Rotation Experiences

 

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Rutgers NJMS, Department of Physical Medicine and Rehabilitation. 

Kessler Institute for Rehabilitation – West Orange, NJ & Saddle Brook, NJ

Kessler is one of the largest comprehensive rehabilitation centers in the United States. It has over 360 licensed rehabilitation beds in four primary inpatient facilities. Accredited by both the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) and the Commission on Accreditation of Rehabilitation Facilities (CARF), the Kessler facilities serve as the primary inpatient training sites for PM&R residents.

Kessler Institute for Rehabilitation is ranked as one of the top four rehabilitation hospitals in the nation.

Rotations where residents are placed include:

• Kessler West (West Orange, NJ) with inpatient spinal cord injury (Model System designation), traumatic brain injury (Model System), amputation, trauma, and stroke services.
• Kessler North (Saddle Brook, NJ) with inpatient cardiac, brain injury, stroke, orthopedic, geriatric services along with outpatient musculoskeletal, neurology rehabilitation services.

Kessler Institute for Rehabilitation Outpatient Services – West Orange, NJ

Kessler offers a wide range of outpatient services. These programs provide a quality care and long-term follow up for patients with stroke, spinal cord injury, brain injury, amputation, and additional neuro-musculoskeletal conditions. Throughout their time at Kessler, residents have the opportunity to participate in the long-term care of these patients and the specialized outpatient clinics including spasticity clinic, swallow evaluations, bracing & prosthetics.

During the dedicated outpatient rotation, residents rotate with multiple specialists and gain experience in cancer rehabilitation, general musculoskeletal disorders, pain management, spasticity management, and urology. Additionally, residents have the opportunity to perform ultrasound-guided procedures, botulinum toxin injections for spasticity, and electrodiagnostic evaluations. Residents also receive exposure to and participate in regenerative medicine/orthobiologic procedures.

University Hospital – Newark, NJ

University Hospital is a Level 1 Trauma Center where residents have the opportunity to perform Neuro Trauma Consults. This rotation provides exposure to PM&R as it integrates with multiple departments in the acute trauma hospital setting. PM&R is integrated with the Trauma service and consulted to manage acute delirium, agitation in the setting of brain injury, as well as involved in the management of acute spinal cord injury and traumatic brain injury.

In addition, residents participate in an outpatient clinic where they perform electrodiagnostic evaluations, manage the sequela of brain injury with a variety of modalities, including injections for spasticity. Residents also receive additional training with prosthetics and orthotics, peripheral joint injections, evaluation of athletes, and concussion assessment/management.

Doctors Office Complex (DOC) – Newark, NJ

University Rehabilitation Associates practice location is in Suites 3100 and 3300 of the DOC. The outpatient rotation focuses on diagnosis and treatment of acute and chronic musculoskeletal conditions of peripheral joints and management of chronic pain of the cervical and lumbar spine. The resident is trained in interpretation of x-rays and MRIs, and in performing diagnostic musculoskeletal ultrasound and ultrasound-guided injections. The resident also spends time in the fluoroscopy suite, acquiring technical skills with procedures such as medial branch blocks, epidural injections, and spinal cord stimulator trials.

East Orange Campus

The East Orange VA acts as a hub for multiple rotations:

1. Outpatient Rehabilitation Medicine: Residents on this rotation rotate through different aspects of outpatient PM&R clinics. The general musculoskeletal clinic involves performing new consultations and providing continuity through follow-up encounters for general MSK complaints as well as prosthetics and orthotics. The “specialty clinic” involves residents being exposed to hands on ultrasound-guided procedures as well as botulinum toxin injections for spasticity and migraines. The wheelchair clinic gives residents the opportunity to evaluate veterans for manual and motorized wheelchairs and learn the basics of a wheelchair fitting. Finally, the electrodiagnostic clinic provides residents with extensive exposure regarding performing and interpreting nerve conduction studies and electromyography.

2. Pain Medicine: During this rotation, residents work directly with an interventional pain physician. Residents are given the opportunity to assist and perform multiple interventional procedures, including ultrasound-guided injections and various spinal procedures under fluoroscopic guidance. In addition, residents are exposed to opioid management for chronic pain, providing a comprehensive education in pain management. Residents also perform pain consults for the VA’s inpatient services.

3. Spinal Cord Injury Unit: The East Orange VA has a dedicated SCI unit staffed by board certified SCI attendings. In contrast to the acute SCI exposure at Kessler and University Hospital, this rotation focuses more on the chronic care of patients with spinal cord injuries, multiple sclerosis, and ALS. Residents work with SCI physicians, a neuro-urologist, a wound care specialist, and other specialists to best manage the care of these veterans. Residents also perform home visits with an SCI physician to evaluate the safety of veterans' homes and determine potential home modifications.

Lyons Campus

The Lyons VA rotation is primarily an outpatient musculoskeletal clinic with dedicated days for MSK injections and wheelchair clinic. Residents also perform electrodiagnostic testing for peripheral nerve injuries. This rotation also provides residents with a unique experience of acting as the rehabilitation physician for patients at the Lyons VA’s inpatient and subacute unit. The Lyons VA rotation is an excellent opportunity to experience both general outpatient rehabilitation and subacute rehabilitation medicine.

New Brunswick, NJ

Children's Specialized Hospital in New Brunswick, NJ is a 60 inpatient-bed comprehensive inpatient rehabilitation center. While taking inpatient call, residents will be exposed to patients with a wide variety of disease processes and post-surgical conditions including multi-trauma, TBI, SCI, selective dorsal rhizotomy, congenital heart disease, neuromuscular disease, and chronic pain.

Mountainside, NJ

Children's Specialized Hospital in Mountainside, NJ is a multidisciplinary outpatient clinic where children from the Tri-State area with special needs go for general pediatric, neurologic, neurodevelopmental, psychiatric, and of course physiatric needs. Our two-month pediatric rotation emphasizes the outpatient management of children with cerebral palsy, spina bifida, neuromuscular disorders, movement disorders, as well as other conditions seen by general PM&R. In clinic, residents will focus on spasticity management, orthotics & bracing, and visual gait analysis. In addition to outpatient clinic, residents participate in school clinic, ultrasound guided chemodenervation, and take inpatient call at Children's Specialized Hospital in New Brunswick, NJ.

The outpatient rotation is open to second and third-year residents who would like further exposure to musculoskeletal medicine and sports-related injuries. The resident is paired up with an attending physiatrist and/or fellow where they are given the opportunity to evaluate athletes with various injuries, participate in concussion management, electrodiagnostic studies, and ultrasound evaluation/intervention. In addition, the resident will spend time in the fluoroscopic suite where they are exposed to various interventional spine procedures.

This outpatient rotation is open to second and third-year residents who would like the opportunity to rotate through a private practice sports & musculoskeletal practice run by renowned sports medicine physicians, Drs. Gerard Malanga, Jay Bowen, Kris Dunn, and Thomas Agesen. The resident will be exposed to the comprehensive evaluation and management of various musculoskeletal diseases from biomechanics to diet. In addition, the resident will be exposed to fluoroscopic and musculoskeletal ultrasound (both diagnostic and interventional); including exposure to cutting-edge orthobiologic/regenerative medicine procedures.