Medical Student Rotation
Elective in PM&R
A fourth year medical student elective is offered to University of Colorado School of Medicine students as well as outside students. The director of medical student education, Dr. Adele Meron, will coordinate the four-week rotation. The elective is offered through the University of Colorado School of Medicine and is listed in their handbook of prospective electives. Students will have the opportunity to rotate in either adult or pediatric rehabilitation settings based on preference and availability.
Students will have exposure to the following areas of PM&R:
Neurorehabilitation: Spinal Cord Injury, Traumatic Brain Injury, Stroke, Multiple Sclerosis, Amyotrophic Lateral Sclerosis, Guillain-Barré, Myasthenia Gravis, Parkinson’s Disease, Gait and Movement Disorders
Pain medicine: Chronic Pain Management, Complex Regional Pain Syndrome (previously named Reflex Sympathetic Dystrophy), Acute and Chronic Musculoskeletal Pain, Arthritis, Carpal Tunnel Syndrome
Musculoskeletal care: Osteoarthritis, Osteoporosis, Rheumatoid Arthritis, Fibromyalgia, Spondyloarthropathies, Back Pain and Sacroiliac Joint Dysfunction
Sports injuries: Achilles Tendonitis, Iliotibial Band Syndrome, Turf Toe, Medial & Lateral Epicondylitis, De Quervain’s Tenosynovitis, Rotator Cuff Pathology, Acromioclavicular Separation, Biceps Tendonitis, Stress Fractures, Concussion
Post-operative care: Joint Replacement, Organ Transplantation, Amputations, Left-Ventricular Assistive Devices, Cardiac / Pulmonary Rehabilitation
Pediatric functional and developmental disorders: Cerebral Palsy, Muscular Dystrophy, Spina Bifida, Traumatic Brain Injury, Spinal Cord Injury, Polytrauma, Amputee Care, Brachial plexopathies
Prosthetics and Orthotics: Amputee Care, Assistive Devices and Ambulation Aids, Spinal Orthoses, Neuro-prostheses
Specialized rehabilitation: Cancer, Cardiac, Burns, Pulmonary, Family Training (for home care)
Students will observe and participate in the following procedures:
- EMG (electromyography): inserting fine needle electrodes in muscles and observing the recorded motor unit potentials when the muscles are activated to help distinguish whether weakness is due to muscle or nerve dysfunction (i.e., myopathy vs. neuropathy).
- NCS (nerve conduction studies): use of electrodes to record motor and sensory responses that are propagated by electrical stimuli. This test can help distinguish location of a nervous system lesion (radiculopathy, peripheral neuropathy, motor neuron disease, or neuromuscular junction).
- Peripheral joint injections: injections to help diagnose and treat bone and soft tissue disorders often seen in orthopedic, rheumatologic, and sports medicine disorders such as knee osteoarthritis, rotator cuff tendinopathy, and epicondylitis. This includes corticosteroid injections, hyaluronic acid, and biologics including platelet rich plasma.
- Trigger point injections: lidocaine or dry needling can be used as an adjunct to proper exercise and physical therapy to treat trigger points, thought to be sources of chronic myofascial (soft-tissue) pain.
- Musculoskeletal ultrasound: Ultrasound may be used to evaluate for soft tissue abnormalities in muscles, tendons, joints, and other soft tissue structures as well as for ultrasound guided injections and procedures.
- Spasticity management: spasticity is a common complication related to CNS injury (e.g., SCI, stroke, cerebral palsy). Physiatrists treat spasticity by using oral antispasticity agents, botulinum toxin injections, phenol injections, and intrathecal baclofen pump management to improve function and decrease pain.
- Interventional spinal therapeutics: image-guided spinal diagnostics and injections, including interlaminar and transforaminal epidurals, and radiofrequency ablations. These techniques are being used as a nonsurgical pain-relieving intervention for back pain and radiculopathy.
- Percutaneous procedures: ultrasound guided tenotomies and fasciotomies for the treatment of recalcitrant soft tissue injuries.
The student at the completion of this educational experience should be able to:
- Demonstrate comprehensive neurologic, spine, and peripheral joint examinations;
- Describe changes in function imposed by pathology of nerves, muscles, joints, bones, brain, or spinal cord;
- Discuss rehabilitation medicine intervention in preventing the complications of disabling illness;
- Formulate a Rehabilitation program for the most common disabling conditions in the United States;
- Outline the common psychosocial issues which occur following the onset of disabling illness.
These goals will be accomplished by involving the student in the evaluation, therapeutic goal setting, team discussion and the integrated treatment process, which is provided for inpatients and outpatients. This experience will allow the student to be thoroughly involved in the medical science and art of rehabilitation medicine.
Students will be assigned to one of the following:
DHMC: Denver Health Medical Center, the Denver County hospital with inpatient experience including TBI, multiple trauma, SCI, and CVA. Outpatient experience with monthly clinics in amputee, seating and positioning (2 x month), and SCI (student should get 2/3), and Electrodiagnostics.
CHC: The Children's Hospital Colorado with primary outpatient exposure in a variety of pediatric rehabilitation clinics including spasticity (Botox) clinic, seating and positioning, cerebral palsy clinic, and other congenital and acquired conditions.
UCH: University of Colorado Hospital with inpatient unit with variety of conditions including CVA, transplant, joint replacement as well as outpatient exposure to general rehabilitation clinic, spine center, spinal injection clinic and spine outpatient (Advanced MSK and Spine care/EMG.
For external students, please visit the Office of Student Affairs for information on applying for externships.
For internal students, please see the Office of Admissions for enrollment information.