • David Gater, MD, PhD, Professor and Chair, Department of Physical Medicine and Rehabilitation

Justification Statement

1. Instructional, educational and course objectives 

This elective is for students interested in gaining experience in the field of Adult Physical Medicine and Rehabilitation, familiarity with complications of disability, and perfecting their neurologic and musculoskeletal examination skills.

The prevalence of disabling conditions within the population is increasing. Therefore, medical students can benefit from exposure to patients with disabilities since it is increasingly likely that they will care for them.

2. Evaluation method

Students will be graded on the five-point scale common to all College of Medicine year III and IV courses (Fail, Low Pass, Pass, High Pass, Honors).

Students will be judged on the following points:

  • Medical knowledge
  • History/physical examination skills
  • Clinical reasoning
  • Patient management
  • Communication skills
  • Professional attributes
  • Procedural skill

The following evaluation methods have been developed specifically for this rotation to assess the knowledge and skills gained in the PM&R elective:

  • Competency sheet
  • Musculoskeletal and neurological examination skill checklist

The student must pass the post-test (a score equal to or greater than 65 percent) and demonstrate all of the items on the musculoskeletal and neurological examination checklist for successful completion of the PM&R elective.

3. Relationship/linkage of course to other courses

There is anticipation that students who are interested in the fields of Pediatrics, Orthopedics and Neurology will find this elective a worthwhile adjunct to acquire new knowledge and build on the knowledge they have gained in the Neurobehavioral course in year II, the required Neurology and Pediatric clerkship, the Sports Medicine elective, and the musculoskeletal examination learned in Island I.

With the aging population and associated increased prevalence of disability, this course would also be relevant for those students interested in Geriatrics and Family and Community Medicine.

4. Relationship of course to major, option, minor or general education

This is an elective within the third and fourth year of medical school.

5. Consultation with appropriate departments and academic support units

Discussions regarding the development and structure of this course have been held with Dr. David Gater, the current PM&R department chair, and Michelle Von Arx, director of Therapy Services at Penn State Hershey Rehabilitation Hospital. This PM&R Elective has been discussed with all attending within the current Department of PM&R. 

This course will be offered only at the Penn State College of Medicine.

The student will spend time at the Penn State Hershey Rehabilitation Hospital and Penn State Hershey Medical Center.

No additional technology needs are anticipated.

This course will be offered at approximate four-week intervals throughout the academic year. Enrollment of four to six students yearly, in individual sessions, is anticipated. Elective enrollment will be limited to two students per session.

PMR 740: Physical Medicine and Rehabilitation Acting Internship

The Physical Medicine and Rehabilitation (PM&R) Acting Internship (AI) will provide an advanced training in PM&R evaluations with a strong focus on neurologic and musculoskeletal rehabilitation.  The course will expose the medical student to the broad field of PM&R including sports injuries, congenital and acquired disabilities, complications of disability, and the restoration and maintenance of function.  Time will be spent on the Rehabilitation consult service, the inpatient Rehabilitation service, and in the various outpatient clinics.  The student will be involved in managing therapies, medications, and procedures typically used in PM&R practice.

PMR 797: Spinal Cord Injury Special Topics Course

The SCI Special Topics Course is designed to give the student an in-depth exposure to the field of spinal cord injury medicine. It consists of daily rounds and patient assignment with the SCI attending physician, weekly chair rounds, hands-on exposure to multidisciplinary teaching, therapies and diagnostic tools essential through the SCI continuum of care.

In addition to inpatient and outpatient exposure, the student is expected to complete reading assignments (SCI Consortium Guidelines) and attend lectures on the SCI special topics provided every Tuesday in HCAR 1103 from 11:30 a.m. to 1:30 p.m., as well as participate in SCI support group activities that month. 

Typical hours are weekdays from 8 a.m. to 5 p.m., but may include additional time for participation in Chair Rounds and SCI Support Group activities. By the end of the rotation, the student is expected to complete an academically focused PowerPoint (or equivalent) presentation on an SCI-related topic of his/her choice. Grading is based on professionalism, participation, knowledge acquisition, and demonstration under both formal and informal conditions.

Faculty

David R. Gater Jr., MD, PhD, MS: Tenured Professor, Chair and PM&R Program Director

Natasha Warnick, DO: Assistant Professor, Assistant PM&R Program Director