Education & Training

Rotations

Rotations

Amputee
This rotation includes exposure to patients with amputations and coexisting medical problems. Participation in weekly team conferences, family conferences and didactic activities is an integral part of this rotation. Residents are taught prosthetic prescription and management. Included in this rotation is a busy weekly amputee clinic for prosthetic prescriptions.

Electromyography
A requirement of PM&R residencies is for each resident to carry out 200 EMG's during their residency training. During their rotations at the Massachusetts General Hospital, Brigham and Women's Hospital and the Jamaica Plain VA, residents have an intensive experience in both observing and performing electromyographic and nerve conduction studies.

Neurology
Residents on this rotation gain experience in managing acute neurological problems on the inpatient Neurology service at MGH. Residents have the same responsibilities and call schedule as the Neurology residents and are supervised by an attending neurologist.  

Outpatient
Residents have multiple rotations in the outpatient setting where they work with attending physiatrists on a one to one basis in a diverse outpatient physiatric practice. Typical patients include those with ongoing rehabilitation associated with neurologic or rheumatologic impairments, musculoskeletal pain syndromes, and occupational medicine patients. Residents also may participate in outpatient Orthotic and Prosthetic Clinics. Opportunities are available for outpatient care at Spaulding Neighborhood Rehabilitation Centers in Medford, Framingham, Newton-Wellesley, and other community settings.

Pediatric Rehabilitation
Under the supervision of a pediatric physiatrist, residents rotate on the pediatric rehabilitation unit at Spaulding. These pediatric patients have a variety of disabilities including brain injury, cerebral palsy, spina bifida and numerous other neuromuscular diseases. The residents learn to manage common impairments and disabilities including spasticity and gait disorders. They will also spend time treating pediatric outpatients during this rotation at Spaulding and Children's Hospital Boston.

Spinal Cord Injury
Residents on this rotation participate in the rehabilitation of acute spinal cord injured patients as well as a large outpatient spinal cord injured population. Outpatient care involves periodic check-ups and care of urinary tract, skin and other complications. The inpatient service is split between the West Roxbury VA Medical Center (a 60-bed facility) and SRH (18-bed unit). This allows the residents exposure to both acute and chronic SCI patients.

Spine Center
This rotation includes resident participation in an outpatient spine clinic. The emphasis of this rotation is on occupational medicine/back pain, and incorporates teaching and exposure to spine injections under fluoroscopic guidance.

Stroke Rehabilitation
This rotation includes an intensive inpatient rehabilitation experience on the stroke unit at Spaulding. Residents are involved in management of all aspects of the patient's medical and rehabilitation care. Residents participate in weekly conferences with the rehabilitation team. They are supervised on a one-to-one basis by an attending physiatrist. Residents gain outpatient follow-up experience in the attending physiatrist's clinic.

Traumatic Brain Injury
This rotation is based in the inpatient traumatic brain injury rehabilitation unit at Spaulding. Team meetings occur four to five times per week to track patient progress closely. Resident responsibilities are similar to those outlined above for the stroke rehabilitation rotation. Supervision is provided on a one- to-one basis by an attending physiatrist.


Sample Rotation Schedule 

Month

PGY-2 PGY-3 PGY-4
July Stroke: Spaulding Rehabilitation Hospital EMG: Massachusetts General Elective: Any location
Aug Stroke: Spaulding Rehabilitation Hospital EMG: Massachusetts General Teaching: Spaulding Rehabilitation Hospital
Sept Inpatient Amputee: Spaulding Rehabilitation Hospital EMG: Massachusetts General SCI Spaulding Rehabilitation Hospital
Oct Outpatient Amputee: Spaulding Rehabilitation Hospital Outpatient Spine: Brigham and Women's Hospital Elective: Any location
Nov Neurology: Massachusetts General Hospital MSK: Spaulding Rehabilitation Hospital EMG: Jamaica Plain VA Hospital
Dec Neurology: Massachusetts General Hospital Elective: Any location EMG: Jamaica Plain VA Hospital
Jan Musculoskeletal: Newton-Wellesley Hospital Traumatic Brain Injury: Spaulding Rehabilitation Hospital Inpatient Consults: Massachusetts General
Feb Musculoskeletal: Newton-Wellesley Hospital Traumatic Brain Injury: Spaulding Rehabilitation Hospital Outpatient MSK: Massachusetts General
Mar Spinal Cord Injury: West Roxbury VA Elective: Any location Traumatic Brain Injury: Spaulding Rehabilitation Hospital
Apr Spinal Cord Injury: Spaulding Rehabilitation Hospital Pain Management: Spaulding Rehabilitation Hospital Outpatient: Spaulding Rehabilitation Hospital
May Spine/MSK: New England Baptist Hospital Sports Medicine Outpatient: Massachusetts General Pediatrics: Spaulding Rehabilitation Hospital
June Spine/MSK: New England Baptist Hospital Consults: Brigham and Women's Pediatrics: Spaulding Rehabilitation Hospital

 

Electives
Common elective experiences are further training in spine care, electrodiagnostic procedures, gait analysis, pediatric rehabilitation, spinal cord injury, traumatic brain injury, sports medicine, industrial rehabilitation / work hardening and chronic pain management. Residents also have the opportunity to perform research during their elective time.