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PGY3 Year

1. Pediatric Rehabilitation

This rotation is offered at MemorialCare’s Miller Children's Hospital Long Beach.

During this rotation, residents will work exclusively with pediatric patients who have physical medicine and rehabilitation needs.

Residents become competent at determining the functional status for infants and children as they participate in the establishment of a diagnosis.

The time is split equally between outpatient clinic and inpatient evaluation and management. Clinics include general pediatric rehabilitation, hypertonicity, spina bifida, as well as other pediatric sub-specialty clinics including rheumatology, neurosurgery, and orthopedics. The multidisciplinary nature of the clinics allows residents to learn from physiatrists, orthopedic surgeons, neurosurgeons, urologists and rheumatologists. Residents also have the opportunity to participate in botulinum toxin injections as well as baclofen pump reprogramming and refills.

Skills that residents acquire during the pediatrics rotation are valuable to understanding the comprehensive management of infants and children in the field of PM&R.

2. Inpatient Rehabilitation & Consults

The Inpatient rehabilitation and PM&R consultation rotation at UCI Medical Center provides the resident with excellent experience and training in management of inpatient rehabilitation patients as well as consultative services for acute hospital inpatients. 

This rotation provides the resident with wide-ranging experiences evaluating and providing treatment recommendations for various neurological, orthopedic, neurosurgical and musculoskeletal diagnoses commonly encountered in acute inpatient settings. 

Because UC Irvine Medical Center receives referrals from many regional hospitals, the consult resident gains experience evaluating and treating complex medical patients with severe injuries or complicated medical issues. 

While on the consultation service, the resident works closely with the primary team, in-hospital therapists, and case management services to optimize post-acute care rehabilitation for patients. Working closely with the consult attending, they conduct follow-ups and new PM&R consultations, as well as work with the inpatient acute rehabilitation team to coordinate admission of appropriate inpatient rehabilitation patients. The resident gains valuable and important experience in longitudinal care of inpatients from the perspectives of PM&R consultative services. In addition, the resident also serves a mentor and supervisor to the PGY2 resident managing the UCI rehabilitation unit.

3. Prosthetics and Orthotics

This rotation is offered at the VA Long Beach Healthcare System.

The VA setting allows residents to manage patients with prosthetic and orthotic needs and to participate in a full-service P&O laboratory and clinic setting, including gait analysis, P&O manufacturing, wheelchair clinic and maintenance of care.

During this rotation, residents will work with prosthetists, orthotists, attending physiatrists, kinesiotherapists, as well as physical and occupational therapists.

The resident focuses on developing clinical expertise in the fundamentals of amputee rehabilitation, wound care, prosthetic and orthotic prescription, and on understanding gait abnormalities and complications of prosthetic and orthotic use.

During this rotation, residents rotate through the PMR outpatient clinic, as well as various specialty clinics, including:

• Prosthetic Clinic: The resident evaluates patients for proper prosthetics. This is run with a supervising attending physician and a prosthetist.
• Wheelchair Clinic: The resident evaluates patients for manual or electric wheelchairs. This clinic is managed by an attending physician and kinesiotherapist.
• Preservation, Amputation Care and Treatment (PACT) Clinic: The resident provides the physiatric management of the postamputation patient under the supervision of a staff physiatrist. It is a multidisciplinary prosthetic clinic that assists with ordering new prostheses for new amputees and replacement prostheses for older amputees.

4.Electrodiagnostics

Takes place at the VA Long Beach Healthcare System.

The objectives are for residents to understand fundamental concepts in electrodiagnostic medicine and to perform and interpret basic NCS/EMG cases.

Common diagnoses encountered include radiculopathy, carpal tunnel syndrome, mononeuropathy, polyneuropathy, and plexopathy.

5. Outpatient Pain Management & Elective 

The rotation is offered at the Center for Pain & Wellness that is located at the Joe C. Wen & Family Center for Advanced Care.

This setting allows residents to manage patients with acute and chronic pain conditions. During this rotation, residents work with an interdisciplinary team, including physiatrists, anesthesiologists and pain fellows.

Residents become competent at comprehensive outpatient pain management via many modalities, including opioid and adjunctive pain medications, and non-interventional and interventional treatments.

Most patients are initially seen as new patient evaluations, where a review of the patient’s pain history and presentation, along with a thorough physical examination, allows residents to formulate a comprehensive differential diagnosis and treatment plan for the pain etiology.

Many patients are managed holistically and many return to the clinic for follow-up visits and interventional procedures. 

There is an opportunity to spend one week with the acute pain service consult team at UC Irvine Medical Center.

Residents also have four weeks during this block dedicated to elective time. This time can be spent on any service staffed by UCI attending faculty. Residents have elected to do rotations in sports medicine, pain medicine, pediatric rehabilitation, radiology and research.