2024-2025 M3/M4 Course Syllabi
Physical Medicine & Rehabilitation
COURSE NUMBER:
18 01 07
TITLE:
CLINICAL P M & R -ICE
This rotation is designed to expose students to inpatient, consultative, and outpatient rehabilitation care. Students will refine their skills in the musculoskeletal/neurologic examination and interdisciplinary team management.
PREREQUISITES:
26931373 (INTERNAL MEDICINE CORE CLKSP), 26940373 (NEUROSCIENCE CORE CLKSP)

For the months of May - October this rotation is limited to those applying to PM&R or Peds/PM&R residency programs.  Exceptions will be considered on a case-by-case basis by the rotation director.
expand all

GENERAL INFORMATION

COURSE YEAR:
M4
CREDIT HOURS:
4
CREDIT WEEKS:
4
DOMESTIC VISITING:
YES
INTERNATIONAL VISITING:
NO
GRADED:
Honors/High Pass/Pass/Fail
COURSE QUALIFICATIONS:
ICE
COURSE TYPE:
Clinical
STATUS:
Full-Time   
OFFERED AS FULL-TIME AND PART-TIME: NO
ALLOWS OVERLAP: NO
COURSE LENGTH:
4 weeks
DIRECTOR:
Ashlee Bolger, MD
Ashlee.Bolger@cchmc.org
513-636-7480
260 Stetson St. , Suite 5200
ADMINISTRATIVE SUPPORT PERSON:
Blaire Kappes
kappesbe@ucmail.uc.edu

SITE(S):
Drake Center Inc.
UC Gardner Neuroscience Institute (UCGNI)
UCMC - PM&R Consu
UCMC - University of Cincinnati Medical Center
MAX ENROLL:
2  MAX/YR: 24
ROTATIONS:
Rotation Dates Max
1 05/06/2024 - 05/31/2024 2
2 06/03/2024 - 06/28/2024 2
3 07/01/2024 - 07/26/2024 2
4 07/29/2024 - 08/23/2024 2
5 08/26/2024 - 09/20/2024 2
6 09/23/2024 - 10/18/2024 2
7 10/21/2024 - 11/15/2024 2
8 11/18/2024 - 12/13/2024 2
9 12/16/2024 - 01/10/2025 2
10 01/13/2025 - 02/07/2025 2
11 02/10/2025 - 03/07/2025 2
12 03/10/2025 - 04/04/2025 2
13 04/07/2025 - 05/02/2025 2

NOTE: If a rotation is offered in both 2 and 4 week slots, the max capacity is limited to the actual spots offered for the 4 weeks. (ie: the 2 week rotations listed share the max of the 4 week rotation)
WORKING HOURS:
8:00am - 5:00 pm Monday - Friday
REPORT 1ST DAY:
You will receive an email from the medical student coordinator prior to the elective. Should you have any questions, she can be reached at 513-558-7635

INSTRUCTION

LEARNING ACTIVITIES:
  • Case-Based Instruction/Learning
  • Clinical Experience - Inpatient
  • Conference
  • Demonstration (description, performance, or explanation of a process, illustrated by examples, observable action, specimens, etc)
  • Journal Club
  • Patient Presentation--Faculty
  • Patient Presentation--Learner
  • Research
  • Ward Rounds
LEARNING ENVIRONMENT POLICIES:
UCCOM strives to provide medical students with a learning environment that is conducive to their professional growth. All UCCOM and visiting medical students are encouraged to review the Student Handbook.

The Office of Student Affairs and Admissions is available to all UCCOM and visiting medical students to discuss any concerns/questions related to the learning environment. Please call 558-6796 to access faculty/staff that can assist you.
TEACHING:
40% Attending Physician
10% Senior Resident
40% Junior Resident
10% Other Allied Health Professional(s)
FEEDBACK:
ASSESSMENT:
Our assessment during the Clinical PM&R Elective is multifaced and includes faculty evaluations, required clinical activities, required additional non-clinical activities, and end of the rotation test.

ASSESSMENT METHODS:
Clinical Performance Rating/Checklist
Exam, Institutionally Developed, Written/Computer-based
Other: Describe other methods not listed above:
Participation
FINAL GRADE:
GRADE ASSIGNED BY: Course director

OBJECTIVES

Curricular Resources :
Various journal articles and learning activities as provided by the rotation director
Instructional Methods:
  • Direct, hands-on patient care.
  • Attendance at resident didactics series & grand rounds.
  • Additional activities (both clinical and non-clinical) targeted at increasing knowledge of PMR topics.
Knowledge/Skills:
Objectives for PM&R

Upon completion of the rotation, the medical student should be able to:

1. Know the World Health Organization’s definition of impairment and disability
2. Be able to differentiate among patients with back pain related to various underlying etiologies including spinal stenosis, radiculopathy, herniated disc, facet pain, and cancer.
3. Be able to distinguish the typical clinical presentation of a patient with strokes of the middle cerebral artery, anterior cerebral artery and posterior cerebral artery.
4. Identify and understand basic treatment of post-stroke complications including neglect, shoulder pain, depression, aphasia and dysphagia.
5.  Know the typical pattern of motor recovery after a stroke
6. Identify and understand basic treatment of common complications following acute spinal cord injury including hematologic, respiratory, urinary, gastrointestinal, and cardiovascular.
7. Differentiate between the following spinal cord syndromes: Brown-Sequard, Dorsal Column, Central Cord, and Anterior cord.
8. Understand the basic uses and limitations of nerve conduction studies and electromyography. 
9. Understand the epidemiology and risk factors related to traumatic brain injury.
10. Know and apply the Glascow Coma Scale and Rancho Los Amigos scale 
11. Identify and understand basic treatment of acquired brain injury complications including seizures, agitation, depression, and cognitive changes.
12. Independently research and succinctly present an overview of topic related to physical medicine and rehabilitation 
13. Identify a structured approach to review of an imaging study typically obtained by a physiatrist 
14. Create a shoulder or knee pain differential & perform appropriate physical exam 
15. Create a low back pain differential & perform appropriate physical exam 
16. Participate in ASIA exam (either with patient or via module) 
17. Observe a PT, OT or SLP session
18. Critically appraise a journal article related to PM&R topics
19. Participate in one community activity associated with PM&R or patients with disability
20. Complete a multimedia activity of their choosing related to PM&R
Main Course Topics :
  • Rehabilitation
  • Traumatic Brain Injury
  • Spinal Cord Injury
  • Stroke
  • Musculoskeletal Injuries
  • Electromyography (EMG)
Procedures:
N/A
Remediation Plan:
 Should students require additional days off in the month, the course director will work with individual students to identify additional clinical and/or non clinical activities to make up the missed time.

SAMPLE WEEK

Monday:
8:00AM 12:00PM Inpatient/Consult Rounds
12:00PM 1:00PM Lunch
1:00PM 5:30PM Outpatient Clinic vs. Inpatient
Tuesday:
8:00AM 12:00PM Inpatient/Consult Rounds
12:00PM 1:00PM Lunch
1:00PM 5:30PM Outpatient Clinic vs. Inpatient
Wednesday:
8:00AM 12:00PM Inpatient/Consult Rounds
12:00PM 1:00PM Lunch
1:00PM 5:30PM Outpatient Clinic vs. Inpatient
Thursday:
7:30AM 12:00PM PM&R Didactic Lectures
12:00PM 1:00PM Lunch
1:00PM 5:00PM Inpatient/Consult Rounds & Patient Care
Friday:
8:00AM 9:00AM PM&R Grand Rounds
9:00AM 12:00PM Inpatient/Consult Rounds
12:00PM 1:00PM Lunch
1:00PM 5:30PM Outpatient Clinic vs. Inpatient
SCHEDULE NOTE:

*Note: A typical four week rotation consists of two weeks on inpatient service and two weeks rotating through a combined consult/outpatient experience.  Thus, the "weekly" schedule varies but can be expected to look similar to the provided schedule

Depending on the assigned service, inpatient activities may include attending therapy session with their assigned patients and attending interdisciplinary team conferences.  Outpatient activities may includ observing nerve and motor poin blocks, spinal injections, joint injections, electrodiagnostic studies.  Travel to different practice sites with their assigned attending physician to do outpatient PM&R care is required

ATTENDANCE AND ABSENCE POLICY

 

Session Attendance for M4 Students

  • Students may miss no more than two days of planned excused absences on a four week rotation without being required to make-up the work, at the discretion of the clerkship/elective/course director or his/her designee.
  • Non-AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the clerkship director to best align with the site schedule. Students may request to schedule 1 or more of these 4 days for planned absences that fall under 1 of the categories listed below for excused absences during non-AI rotations, in consultation with the course/elective director, who may or may not approve such planned absences.
  • AI Rotations - Per the Student Duty Hours Policy, an average of one day (24 hours) in every seven must be free of clinical responsibilities (including seminars, clinic, rounds, lectures) averaged over a four week period. These days off are assigned by the course director to best align with the site schedule. Students may request to schedule 1 or 2 of these days for planned absences that fall under 1 of the categories listed below for excused absences during AI rotations, in consultation with the course director, who may or may not approve such planned absences. Students must avoid scheduling Step 2 examinations during an Acting Internship.
  • Excused Absences - The following will be considered excused absences:
    • Diagnostic, preventative, and therapeutic health services (e.g. doctor appointments, physical therapy, counselling, etc).
    • Personal illness, accident or a major catastrophic event
    • Death or serious illness of immediate family members. Immediate family members, as defined by UC, are Grandparents, Brother, Sister, Brother-in law, Sister-in-law, Daughter-in-law, Son-in-law, Father, Mother, Mother-in-law, Father-in-law, Step-sister, Step-brother, Step-mother, Step-father, Spouse or domestic partner, Child, Grandchild, legal Guardian or other person who stands in place of parent (in Loco Parentis)
  • Whenever possible, planned absences should be requested a minimum of six weeks in advance of the start of the clerkship/elective/course in which the absence will occur; this enables the clerkship/course/elective to help plan for educational event scheduling (e.g. a known appointment could be scheduled around with enough notice and the student might not have any required coursework to make up). Absences requested less than 1 week prior to the planned absence may not be considered for a possible excused absence unless extenuating circumstances prevented the student from providing timely notification per the policy. Students should first submit their request for a planned absence to the clerkship/elective/course director using the online MSSF. All planned/excused absences for any reason should be documented on the MSSF.
  • The COM abides by the UC Religious Observance Policy that respects the religious diversity of its students by providing opportunities, where possible, for accommodation in cases where conflicts exist between students’ religious beliefs/practices and educational activities. In clinical settings, such accommodations must honor the primacy of a commitment to patient care and avoid unduly burdening faculty, staff and the general student population involved in the affected educational and/or patient care activity.
  • The following items are explained in detail in the Medical Student Handbook:
    • Excused/unexcused/unplanned absence, religious holidays, jury duty, and make-up work

See Attendance and Absences Policy, Religious Observance Policy, Medical Student Handbook.




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