Clerkship Goals and Objectives

Goals

The goal of the REHAB 684 clerkship is to learn Physical Medicine and Rehabilitation (PM&R) management of patients with disabilities and functional impairments due to disorders such as back and neck pain, joint and tendon injuries, spinal cord injury, amputation, concussion, and other neuromuscular and musculoskeletal disorders. Students will have a structured clinical experience in a rehabilitation medicine outpatient clinic. Students will learn about the interdisciplinary team management of rehabilitation and recovery for injured workers, identification of impairments, and prevention of secondary medical complications. Students will appreciate the patient-centered function-oriented PM&R approach to patient care to include therapy, modalities, medications, and injections. 

Objectives

For 4-Week Rotations

1. Experience outpatient musculoskeletal medicine, reviewing the work up for common conditions and applying this knowledge in the creation management plans for:
   • Low back and neck pain
   • Shoulder and upper extremity pain
   • Hip and pelvic pain
   • Foot and ankle pain including CRPS
   • Muscle strain and sprain
2. Review the workup of common neuromuscular disorders and demonstrate knowledge in the assessment and management of:
   • Carpal tunnel syndrome
   • Cervical and lumbar radiculopathy
   • Ulnar neuropathy
   • Tarsal tunnel syndrome
   • Polyneuropathy
3. Learn and execute a competent neurological and musculoskeletal examination to include the lumbar and cervical spine.
4. Learn and demonstrate essential components of the shoulder, hip, knee, ankle and foot examinations.
5. Learn how to identify and treat myofascial pain and its distinctions from Fibromyalgia.
6. Identify non-organic signs on physical examination and recognize findings suggestive of symptoms magnification. 
7. Review diagnostic and therapeutic modalities for common problems. This will include trigger point injections, ultrasound guided injections for shoulder impingement, tendonitis, trochanteric bursitis, hip and knee DJD, SIJ, and piriformis syndrome.
8. Participate in the identification and workup of a work-hardening candidate, and applying that knowledge to create an assessment and treatment plan in a multidisciplinary format.
9. Understand the difference between impairment versus disability.
10. Review the essential components of running and maintaining a private practice including staffing, referrals and marketing, scheduling and billing, charting and documentation.
11. Observe and work with other rehabilitation medicine professionals, such as physical therapists, occupational therapists, and speech-language pathologists.

For 2-Week Rotations

1. Experience outpatient musculoskeletal medicine, reviewing the work up for common conditions and applying this knowledge in the creation management plans for at least two of the following:
   • Low back and neck pain
   • Shoulder and upper extremity pain
   • Hip and pelvic pain
   • Foot and ankle pain including CRPS
   • Muscle strain and sprain
2. Review the workup of common neuromuscular disorders and demonstrate knowledge in the assessment and management of at least two of the following:
   • Carpal tunnel syndrome
   • Cervical and lumbar radiculopathy
   • Ulnar neuropathy
   • Tarsal tunnel syndrome
   • Polyneuropathy
3. Understand the difference between impairment versus disability
4. Participate in the identification and workup of a work-hardening candidate, and applying that knowledge to create an assessment and treatment plan in a multidisciplinary format.
5. Review the essential components of running and maintaining a private practice including staffing, referrals and marketing, scheduling and billing, charting and documentation.
6. As time and opportunities allow:
   • Learn and execute a competent neurological and musculoskeletal examination to include the lumbar and cervical spine.
   • Learn and demonstrate essential components of the shoulder, hip, knee, ankle and foot examinations.
   • Learn how to identify and treat myofascial pain and its distinctions from Fibromyalgia.
   • Identify non-organic signs on physical examination and recognize findings suggestive of symptoms magnification. 
   • Review diagnostic and therapeutic modalities for common problems. This will include trigger point injections, ultrasound guided injections for shoulder impingement, tendonitis, trochanteric bursitis, hip and knee DJD, SIJ, and piriformis syndrome
   • Observe and work with other rehabilitation medicine professionals, such as physical therapists, occupational therapists, and speech-language pathologists.