The UC Davis Department of Physical Medicine and Rehabilitation was founded in 1968 by Dr. William M. Fowler, Jr., professor emeritus, former department chairman, and past president of the American Academy of Physical Medicine and Rehabilitation. The department currently has eleven full-time faculty physiatrists based at UC Davis Medical Center, two based at VA Northern California Healthcare System in Sacramento, with numerous volunteer clinical faculty from the Northern California region. The department maintains eleven residency positions. Primary clinical affiliations are with VA Northern California Healthcare System, Kaiser Foundation Hospital, and Shriners Hospitals for Children, Northern California, in Sacramento.  

Physical, occupational, speech, psychosocial, and hand therapy services as well as the orthotic laboratory within UC Davis Medical Center are under the direction of the Department of Physical Medicine and Rehabilitation. The Department of Physical Medicine and Rehabilitation Research Laboratory is located adjacent to outpatient therapy services and included extensive equipment related to measurement of body composition, strength, aerobic performance, and energy cost specifically designed for persons with physical disability. The laboratory provides a facility where faculty and residents in Physical Medicine and Rehabilitation as well as medical students, and graduate and undergraduate students can conduct research. Our research projects are primarily grant funded.

The department houses the primary electrodiagnostic laboratory for the health system with over 1200 studies performed annually. Outpatient physical medicine and rehabilitation clinics offer general and specialized care to those with rehabilitation, musculoskeletal, and neuromuscular disorders. Within the university hospital (a Level 1 trauma center), a 19-bed adult and four-bed pediatric rehabilitation unit serve the needs of patients requiring inpatient rehabilitation. There is an active inpatient consultation service.

The Department of Physical Medicine and Rehabilitation offers a comprehensive training program, originally approved by the Accreditation Council on Graduate Medical Education (ACGME) in July of 1971 and most recently re-accredited for five years in 2007.

• Provide trainees with exposure to patients with a wide range of physical impairments and disabilities who may benefit from physiatric care.
• Develop diagnostic and therapeutic skills which are both current and scientifically based.
• Provide a didactic framework of the basic sciences, interrelated disciplines, and medical rehabilitaton.
• Teach and develop the skills necessary to critically analyze and communicate research literature as a basis for lifelong learning.
• Develop competence in the six core aspects of medical practice: patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism and systems-based practice.
• Provide the comprehensive training and experience necessary to succeed in specialty examination by the American Board of Physical Medicine and Rehabilitation.

In its 1983 ruling, the American Board of Physical Medicine and Rehabilitation stated that training required for eligibility for examination by that board will be four years. Of those four years, one year should be in an accredited transitional year or include at least six months in family medicine, internal medicine, emergency medicine, obstetrics/gynecology, geriatrics, surgery, or any combination of these patient care experiences.

A trainee may enter the four-year program at the first year (PGY-1) of post-graduate training, or at the PGY-II level if there has been one or more years of training in another related specialty acceptable to the American Board of Physical Medicine and Rehabilitation.

PGY-I Year (Internship):  This first year of training consists of six months in internal medicine (one in CCU) and one month each of burn surgery, general surgery, neurology, emergency medicine, orthopaedic surgery (spine service), and one month rotation in inpatient physical medicine and rehabilitation. Training takes place primarily at UC Davis Medical Center, with several rotations to associated institutions, Kaiser Permanente Hospital and Mather VA Hospital.

PG-II Year: For the residents entering from the PGY-I level, a one-month rotation to orthopaedic hand completes one year of non-physical medicine and rehabilitation training.  Six months of outpatient physical medicine and rehabilitation clinic experience is scheduled along with three months of UC Davis Medical Center inpatient ward service. For the residents entering at the PGY-II level, four months are spent on the UC Davis Medical Center inpatient rehabilitation ward and six months in outpatient clinics.  All PGY-2 residents also rotate to Mercy General Rehabilitation Unit for subspecialty brain injury experience in a community setting.

PG-III Year:  All residents spend two two-month blocks as senior UC Davis Medical Center ward resident. A total of three months are spent assigned to physical medicine and rehabilitation EMG clinics, VA clinics, and specific non-physical medicine and rehabilitation clinics including: Kaiser fracture, rheumatology, and musculoskeletal radiology. There is also allotted time for research and an elective during these months. One month is spent on the comprehensive pain service. The remaining four months are completed at Shriners Hospital adjacent to UC Davis Medical Center, where the trainee manages the inpatient rehabilitation of children and adolescents with orthopaedic, neurologic, and burn disabilities.

PG-IV Year: The senior trainee performs inpatient consultations at UC Davis Medical Center during two two-month rotations. During four months as chief clinic resident, there are administrative duties as well as responsibility for supervision of other trainees and advanced clinical experience in an outpatient setting. A one-month elective may be used to complement clinical experience or complete research. The final three months consist of outpatient clinical physical medicine and rehabilitation training, including private hospital clinic experience. 

Neuromuscular Disease Clinics (Sponsored in part by the Muscular Dystrophy Association):The regional Muscular Dystrophy Association (MDA) Clinic includes neuromuscular disorders sponsored by the MDA. This multidisciplinary clinic is directed by a member of the Department of Physical Medicine and Rehabilitation and staffed by Physical Medicine and Rehailitation faculty with expertise in these neuromuscular disorders. New diagnostic workups, including electrodiagnostic studies, molecular genetic studies, and pathologic evaluations are coordinated by Physical Medicine and Rehailitation faculty and residents. Neurology, orthopaedic surgery, pulmonary, and medical genetics faculty are also available for consultation. The clinics include adult neuromuscular disease, child neuromuscular disease, and restrictive lung disease.  In addition, the department maintains an active post-polio clinic.

Pediatric Rehabilitation:Training in care of disabled children is provided through ambulatory clinics directed by a specialist in pediatric physiatry. These include general pediatric, pediatric pump, pediatric amputee, and pediatric neuromuscular disease clinics. Some of these clinics are interdisciplinary, with faculty from the Division of Pulmonary and Critical Care and Department of Orthopaedic Surgery in attendance as well as a nurse specialist and medical social worker. Physical and occupational therapists, orthotists and prosthetists, speech pathologists and a medical social worker are available for consultation. The physical medicine and rehabilitation pediatric inpatient program includes consultations and inpatient care. The new Shriners Northern California regional facility, which opened in 1997, is the only Shriners Hospital in the United States with a burn institute, full service orthopaedic hospital, and pediatric spinal cord injury unit within a single complex. This facility is located across the street from UC Davis Medical Center. Residents on rotation here will be primarily responsible for managing inpatient rehabilitation needs of children and adolescents with varying disabilities.

Electrodiagnostic Laboratory:Electrodiagnosis is used to evaluate neuromuscular diseases and muscle function, and training in this technique improves knowledge of topographical anatomy. Experience is continuous throughout the outpatient training program and represents approximately six months of full-time experience. Electrodiagnostic techniques utilized on adults and children include electromyography, nerve conduction studies, and somatosensory evoked potentials. This electrodiagnostic instruction and experience provides the background for certification by the American Board of Neuromuscular and Electrodiagnostic Medicine. Didactic training is through bimonthly electromyography conferences along with case discussions.

Prosthetics/Orthotics:Prosthetics training is primarily through the adult and child amputee clinics. The UC Davis Medical Center amputee clinic is a multidisciplinary clinic attended by faculty and prosthetic consultants from the community. A large number of traumatic amputees are evaluated as well as those with extremity loss due to vascular disease. The VA amputee clinic provides similar experiencewith the advantage of an on-site prosthetics and orthotics lab. The child amputee clinic at Shriners evaluates children with both congenital and acquired limb deficiencies. Orthotic training is primarily through post-polio and general rehabilitation clinics.  Instruction in prosthetics/orthotics involves didactic seminars including visits to the prosthetics laboratory for exposure to fabrication and fitting skills.

Brain Injury: Physical medicine and rehabilitation residents rotate to Kaiser Foundation Rehabilitation Center (KFRC) in Vallejo for experience on a specialized brain injury unit.  KFRC, a 60-bed acute inpatient unit, is the regional center for rehabilitation of Kaiser members in Northern California.  Six attending physiatrists with fellowship training and subspecialty certification in spinal cord injury and traumatic brain injury are available to provide clinical and didactic instruction.  Residents work closely with the brain injury clinical fellow to learn both inpatient and outpatient management of patients with neurological deficits. 

Spine:The comprehensive spine program is run as a multidisciplinary program including physical medicine and rehailitation, orthopaedic surgery, neurosurgery, and pain management. This program focuses on providing the skills to thoroughly evaluate spinal disorders, treat conservatively, and provide knowledge of surgical indications.

Musculoskeletal:A broad spectrum of musculoskeletal conditions are diagnosed and treated in our specialty musculoskeletal clinics: sports medicine, rheumatology, occupational medicine, and fracture. Experience is provided in physical medicine and rehabilitation clinics, amulti-specialty spine program, and integrated sports medicine program and outside clinics.  Extra-curricular opportunities include high school team physician experience, collegiate event coverage and US boxing event coverage.

 

	Monday	Tuesday	Wednesday	Thursday	Friday
	Clinic Chief
AM	Sports	Didactics	EMG	Spine	Discharge
PM	General	EMG	SCI	Spine	Kaiser
	R4 Clinic
AM	Amputee	Didactics	Kaiser EMG	VA/Accupuncture	EMG
PM	Amputee/EMG	General	Sports	NMD	EMG
	R3 Clinic
AM	Kaiser Fracture	Didactics	EMG	Neuroradiology	Elective
PM	General Peds	EMG	VA	Rheumatology	EMG
	R2 MS
AM	Amputee/Spine	Didactics	Spine/Polio	Spine	EMG
PM	Sports	EMG	SCI	NMD	Spine
	R2 Rehab
AM	Amputee	Didactics	EMG	Peds Pump/RLD	Polio
PM	Gen Peds	General	SCI	NMD	EMG

The didactic program provides a foundation for the basic sciences, interrelated disciplines, and medical rehabilitation. It also develops the skills necessary to critically analyze and communicate research literature.

Physical Medicine and Rehabilitation Basic and Clinical Science Series: These seminars consist of weekly three hour sessions with each topic repeated over an 18 month cycle. Lectures are given by physical medicine and rehabilitation faculty, faculty from other departments or guest speakers. Residents present at least on formal lecture a year. The remainder of the lectures are given by physical medicine and rehabilitation faculty, faculty from other departments, or guest speakers.

Journal club:  Residents are assigned to review current journals and analyze articles for presentation at these monthly meetings. Journal club is supplemented by review of a classic article accompanied by an in-depth discussion of statistical methodology.

EMG conference:  At these bi-monthly meetings, a case-presentation format is used for discussion of interesting or unusual cases requiring electrodiagnostic consultation. Clinical and electrodiagnostic work up is reviewed.

Grand rounds: A monthly presentation, usually by an outside speaker on a topic relevant to physical medicine and rehabilitation.

Case conference: Monthly focused review of a clinical case presenting diagnostic or therapeutic challenges.

Imaging conference: Monthly clinical case conference with an in-depth review of pertinent imaging studies.

Spine conference: Monthly lecture held in conjunction with orthopaedic spine, neurosurgery, and pain management presenting a spine-related topic.

Anatomy lab: Held on the UC Davis campus, residents have the opportunity to review anatomical dissections of the upper and lower extremities and spine. Other prosections are reviewed as available.

Shriners didactic lectures: Orthopaedics lectures are presented each Monday morning. Didactic curriculum lectures are presented each Tuesday morning. Spinal cord injury team conference is held each Wednesday at noon.

The department provides a popular fourth-year elective rotation to UC Davis and visiting medical students. Residents are responsible for bedside teaching, clinic supervision, and providing a didactic lecture to the students during each rotation. They also present lectures yearly as part of the resident didactic series and as therapy inservices

Residents are required to develop a research project and carry it to conclusion, which is the preparation of a manuscript appropriate for publication in a scientific journal. Residents are then required to present the results as a grand rounds during the senior year. They are also encouraged to present at a national conference and to publish their research in a peer-reviewed journal. The department sponsors residents for all national and major regional meetings at which they present a paper, subject to approval by the chair. Instruction in research methods, data collection, and analysis is provided during the seminar series.

As stated previously, the basic program objective is to provide training to enable the resident to become a competent physiatric clinician and to achieve completion of the board requirements. The faculty evaluate the resident's knowledge, skills, performance, jmudgment and attitude every six months. In addition, residents are required to take the yearly Medical Knowledge Self-Assessment Exam (SAE) prepared by the American Academy of Physical Medicine and Rehabilitation. This provides an annual assessment of the resident's knowledge as well as comparison with other residents nationwide. Evaluation of electrodiagnostic training is assessed through the self-assessment examination provided by the American Board of Neuromuscular and Electrodiagnostic Medicine (TP-SAE). Yearly oral examinations by the faculty allow the trainee to assess their progress as well as provides practice preparation for Part II of the specialty certification examination.

Housestaff Salary:  Salary is determined by hospital and university policy and is not under department control.

Vacation:  The amount of vacation time is determined by hospital and university policy (24 days per year). However, for the R-1 through R-3 years, vacation time must be approved by the department. Vacation time for the PGY-1 year is taken in one full block (four weeks).

Paid Leave:  The amount of sick leave is determined by hospital and university policy (12 days per year). Sick leave may be accrued from year to year. The amount of maternity/paternity leave is in accordance with the published policies of the hospital and university. Three weeks educational leave (including review time for Boards) is allowed and is subject to approval by the residency program director.

Benefits:  Health, dental, vision, and life insurance are provided and paid for by the University. Disability insurance is available.

Fourth year medical student electives are available for medical students from other medical schools. For information and available dates, please call Patricia Settje, at (916) 734-5292 or e-mail: patricia.settje@ucdmc.ucdavis.edu.

Detailed Application Process is available (after connecting to this link please ignore the message that appears and wait a few moments for the correct link to appear) http://som.ucdavis.edu/ea/records/visstudents/ choose academic programs/choose externships/choose U.S. visiting students/select application packet and then follow all instructions.

The UC Davis Physical Medicine and Rehabilitation Department is pleased to announce two new sub-specialty fellowship programs. The Neuromuscular and Electrodiagnostic Medicine Fellowship has been established under the direction of Dr. Craig McDonald and Dr. Jay Han. The Sports Medicine Fellowship has been established under Dr. Brian Davis and Dr. Brandee Waite. Both fellowships are one-year programs, pending ACGME accreditation. Below are links to further information about the fellowships:

• Neuromuscular and Electrodiagnositic Medicine Fellowship
• Sports Medicine Fellowship

• Therapy
• Postdoctoral

Application procedure 

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