To Train or Not to Train: Admission of Pediatricians into Pediatric Rehabilitation Medicine Fellowships

Creating and developing a comprehensive pediatric physical medicine program: A 10-year experience

PURPOSE

A multi-institutional and multidisciplinary pediatric physical medicine rehabilitation healthcare system was developed to meet regional patient needs.

METHODS

A ten-year experience meeting regional patient care needs in northeast Florida and southern Georgia is described.

RESULTS

A collaborative effort of multiple institutions resulted in the recruitment of a pediatric physical medicine and rehabilitation physician in June 2009, followed by planning stages that included initiation, development, and structuring of the program.

PHASE I

selection of clinic spaces, training of existing staff, creating specialized programs.

PHASE II

recruitment of an additional physician and dedicated advanced practice registered nurse, hospital nursing and radiology personnel training, development of protocols for specific disease entities, formulating a team approach for patient care, development of dedicated clinics for disease processes. Phase III: incorporating care into existing multidisciplinary clinics, education of existing physical, occupational, and speech therapists in dedicated remote clinics on early detection and management of specialty issues. Phase IV: ongoing education provided by rehabilitation faculty. Quality improvement aspects included outcome studies, coordinating with the Cerebral Palsy Research Network databank, and others. All phases overlapped in time and are ongoing, adapting to new needs.

CONCLUSION

A collaborative program can be created to provide comprehensive pediatric physical medicine and rehabilitation in regions lacking such a system.

Assessing the Field of Pediatric Rehabilitation Medicine's Interest in Expanding Fellowship Training to Pediatricians

BACKGROUND

Training opportunities to pursue a career in pediatric rehabilitation medicine (PRM) have evolved over the last 40 years, with the most recent change being the development and accreditation of PRM fellowships and subspecialty certification in PRM. Currently the American Board of Physical Medicine & Rehabilitation (ABPMR) requires all candidates for PRM subspecialty certification to have completed a physical medicine and rehabilitation (PM&R) residency. The small number of certified PRM physicians has prompted debate within the field about permitting pediatricians to enter PRM fellowships without having to complete a PM&R residency.

OBJECTIVE

To assess the level of interest within the field of PRM in creating a pathway to PRM for pediatricians.

DESIGN

Survey of pediatric physiatrists in the United States in 2017.

SETTING

National.

PARTICIPANTS

Pediatric physiatrists.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASUREMENTS

Favorability toward pediatricians becoming certified in PRM.

RESULTS

Most respondents (62%) were in favor of pediatricians having the opportunity to pursue training in PRM, with an increase in support (70%) after being introduced to workforce issues in PRM. Training time for pediatricians was the largest concern identified by respondents who were not in favor (80%), with additional themes identified including dilution of the essence of the field and operationalization issues.

CONCLUSIONS

With a small number of practicing pediatric physiatrists, the growing number of children with disabilities, and the limited access to our services, most pediatric physiatrists are in agreement that it is time to consider the opportunity to expand the PRM workforce by creating a fellowship pathway to subspecialty board certification in PRM after pediatric residency.