Residency Training Program

The Residency Program in PM&R at the UCI College of Medicine is an integrated three-year program utilizing the facilities of three affiliated hospitals: UCI Medical Center (UCIMC), Veterans Affairs Medical Center, Long Beach (VAMCLB), and Long Beach Memorial Medical Center.

The goal of the UCI PM&R program is to develop highly knowledgeable, clinically competent physiatrists capable of functioning independently in almost any setting following graduation without additional formal training with the one exception of inpatient pediatric rehabilitation where additional special training is required by pediatricians controlling privileges.

The first 12 months of PM&R training are devoted to working on an inpatient rehabilitation unit - 5 months at UCI Medical Center, 5 months on the VA PM&RS unit and 2 months on the VA SCI rehab unit. Due to the nature of these hospitals, experience on each unit is quite different.

UCIMC is a designated Level I trauma center which has a regional center and stroke center in addition to its trauma unit. The rehab unit admits approximately 340 patients per annum with the major diagnoses being spinal cord injury and stroke. The PG2s on the ward serve as the primary physicians writing all orders, including therapy orders, under the supervision of a PG4 resident and the staff physiatrist on service. Each PG2 will admit 12-14 patients per month or 65-70 patients during the 5-month rotation. In addition to making regular rounds, the PG2's run the team and family conferences under the supervision of the staff physiatrist, attend post-discharge clinics, and a number of off-service conferences.

The rehab unit run by the Physical Medicine and Rehabilitation Service at VAMC-Long Beach has 10+ beds for acute cases. Each PG2 manages an average of 6 acute cases and admits 8+ patients per month or 32 during the rotation. As the VA/PM&RS is not subject to the same rules as civilian rehab units, patients with diagnostic problems such as progressive neuromuscular weakness or pain can be admitted to the unit for workup by the PG2 resident. The unit is supervised by a full-time staff physiatrist who is directly responsible for the supervision of the PG2s on the ward. The staff physiatrist assures that these residents do proper physiatric examinations, and learn such procedures as muscle testing, goniometry, arthrocentesis, caudal epidurals, etc., and writing specific physiatric orders. The staff physiatrist makes regular ward rounds, supervises team and family conferences, and attends post-discharge clinic.

At the VAMC, PGY-2 residents also participate in outpatient clinics, including general rehab, neurology, and SCI clinics. 

In summary, PGY-2 residents manage of total of 100+ inpatients in the course of the 10 months they spend on the rehab units at UCI Medical Center and VA Medical Center Long Beach including workups, invasive diagnostic procedures and treatment, and management of team and family conferences.

In addition to the teaching received at bedside, PG2 residents present at grand rounds and participate in journal club with the other PM&R residents at the hospitals to which they are assigned. Special courses are taught for PG2 residents alone: anatomy, physiatric modalities, introduction to electrodiagnosis and prosthetics/orthotics. The PG2s also attend post-hospital care clinics at UCIMC and when they are on the Rehab Unit at the VA.

PGY-3 Year

The PG3 year is devoted to learning how to write consultations, treat outpatients, special clinics, and electrodiagnostic training. The entire time is spent at VAMC. The PM&R consultation clinic does all inpatient and outpatient consultations and writes all the therapy orders on patients referred for medical rehabilitative therapy. Each PG3 spends at least 4 half-days per week in the PM&RS Consultation Clinic. One staff physiatrist is assigned to super-vise the residents in clinic, reviewing all cases. Initially, this review consists of the staff physiatrist examining the patient and reviewing the written consultation and orders. As the year progresses, depending upon the house officer's performance, the degree of supervision decreases to reading the consultation and follow-up notes without actually seeing the patients. On average a resident will manage 500-550 unique patients in this clinic in one year; 3/4 of the patients are outpatients.

In addition to the consultation clinic, a PG3 resident will rotate through 2 months of several specialty clinics. The rotations are as follows: Orthotic Clinic, Wheelchair Clinic, PACT Clinic, Orthopedic Hand Clinic/Amputee Clinic, and Cardiac Rehab. In each case a staff physiatrist is assigned to supervise the resident.

The cardiac rehabilitation rotation is two months. The assigned resident does all cardiac rehab consultations and writes the orders for physical therapy and occupational therapy. The resident is supervised by a staff physiatrist interested in cardiac rehabilitation.

The PACT/Amputee Clinic rotation consists of attendance once a week at the post-amputation clinic run by the Preservation, Amputation Care and Treatment Team (PACT), where the resident provides the physiatric management of the postamputation patient under the supervision of a staff physiatrist. The resident also attends the Amputee Clinic which is the multidisciplinary prosthetic clinic ordering new prostheses for new amputees and replacement prostheses for old amputees. This rotation, like the others, is two months.

The balance of the PG3's experience is devoted to the training in electrodiagnosis. The resident spends half-time in the PM&RS Electrodiagnostic Clinic for the entire year. The training program is designed to meet the requirements of the American Board of Physical Medicine and Rehabilitation and the American Association of Electrodiagnostic Medicine. All faculty training residents in electrodiagnosis are board-certified physiatrists who are also members of AAEM. The didactic course deals with the physiology of the entire nervous system and muscle, pathology of peripheral nerve, muscle and spinal cord; electrophysiology of nerve/muscle; applied electronics, instrumentation techniques and interpretations of nerve conduction studies, needle electromyography, neuromuscular junction testing, somatosensory evoked potentials; ethics; infection control; and use of statistics. All procedures are supervised by faculty. The electrodiagnostic lab has three important pieces of equipment: a Nicolet Viking IV and two Medtronics systems. Interesting cases are stored to be shown to all the residents. Residents have access to teaching tapes developed by the University of Washington and University of Texas, San Antonio.

PGY-4 Year

The PG4 year is composed of rotations at UCI Medical Center, Memorial Rehabilitation Hospital and Miller Children's Hospital/Memorial Medical Center. Each of these rotations provides a unique experience.

The PG4 experience at UCI Medical Center consists of performing adult and pediatric consultations on patients who require acute intensive rehabilitation (inpatient rehab), attending PM&R (Post-Discharge and general) Clinic and Prosthetic Clinic. PG4s together with faculty may be called upon to provide physiatric consultative services to the clientele of Fairview Developmental Center (for the developmentally disabled). The UCI rotation totals 146 days.

Memorial Medical Center consists of several hospitals including Memorial Rehabilitation Hospital, and the Earl and Lorraine Miller Children's Hospital. There is a full-time pediatric physiatrist at the Children's Hospital and five physiatrists at Memorial Rehabilitation Hospital.

Seventy-three (73) days will be spent at the Children's Hospital under the pediatric physiatrist taking care of inpatients on the rehab unit. In addition, the resident will do consultations, and attend clinics under the supervision of the pediatric physiatrist. This PG4 will also be the resident on the SCI program, which is a small program not including respiratory-dependent acute cases.

The rotation at the Memorial Rehabilitation Hospital (MRH) totals 219 days. Memorial Rehab has a programmatic structure. There is a Traumatic Brain Injury (TBI) program, a general rehab program which includes the sub-acute cases, and an SCI program, described under the Peds rotation.

Salary and Fringe Benefits

The current yearly stipend for residents is as follows:

All residents receive 4 weeks of vacation and 8 days of sick leave.

Malpractice insurance is provided at no charge. Health and life insurances are part of your comprehensive benefits package.

Combined Teaching Programs

In addition to the teaching activities in each affiliated hospital, a weekly afternoon teaching session with a lecture series on clinical PM&R is given to all residents. The residents are also required to attend the following courses: Anatomy, including dissection; Neuromuscular Physiology and Pathology; Electronics and Instrumentation; Electromyography and Electrodiagnosis; Prosthetics and Orthotics; and an orientation to research. PGY2 residents participate in an introduction to rehabilitation medicine course, supplemented by "dry labs" in physical and occupational therapy plus hands-on experience providing selected patients physical and occupational therapy.

Resident Research Opportunities

All of the residents are encouraged to follow a 3-year research plan. A review article and a research or case report are to be completed. "An Orientation to Research" course is given, covering selection of problems, research design, organization of the research team, data analysis, writing and publication of the research paper, grant proposal writing, and legal aspects and ethics of research. Time is allocated from the regular schedule for those residents involved in approved research projects.

Resident Teaching Opportunities

The Department offers fourth-year UCI medical students a 2-week required Musculoskeletal and Rehabilitation clerkship. The Department also offers a 4-week research or clinical PM&R elective to medical students from UCI or other schools. Residents participate in these teaching activities. Residents also give in-service sessions to allied health personnel in the affiliated hospitals.

Recreation, Cultural, and Social Opportunities

The climate of Southern California is defined as semitropical and semi-arid; despite what you may have read or heard in the winter of '97-98, the average annual rainfall is 14". The temperature ranges from 50-75 in the winter and 60-90 in the summer.

The climate and proximity of the mountains and the ocean allow for a wide variety of activities - from skiing, which is available in the San Bernardino mountains, to windsurfing, sailing, and other water sports. Superb beaches are available within an easy drive. It is possible to swim in the ocean almost 8 months of the year, and boating, surfing, skin diving, and fishing are year-round sports. The area abounds with jogging and bike paths, and there are numerous public golf courses and tennis courts in the metropolitan area.

The Los Angeles-Orange County area offers a wide choice of entertainment activities. The Los Angeles County, Norton Simon, Getty, and Huntington Hartford Museums contain extensive art collections, and there are a number of smaller galleries throughout the two-county area. The Performing Arts Center in Costa Mesa in Orange County and the Music Center in downtown Los Angeles are major theaters for symphony, drama, and ballet. There are many smaller less well-known theaters offering diverse dramatic material within easy driving distance in Orange and Los Angeles Counties. Pop concerts with well-known artists are given both indoors and outdoors throughout the year.

For sports fans there are professional teams in baseball, basketball, and hockey. The area is equally well-known for its collegiate teams and the hosting of the Rose Bowl game.

The extensive freeway system makes all of these activities readily available. San Diego and the U.S./Mexican border are only a 2-hour drive away.

Faculty Roster

• Neurobiological basis of PM&R, including interrelated areas of neural plasticity, such as brain development, learning and memory, control of movements and recovery after injury.

• Rehabilitation pharmacotherapy.

• Scientific basis of physical medicine techniques for management of nerve and muscle dysfunction.

• Functional magnetic stimulation.

• Pathophysiology and management of myofascial pain syndrome.

• Biomechanics of bone and joint.

• Falls in the elderly, functional facilitation in the elderly.

• Complementary health care.

• Clinical neurophysiology and electrodiagnosis.

Selected Publications

Nondiscrimination Statement

UCI provides equal opportunity in its admission, services, and employment regardless of a person's race, color, religion, sex, marital status, national origin, sexual orientation, physical or mental disability, cancer-related medical condition, status as a Vietnam-era or disabled veteran or, within the limits imposed by law or University regulations, because of age or citizenship. The University also implements student, staff, and faculty affirmative action programs. Direct inquiries regarding this policy to: University of California, Office of Affirmative Action and Equal Opportunity, Irvine, CA 92657; (949) 824-5594.

The information in this publication will be made available in alternative formats upon request for people with disabilities. Requests should be directed to Physical Medicine and Rehabilitation at (714) 456-6668.