Physical Medicine and Rehabilitation

Goals and Objectives:
A rotation in Rehabilitation Medicine is carried out at the Health Sciences
Centre in the Rehabilitation Hospital. The major objective of this rotation
is to provide exposure for undergraduates to the field of Physical Medicine
and Rehabilitation and offers the student an opportunity to gain knowledge
on common problems related to this field and specifially expose the student
to a team approach in the management of client's physical, medical and
psychosocial problems associated with disability. In addition, the
management of vocational problems related to the client's impairment or
disability.

There are six geographical full-time physicians in the section of Physical
Medicine and Rehabilitation who are involved both in inpatient care as well
as ambulatory care clinics and in research. There are two part-time academic
physiatrists who are part of the teaching program.

During the rotation of the student, there will be exposure to the numerous
clinical teaching units, which are:

1. Spinal Cord Injury Unit:Here the student will be exposed to
   management of clients with acute and chronic spinal cord injuries.
   In the Unit, there is a close integration of numerous specialties
   such as orthopedic surgery, plastic surgery, urology and neurosurgery.
   Experience will be obtained in the diagnosis and management of traumatic
   and non-traumatic spinal cord injuries. In addition, the student will learn
   the management of neurogenic bladder, bowel and sexual dysfunction.
   The major focus of this unit is the integration of the client back into the
   community and this includes psychosocial as well as vocational
   management. The spinal cord injury unit also has an excellent
   out-patient program where most of the clients who are discharged
   are followed up frequently and the problems related to the injury are
   dealt with by the attending physicians.
2. Amputee Program Clinical Teaching Unit: In this service, the student
   will be exposed to clients who have had traumatic and non-traumatic
   amputations. The major focus of these clients is in prosthetic fitting.
   Total patient care approach is the major emphasis in this unit. During
   their attendance on this unit, the student will have a lot of exposure
   to common medical problems such as diabetes and its sequelae,
   peripheral vascular occlusive disease of various etiology and the
   management of the complications related to these diseases. There is also
   an outpatient clinic which deals with the management of the amputee.
3. Neurological Rehabilitation Unit:This deals with clients with
   neurological disorders. On this unit, exposure is to clients with
   cerberal vascular accidents and brain injuries. Since this unit has a
   large referral source even from the community hospitals, you see a
   variety of clients with neurological disorders and major emphasis is
   on the diagnosis, as well as managemet of the sequelae related to
   these disorders. Again, the major emphasis is in total patient care so
   involvement in both management of physical and neurological deficits is
   combined with management of the neuropsychological sequelae as well
   as vocational planning since 50 to 60% of clients admitted to the unit
   are young and of employable age.
4. Musculoskeletal/Neuromuscular Program: The musculoskeletal
   program is mainly in the ambulatory care clinics though there are few
   beds allotted to inpatient management of musculoskeletal disorders.
   During this rotation, one gets a wide experience in musculoskeletal
   problems and again the emphasis is on diagnosis and management of
   impairments and disabilities. The ambulatory care clinics are specifically
   dealing with soft tissue injuries and there is a large volume of clients
   that come through this clinic so wide exposure is given to the student.
   Most students get very good experience in doing a musculoskeletal
   examination and managing common musculoskeletal problems. There is a
   specialty clinic in this program, which is the Hand Clinic where clients with
   hand dysfunction secondary to trauma or to disease are seen and treated.
   The Neuromuscular Program is again under this clinical teaching unit and
   students will get excellent exposure to common neuromuscular problems
   which would help them in the future as physicians dealing with the
   common problems seen in practice.

In addition, students are exposed to electrophysiological mechanisms of
diagnosis, which includes EMG, and nerve conduction study. A clinic is run by
one of the attending physicians every week and usually this provides good
exposure to neuromuscular disease. Private practice physiatrists provide
teaching in Sports Medicine.

In addition to the above mentioned clinical teaching unit, there is exposure
of the students to research both in the areas of spinal cord injury as well
as the peripheral vascular occlusive diseases and to a smaller extent on
the neurological rehabilitation clinical teaching unit.

Students also get the opportunity to attend with our physicians in St. Boniface,
Deer Lodge Hospital and community hospitals where attending physicians have
outreach clinics. Pediatric Rehabilitation exposure is also available.

Call Requirements: As far as the student is concerned during their rotation,
they are rarely on call. Most of the rotation is spent in learning and not in
service. The attending physicians provide a large supervisory role during
this rotation.

Number of Students: On average 5 - 6 student rotate through this specialty
every year.

To arrange this elective, please contact:
Electives_Administrator@umanitoba.ca