Postgraduate Medical - Page 17
Physical Medicine and Rehabilitation
War injuries and polio epidemics led to the
development of physicians especially trained
in treating pain and in rehabilitation therapy.
Although debilitating diseases such as
polio have been eradicated, accident and stroke
victims and paralytics live much longer
today, and thus the need for the services of
physiatrists has increased.
Physiatrists are largely hospital based in terms
of their practice, but more are
moving into part-time private practice.
Moreover, the approach of customizing treat-
ment plans within the context of the patient's
quality of life and maximal potential is
becoming the norm. This specialty continues to
use the multidisciplinary approach in
patient care, which is an especially attractive
feature for those who choose training in
this area.
Sports Medicine
This specialty is still in its infancy, and
there are as yet no formal residency programs.
Nevertheless an increasing number of
physicians, including those trained in orthopedics
and family practice, are entering full-time
sports medicine. This field is developing
because of the dramatic increase in popularity
of physical fitness. In addition, the field
is expanding beyond treatment to an
understanding of the disease process and to preven-
tion. In time, certification and a clearer
definition of this specialty will evolve.
Cosmetic Surgery
This developing field is an offshoot of
reconstructive surgery. It comes in response to a
more affluent society and the desire to obtain
a greater degree of self-worth. Technical
advances have also promoted cosmetic surgery as
a distinct area of specialization.
Breast reconstruction, liposuction, and certain
kinds of laser surgery are but a few of the
more recent developments that are encompassed
by this field. In 1979 the American
Board of Cosmetic Surgery was established; it
certifies physicians from varying special-
ties who are primarily involved in cosmetic
surgery.
Geriatrics
This emerging specialty deals with medical care
of the aged, usually defined as being
over 65. It involves review of a patient's
medical and social history, marital status, and
functional ability. The geriatrician aims to
address the patient as a whole.
The need for geriatricians is great and will
increase as the percentage of the aged in
the population gradually increases. The aged
spend more than double the nation's health
care dollars in proportion to their group
size.
Geriatricians are usually initially trained in
a specialty such as internal medicine or
other relevant area and spend a two-year
fellowship training period. Standards for fel-
lowships are being developed.
Career Placement
National trends in career placement are not
directly available, and specialty imbalances
change from year to year as well. The
activities of the AMA Physician's Placement Ser-
vice for the past few years do provide an
insight into what is happening. The AMA's sta-
tistics show that there is a general pattern of
undersupply of physicians for general and
family practice and an oversupply of
anesthesiologists, dermatologists, pediatricians,
psychiatrists, radiologists, surgeons, and
urologists. The only area other than general
practice in which there currently seems to be a
shortage is otolaryngology, with fewer
specialists in this field in proportion to the
opportunities available. Note, however, that
the oversupply of particular specialists
reflects the desires for prime locations, rather
than a national oversupply.
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