Mission Statement
The mission of the Vanderbilt Physical Medicine and Rehabilitation Residency Training is to train future leaders in physiatry medicine in a collaborative and supportive environment that provides training in complex clinical skills, didactic education, and research opportunities in physical medicine and rehabilitation.
Our program aims to:
- Provide a dynamic, interdisciplinary, and appropriately supervised academic setting in which advanced, highly skilled education in physiatry can occur.
- Develop the resident academically and professionally, while providing resident wellness and balance. Competencies to be acquired include those of medical knowledge, patient care, practice-based learning and improvement, communication and interpersonal skills, professionalism, and systems-based practice.
- Provide collaborative opportunities for residents to engage in scholarly activities with faculty who are engaged in leadership positions across the spectrum of PM&R.
- Continuously evaluate the residency program in order to provide the most relevant and diverse educational experience in order to foster stellar physiatrists.
Program Goals
The overarching goal of the Vanderbilt Physical Medicine and Rehabilitation Residency Training Program is to produce physicians who can competently and independently practice general physical medicine and rehabilitation medicine, also known as physiatry medicine.
Upon completion of this program, residents will be able to:
- Demonstrate sufficient competence in the Physical Medicine and Rehabilitation Milestones of The Accreditation Council for Graduate Medical Education (ACGME)*.
- Complete and present a Quality Improvement (QI) Project approved by the American Board of Physical Medicine and Rehabilitation (ABPM&R).
- Admissible for Part 1 of the ABPM&R certifying examination.
ACGME Competencies*
Excerpts from Physical Medicine and Rehabilitation Milestones located at:
https://www.acgme.org/globalassets/pdfs/milestones/pmrmilestones.pdf
PATIENT CARE
1) Physiatric History, Appropriate for Age and Impairment
- Elicits key history, including subtleties, in a prioritized and efficient fashion across a spectrum of ages and impairments.
2) Physical Examination
- Efficiently performs a hypothesis-driven physiatric examination that identifies subtle or atypical findings over a spectrum of ages and impairments.
3) Medical Management (e.g., Inpatient, Outpatient, Consultative Settings)
- Develops and implements a comprehensive treatment plan that anticipates, identifies, and addresses complications related to neurological and musculoskeletal disorders over a spectrum of ages and conditions.
4) Procedural Skills: Injections for Abnormalities of Tone or Movement (e.g., Chemodenervation, Neurolysis) Performed under Guidance (e.g., Anatomic, Electromyography, Electrical Stimulation, Ultrasound)
- Performs all components of the procedure across a spectrum of presentations.
5) Procedural Skills: Joint and Soft Tissue Injections(e.g., Intra-articular, Trigger Point, Bursal, Perineural, Tendon Sheath), Including Those Performed under Guidance (e.g., Ultrasound, Fluoroscopy)
- Performs all components of the procedure across a spectrum of diagnoses.
6) Procedural Skills: Electrodiagnostic Procedures (Planning, Performance, and Interpretation)
- Plans and performs all components of the electrodiagnostic procedure across a spectrum of diagnoses.
- Interprets electrodiagnostic data and modifies the study as it is being performed.
- Generates tailored electrodiagnostic reports meeting the needs of the referring provider.
7) Assistive Technologies (e.g., Prosthetics and Orthotics, Adaptive Equipment, Mobility Devices, Seating Systems, Communication Technologies)
- Generates a detailed prescription, in consultation with other professionals, for a full range of assistive technologies including justification and advocacy where needed.
8) Rehabilitation Interventions
- Integrates comprehensive knowledge of impairments, activity limitations, and participation restrictions to prescribe rehabilitation interventions.
MEDICAL KNOWLEDGE
1) Foundational Principles of Physiatric Practice (Anatomy, Pathophysiology, Kinesiology, Pharmacology)
- Integrates foundational knowledge into physiatric practice across a spectrum of ages, impairments, and clinical settings
2) Clinical Reasoning
- Synthesizes information to reach high-probability diagnoses with continuous re-appraisal to minimize clinical reasoning errors.
- Considers diagnostic testing based on cost effectiveness and likelihood that results will influence clinical management.
- Anticipates and accounts for errors and biases.
SYSTEMS-BASED PRACTICE
1) Patient Safety
- Conducts analysis of patient safety events and offers error prevention strategies (simulated or actual).
- Discloses patient safety events to patients and families (simulated or actual).
2) Quality Improvement
- Demonstrates the skills required to identify, develop, implement, and analyze a quality improvement project.
3) System Navigation for Patient-Centered Care
- Role models effective coordination of patient-centered care among different professions and specialties.
- Role models and advocates for safe and effective transitions of care/hands-offs within and across health care delivery systems and settings.
- Participates in changing and adapting practice to provide for the needs of specific populations.
4) Physician Role in Health Care Systems
- Navigates the various components of the complex health care system to provide efficient and effective patient care and transition of care.
- Advocates for patient care needs (e.g., community resources, patient assistance resources) with consideration of the limitations of each patient’s payment model.
- Analyzes individual practice patterns and professional requirements in preparation for independent practice.
PRACTICE-BASED LEARNING AND IMPROVEMENT
1) Evidence-Based and Informed Practice
- Critically appraises and applies evidence even in the face of uncertainty and conflicting evidence to guide care, tailored to the individual patient.
2) Reflective Practice and Commitment to Professional Growth
- Seeks and incorporates verbal feedback and other performance data consistently, with humility and adaptability.
- Uses data to measure the effectiveness of the learning plan to address performance gaps and modifies it when necessary.
PROFESSIONALISM
1) Ethical Practice
- Manages ethical dilemmas, using appropriate resources as needed to facilitate resolution (e.g., ethics consultations, literature review, risk management/legal consultation).
2) Professional Behaviors
- Demonstrates professional behavior across situations and settings.
- Proactively intervenes to prevent lapses.
3) Accountability
- Proactively implements strategies to ensure that the needs of patients, teams, and systems are met in a timely manner.
4) Patient Care Etiquette with Patients of All Abilities
- Proactively maintains patient’s comfort and dignity during history taking and physical examination for those with severe impairments or disabilities.
5) Resident Well-Being and Help-Seeking
- Independently develops, implements, and refines a plan to optimize personal and professional well-being.
INTERPERSONAL AND COMMUNICATION SKILLS
1) Patient- and Family-Centered Communication
- Easily establishes therapeutic relationships, with attention to patient/family concerns and context, regardless of complexity.
- Overcomes personal biases while proactively minimizing communication barriers.
- Independently, uses shared decision making to align patient/family values, goals, and preferences with treatment options to make a personalized care plan.
2) Interprofessional and Team Communication
- Coordinates recommendations and communication from different members of the health care team to optimize patient care.
- Communicates feedback and constructive criticism to superiors.
3) Communication within Health Care Systems
- Provides feedback to improve others’ written communication.
- Achieves written or verbal communication that serves as an example for others to follow.