Physical Medicine and Rehabilitation Residency Program

There is no medical specialty in which your relationship with your patients will be more rewarding.

Click here for a list of Current REHAB Residents.

Program Overview

Physical Medicine and Rehabilitation Residency Program at Washington University is offered through the Division of Rehabilitation in the Department of Neurology.
Barnes-Jewish Hospital, St. Louis Children's Hospital, The Rehabilitation Institute of St. Louis, Shriner's Hospital and VA system are participating institutions that serve as a training base for the PM&R Residency Program.

Our PM&R Residency Program is fully accredited by the Accreditation Council for Graduate Medical Education (ACGME) and offers outstanding clinical experiences in all aspects of adult and pediatric clinical neuro-rehabilitation, musculoskeletal medicine to include interventional physiatry, electrodiagnostic medicine and amputee care.

The Program provides residents with comprehensive Core didactic curriculum, which covers all aspects of Rehabilitation Medicine. In addition to core curriculum, there are monthly Grand Rounds, clinical case conferences, journal club and several lecture series in Neuromuscular Medicine, Musculoskeletal Core and Evidence-Based Core for management of Brain and Stroke population.

There are many challenges in the constantly expanding field of rehabilitation. PM&R Program makes all efforts to incorporate new areas of training into the clinical and academic curricula.

The main objective of the PM&R residency program is to provide trainees with clinical skills necessary to acquire competencies in clinical practice of rehabilitation medicine. Every effort is made to keep the program flexible and to provide the most effective way of clinical and academic training based on the unique talents of each resident. Program takes into consideration special clinical, academic and research interests of each resident and helps to channel their career growth and development.

We believe, that our PM&R Residency Program will prepare you well for a career in either private practice or academic medicine, as well as Board certification in Physical Medicine and Rehabilitation.

Training options

PM&R Residency program offers two training tracks: 4-year categorical track, and 3-year advanced track.
Program is approved for a total of 15 resident positions, two at PGY-I level, and 13 about evenly distributed between PGY-II, III and IV levels.

Categorical Track

This 48 month track integrates 12 months of basic clinical rotations and 36 months of PM&R training. 12 months of basic clinical rotations usually include 6 months of internal medicine and 6 months of selective clinical rotations such as neurology, neuromuscular, rheumatology, radiology, geriatrics, infectious diseases etc. Six months of internal medicine rotation is scheduled in the first half of the PGY-I year, while the remaining six months of selective clinical rotations are scheduled throughout the PGY-II year.

Advanced Track

Residents who join the program on the advanced track complete 36 months of PM&R training. The prerequisite for this track is a completion of 12 months of basic clinical training, such as a transitional year or internship; these must be accredited by ACGME, Royal College of Physicians, or AOA.

Teaching Faculty

The teaching faculty of the PM&R residency program is composed of both physiatrists and neurologists dedicated to practice of clinical rehabilitation and neurosciences. There is a close collaboration with many other departments at Washington University serving the aim of enhancing physiatry residents training. Residents rotate with the group of interventional and musculoskeletal physiatrists in the department of Orthopedics, pain management service in the department of Anesthesia, Radiology department, Geriatrics and Rheumatology in the Internal Medicine Department. Residents acquire skills in neuro-muscular and electrodiagnostic medicine under the guidance of our colleagues in the department of Neurology, as well as with clinical physiatric faculty.
PM&R residents have an opportunity to gain administrative skills through close ties with The Rehabilitation Institute of St. Louis. Residents participate in many hospital committees and get regular presentations from the senior administrative team members of the facility.

Didactic Curriculum

Residency training program provides comprehensive 18 - month cycle Core didactic curriculum organized in blocks by major topics. Core curriculum lectures cover, but are not limited to the following topics: Anatomy, neuro-anatomy, pathophysiology and kinesiology; brain, stroke and spinal cord disorders, neuromuscular and musculoskeletal conditions, sports medicine, cardiopulmonary rehabilitation, industrial rehabilitation, joint and connective tissue disorders, geriatrics, cancer and pediatric rehabilitation, prosthetic, orthotics and assistive devices, electrodiagnostics, physical modalities, ethics, professionalism and business aspects of a PM&R practice.
Other curriculum activities include monthly clinical case conferences, grand rounds, journal clubs and internal medicine series. In addition, there are weekly EMG and MSK seminars and Board review sessions. Each resident is also responsible for presenting a topic of choice at the Resident Seminar.

Journal Club offers residents and faculty up to date information on current research in physiatry and other fields of medicine pertinent to rehabilitation and helps residents to develop critical and analytic skills with respect to methodology, content, results and outcome data.
Board review seminars facilitate resident's self-directed learning, independent work with referenced literature and encourage group discussions.

Clinical and EMG case conferences are facilitated by the faculty and focus on clinical cases with incorporation of evidence-based data.

Anatomy and Kinesiology series are moderated by the senior residents and provide both didactic knowledge and hands on experience.

Formal curriculum on such topics as medical ethics, medical/legal issues, cost containment and infection control is developed and sponsored by the GME Consortium. PM&R residents are required to attend lectures of this curriculum. There are numerous other educational opportunities within the Washington University Medical Center which residents are encouraged to attend depending on their relevance and other clinical assignments.

The Anatomy Dissection Laboratory is available through the arrangement with Physical and Occupational Therapy Schools at Washington University. PM&R residents have an opportunity to attend anatomy lectures and participate in dissection labs mainly with focus on anatomy of nervous and musculoskeletal systems.

Clinical Rotations

Inpatient Rehabilitation rotations are located exclusively at The Rehabilitation Institute of St. Louis (TRISL).

TRISL is a free standing 96-bed comprehensive rehabilitation facility located a few blocks from the main campus of the Washington University School of Medicine and Becker Medical Library. A multitude of inpatient and outpatient programs are available at TRISL. These programs form a solid teaching base for residents and medical students training.

Patient referral sources to TRISL are mainly from Barnes-Jewish Hospital, St. Louis Children's Hospital and other community and regional hospitals of BJC Health Care System.

Comprehensive Rehabilitation Services are structured programmatically and comprise the following programs: Stroke Rehabilitation, Traumatic Brain Injury , Spine and Spinal Cord Injury, Bone and Joint Rehabilitation, Amputee and General Rehabilitation.

Each program provides a continuum of rehabilitative care for inpatients and outpatients. Each program's medical and administrative leadership, program development, teaching and research activities are spearheaded by the Medical Director of the individual program. Each program has a dedicated team of multidisciplinary rehabilitation professionals (rehabilitation nurses, physical and occupational therapists, social workers, recreational therapists, speech therapists, etc.) who provide highly specialized and comprehensive rehabilitation management.

Inpatient Rotations

Stroke
Traumatic Brain Injury
Spine & Spinal Cord
Bone & Joint Rehabilitaion
Amputee

Stroke Rehabilitation and Brain Injury

Residents rotate on the inpatient Stroke and Traumatic Brain Injury units at TRISL. Residents are involved in the management of all aspects of the patient's medical and rehabilitation care to include agitation, cognitive impairment and seizures. They have an opportunity to participate in aphasia clinic and neuro-psychological testing. Residents are actively involved in rehabilitation team and family conferences.

Spinal Cord Injury
Residents rotate on the Spinal Cord Injury unit at TRISL and have an opportunity to be involved in the management of a wide range of traumatic and non-traumatic spinal cord patients to include multiple sclerosis, transverse myelitis, tumors and post surgical degenerative spine diseases, scoliosis, failed back syndrome etc. Residents acquire clinical skills in providing primary care to spinal cord patients along with specific medical and rehabilitative care and complications as related to spinal cord injury.

Bone and Joint
Residents rotate on Bone and Joint inpatient unit at TRISL. Most common diagnoses on this unit include knee and hip joint replacements, fractures and major trauma. Residents are involved in the management of all aspects of the patient's medical and rehabilitation care and participate in weekly conferences with the rehabilitation team.

Amputee
This rotation includes exposure to patients with amputations and co-existing medical conditions. Rotation covers the entire continuum of care for amputee population to include: pre-prosthetic acute inpatient program and prosthetic gait training rehabilitation. Residents are involved in management of all aspects of the patient's medical and rehabilitation care. They acquire clinical skills in wound care, pain management, gait analysis, prosthetic prescription and management.

Outpatient rotations

Musculoskeletal Rotation

Residents have an extensive exposure to acute and chronic musculoskeletal conditions and pain syndromes through a variety of clinics in the outpatient setting. They work with physiatric faculty in a one-on-one basis in diverse outpatient setting to include both academic environment and private physiatric practices. Residents acquire skills in various interventional spine procedures, MSK ultrasound, arthrocentesis and trigger point injections and electrodiagnostic testing.

Specialty Rehabilitation Clinics Rotation

This rotation is located at the Center for Advanced Medicine on Washington University Medical Campus.
Residents participate in Stroke and Brain Injury, Spinal Cord, Spasticity Clinic and Amputee Clinics. These are all continuity clinics where residents acquire clinical skills and knowledge in long term rehabilitation management of wide range of neurological conditions, pain management, amputee care, evaluation and management of spasticity to include Botulinum toxin therapy and Intrathecal Pump management.

Orthotic and Prosthetic Rotation

Residents attend clinics and production labs at the local orthotic & prosthetic companies: Prosthetic & Orthotic Design and Hanger. They have an opportunity to work with very experienced practitioners and do hands-on evaluation, casting and fitting of orthotics and prosthetics.

Electrodiagnostic Rotation

Residents rotate through the Electrodiagnostic Lab of the Department of Neurology where more than 2,000 studies are performed each year. Residents receive the extensive training in performing NCSs and EMG and attend weekly clinical neuroscience lecture series that cover mechanisms of neuromuscular diseases, nerve and muscle pathology and electrodiagnostic testing and interpretation. During this rotation, residents perform over 200 NCS / EMG studies under the direct guidance and supervision of AANEM Board certified neurologists.

Cardiac and Pulmonary Rehabilitation

Residents on this rotation gain experience in cardiac exercise stress testing, rehabilitation exercise prescription, pulmonary function testing.

Pediatric Rehabilitation

Residents rotate on a pediatric neuro-rehabilitation inpatient unit and attend outpatient clinics at St. Louis Children's hospital and Shriner's Hospital. Residents gain clinical skills and knowledge in diagnosis and rehabilitation management of a variety of conditions to include spinal cord and brain injury, cerebral palsy, spina bifida, scoliosis, hip dysplasia, and numerous other neuromuscular and musculoskeletal diseases.

Research Requirements
Residents are required to participate in clinical research projects during their training period and produce at least one paper or case report to be submitted to the peer review journals. All residents are required to submit one poster for the Annual Residents' Day Symposium held in May in the Department of Neurology. Residents are also encouraged to submit their papers or posters to the PM&R related scientific meetings such as American Academy of Physical Medicine and Rehabilitation (AAPM&R) and the Association of Academic Physiatrists (AAP).

All residents are required to submit review abstract to the "Rehab in Review" journal produced by the Emory University Department of Rehabilitation Medicine, which is distributed to many PM&R Departments in the US.
Residents also have an opportunity to participate in interdepartmental clinical research projects at the Washington University Medical Center.

General Information for Application Procedure

Application

To apply for the PM&R residency training program, please submit all required documentation to ERAS (Electronic Residency Application System). U.S. medical school graduates should contact office of Student Affairs or other designated Dean's office for information and software for ERAS. Foreign medical graduates should contact ECFMG for information and further instructions.
Paper applications are not accepted.

We accept applications from candidates from osteopathic schools and foreign medical graduates.

Graduates of foreign medical schools are required to hold a valid ECFMG certificate.

All applicants are required to complete Step I and II of USMLE. COMPLEX scores are also accepted.

Deadline

Deadline for applications is October 31.

Interview process

Applicants are interviewed between early November and mid January. Invitation for the interview is sent out via email.

This program participates in the National Residency Match and adheres strictly to the rules of the Match. Applications are accepted for both Categorical and Advanced tracks. Usually, 2 positions are available for each track annually.

For more information, please contact:

PM&R Residency Coordinator Donna Barbier at barbierd@neuro.wustl.edu

Washington University encourages and gives full consideration to all applicants for admission, financial aid, and employment. The University does not discriminate in access to, or treatment of, or employment in its programs and activities on the basis of race, color, age, religion, sex, sexual orientation, national origin, veteran status or disability. Present Department of Defense policy governing ROTC and AFROTC programs discriminates on the basis of sexual orientation; such discrimination is inconsistent with Washington University policy. Inquiries about compliance should be addressed to the University's Vice Chancellor for Human Resources, Washington University, Campus Box 1184, One Brookings Drive, St. Louis, MO 63130-4899 tel: (314) 935-5949.

Student Clerkship Opportunities

Four week elective rotation is offered for the third and fourth year medical students of the Washington University School of Medicine, and Fourth year students of other allopathic medical schools (schools that award MD degrees).

All requests from medical students from the institutions other than Washington University are considered on a space-available basis and are reviewed by the clerkship director. To request clerkship information or to schedule a rotation, please contact the WUSM curriculum office at 314-747-3854.