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  • So you want to be a physiatrist, or a physical medicine & rehabilitation doctor, also known

    所以你想成為一名物理學家,或物理醫學和康復醫生,也被稱為

  • as PM&R for short. You like the idea of dealing with chronic physical illness and having a

    簡稱PM&R。你喜歡處理慢性身體疾病的想法,並有一個

  • chill lifestyle. Let's debunk the public perception myths, and give it to you straight. This is

    寒冷的生活方式。讓我們揭穿公眾認知的神話,並直接告訴你。這就是

  • the reality of PM&R. Dr. Jubbal, MedSchoolInsiders.com.

    醫學與康復的現實。Jubbal醫生,MedSchoolInsiders.com。

  • Welcome to our next installment in So You Want to Be. In this series, we highlight a

    歡迎來到《你想成為什麼樣的人》的下一期節目。在這個系列中,我們將重點介紹一個

  • specific specialty within medicine, such as physiatry, and help you decide if it’s a

    醫學中的特定專業,如物理學,並幫助你決定它是否是一個

  • good fit for you. You can find the other specialties on our So You Want to Be playlist. If you

    很適合你。你可以在我們的 "你想成為 "播放列表中找到其他專業。如果你

  • want to vote in upcoming polls to decide what future specialties we cover, make sure youre

    想在即將舉行的民意調查中投票,以決定我們未來涵蓋的專業,請確保你是

  • subscribed. If you’d like to see what being a physiatrist

    已訂閱。如果你想了解作為一名物理學家的情況

  • looks like, check out my second channel, Kevin Jubbal, M.D., where we'll be covering a day

    看起來像,看看我的第二個頻道,凱文-朱巴爾,醫學博士,在那裡我們將涵蓋一天的

  • in the life of a PM&R doctor in the future.

    在未來的PM&R醫生的生活中。

  • PM&R is the jack-of-all-trades specialty focusing on both inpatient and outpatient management

    婦產科是全能型專科,專注於住院和門診管理。

  • of non-operative orthopedics and neuro-rehabilitation. These are the primary physicians for certain

    非手術骨科和神經康復科的醫生。這些醫生是某些

  • nervous system or non-surgical orthopedic disorders, offering both medical and procedural

    神經系統或非手術性骨科疾病,提供醫療和程序方面的服務。

  • treatment modalities. These are the doctors handling their unique conditions on an ongoing

    治療方式。這些是持續處理其獨特情況的醫生。

  • and outpatient basis. Some patients present with spinal cord or

    和門診的基礎上。一些患者出現脊髓或

  • traumatic brain injuries, for whom you'll manage their pain, neuropathy, and bowel and

    腦外傷患者,你要為他們處理疼痛、神經病變、腸道和胃病。

  • bladder care. Other patients may have other mixed connective tissue or nervous system

    膀胱護理。其他患者可能有其他混合的結締組織或神經系統

  • issues that you'll treat, such as mallet finger or jersey finger.

    你要治療的問題,如棒狀指或澤西指。

  • There are a few ways to categorize the specialty.

    有幾種方法可以對專業進行分類。

  • Non-operative orthopedics includes diagnosing and treating peripheral nerve diseases. This

    非手術骨科包括診斷和治療周圍神經疾病。這

  • often includes procedures with ultrasound or fluoroscopy assistance, or injections of

    通常包括在超音波或透視的協助下進行的手術,或注射藥物。

  • various types. For example, trigger point injections with lidocaine or steroids are

    各種類型。例如,使用利多卡因或類固醇的觸發點注射是

  • used at sites of myofascial pain, whereby there is tightness around a muscle focal point.

    用於肌筋膜疼痛的部位,即肌肉焦點周圍有緊繃感。

  • This is a rapidly evolving area of PM&R, with research and new therapies in regenerative

    這是一個快速發展的醫學和康復領域,再生醫學的研究和新療法在不斷髮展。

  • medicine such as platelet rich plasma, mesenchymal stem cells, or peripheral nerve stimulators.

    諸如富含血小板的血漿、間充質幹細胞或外周神經刺激器等藥物。

  • Neuro-rehabilitation focuses on traumatic brain and spinal cord injuries, and is primarily

    神經康復的重點是腦部和脊髓的創傷,主要是

  • inpatient in nature. These physiatrists serve as the patient's primary hospitalist, not

    在性質上屬於住院病人。這些理療師作為病人的主要住院醫生,而非

  • as a consulting service, for patients requiring neuro-rehabilitation. Their main area of specialization

    作為一項諮詢服務,為需要神經康復的病人提供服務。他們的主要專業領域是

  • is in dealing with the neuromuscular diseases and related issues, and they may consult other

    在處理神經肌肉疾病和相關問題方面,他們可能會諮詢其他機構。

  • specialties, like pulmonology, neurology, and other specialties for specific concerns.

    像肺病學、神經病學和其他專科的具體問題。

  • This is very collaborative and highly inter-disciplinary, working with a wide variety of specialists

    這是一個非常協作和高度跨學科的工作,與各種各樣的專家合作。

  • and therapists, from physical therapists and occupational therapists to speech therapists,

    和治療師,從物理治療師和職業治療師到語言治療師。

  • recreational therapists, and respiratory therapists.

    康樂治療師,和呼吸治療師。

  • The practice of physiatry varies substantially between practice settings.

    在不同的實踐環境中,物理醫學的實踐有很大的不同。

  • Academic physiatrists deal primarily with brain and spinal cord injuries. These tend

    學術型物理學家主要處理腦和脊髓損傷。這些人往往

  • to be more severe cases than in other practice settings, and are heavy on neuro-rehabilitation.

    與其他實踐環境相比,這類病例更為嚴重,而且重在神經康復。

  • As with any academic position, research and teaching residents and medical students is

    與任何學術職位一樣,研究和教授住院醫生和醫學生是

  • part of the job. On the other hand, some clinical aspects are more relaxed because you'll have

    工作的一部分。另一方面,一些臨床方面的工作則比較輕鬆,因為你會有

  • residents to help carry out various clinical responsibilities. Overall, there are fewer

    居民幫助履行各種臨床職責。總的來說,有較少的

  • procedures, and therefore lower compensation, because more of your cases will be traumatic

    程序,從而降低了賠償,因為你的更多案件將是創傷性的

  • brain, spinal, or stroke in nature. Community physiatrists deal with less severe

    腦部、脊柱或中風的性質。社區理療師負責處理不太嚴重的

  • cases in comparison to academia. On average, you'll have more outpatient orthopedics, more

    與學術界相比,你會有更多的門診骨科病例。平均而言,你會有更多的骨科門診病人,更多的

  • procedures, and higher compensation. While your academic colleagues will be dealing with

    程序,以及更高的報酬。當你的學術界同事將處理

  • more amyotrophic lateral sclerosis, also known as ALS, or unique cases of Guillain Barre

    更多的肌萎縮性脊髓側索硬化症,也被稱為ALS,或吉蘭巴雷的獨特病例

  • syndrome, you'll be doing more EMG's as a community physiatrist, for things like ulnar

    作為一名社區理療師,你將會做更多的肌電圖檢查,比如尺橈骨肌電圖。

  • entrapment, carpal tunnel, and basic radiculopathies. Private practice physiatrists are uncommon,

    纏結、腕管和基本的根管病。私人執業理療師並不多見。

  • unless they specialize in pain or sports. Part of the reason private practice is uncommon

    除非他們專門從事疼痛或運動。私人診所不常見的部分原因是

  • is that owning your own rehabilitation center is expensive, requiring a large interdisciplinary

    是,擁有自己的康復中心是昂貴的,需要一個龐大的跨學科的

  • team to treat a small number of patients.

    團隊來治療少量的病人。

  • There are a handful of misconceptions about PM&R, as it's a smaller specialty most lay

    對PM&R有一些誤解,因為它是一個較小的專業,大多數人都不瞭解。

  • people haven't even heard of. First, get used to people asking if you're

    人們甚至沒有聽說過。首先,要習慣於人們問你是否是

  • a physical therapist, or your friends and family requesting stretching exercises. PM&R

    物理治療師,或你的朋友和家人要求進行拉伸練習。物理與康復

  • doctors are physicians, not PT's. While physical therapists are prescribing exercises and therapy

    醫生是內科醫生,不是物理治療師。當物理治療師在開具練習和治療處方時

  • treatment plans, the physiatrists manage the medications, pain, spasticity, neuromuscular

    治療計劃,物理治療師負責管理藥物、疼痛、痙攣、神經肌肉等問題。

  • dysfunction, and general medication management. Second, because it's a newer and smaller specialty,

    障礙,以及一般的藥物管理。第二,因為它是一個較新和較小的專業。

  • many of your physician colleagues won't even know what you do. You'll get random consults

    你的許多醫生同事甚至不知道你是做什麼的。你會得到隨機的諮詢

  • for things that are not appropriate, like a hospitalized patient who hasn't gotten out

    對於那些不合適的事情,比如一個還沒有出院的住院病人。

  • of bed in several days.

    幾天來,他一直躺在床上。

  • After medical school, PM&R residency is 4 years. As with any specialty, intern year

    醫學院畢業後,PM&R住院醫生是4年。與任何專業一樣,實習年

  • will be a mix of various specialties, many of which are less clinically relevant to your

    將是各種專業的混合體,其中許多專業與你的臨床相關性較低。

  • future as a PM&R doctor. As a PGY2, you'll be focused primarily on inpatient rehabilitation.

    作為一名PM&R醫生的未來。作為PGY2,你將主要專注於住院康復。

  • Every residency requires at least 12 months of acute inpatient rehab, and you'll get the

    每個實習生都需要至少12個月的急性住院康復治療,你將獲得

  • majority of that in your second year. The rest will be clinic and consult months cycled

    其中大部分是在你的第二年。其餘的將是診所和諮詢月的循環。

  • throughout. As a PGY3 and PGY4, you'll have more elective time, usually with more relaxed

    自始至終。作為PGY3和PGY4,你會有更多的選修課時間,通常有更多輕鬆的時間。

  • schedules and relaxed call. These will also be the years where you can gain greater exposure

    時間表和輕鬆的通話。這些年也將是你可以獲得更多曝光的年份

  • to procedures, such as EMG's and injections. In terms of competitiveness, you're in luck,

    到程序,如EMG和注射。在競爭力方面,你很幸運。

  • as PM&R ranks second to last, above only family medicine. While the match rate is lower than

    因為醫學與康復部排名倒數第二,僅高於家庭醫學。雖然匹配率低於

  • expected at roughly 90%, USMLE Step 1 has averaged 224 and Step 2CK at 238. Given the

    預計約為90%,USMLE第1步平均為224,第2CK步平均為238。鑑於

  • relative lower competitiveness, it tends to be more DO and IMG friendly as well, although

    競爭力相對較低,它往往也對DO和IMG更友好,儘管

  • it's been trending upward. To see the full list of specialties by competitiveness, check

    它一直呈上升趨勢。要查看按競爭力分類的全部專業名單,請查看

  • out my videos explaining the methodologies and the full data set.

    請看我解釋方法的視頻和完整的數據集。

  • Because it's less competitive, the stereotype is that its for students who didn't do well

    因為它的競爭性較小,人們的刻板印象是,它是為那些成績不好的學生準備的。

  • on their USMLE or who wanted to do orthopedics but couldn't get in, but I don't think that's

    在他們的USMLE考試中,或想做骨科但不能被錄取的人,但我不認為那是

  • fair to the specialty. Medical students that apply into PM&R are generally optimistic,

    對該專業來說是公平的。申請進入PM&R的醫學生一般都很樂觀。

  • as it's an almost necessary trait in the rehabilitation setting. You'll have to be encouraging to

    因為這幾乎是康復環境中的一個必要特徵。你必須要鼓勵

  • your patients and help inspire hope.

    你的病人,並幫助激發希望。

  • After completing a PM&R residency, you can subspecialize further with fellowship.

    在完成PM&R住院醫師培訓後,你可以通過獎學金進一步細分專業。

  • Pain is a 1 year fellowship and is the most competitive, resulting in the highest compensation

    疼痛是為期1年的研究金,競爭最激烈,報酬最高。

  • for PM&R doctors. You can go into pain through PM&R, but also after residency in anesthesia,

    為PM&R醫生。你可以通過PM&R進入疼痛領域,但也可以在麻醉科住院醫師培訓後進入。

  • neurology, or psychiatry. You'll be dealing with chronic pain patients,

    神經病學或精神病學。你將與慢性疼痛患者打交道。

  • which some find depressing, but others find deeply meaningful. A large part will be prescribing

    有些人認為這是令人沮喪的,但有些人認為這是深具意義的。很大一部分將是開出

  • pain medications, although given the opioid epidemic, physicians are moving more toward

    儘管鑑於阿片類藥物的流行,醫生們正更多地轉向使用止痛藥。

  • procedures. These includes radiofrequency ablations for facet pain, epidural injections,

    手術。這些手術包括射頻消融治療面痛、硬膜外注射。

  • and spinal cord stimulators. This is great for those who like working with their hands,

    和脊髓刺激器。這對那些喜歡用手工作的人來說是很好的。

  • as it's more procedural than other PM&R subspecialties.

    因為它比其他PM&R亞專業更具有程序性。

  • Pediatrics is a 2 year fellowship focusing primarily on cerebral palsy. You'll be managing

    兒科是一個為期兩年的研究項目,主要側重於腦癱。你將負責管理

  • spasticity and doing a few procedures like botox injections in spastic muscles.

    痙攣和做一些程序,如在痙攣的肌肉中注射肉毒桿菌。

  • You'll also come across some rare conditions like Duchenne's muscular dystrophy, Becker's

    你還會遇到一些罕見的病症,如杜興氏肌肉萎縮症、貝克爾氏肌肉萎縮症。

  • dystrophy, spina bifida, myelomeningoceles, and meningoceles. Because these are so rare,

    營養不良症、脊柱裂、脊髓膜炎和腦膜炎。因為這些都是非常罕見的。

  • you'll more or less become these patients' primary care physician, often continuing care

    你將或多或少地成為這些病人的主治醫生,經常繼續照顧他們。

  • into their adulthood. This is the fellowship for those who not only

    進入他們的成年。這是為那些不僅是

  • enjoy working with kids, but who are also very patient.

    喜歡和孩子們一起工作,但也很有耐心。

  • Sports medicine is a 1 year fellowship and is the second most competitive subspecialty.

    運動醫學是一個為期1年的研究項目,是競爭最激烈的第二個亞專業。

  • You can also get into a sports medicine fellowship after a residency in family medicine or emergency

    你也可以在完成家庭醫學或急診住院醫師培訓後,進入運動醫學研究室。

  • medicine as well. It's a procedure-heavy subspecialization,

    醫學也是如此。這是一個重程序的亞專業。

  • including primarily steroid, hyaluronic acid, and platelet rich plasma injections, and also

    主要包括類固醇、透明質酸和富含血小板的血漿注射,還包括

  • the occasional EMG. Sports medicine also includes regenerative medicine, ultrasound, and sideline

    偶爾的EMG。運動醫學還包括再生醫學、超音波和邊線。

  • coverage on sports games. This is the fellowship for physiatrists who

    關於體育比賽的報道。這是為物理學家提供的研究金,他們是

  • love sports and working with their hands.

    喜歡運動和用他們的雙手工作。

  • Palliative care is a 1 year fellowship that focuses on improving the quality of life for

    姑息治療是一個為期一年的研究項目,重點是改善病人的生活品質。

  • patients living with serious chronic illnesses. It's not quite hospice care, which is more

    患有嚴重慢性疾病的病人。它不完全是安寧療護,安寧療護更多的是

  • focused on the terminally ill, but you will still have some end-of-life patients who can

    著重於臨終病人,但你仍然會有一些臨終病人,他們可以

  • make substantial improvements and prolong their lives beyond the initial prognosis.

    在最初的預後之外,使他們的病情得到實質性的改善並延長他們的生命。

  • Cancer is common amongst this patient population, and you'll be helping managing pain and making

    癌症在這個病人群體中很常見,你將幫助管理疼痛,並使他們的生活更加美好。

  • patients more comfortable. This is for the physiatrists who are positive and wouldn't

    病人更舒適。這是為那些積極的物理學家準備的,他們不會

  • mind dealing with a great deal of death and end-of-life care.

    心中處理著大量的死亡和臨終關懷。

  • Traumatic brain is a 1 year fellowship that's more academic in nature and is more heavily

    創傷性腦病是一個為期1年的研究項目,在性質上更具有學術性,而且更注重於研究。

  • concentrated at larger research centers. You'll be dealing with traumatic brain injury sequelae,

    集中在較大的研究中心。你要處理的是創傷性腦損傷的後遺症。

  • including headaches, changes in attention, and behavioral changes. New innovative therapies

    包括頭痛、注意力變化和行為變化。新的創新療法

  • are on the horizon, such as stem cells and other regenerative medicine to regrow damaged

    我們可以看到,幹細胞和其他再生醫學可以使受損的細胞重新生長。

  • tissue. On average, you'll have more complicated patients and more complicated rehabilitation

    組織。平均而言,你會有更復雜的病人和更復雜的康復。

  • management. This is for the physiatrists who don't mind

    管理。這是為那些不介意的理療師而設的。

  • some research, are ok with uncertainty, as there is more trial and error, and want to

    一些研究,可以接受不確定性,因為有更多的試驗和錯誤,並希望

  • work in an academic center.

    在一個學術中心工作。

  • Spinal cord is also a 1 year academic fellowship, focusing on spinal cord injuries rather than

    脊髓也是一個為期1年的學術研究項目,重點是脊髓損傷而非

  • brain injuries. Thankfully, spinal cord injuries are becoming less common in modern era with

    腦損傷。值得慶幸的是,隨著現代社會的發展,脊髓損傷越來越少見。

  • improvements in safety technology, such as airbags in cars. Most spinal cord injuries

    安全技術的改進,如汽車的安全氣囊。大多數脊髓損傷

  • are the result of either elderly patients falling or hyperextension injuries.

    是由老年患者跌倒或過度伸展受傷造成的。

  • There's a lot to love about PM&R. It's heavily team focused, and you'll be working with PT,

    PM&R有很多值得喜愛的地方。它非常注重團隊,你將與PT一起工作。

  • OT, and speech therapy on the regular, in addition to case management and liaisons to

    除了個案管理和聯絡外,還定期進行OT和語言治療。

  • help coordinate care at outside hospitals. In terms of lifestyle, your hours are predictable

    幫助協調外部醫院的護理。就生活方式而言,你的工作時間是可以預測的

  • and not too longexpect no more than 8 hours per day, and no nights or weekends,

    而且時間不要太長--預計每天不超過8小時,沒有夜晚或週末。

  • with minimal call. For the lifestyle demands, you will be getting compensated quite well,

    以最少的電話。對於生活方式的要求,你將會得到相當好的補償。

  • around $300,000 on average. If you enjoy the musculoskeletal system but

    平均30萬美元左右。如果你喜歡肌肉骨骼系統,但

  • don't enjoy the operating room or being scrubbed in, PM&R allows for an office-based practice

    如果你不喜歡手術室或不喜歡被洗刷,PM&R允許你在辦公室進行練習。

  • with shorter and smaller procedures.

    以較短和較小的程序。

  • While PM&R is a great specialty, it's definitely not for everyone. It's slower paced and requires

    雖然PM&R是一個偉大的專業,但它絕對不適合所有人。它的節奏較慢,需要

  • a great deal of patience. After all, rehab takes time. You'll have to enjoy the small

    要有很大的耐心。畢竟,康復需要時間。你將不得不享受小

  • victories and the ups and downs of treatment and management, as patients aren't generally

    勝利以及治療和管理的起伏,因為病人一般不會

  • getting back to 100% baseline functional status. For some, this can grow quite frustrating.

    恢復到100%的基線功能狀態。對一些人來說,這可能會變得相當令人沮喪。

  • Patients and families can often have unrealistic expectations and hope to return to their prior

    患者和家屬往往會有不切實際的期望,希望能恢復到以前的狀態。

  • baseline. The reality of them eventually seeing that long term assistance is part of their

    基準線。他們最終看到的現實是,長期援助是他們的一部分。

  • future is difficult and disheartening. And chronic pain patients are not everyone's

    未來是困難和令人沮喪的。而慢性疼痛患者並不是每個人的

  • cup of tea. Even if you don't specialize in pain, you will be seeing some of these patients.

    杯茶。即使你不專攻疼痛,你也會看到一些這樣的病人。

  • How can you decide if PM&R is the right field for you?

    你如何決定PM&R是否是適合你的領域?

  • Those who are happiest in the field tend to be optimistic, seeing the potential for patients

    那些在該領域最快樂的人往往是樂觀的,看到了病人的潛力。

  • who present with terrible disease and finding the silver lining and ways to improve.

    呈現可怕疾病的人,並找到一線生機和改善的方法。

  • It's not nearly as hands-on as something surgical, but you should enjoy procedures, as it is

    它不像外科手術那樣親力親為,但你應該享受程序,因為它是

  • more procedural than the average office-based specialty.

    比一般基於辦公室的專科更有程序性。

  • And finally, if you're collaborative and enjoy working with others in an interdisciplinary

    最後,如果你善於合作,並喜歡在一個跨學科的工作環境中與他人合作

  • team-based approach to patient care, you'll get a great deal of that with physiatry.

    以團隊為基礎的病人護理方法,你會在理療室得到大量的這種方法。

  • Special thanks to Dr. Benjamin Shekhtman, physiatrist and current Insider at Med School

    特別感謝Benjamin Shekhtman博士,物理學家和醫學院的現任內行

  • Insiders, for helping me in the creation of this video.

    內幕人士,感謝他們幫助我創作這個視頻。

  • Are you hoping to become an physiatrist? To get into medical school and match into a desirable

    你是否希望成為一名物理學家?為了進入醫學院和匹配到一個理想的

  • PM&R residency, youll need to not only crush your MCAT and USMLE, but also shine

    在PM&R住院醫生的崗位上,你不僅需要粉碎你的MCAT和USMLE考試,還需要閃亮登場。

  • on your personal statement, secondaries, interviews, and other soft components of your application.

    在你的個人陳述、第二部分、面試和你的申請的其他軟組成部分上。

  • At Med School Insiders, our PM&R doctors can help you get there. We've had over 3,500 customers

    在Med School Insiders,我們的PM&R醫生可以幫助你達到目的。我們已經有超過3,500名客戶

  • so far and have an industry leading 99% customer satisfaction rating. That's not an accident

    迄今為止,我們有一個行業領先的99%的客戶滿意度評級。這並不是一個意外

  • we've obsessed and invested heavily over the past few years in creating our proprietary

    - 在過去的幾年裡,我們痴迷於創造我們的專利,並進行了大量的投資。

  • systems that allow us to consistently provide excellent service and deliver stellar results.

    系統,使我們能夠始終如一地提供出色的服務,並取得卓越的成果。

  • That's the Med School Insiders difference. Learn more about why our customers love us

    這就是Med School Insiders的與眾不同之處。瞭解更多關於我們的客戶為什麼喜歡我們

  • at MedSchoolInsiders.com. Thank you all so much for watching! If you

    在MedSchoolInsiders.com。非常感謝大家的觀看!如果你

  • enjoyed this video, check out So You Want to Be a Sports Medicine Doctor, or another

    欣賞這段視頻,請查看《你想成為一名運動醫學醫生》,或其他視頻。

  • specialty on our So You Want to Be playlist. Much love, and I'll see you guys there.

    在我們的 "你想成為的人 "播放列表中的專業。非常感謝,我們會在那裡見到你們。

So you want to be a physiatrist, or a physical medicine & rehabilitation doctor, also known

所以你想成為一名物理學家,或物理醫學和康復醫生,也被稱為

字幕與單字
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影片操作 你可以在這邊進行「影片」的調整,以及「字幕」的顯示

B2 中高級 中文 醫學 康復 醫生 專業 脊髓 治療師

你想成為一名物理學家(PM&R)[第26集]。 (So You Want to Be a Physiatrist (PM&R) [Ep. 26])

  • 8 1
    Summer 發佈於 2021 年 06 月 05 日
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