Physiatry is also known as physical medicine and rehabilitation (PM&R). This medical specialty deals with diagnosing, treating, and managing conditions that affect a patient's ability to function in everyday life. Learn more about this emerging specialty and the requirements to enter the field.
What Are Physiatrists?
Physiatrists, also known as physical medicine and rehabilitation (PM&R) physicians, specialize in diagnosing and managing physical and cognitive conditions that affect the nervous system, muscles, joints, and bones. Their comprehensive approach to treatment focuses on improving functionality and quality of life. Treatment plans may include physical therapy, occupational therapy, medication, and nonsurgical procedures tailored to each patient's unique needs.
Physiatrists often work in skilled nursing facilities, inpatient rehabilitation centers, and long-term acute care hospitals. They also play a role in outpatient care when managing sports-related injuries, chronic pain, and musculoskeletal or spine conditions. In these settings, physiatrists collaborate with other specialists to provide integrated care for patients dealing with various functional challenges.
One notable aspect of physiatry is its procedural versatility. As licensed medical doctors, physiatrists can perform specialized nonsurgical procedures, including:
- Therapeutic Injections: These may include corticosteroid injections, hyaluronic acid injections for joint pain, and trigger point injections for muscle-related pain relief.
- Ultrasound-Guided Injections: Physiatrists use ultrasound technology to enhance precision when delivering medications to affected areas.
- Epidural Steroid Injections: These injections are used to alleviate nerve root pain, commonly associated with conditions such as herniated discs or spinal stenosis.
- Botox Injections: For conditions such as spasticity or chronic migraines.
By leveraging these skills, physiatrists effectively bridge the gap between conservative therapies and surgical interventions. Their expertise in settings like skilled nursing facilities (SNFs) includes performing procedures to manage chronic pain and enhance patient recovery during rehabilitation.
Is a Physiatrist a Doctor?
Yes, physiatrists complete four years of medical school and four years of residency, like other medical doctors. They must also pass licensing and board certifications to practice. Physiatrists can hold either a Doctor of Medicine (MD) or a Doctor of Osteopathic Medicine (DO) degree. Physiatry is one of many medical specialties. Others include dermatology, emergency medicine, general surgery, and family medicine.
Physiatrists and Physical Therapists: A Collaborative Team
Physiatrists and physical therapists work closely together to provide comprehensive care for patients with musculoskeletal or neurological conditions. While physiatrists are medical doctors (MDs or DOs) responsible for diagnosing conditions, creating treatment plans, and managing care, physical therapists focus on implementing these plans through strengthening exercises, manual therapies, and electrotherapies.
These professionals collaborate to ensure patients achieve the best possible outcomes. For instance, physiatrists often perform an initial evaluation and may refer patients to physical therapists for hands-on treatment. The ongoing exchange of information between the physiatrist and the therapy team helps tailor interventions to the patient's progress and needs.
This close collaboration underscores the importance of an interdisciplinary approach in physiatry, where teamwork is central to optimizing patient recovery and improving quality of life.
How Long Does It Take to Become a Physiatrist?
On average, physiatrist schooling is 12 years, including becoming licensed and board-certified. Some steps may take more or less time depending on the person and the programs they're involved in.
Undergraduate Education
Physiatrist education begins with an undergraduate bachelor's degree to set the foundation for future learning. This degree typically takes four years. Those planning to get a medical doctorate degree often major in pre-med, biochemistry, or anatomy. These degrees give knowledge about the human body, various medical practices, and how the body reacts to injury, illness, and medication.
Medical School
After completing an undergraduate degree, students enter medical school. First, they must take the Medical College Admission Test (MCAT). This multiple-choice exam assesses your knowledge in various areas, including biology, chemistry, psychology, and critical reasoning.
After passing the MCAT, students can apply to medical schools. Medical school education takes four years. Two years are spent in the classroom, called the preclinical phase. This phase involves education about the body, diseases, diagnoses, and treatment, plus basic doctoring skills. The following two years are the clinical phase. During this stage, you receive hands-on experience and patient interaction in the primary medical specialties.
Physical Medicine and Rehabilitation Residency
Once you complete medical school, you will enter a four-year residency program. Before starting residency, you must pass the United States Medical Licensing Examination (USMLE) Step 1 and Step 2 Clinical Knowledge (CK). Most students take Step 1 after their first two years of medical school and Step 2 after their clinical rotations.
To enter the physiatry field, you will complete your residency in physical medicine and rehabilitation. During your residency, you'll work with licensed professionals diagnosing and treating neurological and musculoskeletal conditions.
Fellowship
A fellowship is an optional one- to two-year period of medical training. Physicians may choose this training to pursue a specialty within their selected job role. The available specialties for physiatrists include:
- Sports medicine
- Pain medicine
- Musculoskeletal treatment
- Spinal treatment
- Pediatric rehabilitation
- Brain injuries
- Palliative care
Among these specialties, pain medicine is the most competitive. The fellowship for this specialty lasts two years. Physicians with this training often earn better pay than other physiatrists.
Licensing and Board Certification
Once physicians finish their residency or fellowship, they must complete licensing and board certification exams. Those in physiatry must pass the American Board of Physical Medicine and Rehabilitation (ABPMR) exam. The exam consists of two parts. Most students take Part I after graduating from residency. The first part is a computer-based written exam.
Physicians take Part II about six months after passing Part I. Some may do their fellowship between the two parts. The second part consists of oral assessments. Those who study a subspecialty may take a third exam to become board-certified in their subspecialty.
How Competitive Is the Physiatry Field?
As of 2024, Physical Medicine and Rehabilitation (PM&R) has become increasingly competitive. According to recent data from the National Resident Matching Program (NRMP), the overall fill rate for residency positions across specialties was 93.8%, reflecting a highly competitive environment. For PM&R, strong academic performance remains crucial, with average USMLE Step 1 scores around 230 and Step 2 CK scores around 242.
Physiatrists Annual Compensation
Physiatrist salaries vary depending on subspecialty, geographic location, and years of experience. According to 2024 data, the average annual compensation for a full-time physiatrist is approximately $364,000. Those specializing in pain management or other high-demand areas tend to earn more. While averages provide general benchmarks, individual compensation may differ based on specific practice settings and regions.
Ways to Increase Your Chances of Becoming a Physiatrist
If you're considering entering this field, the primary way to increase your chances of residency in your desired field is hard work in your schooling and examinations. Here are some factors that may influence your chances:
- Going to a top medical school: While your performance matters more, attending a top medical school may slightly improve your chances of getting a physical medicine and rehabilitation residency.
- Shadowing a physiatrist: Gaining firsthand exposure to the field through shadowing can provide valuable insights and strengthen your application.
- Getting good scores on your USMLEs: Your USMLE scores are one of the main factors in residency placement. Try to reach the average or score above average in your desired field.
- Getting strong letters of recommendation: Letters from experienced professionals, especially physiatrists, can significantly enhance your application and residency interviews.
- Honing your interpersonal skills: During your residency interviews, having strong interpersonal skills can increase your chances of being placed.
Speak With Our Expert Physicians to Learn More
Medrina contracts physiatrists for work in post-acute settings such as skilled nursing centers and inpatient rehab facilities. We help new physicians start their careers in physiatry by offering mentorship, support, and comprehensive training. Speak with our team online to learn more about PM&R and how you can assist patients in achieving a better quality of life!
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