PM&R CaRMS PORTAL

Frequently Asked Questions

Specialty/Field Questions

1) What are the best things about your specialty?

Broad knowledge base and variety of subspecialties allows one to tailor practice to interests. I.e., You can have a very diverse or focused practice depending on interests.
You can be academic or community-based, inpatient or outpatient.
There’s a focus on helping patients improve their quality of life.
Lots of opportunities for procedural skills with ultrasound and fluoroscopic guided injections and EMGs if you want hands-on work, but doesn’t have to be a part of your practice if you prefer not to.
You can have a very good home life.
Opportunity to augment income with 3rd party assessments (i.e., independent medical examinations).

2) What are the worst things about your specialty?

Limited knowledge and recognition of the specialty within medicine.
Broad knowledge base requires considerable academic diligence.
Sometimes patients have expectations we cannot meet.
We don’t offer “cures”; rather our specialty focuses on managing complications from chronic/degenerating conditions and maximizing function based on ability.

3. Why did you choose your specialty?

I chose this specialty for many reasons, including those stated in question 1. In addition, there are many inspiring mentors within physiatry and a highly sociable resident group at the University of Alberta.

4. What types of clinical cases do you commonly see?

Cases can be broken down into 3 general categories:

Neuro rehab cases: spinal cord injury, stroke, brain injury, spasticity, cerebral palsy, spina bifida, post-polio, neuromuscular disorders, multiple sclerosis.
MSK cases: sports injuries, chronic pain, work related injuries, degenerative joint disease, joint injections, and complicated orthopedic cases.
Electrodiagnostic cases: involves performing nerve conduction studies and electromyography to diagnose neuromuscular conditions.

5. Briefly describe a typical day

This depends on the nature of practice. It can be purely outpatient, purely inpatient, or a mixture. It may involve:

Scheduled ward rounds on inpatients two to three times a week.
Attending team conferences and family conferences one half day a week.
Outpatient clinics usually two to three days a week.
Inpatient consults in acute care hospitals about one day a week.
Administration and paperwork one half-day a week.

Alternatively, a pure outpatient MSK practice may include:

Clinic 1-2 days per week.
EMG 1 day per week.
Ultrasound-guided injections 1 day per week.
Fluoroscopic-guided interventions 1 day per week.

There can be academic teaching and research responsibilities as well. Sub-specializations offer opportunities for various interventional procedures such as fluoroscopic- or ultrasound-guided injections.

6. What are the varieties of lifestyles within your field?

It can be a 9:00 a.m. - 4:00 p.m. outpatient practice if so desired, but can also be working 12 hours a day and weekends if so desired, including being on-call.

6.1 Specifically, how able is your specialty to accommodate family life?

It can be very accommodating for family life. In an inpatient practice, there are very few acute medical emergencies that would require coming into the hospital immediately while one is on call. In addition, there is no need for us to provide a consult service for emergency departments, so inpatient consults are done during normal work hours. In an outpatient practice, the hours depend on how many patients you book in a day.

7. Range of incomes?

Very variable. In Alberta, usually at least $300-400,000 annually for a full-time practice; independent medical examinations can also be very lucrative.

8. How do you see your discipline changing over the next decade?

There is a movement toward more of an outpatient based practice. With regards to an inpatient practice, many rehab hospitals have physiatrists in a consultant role with internists, family physicians, or nurse practitioners managing the day-to-day inpatient issues. This is in contrast to the past, where physiatrists were the most responsible physician. There is also the emergence of other rehabilitation subspecialties such as cancer rehab.

Residency Program Questions

1. What are you looking for specifically in an impressive candidate?

An impressive candidate is a well-rounded, independent learner with patience and compassion. They need a firm grasp of anatomy, musculoskeletal, and neurological concepts. They need to have leadership qualities while being able to work in a multidisciplinary team setting. We are also looking for individuals who are willing to become involved in a progressive residency program by applying the CanMEDs roles to all aspects of residency training. Being a strong team player is also highly valued.

1.1 What can a potential candidate do now in order to be an appealing applicant to your program?

They should do electives and be sure to know what the specialty is about and involve themselves in activities with a leadership role. Research involvement is also beneficial, no matter how minor a role. The Canadian Association of PM&R offers a medical student essay contest every year at its annual conference. You are encouraged to apply and attend.

2. How is your residency program organized? (i.e., year by year breakdown and schedule of rotations)

Overall, with the implementation of CBME, the program is divided into the stages of Transition to Discipline, Foundations of Discipline. Core of Discipline and Transition to Practice. These roughly match up with the PGY-1 years. Please refer to our curriculum page for more details.

PGY-1: basic clinical training year (including 2 months of PM&R elective).
PGY2: 2 months each of rheumatology, orthopedic surgery, and neurology, plus some inpatient rehab.
PGY3-5: core rehab rotations of 3-6 months in stroke rehab, brain injury rehab, spinal cord injury rehab, MSK, neuromuscular, pediatric rehab and amputee rehab.
The exact schedule is variable and based on coordinating rotations among all residents in the program.

3. What is your residency program's orientation and focus?

It has a strong academic focus with an emphasis on resident directed learning. We also provide well rounded exposure to in-patient and out-patient PM&R as well as neuro and MSK rehab.

4. What is the availability of experiences in subspecialty areas during training?

See above, this is the strength of our program. There is also access and exposure to emerging subspecialty areas not available in all centres – multidisciplinary spasticity management and fluoroscopic guided injections for back pain. Edmonton is also a leader in ultrasound guided procedures for a wide variety of musculoskeletal issues.

5. Are there sufficient elective opportunities during training to explore your special interests?

Yes, there are 12 months of elective time across your fourth and fifth years.

6. What is the on-call schedule during each year of residency?

During first year, your call can either be in-house or home call depending on the off-service rotation you are on. Starting second year, you do home call for staff who have admitting privileges at the Glenrose Rehabilitation Hospital. This is dependent on the number of residents as residents must provide coverage for all weeks of the year.
With a full complement of ~14 residents, we do an average of 6 week-long home calls per year (call is taken a week at a time). Call is generally quiet with occasional urgent issues requiring going to the hospital to assess patients.

7. What are teaching sessions like in the residency program?

Formal teaching specific to the rotation occurs in each of the rotations and is preceptor-based.
Residents are freed from clinical responsibilities to attend weekly academic half-day sessions. Core modules incorporate basic science and clinical application sessions followed by problem-based learning (PBL) and application of the material learned. Topics can include clinical management, research, evidence-based medicine, CanMEDS roles, prescription rounds, and diagnostic imaging rounds.
Monthly half-day anatomy sessions are also held throughout the year in the anatomy lab.

8. What distinguishes the U of A program from other programs?

Compared to other physiatry programs, the U of A offers one of the most comprehensive residency training programs in the country, encompassing all of the major fields of physiatry. We are well known for our MSK specialists as well as academics and we have a national reputation for being one of the best programs in the country.
We also have the advantage of hosting the PM&R Review Course every 4 years. The course is a gathering of all the physiatry residents and many physiatry staff members across the country. We also provide access and exposure to emerging subspecialty areas not yet available elsewhere.

9. How competitive is it to get in, and then to succeed in your field?

Because Physiatry is a relatively small specialty in terms of residency spots across the country, this can be highly variable depending on how many people apply in a given year. It has certainly become more competitive in the past 5 years or so; usually the applicant to residency spot ratio across Canada is just over one. It can be competitive to get into one of the more popular programs because most only take one or two residents per year. Currently the University of Alberta program has funding for three positions per year.

10. Is there active and/or required research in your residency program?

For entry into the program, research experience is helpful, but not required. During residency, it is a requirement to complete a research project. Residents are given three months of research time throughout their residency. There are many active research projects, as we have several staff physiatrists in our program who are heavily involved in research.

10.1 What role does research play in your career?

Research is helpful in critically reviewing literature and practicing evidence based medicine, especially with a number of emerging treatments (e.g. PRP, stem cell therapies) that our specialty is at the forefront of. Being able to stay on top of the latest evidence will be crucial to providing optimal care to patients moving forward.

11. What local, national or international conferences would be of benefit to candidates interested in your program?

12. Who can we contact for more information to set up electives?

Medical Education Program Coordinator: Roxanne (Roxy) Perich - pmrrespr@ualberta.ca

12.1 Specifically, if there a list of residents whom we can call or email?

Everett Claridge (Chief Resident) - eclaridg@ualberta.ca
Matthew Carter (Chief Resident) - mjcarte1@ualberta.ca

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