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PGY4 Year

uc pmr residency pgy4 inpatient1. Inpatient PM&R Consultations

The inpatient PM&R consultation rotation at UC Irvine Medical Center (UCI General-2) provides the PGY4 resident with excellent experience and training in consultative services for acute hospital inpatients.

This busy rotation provides the resident with wide-ranging experiences evaluating and providing treatment recommendations for various neurological, orthopedic, neurosurgical and musculoskeletal diagnoses commonly encountered in acute inpatient settings.

Because UC Irvine Medical Center receives referrals from many regional hospitals, the consult resident gains experience evaluating and treating complex medical patients with severe injuries or complicated medical issues.

The PGY4 resident will work closely with a consult attending physiatrist, and conducts all follow-up and new PM&R consultations with an attending physician.

The senior consult resident works closely with the primary team, the hospital therapy (PT, OT, speech), and case management services to optimize post-acute care rehabilitation for patients.

The senior consult resident may also gain additional inpatient rehabilitation training through assisting with Acute Rehabilitation Unit (ARU), working with a junior ward resident.

2. Traumatic Brain Injury and Neurologic Rehabilitation

The traumatic brain injury rotation at Long Beach Memorial Medical Center (TBI/Neuro-2) allows residents to manage patients with brain injuries and strokes.

During this rotation, residents work with an interdisciplinary team, including physiatrists, hospitalists/internists, neuropsychologists, physical therapists, occupational therapists and speech therapists.

Residents learn how to care for patients with brain injuries and strokes in the rehabilitative setting. They also have a unique opportunity to rotate with a specialist in pain management and assist in inpatient pain consults. This rotation allows the PGY4 to mentor a PGY2.

3. Outpatient

During the outpatient rotation at VA Long Beach Healthcare System (Outpatient), the resident rotates through the VA’s Palliative Care Clinic and the Interventional Pain Practice and the RMS clinic.

These settings allow residents to manage patients with acute and chronic pain conditions, and end-of-life pain and symptom management.

During this rotation, residents work with an interdisciplinary team, including physiatrists (physicians trained in physical medicine and rehabilitation), hospitalists/internists and anesthesiologists.

Residents become competent at comprehensive outpatient pain management via a multitude of modalities, including opioid and adjunctive pain medications, and non-interventional and interventional treatments.

Most patients are initially seen as new patient evaluations, where a review of the patient’s pain history and presentation, along with a thorough physical examination, will allow residents to formulate a comprehensive differential diagnosis and treatment plan for the pain etiology.

Many patients are managed holistically, meaning we treat the whole person, and many return to clinic for follow-up visits and interventional procedures. Interventional procedures are done in the clinic or VA fluoroscopy suite, which also includes access to an ultrasound machine. Patients go home the same day, about 30 minutes after each procedure.

Residents’ time will be split between clinical evaluations and interventional procedures. The skills that residents acquire during the outpatient rotation will be valuable to understanding the comprehensive management of patients in the perioperative, end-of-life and chronic pain environments.

The PM&R consultation clinic at VA Long Beach does all outpatient consultations and writes all the therapy orders on patients referred for medical rehabilitative therapy. One staff physiatrist is assigned to supervise the residents in clinic, reviewing all cases.

uci pm&r residency electromyography4. Electromyography

The electromyography rotation takes place at the VA Long Beach Healthcare System (EMG-2).

Residents continue their electrodiagnostic training and gain greater in-depth knowledge by performing and interpreting more moderate-complex cases.

Residents become more proficient with technical skills and develop more independence.

5. Musculoskeletal Clinic at VA Long Beach Healthcare System (MSK-2)

The musculoskeletal clinic takes place at the VA Long Beach Healthcare System (MSK-2). The VA setting allows residents to manage patients with acute and chronic musculoskeletal rehabilitation needs, including cardiac and orthopedic rehabilitation needs.

During this rotation, residents work with attending physiatrists, kinesiotherapists, physical therapists and occupational therapists.

Residents become competent at comprehensive outpatient musculoskeletal management, via a specific diagnostic examination, therapy planning, quantified goal setting, medical management and interventional treatments.

uci pgy4 musculoskeletal residency rotation Initially, patients are seen as new consultation evaluations, where a review of the patient’s chief complaint and medical history are determined by interview, followed by a comprehensive and focused physical examination.

This enables residents to formulate a differential diagnosis and treatment plan for the MSK-related diagnosis. Many patients are managed holistically and many return to clinic for follow-up visits, and interventional procedures.

Interventional procedures are done in the clinic, where there is access to ultrasound machines. The skills that residents acquire during the MSK rotation are valuable in understanding the comprehensive management of acute and chronic MSK conditions.

During this rotation, residents also attend musculoskeletal radiology once a week. During this half day, residents learn to read X-rays and MRIs from musculoskeletal fellows and attendings.

The second half of the day is spent at the Orthopedic Hand Clinic. During this clinic, residents evaluate patients with various hand disorders, ranging from carpal tunnel syndrome and Dupuytren’s contracture to trigger finger. Orthopedic surgeons staff the clinic and orthopedic residents assist in teaching our residents.