Tips to Excel on a PM&R Sub-I

Written by Sara Kurtevski, MD

Welcome to the amazing field of Physical Medicine & Rehabilitation (PM&R)! You are probably reading this because you are either planning on or have already secured a Sub-I rotation in this field, and are now wondering how to prepare to excel. It’s completely normal to feel nervous, but try to remind yourself that you are not the only one in the spotlight. During the rotation, you are also evaluating the program, and more importantly, you are there to learn. Now, let’s talk about how to shine on your rotation:  

Learn

Most people do not get much exposure to PM&R, and the residents and attendings understand that. Therefore, the expectation is NOT that you know the answer to every question or know how to treat everything you encounter. The biggest expectation is that you are open to learning and bring a good attitude to work. Come prepared, pay attention, ask questions, take initiative, and read about topics you are learning about.

Interact

PM&R is truly a multidisciplinary field so being a team player is important. Do not be afraid to get to know the rest of the staff. Ask them questions as well so that you can better understand what each person’s role is and how all of it comes together to help a patient.

Be Willing to Help

Being proactive and incorporating yourself into the team with whatever role you can do is appreciated by residents. As a medical student, it can feel difficult to integrate yourself. Do not be afraid to ask how you can help out by taking some of the patient histories. Always communicate with other members of the team and ask to help during procedures by preparing the room. 

Review your basics

With all the information you need to know it's easy to forget things. Refreshing some big topics like general MSK and neuroanatomy, some common pathology in those systems, and physical exam maneuvers are a good idea. This will make it easier to follow along with some things like ultrasound-guided procedures and patient evaluations. You will get the opportunity to do some of the physical exams and it will be a great opportunity to fine-tune your skills. 

Resources:

There are lots of resources out there, but these are some of my favorites to start with:

• Physical Medicine and Rehabilitation Pocketpedia

  • This is a great reference during the rotation. It fits into your pocket. It has an overview of many topics in PM&R and it's quick to read.

• https://www.physio-pedia.com (you can view physical exam maneuvers here)

  • This website is great for looking up how to properly do certain physical exam maneuvers and is very user-friendly.

• https://asia-spinalinjury.org/wp-content/uploads/2019/04/ASIA-ISCOS-IntlWorksheet_2019.pdf

  • If you will be seeing a spinal cord patient, especially in an acute rehabilitation setting, familiarize yourself with this resource.

• Complete Anatomy application

  • This is great if you are a visual person and want to refresh your anatomy.

• Complete PM&R Instagram page

  • This page has lots of posts on various topics in PM&R along with free Stroke notes that are available to download.