Program Overview

The University of Colorado PRM Education

Training in either combined Peds/PM&R residency or PRM Fellowship provides both breadth and depth of experiences in PRM including robust acute inpatient rehabilitation (one of the country's first neurotrauma rehabilitation programs), consult services, and outpatient care, all within Children's Hospital Colorado (CHCO), a U.S. News Top 10 Best Children's Hospital. Our hospital serves a 7 state region and provides primary through quaternary care services to children and young adults.

Combined Pediatrics/PM&R residents in PGY-5 year and PRM fellows work together in our learning community and complement each other in clinical leadership skills, collaboration in research projects, educational cohort and peer camaraderie.

Learn more about Colorado's Pediatric Rehabilitation training...

PRM Fellowship: The Colorado PRM Fellowship program is a 2-year fellowship program that starts in early July each year.  Our fellowship program has been ACGME-accredited since 2004 and has graduated many leaders in PRM across the country and the world!  Our fellows matriculate from varying ACGME-accredited PM&R residency programs and at the end of training are qualified to take the ABPM&R Pediatric Rehabilitation Medicine certification exam.  

Pediatrics / PM&R Combined Program: This is a 5-year residency program where medical students apply during MS-4 year of medical school, matching into a training track that leads to triple board eligibility in Pediatrics, PM&R and Pediatric Rehabilitation Medicine.  Combined residents train in our nationally ranked CU/CHCO Pediatrics Residency Program as well as the ranked CU PM&R Residency Program.

No matter the training track, we strive to train well-rounded, well-prepared graduates to enter any job whether in academics or private practice.  

Rotation Schedule - PRM Fellowship

PRM Fellowship: During this 2-year program, fellows participate in 12 rotations per year (3 months inpatient, 2-3 months consults, 5-6 months outpatient (PRM clinics and electives), 1 month research).  Outpatient clinics vary from general rehabilitation, 30+ types of multidisciplinary clinics, diverse spasticity injections, and other PRM procedures including EMGs and ITB pumps.  

Peds Rehab rotation schedules are created by the program director with the goal to give each trainee a wide variety of Colorado's clinical and procedural experiences.  As all trainees near the end of training, the program is tailored to hone expertise in areas a fellow may be leading in their next job.  For instance, if a fellow will be doing neuromonitoring for Selective Dorsal Rhizotomy surgery in their future job, then they may desire to do more SDR experiences with Dr. Oleszek; if a fellow is leading a spinal defects clinic, then they can choose to do more clinical time in that area.  

Details: See "Clinical Sites & Rotations" for more details about Peds Rehab rotations and the clinical learning experiences, procedures and electives.

Rotation Schedule - Pediatrics/PM&R Residency

Pediatrics / PM&R Combined Program: EXAMPLE schedule (CHCO = Children's Hospital Colorado, DH = Denver Health, UCH = University of Colorado Hospital, VA = Veterans Administration Hospital)

PGY-1: 12 months Pediatrics (internship)

PGY-2: 6 months PM&R (inpatient/consults) --> 6 months Pediatrics 

PGY-3:  4 months Pediatrics --> 4 months PM&R --> 4 months PM&R (with Peds Rehab) 

PGY-4:  6 months PM&R (end of adult PM&R) --> 6 months Pediatrics 

PGY-5: 10 months Pediatric Rehabilitation Medicine + 2-3 months Pediatrics electives 

**PM&R rotations are estimated examples here and variation with PGY3/4 possible**

Electives: Pediatrics Requires Electives for board certification: Pulmonary and Heme/Onc count if doing 1 week outpatient.  

Pediatrics/PM&R Residency Electives: 

Peds Rehab rotation schedules are created by the program director with the goal to give each trainee a wide variety of Colorado's clinical and procedural experiences.  As all trainees near the end of training, the program is tailored to hone expertise in areas a fellow may be leading in their next job.  For instance, if a fellow will be doing neuromonitoring for Selective Dorsal Rhizotomy surgery in their future job, then they may desire to do more SDR experiences with Dr. Oleszek; if a fellow is leading a spinal defects clinic, then they can choose to do more clinical time in that area.  

Details: See "Clinical Sites & Rotations" for more details about Peds Rehab rotations and the clinical learning experiences, procedures and electives.

EXAMPLE 5-year schedule for the Combined Pediatrics/PM&R Residency Program

Pediatrics = purple (electives in light purple); PM&R = Dark Green; Pediatric Rehabilitation = Light Green

Didactic Curriculum

Comprehensive Pediatric Rehabilitation Education: Our trainees participate in a well-rounded ACGME-guided curriculum.  "Curriculum" encompasses how you become the best possible Pediatric Rehabilitation physician you can be by the end of the training program.  We use multiple educational strategies to achieve the goals and objectives of the program.  The educational strategies used include methods such as readings, lectures, online learning resources (Canvas), inquiry-based learning, team-based learning, peer teaching, supervised clinical experiences, role modeling, and demonstration.  These methods are more clearly seen in our diverse clinical experiences, diverse didactic model, Event Review (M&M), workshops, seminars and fellow presentations. Didactics cover major topics of PRM training and occur 2-4 times per month. For the 2023-2024 academic year, didactics are offered in a hybrid model to include options in-person on campus and virtual (Zoom). Didactics are attended by all PRM fellows, Pediatrics/PM&R combined residents (required by those on rotation and recommended if able to participate during another rotation) and PM&R residents on rotation and various PRM faculty members. Fellows are excused from clinical duties during didactics. 

Canvas Co-Curricular course content: We are developing a co-curricular course in the Learning Management System Canvas where fellows and faculty can access recommend readings for a didactic session, journal articles, multimedia links, and videos to show kids in action.  This Canvas content will continue to grow and is collaborative between all faculty educators and fellow learners.  This curricular content allows all Peds Rehab learners to access learning topics at asynchronous times, especially important for the combined Pediatrics/PM&R residents who track through their comprehensive learning over 5 years.  

PRM Didactic modules:  These include but aren't limited to the following:

Additional PRM Educational activities:

Diversity & Inclusion

The Pediatric Rehabilitation Medicine Fellowship program and the combined Pediatrics/PM&R residency program continues to recruit, select, and retain diverse trainees in regard to diversity and inclusion including, but not limited to, race, gender/identity, ethnicity, mobility status, sexual orientation nor religious affiliation.  We strive to develop a respectful, diverse, and inclusive environment in our learning community. Having a program environment that models diversity and inclusion is the way to ensure diverse trainees are recruited and retained. At the University of Colorado, we believe diversity enhances the learning environment, strengthens the visibility and ties to nearby communities, and contributes to the community’s overall health through programs and trainings focused on shedding light on health disparities, health equity, and accessibility. 

Additional Resources:

Benefits/GME

There is a generous benefit package offered by CU GME. Click here for additional details on all Benefits & Resources.

Vacation: 20 vacation days per academic year. Check-out the leave policy for details.

Insurance: Medical, dental, vision, disability, and life insurance are offered by University of Colorado (CU) Graduate Medical Education (GME). View CU GME Benefits.

Stipend: determined by CU School of Medicine (SOM) and paid monthly.  Residents and Fellows are employees of the University of Colorado and are paid by direct deposit.

Retirement: tax-deferred retirement savings plan offered by CU GME. Currently, employer match is not available to residents/fellows, but this benefit is on the Housestaff Association's ongoing agenda.

Parking: Free and on-site, both for cars and bicycles

Other Benefits:

Home Call for Peds Rehab Rotations

Fellows take home call over 2 years.  Pediatrics/PM&R combined residents take Peds Rehab call only during their 12 months of Peds Rehab rotations.  During this time the combined residents take about 1 week/month on average.  (See Pediatrics and PM&R programs for their specific call schedules.)

PRM Fellows' Call Frequency: 10 weeks/year in 2023-2024 and 8 weeks/year in 2024-2025.  (Fellow call frequency is capped at 12 weeks/year in any given academic year.)  Friday night through Friday morning, 5pm-7:30am during the week.  Saturday/Sunday AM inpatient rounds, visit consults in ICU and PRN consults, new consults

On-Call team: Fellow + Attending

Peds Rehab rotations: Home-based call, no in-house call.

Call Questions: most questions are for being first call on the inpatient rehabilitation service; also consult and ITB pump questions, some from outpatient, outside facilities without rehab issues

Supervision: Attending rounds on Saturday and Sunday with resident or fellow, always available 24/7 for support and supervision.

When a rehab patient needs increased medical care:  CHCO has all the specialty consultants and in-house medical team for medical care for any change in patient acuity.  The Rapid Response Team (RRT) will evaluate any patient within 20 minutes of calling an RRT.  The Code team is in-house for any needs as well.  If a child requires increased medical monitoring and care, the primary team assigned can be transferred to a surgical or Pediatrics inpatient team or the child can be physically moved to the PICU if needing a higher level of inpatient care.  Transfers to another service just require a transfer order and interval Transfer Summary, no readmission or discharge. 

Details: Each fellow takes call for Children's Hospital Colorado Rehabilitation service and call weeks are divided between PRM fellows, PM&R residents, and a Peds/PM&R combined resident.  Fellows currently have approximately 8-10 weeks of home call, including 1 major holiday and 1 minor holiday, per academic year.  Call frequency is <=12 weeks per year, no matter the number of fellows or residents.  Fellows receive program-specified a "holiday comp" day for holidays worked. Call starts on Friday evening until the next Friday morning with an attending available 24/7 as second call. On weekends and holidays during a call week, fellows round with an attending on the children on the inpatient rehabilitation service, some existing consult patients, and see and staff any new consults.  The call team takes ITB pump call with rare calls about pump management, overdose, withdrawal, and troubleshooting.  Calls can also come in from community providers or families with rehab-related health questions.  Call teaches acute medical care of children in the community and prepares our fellows for practice in any setting following fellowship.

In late May, fellows submit requests for vacations and other time off of call (boards, educational, conferences, important personal events, etc.) for the upcoming year, then the program director creates the call schedule with all of the requests in mind. Fellows can trade call weeks among the group of rotating trainees (fellows, combined Peds/PM&R residents and PM&R residents) as needed.

Epic

Epic is the Electronic Medical Record system used at CHCO and we have Care Everywhere which is a system that connects our Epic system to other medical systems across the city and even nation.  PACS imaging is the Radiology system that is integrated into Epic.  Trainees can use Epic from anywhere, including Epic Haiku for use from a mobile divice for reviewing vitals, labs, notes or sending updates in Epic Chat to care team members.  

Peds/PM&R Combined residents:  Epic is also used at Denver Health and the University of Colorado Hospital. 


Conferences

Pediatrics Rehabilitation trainees can participate in conferences both locally and nationally.  

1) Pediatrics/PM&R residents typically receive $4,000 over 5 years of training for conference fees, books, educational supplies.

2) PRM Fellows often attend one national conference per year.  Dr. Apkon is committed to ensure our fellow are still able to participate in national-level learning and in supporting opportunities for research training, attending a CU Teaching Elective, etc.  PRM fellows typically receive $2,400 over 2 years of training.

The positive aspect of learning in Colorado is that CHCO still offers often free, high quality conferences such as Pediatrics Grand Rounds, PM&R Grand Rounds, Neurology Abby Stoddard Conference, Neurology Movement Disorders, Pediatric Sports Medicine Day, Rheumatology conferences, and even a past Ehlers-Danlos Conference.  There are also a number of virtual conferences nationally held free or with minimal charge that the department will support a fellow to attend for their individual learning goals.  

Recent & Future Program Changes 

Canvas curriculum growth: growth of the content, depth and breadth of our Pediatric Rehabilitation Medicine longitudinal co-curricular course materials in the Canvas platform.  High-yield learning materials by PRM topic as well as recorded lectures are available on computer and smart phone with the Canvas app.  This will continue to deepen and improve access to high-yield learning resources for fellows and faculty. 

TeleHealth expansion: During the COVID-19 pandemic Children's Hospital Colorado expanded TeleHealth access in their already existing TeleHealth practice.  Residents and fellows will continue to learn about TeleHealth best practices and how to provide care in the TeleHealth setting. 

Ultrasound curriculum creation:  PRM fellows Teddy Yip (PRM Fellow '21) and Lauren Desmarais (PRM Fellow '22) participated in the Fellows as Teachers Elective in December 2020.  They began creating an ultrasound curriculum for chemodenervation guidance for residents, fellows, and faculty.  Dr. Desmarais is leading an ultrasound curriculum 1.5 hours/week that started July 2021 that repeats every 2 months to build fellow expertise in Ultrasound or opportunities to each each other and the residents.  PRM Fellows Andrew McCoy (PRM Fellow '23) and Dr. Carly Rothman (PRM Fellow '23) worked expanding our MSK Ultrasound curriculum in partnership with the CU PM&R Residency Program leaders.  Our PRM Fellows are educational leaders and get to share their Ultrasound knowledge and experience with PM&R residents.  The goal of this curriculum is to continue and grow in the years to come.

CARF-Accreditation:  Our Inpatient Rehabilitation unit achieved CARF-accreditation (Commission on Accreditation of Rehabilitation Facilities).  Dr. Aaron Powell, as the prior inpatient medical director, led a team for this exciting step in November 2021. 

Research mentorship growth:  Dr. Susan Apkon will be leading and developing a PRM Fellow specific research curriculum and cohort for research collaboration throughout fellowship.  The department partners with research methodologist Beth McManus, a PhD physical therapist, in mentoring through the path of research.