Physical medicine and rehabilitation (PM&R), or physiatry, is a branch of medicine dealing with functional restoration of a person affected by physical disability. A physician who has completed training in this field is referred to as a physiatrist [fɪz'aiətrɪst]. In order to be a physiatrist in the United States, one must complete four years of medical school, one year of internship and three years of residency. Physiatrists specialize in restoring optimal function to people with injuries to the muscles, bones, tissues, and nervous system (such as stroke patients).[1] For the chemical substances known as medicines, see medication. ... For other uses, see Doctor. ... Texas Tech University Health Sciences Center in Lubbock, Texas, USA. A medical school or faculty of medicine is a tertiary educational institution — or part of such an institution — that teaches medicine. ... A medical intern, in the context of medical education in the United States, is a historical term for a physician in training who has completed medical school, passed step two of the USMLE or COMLEX-USA, and is undergoing his or her first year of post-graduate training (PGY1). ... Residency is a stage of postgraduate medical training in North America and leads to eligibility for board certification in a primary care or referral specialty. ...

Basic Medical Education

United States

Most allopathic and osteopathic medical schools in the United States require an undergraduate degree from an accredited four-year university prior to starting medical school. After completion of medical school and receipt of a medical degree, one participates in residency, which is typically four years in total length for physical medicine and rehabilitation. Advocates of homeopathy and other forms of alternative medicine often use the term allopathy or allopathic medicine to refer to mainstream, Western medicine. ... This article is about a type of complementary medicine practiced worldwide. ... Motto: (traditional) In God We Trust (official, 1956–present) Anthem: The Star-Spangled Banner Capital Washington, D.C. Largest city New York City Official language(s) None at the federal level; English de facto Government Federal Republic  - President George W. Bush (R)  - Vice President Dick Cheney (R) Independence - Declared - Recognized... For the community in Florida, see University, Florida. ... Residency is a stage of postgraduate medical training in North America and leads to eligibility for board certification in a primary care or referral specialty. ...

United Kingdom

In the United Kingom, medical students could enter medical education straight after secondary school. They can choose how long they want the medical education to be, usually five to six years (depending on University or progress). Several universities now offer an accelerated medical course, and this takes four years (pre-clinical and clinical). After medical education, students will enter a Foundation phase (two years). The first year of the Foundation phase is called F1, and the student has already become a physician (entering F1 means entering paid employment). F1 practitioners are supervised, but F2 (year two of Foundation) practitioners may be unsupervised by a professional physician or trained medical supervisor.

After F2, a practitioner can choose to study general practice, or specialised practice. The physician can quit, or he can study further whilst working as an 'infant' physician. After the specialty or general studies, the physician qualifies as a proper medical practitioner.

Salaries afterwards range from several thousand per year to a million per year (the most common million-per-year being the specialty of private neurology).

The First Department of Physical Medicine was established at Mayo Clinic in 1936

Image File history File linksMetadata Download high-resolution version (2424x1211, 557 KB) Photo I took today north of the Mayo Clinic main campus in Rochester, Minnesota. ... Image File history File linksMetadata Download high-resolution version (2424x1211, 557 KB) Photo I took today north of the Mayo Clinic main campus in Rochester, Minnesota. ... Mayo Clinic is a medical practice based in Rochester, Minnesota, USA, integrated with hospital facilities and a medical school. ... Year 1936 (MCMXXXVI) was a leap year starting on Wednesday (link will display the full calendar) of the Gregorian calendar. ...

History

The term 'Physiatry' was coined by Dr. Frank H. Krusen in 1938. The term was accepted by the American Medical Association in 1946. The field grew notably in response to the demand for sophisticated rehabilitation techniques for the large number of injured soldiers returning from World War II. The American Medical Association (AMA) is the largest association of medical doctors in the United States. ... Combatants Allied powers: China France Great Britain Soviet Union United States and others Axis powers: Germany Italy Japan and others Commanders Chiang Kai-shek Charles de Gaulle Winston Churchill Joseph Stalin Franklin Roosevelt Adolf Hitler Benito Mussolini Hideki Tōjō Casualties Military dead: 17,000,000 Civilian dead: 33,000...

Scope of the field

Physical medicine and rehabilitation involves the management of disorders that alter the function and performance of the patient. Emphasis is placed on the optimization of function through the combined use of medications, physical modalities, physical training with therapeutic exercise, movement & activities modification, adoptive equipments and assistive device, orthotics (braces), prosthesis, and experiential training approaches.

Physical Medicne & Rehabilitation physicians may also perform Electrodiagnostics which are used to provide nervous system functional information for diagnose and / or prognosis for various neuromuscular disorders. The common electrodiagnostic test performed by physiatrist are nerve conduction velocity study (NCV) and needle electromyography (EMG). Nerve conduction velocity study involves electrical stimulation to peripheral nerves and the nerves' responses are measured such as onset latency, amplitude and conduction velocity. Needle electromyography requires needle electrode insertion into the examined muscles to detect the electrical potential generated from muscle fibers. Abnormal electrical potentials suche as fibrillation potential or positive sharp wave detected by EMG needle indicates the presence of muscle fibers that lost the nerve supply. Electromyography (EMG) is a technique for evaluating and recording physiologic properties of muscles at rest and while contracting. ... Diagnosis (from the Greek words dia = by and gnosis = knowledge) is the process of identifying a disease by its signs, symptoms and results of various diagnostic procedures. ... Prognosis (older Greek πρόγνωσις, modern Greek πρόγνωση - literally fore-knowing, foreseeing) is a medical term denoting the doctors prediction of how a patients disease will progress, and whether there is chance of recovery. ...

Common conditions that are treated by physiatrists include amputation, spinal cord injury, sports injury, stroke, musculoskletal pain syndromes such as low back pain, fibromyalgia and traumatic brain injury. Cardiopulmonary rehabilitation involves optimizing function in those afflicted with heart or lung disease. Chronic pain management is achieved through multidisciplinary approach involving psychologists, physical therapists, occupational therapists, and interventional procedures when indicated. Partial hand amputation Amputation is the removal of a body extremity by trauma or surgery. ... Spinal cord injury, or myelopathy, is a disturbance of the spinal cord that results in loss of sensation and/or mobility. ... For other uses, see Stroke (disambiguation). ... See also back pain Low back pain is a common musculoskeletal disorder which affects the lumbar segment of the spine. ... Fibromyalgia (FM) is stated to be a disorder classified by the presence of chronic widespread pain and tactile allodynia. ... Traumatic brain injury (TBI), traumatic injuries to the brain, also called intracranial injury, or simply head injury, occurs when a sudden trauma causes brain damage. ... A psychologist is an expert in psychology, the systematic investigation of the human body, including behavior, cognition, and affect. ... Physical therapy can help restore lost functionality in many people. ... It has been suggested that this article or section be merged into Occupational therapy. ...

Philosophy

The major concern of the field is the ability of the person to function optimally within the limitations placed upon them by a disease process for which there is no known cure. The emphasis is not on the full restoration to the premorbid level of function, but rather the optimization of the quality of life for those who may not be able to achieve full restoration. A team approach to chronic conditions is emphasized, using transdisciplinary team meetings to coordinate care of the patients. Transdisciplinary refers to an entity (usually a person) having training in two or more disparate fields of inquiry. ...

Pediatric physiatrists manage conditions such as cerebral palsy, spina bifida and Duchenne's muscular dystrophy

Image File history File links IMG_0085-1-.JPG Licensing I, the creator of this work, hereby release it into the public domain. ... Image File history File links IMG_0085-1-.JPG Licensing I, the creator of this work, hereby release it into the public domain. ... Cerebral palsy (CP) is an umbrella term encompassing a group of non-progressive,[1] non-contagious conditions that cause physical disability in human development. ... Duchenne muscular dystrophy (DMD) (also known as muscular dystrophy - Duchenne type) is an inherited disorder characterized by rapidly progressive muscle weakness which starts in the legs and pelvis and later affects the whole body. ...

Subspecialty

Six formal sub-specializations are recognized by the field in the United States: pain medicine, pediatric rehabilitation, spinal cord injury medicine, neuromuscular medicine, sports medicine, and hospice and palliative medicine. Many in the field also subspecialize in areas of amputee care, musculoskeletal medicine, electrodiagnostics, traumatic brain injury (TBI), and cardiopulmonary rehabilitation. Pain medicine is a branch of anaesthetics concerned with the treatment of acute and chronic pain. ... Spinal cord injury, or myelopathy, is a disturbance of the spinal cord that results in loss of sensation and/or mobility. ... This article or section is in need of attention from an expert on the subject. ... Palliative care (from Latin palliare, to cloak) is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than providing a cure. ... Electromyography (EMG) is a technique for evaluating and recording physiologic properties of muscles at rest and while contracting. ... Traumatic brain injury (TBI), traumatic injuries to the brain, also called intracranial injury, or simply head injury, occurs when a sudden trauma causes brain damage. ...

Residencies in the United States

There are no clear rankings among PM&R residencies, but a list of the most commonly cited top programs in the United States would include

• Rehabilitation Institute of Chicago (RIC) at Northwestern University, Chicago
• Kessler Institute for Rehabilitation, West Orange, NJ (UMDNJ: New Jersey Medical School, Newark, NJ)
• University of Washington Program, Seattle
• Baylor College of Medicine/University of Texas at Houston Alliance Program, Houston
• Mayo Clinic Program, Rochester, MN
• Spaulding Rehabilitation Hospital of Partners HealthCare affiliated with Harvard Medical School, Boston
• Ohio State University Program, Columbus, OH
• Thomas Jefferson University Program, Philadelphia
• University of Michigan Program, Ann Arbor, MI
• Temple University Program, Philadelphia

There are approximately 350 total positions available via the National Resident Matching Program (NRMP) per year. Rehabilitation Hospital located in Chicago, Illinois, United States. ... Northwestern University (NU) is a private, nonsectarian, coeducational research university with campuses located in Evanston, Illinois and downtown Chicago. ... For other uses, see Chicago (disambiguation). ... West Orange is a township located in Essex County, New Jersey. ... The University of Medicine and Dentistry of New Jersey, an umbrella designation used to refer to one of eight New Jersey state institutions of higher education in medicine. ... Skyline of downtown Newark as seen from the Newark Bay Bridge. ... The University of Washington, founded in 1861, is a public research university in Seattle, Washington. ... City nickname Emerald City City bird Great Blue Heron City flower Dahlia City mottos The City of Flowers The City of Goodwill City song Seattle, the Peerless City Mayor Greg Nickels County King County Area   - Total   - Land   - Water   - % water 369. ... Baylor College of Medicine (BCM) is ranked among the top Schools of medicine in the United States. ... Houston redirects here. ... Mayo Clinic is a medical practice based in Rochester, Minnesota, USA, integrated with hospital facilities and a medical school. ... Rochester is a city located in Olmsted County, Minnesota. ... Spaulding Rehabilitation Hospital is a rehabilitation hospital located in Boston, Massachusetts. ... Partners HealthCare is a non-profit organization that owns several hospitals in Massachusetts, primarily in the Boston area. ... Harvard Medical School (HMS) is one of the graduate schools of Harvard University. ... Nickname: City on the Hill, Beantown, The Hub (of the Universe)1, Athens of America, The Cradle of Revolution, Puritan City, Americas Walking City Location in Massachusetts, USA Counties Suffolk County Mayor Thomas M. Menino(D) Area    - City 232. ... The Ohio State University (OSU) is a coeducational public research university in the state of Ohio. ... Skyline of downtown Columbus, Ohio, viewed across the Scioto River. ... Thomas Jefferson University is an independent medical school, health professions and medical research institution. ... For other uses, see Philadelphia (disambiguation) and Philly. ... The University of Michigan, Ann Arbor (U of M, UM, U-M or simply Michigan) is a coeducational public research university in the state of Michigan. ... Ann Arbor is a city in the U.S. state of Michigan. ... For the private Christian university in Tennessee, see Tennessee Temple University. ... For other uses, see Philadelphia (disambiguation) and Philly. ...

Notable Rehabilitation Hospitals in the United States

In addition to those associated with elite PM&R residency programs, notable US rehabilitation hospitals, many of which are teaching hospitals, include:

• Children's Specialized Hospital in Mountainside, New Jersey, a pediatric teaching hospital affiliated with both UMDNJ programs
• Rehabilitation Institute of Chicago (RIC) at Northwestern University, Chicago
• Craig Hospital in Englewood, Colorado, a teaching hospital for University of Colorado
• Magee Rehabilitation, Philadelphia, a major teaching hospital for Thomas Jefferson University
• Moss Rehabilitation Hospital in Elkins Park, Pennsylvania, a teaching hospital for Temple and Thomas Jefferson University
• National Rehabilitation Hospital in Washington, principal teaching hospital for Georgetown University
• Rancho Los Amigos National Rehabilitation Center in Downey, California
• Rusk Institute of NYU Medical Center in New York, major teaching site for New York University
• Shepard Hospital in Atlanta, major teaching affiliate for Emory University
• Spaulding Rehabilitation Hospital in Boston, a member of Partners HealthCare, affiliated with Harvard Medical School
• TIRR: The Institute for Rehabilitation and Research in Houston, Texas, principal teaching hospital for Baylor/UT residency program.
• Johns Hopkins Physical Medicine and Rehabilitation in Baltimore, Maryland
• Rehabilitation Center at Santa Clara Valley Medical Center, San Jose, California

Map of Mountainside in Union County Mountainside is a borough in Union County, New Jersey, United States. ... The University of Medicine and Dentistry of New Jersey, an umbrella designation used to refer to one of eight New Jersey state institutions of higher education in medicine. ... Rehabilitation Hospital located in Chicago, Illinois, United States. ... Northwestern University (NU) is a private, nonsectarian, coeducational research university with campuses located in Evanston, Illinois and downtown Chicago. ... For other uses, see Chicago (disambiguation). ... Englewood is a city in Arapahoe County, Colorado, USA. As of 2005, the city is estimated to have a total population of 32,350. ... It has been suggested that this article or section be merged into University of Colorado at Denver and Health Sciences Center. ... Nickname: City of Brotherly Love, Philly, the Quaker City Motto: Philadelphia maneto (Let brotherly love continue) Location in Pennsylvania Coordinates: Country United States State Pennsylvania County Philadelphia Founded October 27, 1682 Incorporated October 25, 1701 Mayor John F. Street (D) Area    - City 369. ... Thomas Jefferson University is an independent medical school, health professions and medical research institution. ... Elkins Park is an unincorporated community, portions of which are located in both Cheltenham Township, Pennsylvania and Abington Township, Pennsylvania in the suburbs of Philadelphia, Pennsylvania. ... For the private Christian university in Tennessee, see Tennessee Temple University. ... Thomas Jefferson University is an independent medical school, health professions and medical research institution. ... Aerial photo (looking NW) of the Washington Monument and the White House in Washington, DC. Washington, D.C., officially the District of Columbia (also known as D.C.; Washington; the Nations Capital; the District; and, historically, the Federal City) is the capital city and administrative district of the United... Georgetown University is a Jesuit private university located in Georgetown, Washington, D.C. Father John Carroll founded the school in 1789, though its roots extend back to 1634. ... Rancho Los Amigos National Rehabilitation Center is a rehabilitation hospital located in Downey, California, United States. ... Location of Downey in Los Angeles County, California Coordinates: , Country State County Los Angeles Founded 1800s Incorporated 1956 Government  - Type Council-Manager government  - City Council David R. Gafin Mario A. Guerra Rick Trejo (Mayor) Anne Marie Bayer Kirk Cartozian Area  - City  12. ... New York, New York and NYC redirect here. ... New York University (NYU) is a private, nonsectarian, coeducational research university in New York City. ... This article is about the state capital of Georgia. ... Emory University is a private university located in the metropolitan area of the city of Atlanta and in western unincorporated DeKalb County, Georgia, United States. ... Spaulding Rehabilitation Hospital is a rehabilitation hospital located in Boston, Massachusetts. ... Nickname: City on the Hill, Beantown, The Hub (of the Universe)1, Athens of America, The Cradle of Revolution, Puritan City, Americas Walking City Location in Massachusetts, USA Counties Suffolk County Mayor Thomas M. Menino(D) Area    - City 232. ... Partners HealthCare is a non-profit organization that owns several hospitals in Massachusetts, primarily in the Boston area. ... Harvard Medical School (HMS) is one of the graduate schools of Harvard University. ... Houston redirects here. ... Baltimore redirects here. ... For other uses, see San José. Nickname: Location of San Jose within Santa Clara County, California. ...

Popular textbooks

Two main textbooks often used by those in the specialty are Physical Medicine and Rehabilitation: Principles and Practice by Joel DeLisa and Physical Medicine and Rehabilitation Medicine by Randall Braddom. Useful handbooks for medical students and residents include PM&R Secrets by Mark Young, Brian O'Young and Steven Stiens, and PM&R Pocketpedia by Howard Choi and colleagues.

Book Reference

• Joel DeLisa (2004). Physical Medicine and Rehabilitation: Principles and Practice. Lippincott Williams & Wilkins. ISBN 0-7817-4130-0. 

• Randall Braddom (2006). Physical Medicine and Rehabilitation. WB Saunders. ISBN 978-1416026105. 

• Bryan J. O'Young, Mark A. Young, Steven A. Stiens (2002). Physical Medicine and Rehabilitation Secrets. Hanley & Belfus. ISBN 1-56053-437-0. 

• Howard Choi, Ross Sugar, David E. Fish, Matthew Shatzer, Brian Krabak (2003). Physical Medicine and Rehabilitation Pocketpedia. Lippincott Williams & Wilkins. ISBN 0-7817-4433-4. 

Journals

The two main journals of the PM&R field are Archives of Physical Medicine and Rehabilitation and American Journal of Physical Medicine and Rehabilitation. Both journals are published monthly. Archives, which had been co-owned by the American Academy of Physical Medicine and Rehabilitation (AAPM&R) and the American Congress of Rehabilitation Medicine (ACRM), will be solely owned by the Congress beginning January 2009. At that time, the Academy will launch a new journal: PM&R, The journal of injury, function and rehabilitation.^[1]

Quaterly journal Physical Medicine And Rehabilitation Clinics of North America [2] published by Elsevier / Saunders also provides indepth updated information on specific Physical Medicine & Rehabilitation topic.

Individual Residency Programs

• PM&R Residency Programs in the United States
• PM&R Residency Programs in Canada

PM&R Residency Programs in Canada are represented by nine institutions offering post-graduate residency in physical medicine and rehabilitation. ...

Notes

References

• Famous Canadian Physicians: Dr. Gustave Gingras at Library and Archives Canada

External links

Organizations

• American Academy of Physical Medicine and Rehabilitation National medical society, has a PM&R resident/medical student mentoring feature
• American Board of Physical Medicine and Rehabilitation ABMS recognized entity for board certification in PM&R
• [3] Courage Center, Minneapolis-based nonprofit rehabilitation and resource center for people of all ages and abilities.
• Association of Academic Physiatrists Organization consisting largely of those with interests in academic PM&R
• StudentDoctor.Net Student mentoring site, has a PM&R forum
• Physical Medicine and Rehabilitation - eMedicine Journal medical reference
• Canadian Association of Physical Medicine and Rehabilitation - Canadian National PM&R Medical Society
• International Society of Physical Medicine and Rehabilitation
• American Association of Neuromuscular and Electrodiagnostic Medicine - National medical society comprised primarily of physiatrists and neurologists who perform electrodiagnostic studies (eg. electromyography and nerve conduction studies) and provide medical care to individuals with neuromuscular disorders.
• Iranian Society of Physical Medicine and Rehabilitation
• Department B National organization providing comprehensive business resources to practicing physiatrists
• http://www.iapmr.com/ Indian Association of Physical Medicine and Rehabilitation- Physiatrists from anywhere in the world can be a life member.

Additional Resources

• Reminiscence_therapy
• Physiatry Practice Management Portal Resources for physiatrists
• Patient Information Physiatry-related informtion for patients including searchable database of physicians.
• Accurate Billing/Coding resources Comprehensive business resources for practicing physiatrists
• SpineUniverse Portal for spine-related physiatry - glossary of terms, procedures explained, global physician directory.

Reminiscence therapy is a relatively low cost therapy usually used to counsel and support older people, and is a useful intervention in work with brain-injured patients. ...

Rehabilitation hospital links

• Johns Hopkins Department of Physical Medicine and Rehabilitation
• The Howard A. Rusk Institute of Rehabilitation Medicine at the New York University Medical Center
• TIRR - The Institute for Rehabilitation and Research Houston
• New York-Presbyterian Hospital
• CNS Centre for Neuro Skills