Physiatrists

High School

Physiatrists must study many years before being admitted to practice. Enroll in a college preparatory course, and take courses in biology, chemistry, health, physics, as well as English, languages, the humanities, and social studies. Be sure to take advanced placement or honors classes and strive to achieve high grades, ideally graduating in the top of your class.

Postsecondary Training

The first step in becoming a physiatrist is to earn a bachelor's degree from an accredited undergraduate institution. Some colleges offer a premedical course, but a good general education, with as many science courses as possible and a major in biology or chemistry is considered adequate preparation for the study of medicine. Courses should include physics, biology, inorganic and organic chemistry, English, mathematics, and the social sciences.

College students should begin to apply to medical schools early in their senior year, so it is advisable to begin your research into schools well before that and prepare to take the Medical College Admission Test (MCAT). All medical colleges in the United States require this test for admission, and a student's MCAT score is one of the factors that is weighed in the decision to accept or reject any applicant. The examination covers four areas: Biological and Biochemical Foundations of Living Systems; Psychological, Social, and Biological Foundations of Behavior; Chemical and Physical Foundations of Biological Systems; and Critical Analysis and Reasoning Skills.

It is recommended that you apply to at least several institutions to increase your chances of being accepted by one of them. About 45 percent of applicants to medical schools are admitted each year. The American Medical College Application Service (AMCAS) will check, copy, and submit applications to the medical schools you specify.

In addition to the traditional medical schools, there are several schools of basic medical sciences that enroll medical students for the first two years (preclinical experience) of medical school. They offer a preclinical curriculum to students similar to that which is offered by a regular medical school. At the end of the two-year program, you can then apply to a four-year medical school for the final two years of instruction.

Grades are only one of the criteria considered for admission. Other factors include an interview, emotional stability, integrity, reliability, resourcefulness, and a sense of service. Extracurricular activities and awards are a great way to display these traits.

During the first two years of medical school, studies cover human anatomy, biochemistry, physiology, pharmacology, psychology, microbiology, pathology, medical ethics, and laws governing medicine. Most instruction is given through classroom lectures, laboratories, seminars, independent research, and the reading of textbook material and other types of literature. Students also learn to take medical histories, examine patients, and recognize symptoms.

Students become actively involved in the treatment process in the last two years of school. They spend a large proportion of the time in the hospital as part of a medical team headed by a teaching physician who specializes in a particular area. Others on the team may be interns or residents. Students are closely supervised as they learn techniques such as how to take a patient's medical history, conduct a physical examination, work in the laboratory, how to make a diagnosis, and how to keep all the necessary records.

As you rotate from one medical specialty to another, you obtain a broad understanding of each field. You are assigned to duty in internal medicine, pediatrics, psychiatry, obstetrics and gynecology, surgery, and other specialties. In addition to this hospital work, you continue to complete course work. You are responsible for assigned studies and also for some independent study.

Most states require all medical school graduates (M.D. or D.O.) to complete at least one year of postgraduate training, and a few require an internship plus a one-year residency. Specialization requires more years of residency training. For the physical medicine and rehabilitation specialization, three to four years of residency training is required. PM&R residency consists of one year of general clinical training (internship), followed by three years of PM&R training.

The Accreditation Council for Graduate Medical Education offers a list of accredited post-M.D. medical training programs in the United State on its Web site, https://www.acgme.org. Also, you can find information about PM&R residencies on the American Academy of Physical Medicine and Rehabilitation's Web site, https://www.aapmr.org.

Students must pass a specialty board examination to become a board-certified physician. The residency years are stressful—residents often work 24-hour shifts and put in up to 80 hours per week while earning a relatively meager salary. Additionally, some physicians who are interested in practicing in a subspecialty participate in fellowships that last one to three years. For a teaching or research career, you may also earn a master's degree or a Ph.D. in a biology or chemistry subfield, such as biochemistry or microbiology.

Certification

The American Academy of Physical Medicine and Rehabilitation offers STEP Certificate Programs, which it defines as "multi-tiered training programs that teach and assess important physiatric skills using a progressive, competency-based curriculum. STEP Stands for Skills, Training, Evaluation, and Performance." STEP programs are available in Ultrasound; Interventional Spasticity; and Concussion and Mild Traumatic Brain Injury. Visit https://www.aapmr.org/education/step-certificate-programs for more information.

Other Education or Training

To keep their knowledge up to date and satisfy continuing education requirements for recertification, physiatrists can take classes and webinars that are offered by the American Academy of Physical Medicine and Rehabilitation, American Association of Neuromuscular & Electrodiagnostic Medicine, Association of Academic Physiatrists, American Medical Association, and the American Osteopathic association, to name just a few. Contact these organizations for more information.