Health Education England, working across the East of England - Rehabilitation Medicine
Rehabilitation medicine is a constantly varied and dynamic specialty dealing with the needs of complex and, sometimes, challenging patients. This can encompass a wide range of clinical skills from the assessment of cognitive changes following traumatic brain injury to the prescription of computerised prosthetic components in amputees.
Unlike many of the organ-based specialties where discrete pre-determined pathways are followed in managing well-defined diagnoses, rehabilitation medicine is about treating individuals. Being able to bring medical expertise to bear in ameliorating the impact of physical and psychological impairments is immensely rewarding and has a real and ongoing effect on improving the quality of life for patients with chronic illnesses.
Trainees in rehabilitation medicine will be able to acquire various personal and clinical skills, including hands-on procedures in managing complex patients with physical and cognitive impairments, examples:
- Working with interdisciplinary team of nurses, and therapists
- Leading the team, and ability to deal with challenging patients
- Tracheostomy & respiratory management,
- Tissue viability and pressure areas,
- Amputees and complex trauma,
- Spinal injuries including autonomic dysreflexia and autonomic disorders
- Botulinum injections, nerve blocks, intra-articular injections
Rehabilitation medicine training is divided into five sub-specialities;
Neuro-rehabilitation covers a considerable number of conditions. In adulthood, most arise from injury or disease within the central and peripheral nervous system, such as acquired brain or spinal cord injuries (e.g. trauma, stroke, multiple sclerosis, and motor neurone disease). Other conditions arising in childhood, such as cerebral palsy, spina bifida, and muscular dystrophies will continue into adulthood and these people will have complex ongoing health problems. A Rehab Physician will be involved in the management of spasticity, spasms, seizures, pain, and work with multidisciplinary teams on areas such as postural support, communication, and behavioural management.
2) Musculoskeletal Rehabilitation
Individuals with chronically disabling musculoskeletal conditions are, sometimes, looked after by rehabilitation medicine specialists. The majority of patients with musculoskeletal symptoms have back pain, osteoarthritis or soft tissue disorders. Training includes specialised injection techniques for the neck and spine, joints, muscles, tendons and ligaments. Work also involves pain management and the use of orthotics. Training will include working along side Rheumatologists at Addenbrookes Hospital and include both inpatient and outpatient work in Rheumatology.
3) Amputee Medicine
Rehabilitation medicine also deals with the needs of people requiring lifelong technical assistance following amputation or with congenital limb deformity. Technological provision such as environmental control equipment and the prescription of wheelchairs, prosthetics and orthotics are not disease specific and cover a considerable range of disabilities.
4) Spinal Rehabilitation
Spinal cord injury is related to the damage of the spinal cord in any part or to the nerves that form the integral parts of the spinal cord. The injury might be caused by severe trauma or certain inflammatory conditions. Complications depend on the level of injury. The role of a Rehab Physician ranges from the recognition and the management of the sometimes urgent and life threatening medical complications from the spinal cord injury, to the management of general health and daily body functions to facilitate therapy from the multidisciplinary team. Trainees will have the opportunity to work in any of the nationally recognised Spinal Injury Units around the country.
5) Trauma Rehabilitation
This is a new and exciting developing field in rehabilitation. With the development of Trauma Centres in the UK there is recognition for the need of early, specialist led rehabilitation as soon as possible after trauma. Working with intensivists, neurosurgeons, orthopaedic surgeons among others the Rehab Physician’s role is to help manage the acute medical problems, but also to be able to see the larger picture and longer term route to recovery coordinating input from various teams.
Entrants to specialist training in rehabilitation medicine must have successfully completed Core Medical Training including the MRCP(UK) examination, Core surgical training including the MRCS examination, core psychiatry training including MRCPsych or General Practice specialty training including MRCGP.
Current specialists in RM have had diverse basic specialty training in medical, surgical, psychiatric or general practice, and the intention is to continue to recruit medical practitioners from a wide background of expertise.
Dr M Gaid
||Training Programme Director &
Consultant in Rehabilitation Medicine
|Colman Centre for
Tel: 01603 255772
|Dr Fraz Mir||Head of School of Medicine||
Health Education England, working across the East of England
|Joseph Crowe||School of Medicine Administrator||Norfolk and Norwich University Hospitals NHS Foundation Trust|
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