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Overview of Residency Program

It is the intent of the Physical Medicine and Rehabilitation (PM&R) program to develop physicians well trained and able to practice in a competent and independent manner as Physiatrists.  This training will be achieved through a) supervised clinical work with increasing responsibility for outpatients and inpatients and b) a foundation of organized instruction in the basic neurosciences.  Physicians completing the program will be eligible for certification by the American Board of Physical Medicine and Rehabilitation with an ultimate goal of an eventual 100% pass rate on both the oral and written examinations.  This program has training level specific educational goals that must be met to ensure residents are aware of the level of education in this program.  They are:

Mastery Level: Competent in all essential knowledge areas; technically proficient in skill areas; minimal input by attending faculty required for subtle or fine points only; capable of unsupervised independent PM&R practice.

Advanced Level: Competent in most essential knowledge areas; basic knowledge areas have been mastered, but some advanced areas may need further improvement; technically proficient in many, but not all skills areas; requires some supervisory input by attending faculty, but less than basic level resident.

Basic Level: Familiar with basic PM&R knowledge areas; competence still improving; familiar with some PM&R technical skills; requires moderate supervisory input by attending faculty, especially for advanced areas.

Residents are also required to develop competencies in the six areas below to the level expected of a new practitioner.  Toward this end, the resident is provided through the training program with the appropriate experience to develop and demonstrate the following specific knowledge, skills, and attitudes:

  1. Patient Care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health.
  2. Medical Knowledge about established and evolving biomedical, clinical and cognate (e.g., epidemiological and social-behavioral) sciences and the application of this knowledge to patient care.
  3. Practice-based Learning and Improvement that involves investigation and evaluation of their own patient care, appraisal and assimilation of scientific evidence, and improvement in patient care.
  4. Interpersonal and Communication Skills that result in effective information exchange and learning with patients, their families, and other health professionals.
  5. Professionalism as manifested through a commitment to carrying out professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population.
  6. Systems-Based Practice as manifested by actions that demonstrate an awareness of and responsiveness to the larger context and system of healthcare and the ability to effectively call on system resources to provide care that is of optimal value.

 

Physical Medicine and Rehabilitation residency program must document that it provides an educational experience of such quality and excellence as to offer its graduates the opportunity for attainment of those competencies necessary for entry level independent practice of this specialty.  This must include knowledge about the diagnosis, pathogenesis, treatment, prevention and rehabilitation of those neuromusculoskeletal, neurobehavioral, cardiovascular, pulmonary, and other system disorders common to this specialty in patients of both sexes and all ages.  This program will provide the opportunity for the graduate to develop the attitudes and psychomotor skills required to:

  1. modify history-taking technique to include data critical to the recognition of functional abilities and physical and psychosocial impairments that may cause functional disabilities;
  2. perform the general and specific physiatric examinations, including electromyography, nerve conduction studies, and other procedures common to the practice of physical medicine and rehabilitation;
  3. make sound clinical judgments; and
  4. design and monitor rehabilitation treatment programs to minimize and prevent impairment and maximize functional abilities.

 

In addition, this program must provide the opportunity for the graduate to be able to coordinate effectively and efficiently an interdisciplinary team of allied rehabilitation professionals for the maximum benefit of the patient by:

  1. an understanding of each allied health professional’s role,
  2. the ability to write adequately detailed prescriptions based on functional goals for physiatric management, and
  3. the development of management and leadership skills.

 

Additionally, this training program will stress the importance of self-evaluation, continuing medical education and continued professional development after graduation.  The training program must provide the opportunity for the resident to develop the necessary written and verbal communication skills essential to the efficient practice of physiatry.  The organization and philosophy of the residency program must provide the opportunity for development of the clinical competence of the resident.  The curiosity and creativity of all residents must be stimulated and must be involved in the critical appraisal of current literature.  All provisions of the Institutional Requirements must also be met for accreditation.

Clinical competence requires:

  1. A solid fund of basic and clinical knowledge,
  2. The ability to perform an adequate history and physical exam,
  3. The ability to order and interpret appropriate diagnostic tests,
  4. Adequate technical skills to carry out selected diagnostic procedures,
  5. Clinical judgment to critically apply the above data to individual patients,
  6. Attitudes conducive to the practice of Physiatry, including appropriate interpersonal interactions with patients, professional colleagues, supervisory faculty, and all paramedical personnel,
  7. Personal integrity,
  8. Regular, timely attendance at departmental and divisional educational activities,
  9. Timely dictations and signature of inpatient discharge summaries and outpatient notes, as well as completion of appropriate letters or phone calls to referring physicians,
  10. Recognition of personal limits. Controversial issues require direct and immediate participation of the responsible attending,
  11. Ongoing dedication to critical evaluation of one’s own skills and knowledge and to continuing education through literature review, communication with colleagues, and attendance at society meetings and other educational forums, and
  12. Interaction with other facets of the health care delivery system at large in a comprehensive yet cost-effective manner.

 Our residents work in UAMS outpatient, BHRI inpatient, VA Outpatient, VA EMG rotation, ACH IP and OP, as well as some private offices with adjunct professors.  We are a categorical program and keep a close watch on our PGY1′s who do their Internship here at UAMS.