Physical Medicine & Rehabilitation

This 2-week elective provides the student with exposure to the specialty of PM&R under the direction of attending Physiatrists. The students will have the opportunity to gain clinical experience and participate in the evaluation and rehabilitation management of patients with various disabling conditions such as stroke, acquired brain injury, amputation, multiple trauma, arthroplasty, acute and chronic musculoskeletal conditions, and spinal cord injury. In addition to management of the medical care of patients with disabilities, the student will gain an understanding of the rehabilitation team approach, which is an integral part of the overall management of such patients. The student will also have the opportunity to participate in the management of patients with acute and chronic pain. Management of a patient’s care through interaction with other health professionals such as neurologists, orthopedic surgeons, psychiatrists, social workers, occupational therapists, speech and language pathology therapists, and physical therapists will be an integral part of this elective. The students will have the opportunity to participate in the interdisciplinary rehabilitation team meetings held regularly in the inpatient rehabilitation setting. The student will be exposed to the treatment modalities and therapeutic and diagnostic interventions performed by Physiatrists. These interventions can include, but are not limited to, therapeutic exercise, therapeutic modalities (heat, cold, functional electrical stimulation, biofeedback), intrathecal baclofen, and therapeutic injection procedures such as interventional spine injections, corticosteroid joint injections, and botulinum toxin injections. The students may also be exposed to diagnostic tools, used by Physiatrists in clinical practice, such as electro diagnostic testing (electromyography or EMG and nerve conductions studies) and musculoskeletal ultrasound. There will be emphasis placed on the student learning to take a comprehensive rehabilitation history and performing complete musculoskeletal and functional examinations. Students will have the opportunity to observe their assigned patients during the patient’s course of rehabilitation therapies (PT, OT, SLP). Clinical settings for the elective may include inpatient consultations in the Yale New Haven Hospital (both York Street and St. Raphael campuses), outpatient consultations at the Yale Spine Center at Long Wharf, outpatient consultations at the YNHH Center for Musculoskeletal Care in Stamford, Old Saybrook, Milford, and/or North Haven, outpatient consultations with the Physiatrists at the West Haven VA Hospital, and inpatient rehabilitation care of patients admitted to the YNHH inpatient rehabilitation unit (IRU) at the Rehabilitation and Wellness Center located in the Milford Campus of the Bridgeport Hospital in Milford, CT. Future potential elective locations may include Gaylord Hospital in Wallingford, CT and additional locations of the Yale Center for Musculoskeletal Care throughout CT.

Note: Students will be assigned to various sites and will need to have their own transportation.

At the end of the rotation, the student should be able to:

1. Demonstrate an understanding of the breadth of the specialty of Physical Medicine and Rehabilitation and an awareness of how the field functions in the healthcare setting.
2. Demonstrate an understanding of the team approach in the field of Physical Medicine and Rehabilitation and the importance of communication skills.
3. Demonstrate an understanding of the Physiatrist’s role in the management of patient’s with disabling conditions.
4. Demonstrate an understanding of the multiple facets involved in the management of patients with disabling conditions.
5. Demonstrate an understanding of the multiple therapeutic interventions routinely used by Physiatrists.
6. Demonstrate an understanding of the rehabilitation therapy prescriptions provided by Physiatrists.
7. Obtain a functional history from patients with neurological and musculoskeletal impairments.
8. Perform physical examinations with a focus on the neurological and musculoskeletal examinations.
   
   

Length of Rotation: 2 weeks (maximum- 1 student)

Scheduling Restriction(s): Not offered mid-June – mid-July

Student's Class Level: 4th year

Prerequisite: Completion of all clerkship medical school clinical rotations.

Accept Visiting Students: No

Learning Objectives

This is a 4-week rotation and is restricted to 4th year medical students. The student should be familiar with Physical Medicine and Rehabilitation (PM&R) as a specialty. During the rotation the student will interact and participate in different treatment modalities and interventions in the outpatient setting of PM&R. The student will gain understanding of appropriate situations for referrals to PM&R while being able to perform a focused medical, functional history and physical examination. Furthermore, the student shall formulate rehabilitation diagnoses, construct a comprehensive rehabilitative plan, and understand the roles of the various disciplines in an interdisciplinary rehabilitation team.

Clinical rotation will be surrounding approximately 2 weeks of inpatient rehabilitation divided between Lawrence Memorial Hospital and at Bridgeport Hospital Milford Campus. The remaining 2 weeks of the rotation will focus on outpatient practices such as general physiatry, consults, wound care, sports, interventional physiatry and neurological rehabilitation.

Note: Students will be assigned to various sites and will need to have their own transportation.

At the end of the rotation, the student will be required to present a journal article of their choosing related to the PM&R field or present a case report obtained during their rotation.

This is a comprehensive and hands-on rotation for 4th year medical students interested in Physical Medicine and Rehabilitation (PM&R). The elective provides the student with an opportunity to work in a diverse range of clinical settings such as inpatient rehabilitation units and outpatient offices in a variety of locations. The rotation will provide the student with a broad perspective of the field of PM&R. The requirement for students to present a journal article or a case report related to the PM&R field at the end of the rotation encourages students to engage with current research and clinical practices in the field, promoting a deeper understanding of PM&R and fostering academic development. Overall, the rotation is well-structured and provides a holistic learning experience for students interested in pursuing a career in Physical Medicine and Rehabilitation. The students will work with the Yale PM&R residents (once the residents are available – first class of PM&R residents start PGY-1 year at Yale in internal medicine in June/July 2024)

At the end of the rotation, the student should be able to:

1. Demonstrate an understanding of the breadth of the specialty of Physical Medicine and Rehabilitation and an awareness of how the field functions in the healthcare setting.
2. Demonstrate an understanding of the team approach in the field of Physical Medicine and Rehabilitation and the importance of communication skills.
3. Demonstrate an understanding of the Physiatrist’s role in the management of patient’s with disabling conditions.
4. Demonstrate an understanding of the multiple facets involved in the management of patients with disabling conditions.
5. Demonstrate an understanding of the multiple therapeutic interventions routinely used by Physiatrists.
6. Demonstrate an understanding of the rehabilitation therapy prescriptions provided by Physiatrists.
7. Obtain a functional history from patients with neurological and musculoskeletal impairments.
8. Perform physical examinations with a focus on the neurological and musculoskeletal examinations.

Length of Rotation: 4 weeks (maximum- 1 student)

Scheduling Restriction(s): Not offered off block; must follow YSM scheduling blocks

Student's Class Level: 4th and 5th year

Prerequisite: Completion of 3rd year required rotations including internal medicine, surgery, pediatrics, neurology

Accept Visiting Students: Yes – domestic visiting students only

Learning Objectives