Medical Student Referral Patterns for Musculoskeletal Disorders1

Abstract

The purpose of this study was to determine the relationship between medical student knowledge and exposure to physiatry and the student's referral patterns for musculoskeletal disorders. Surveys were mailed to senior medical students at five United States medical schools across the country with a response rate of 26% (n=191). Five common musculoskeletal and neurologic disorders were presented as clinical vignettes and the student was asked to assume the role of a primary care physician and refer the patient to one of eight specialists listed. A section to assess the student's subjective overall knowledge and exposure to these fields was also included. Physiatrists received 27% of the referrals for evaluation and treatment of chronic low-back pain, 3% of the referrals for acute low-back pain, 10% of the referrals for carpal tunnel syndrome, 22% of the referrals for an industrial medicine injury, and 20% of the referrals for a sports medicine injury. The frequency of physiatry referrals for three of the five cases was significantly correlated (P < 0.05) with the student's overall knowledge of physical medicine and rehabilitation (PM&R). The presence of a department of PM&R at the student's school, however, did not have a significant impact on the rate of referrals. The results indicate that senior medical students referral patterns are strongly influenced by knowledge of PM&R. This suggests that focusing efforts on increasing this awareness may be an effective means of increasing referrals to physiatry in the future.

Content Evaluation of Physical Medicine and Rehabilitation Residency Websites

“…[3][4][5][6][7][8][9] There are various levels of familiarity and attitude toward the different areas of PM&R; however, the field as a whole is becoming more well-known as medical students start to recognize the value of physiatric skillsets in enhancing their understanding of how to comprehensively evaluate, diagnose, and treat a wide range of pathologies. [10][11][12][13] A prior 16-item, 130-factor questionnaire administered to graduating PM&R residents by DeLisa et al found that some of the most popular factors influencing resident decisions for residency programs included: "flexibility for family obligations, opportunities to make a difference in peopleʼs lives, interest in helping people, type of patient problem encountered, and consistency with the personality." 14 Given the increasing popularity of PM&R and a lack of a dedicated study evaluating the PM&R residency websites and online content, we found a need to further address this deficit.…”

Evaluation of physical medicine and rehabilitation course for undergraduate medical students

“…Our result is in line with Abramson's study at Harvard medicine school, suggesting that senior medical students' referral patterns strongly correlated with the knowledge of PMR. [ 22 ]…”