Derrick Allred, MD, Director of Resident Education
The goal of formal didactics is to provide resident education in regards to clinically and board-relevant material. The module system was de-signed to encompass the topics that may be tested on the national board exams per American Board of Physical Medicine and Rehabilita-tion (ABPM&R) guidelines once every 18 months. The topics are separated into core topics, high yield fundamental topics to the ABPM&R examination, and specialty topics, topics that are still beneficial but not as high yield. Core topics are allocated more lecture time as they appear more frequently on the written boards.
CORE TOPICS: 9 weeks (at least 18 lecture hours) each
- PHYSICAL MEDICINE NEUROLOGY
- INTERNAL MEDICINE
- ANATOMY/MSK (Additional 6 weeks cadaver dissection every 3 years)
SPECIALTY TOPICS: 6 weeks (at least 12 lecture hours) each
- SPINAL CORD INJURY
Monthly lecture time is also allocated during didactics for reviewing content directly relevant to the written board exams, oral board examination preparation, and Journal Club, M&M, research presentations, quality improvement presentations, and on content that may be more clinically relevant such as ultrasound procedure workshops, botox workshops, special speakers, etc.
LECTURE SCHEDULE & SPEAKERS:
It is the belief of the Rehabilitation Medicine Residency Program that an important component of the resident’s education is gained by way of self-directed learning. Therefore, residents are requested to deliver a number of lectures within each module, after being provided with lecture goals and objectives and guidance for material research. Faculty and extra-departmental experts participate as well. Didactics are scheduled every Thursday 8-10am and Friday 8-9am, and are overseen by an assigned faculty module director. Each module has an associated self-assessment examination to objectively assess the efficacy of the lecture series. Lectures are held at the new Polytrauma Rehabilitation Center lecture room. Rehabilitation Medicine resident attendance is mandatory for all on-service residents. In addition, a number of rotation-specific didactics are held at the discretion of the rotation’s Attending.
Every 3 years, a series of cadaveric dissections are carried out by the residents under supervision of a Faculty advisor in order to study anatomy with focus on the musculoskeletal system. During the Anatomy Module, residents have the opportunity to perform active dissections in the anatomy laboratory. Dissections are divided by body regions, including the upper and lower extremities, the shoulder, the knee, and the spine. Dissections allow residents a unique view of pertinent musculoskeletal and neuroanatomy, which in turn facilitates mastery. Important clinical correlation points are emphasized during in-lab lectures and during corresponding in-class didactics.
The basic science portion of each module consists of lectures addressing the fundamental aspects of topics in Rehabilitation Medicine prior to more detailed and extensive discussions. For instance, in addressing neurogenic bladder, the pathophysiology, neurology, and biochemistry involved are first discussed before medical and surgical management issues are explored.
An hour of didactics each month is dedicated to reviewing journal articles with a faculty mentor. The journal topic is chosen within current lecture module objectives. This is in addition to articles that are reviewed during the module lecture presentations, as multiple lectures in any given module are the requirements to review current literature on a given topic and present this information within the body of the lecture. Articles are presented and then critiqued with respect to content, methodology, results, and whether the hypothesis was proved. Applicable review of statistics and analysis are discussed during this time as well.
In accordance with requirements set forth by the American Council of Graduate Medical Education (ACGME) regular lectures are held regarding: stress and fatigue management, developing communication and negotiating skills. All Core Competency training is available online through the Graduate Medical Education.
RESEARCH CONFERENCE & QUALITY IMPROVEMENT:
All Rehabilitation Medicine residents are mandated to complete at least one academic research project during their residency tenure. In their fourth year, residents are required to deliver a conference educating the residency program about their project and findings in the presence of their research faculty mentor. Each resident is also responsible for being involved in a quality improvement project that improves patient care. Part of this process involves each resident presenting a summary of their project during PGY-4 year.
MODULE SELF ASSESSMENT:
Each academic module is completed with a module self assessment, which objectively assesses not only the resident’s proficiency of the topics recently presented but also of the module’s efficacy in educating the residents. Performance on these assessments may be used to assess the resident’s academic progress during their mid-year and annual evaluation with the Residency Program Director.
Finally, all PGY-4 residents attend the annual American Association of Physical Medicine and Rehabilitation National Convention. This offers the residents an opportunity to learn up-to-date information and innovations in the field, as well as networking and professional development.
The following facilities serve as clinical rotation sites for Rehabilitation Medicine residents:
University Health System
South Texas Veterans Health Care System
Warm Springs Rehabilitation System
Christus Santa Rosa Children’s Hospital
Reeves Rehabilitation Center
Residents have the opportunity to do elective rotations during their PGY-3 and PGY-4 years. Available elective rotations include Musculoskeletal and Neuroradiology, Hyperbaric Medicine and Wound Care, Interventional Pain Medicine, dedicated research time, or Sports Medicine with the Sports Medicine Associates of San Antonio, team physicians for local high school, collegiate and professional sports teams.