Rotations

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

Residents gain experience evaluating gait disorders using sophisticated equipment, including a computer integrated multi-video analysis system, force plates, and a dynamic electromyography unit. They learn to use this advanced technology to better define gait deviations associated with disability. Residents spend at least one month in the laboratory and actively participate in the acquisition and analysis of data. Medical diagnoses most commonly evaluated include stroke, head injury, spinal cord injury, multiple sclerosis, and cerebral palsy. There is also time on this rotation dedicated to learning about outpatient therapies and vision rehabilitation.

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.  

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.

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.

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.

RThis 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.

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.

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.

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.