Residency Curriculum

A minimum of four years of graduate medical education is required to complete the Physical Medicine and Rehabilitation (PM&R) Residency. This specialty training program begins at the PGY 2 level, following completion of a transitional year. In each of the three PM&R program years, residents complete both inpatient and outpatient rotations along with their choice of electives.

Year One (PGY 1)

The first year of training is dedicated to the development of fundamental clinical skills and is completed through a Transitional Year or Preliminary Medicine Internship. Residents interview and match for these positions separately.

The internship experience can include six months in family practice, internal medicine, pediatrics or general surgery. The remaining six months may be in primary care field or specialty, including neurology, neurosurgery, orthopaedic surgery/sports medicine, pediatrics, radiology or urology.

Year Two (PGY 2)

As part of the three-year program, PM&R residents are required to spend a minimum of one year—and no more than two years—caring for hospitalized patients to provide inpatient services, including general rehabilitation, stroke brain injury spinal cord injury and pediatrics.

Second-year residents complete foundational rotations in inpatient rehabilitation, emphasizing general rehabilitation, stroke, spinal cord injury and traumatic brain injury. Consultations and an introduction to musculoskeletal medicine also occurs during residents’ PGY 2 year.

Year Three (PGY 3)

The rotation schedule for PGY 3 residents consists of three months of electrodiagnosis (electromyography), two to three months of inpatient/outpatient pediatric rehabilitation, one month of radiology, and one month of sports medicine training. Elective opportunities as well as training focused on prosthetics and orthotics is available. Residents can also gain exposure to amputee and chronic pain management techniques.

Year Four (PGY 4)

Fourth-year PM&R residents finalize their training with exposure to injection techniques, including significant hands-on patient experience. Inpatient rotations are reviewed to sharpen practice skills, and PGY 4 residents are allowed extensive review and preparation for medical Boards examinations.

Lifestyle medicine is a relatively new branch of medicine which takes a novel, yet basic approach to address the root cause of many chronic diseases. It is aimed at not only treating but preventing common ailments through rigorous, evidence-based methods. There are six pillars of lifestyle medicine: diet (predominantly a whole food, plant based diet), physical activity, sleep and stress management, social connectedness, and avoidance of high risk habits. We are thrilled to work with the American College of Lifestyle Medicine to incorporate the Lifestyle Medicine Residency Curriculum (LMRC) into our PM&R residency program. This is a dedicated program which can lead to board certification through the ABLM. The curriculum consists of a combination of synchronous and asynchronous lectures, application of didactics, patient encounters, and intensive therapeutic lifestyle change (ITLC) programs. We work with other academic departments at IU School of Medicine.

Lifestyle medicine has steadily gained popularity amongst medical schools and we are honored to be the 3rd PM&R based LMRC program in the country.

Workshops

PM&R incorporates a broad range of diagnostic and therapeutic procedures through workshops in the 12-month didactic curriculum.

• Ultrasound: dedicated faculty who are proficient at ultrasound lead this workshop, with various “stations” such as the shoulder, knee, etc., with the trainee getting hands-on exposure with identifying structures. We also incorporate knobology and use different ultrasound machines, so the residents get cross-trained. Residents also learn interventional approaches and practice needle advancement on a phantom.
• Spasticity: similar to the ultrasound workshop, we set up various stations: baclofen pumps, ultrasound for botulinum toxin, upper and lower limb, cervical dystonia, headache, reconstitution. Throughout the day, residents work in small groups getting hands-on experience with needle placement, learning relevant anatomy, and optimizing outcomes.
• Fluoroscopic injections: PM&R residents get plenty of hands-on exposure to fluoroscopic procedures, but in addition to this, we have a devoted workshop with a spine model, where the residents take turns practicing needle driving under real-time fluoroscopy for procedures like epidurals, radiofrequency neurotomies, SI joint injections, etc.
• Virtual reality: residents take turns learning functional limb anatomy. They can virtually “peel away” skin and muscle layers to learn in-depth anatomy of muscles and nerves. They can also practice virtual injections, including ultrasound. 
• Cadaver workshops: trainees are able to practice various interventions on cadavers using fluoroscopy and ultrasound.