As the calendar turned to the new academic year, hundreds of new residents have made the transition from their more generalized intern years to their advanced residency in rehabilitation medicine. To many (including myself), this can be a daunting change, as the focus shifts from making medical diagnoses and new treatment plans to treating functional impairments in the setting of established medical comorbidities and to help our patients get home. We find ourselves wearing many hats in a short period of time, from covering inpatient rehab units, consult services, and different outpatient subspecialty clinics. The level of responsibility also ramps up, as we’ve graduated from being an intern on a team with a senior and attending looking over our work to often being the senior-most trainee on a service or a clinic. How do we set ourselves up for success in the first few months in a new program?
The main focus I had in my first few rotations was to get comfortable with the basics. I started with subspecialty rotations in cancer rehabilitation and pediatrics, which allowed me the opportunity to see a broad range of diagnoses in inpatient and outpatient settings. I watched how different attendings performed their physical exam, related to the pathology of their diagnosis to the neuromuscular anatomy and read up on what I saw during the workday. Through the patient encounters, I was able to learn about topics such as brain injury, spinal cord injury, the peripheral nervous system and bracing/orthotics all through the lens of diagnoses such as metastatic cancer, spina bifida and cerebral palsy.
Regardless of what rotation you start with, look for opportunities to learn the fundamentals of physiatry, management options and diagnostic tools and when to use them. Connect with members of the interdisciplinary team, including nurses, therapists and social workers, as many of them have years of experience in their professions and can offer a wealth of information and assistance as you get acclimated. And most importantly, get to know your patients. Many of them are going through incredibly difficult periods in their lives, and taking an extra moment to get to know them and how their disability has impacted them can make a real difference in their day and have a positive impact on their recovery. The relationships you build in this field with patients, colleagues and all members of your team are what make physiatry such a special area of medicine. As your knowledge and comfort grows, the more you will be able to slow down and cherish it all.