Rehabilitation Medicine

What is the primary purpose of the specialty?

Rehabilitation medicine is the specialty that is concerned with the prevention, diagnosis, treatment and rehabilitation management of people with disabling medical conditions.  It was developed primarily to meet the needs of young adults and those of working age, but aspects of the specialty, particularly relating to technical aids, provision of wheelchairs, orthotics or prosthetics, are relevant to people of all ages.  The principal aims are to identify the impairments that limit activity and daily tasks; optimise physical and cognitive functioning; and modify personal and environmental factors to enable greater participation and quality of life. Rehabilitation medicine covers a large number of disabling conditions. The majority are acquired, such as traumatic brain injury, stroke, spinal cord injury, multiple sclerosis and limb loss. Congenital conditions or those arising in childhood, such as cerebral palsy, muscular dystrophies and limb deficiency, will continue into adulthood and require ongoing support, advice and assistance. The specialist services that deal with these are neurological and spinal cord injury rehabilitation, limb loss or deficiency rehabilitation and prosthetics, and musculoskeletal rehabilitation.  Rehabilitation medicine consultants also have specialist expertise in assistive technology, including environmental control equipment, wheelchairs and orthotics; these are not disease specific and cover a wide range of complex disabilities.

What are the core skills/competencies in Rehabilitation Medicine?

Rehabilitation medicine physicians are part of the multidisciplinary team and have responsibility for the medical aspects of rehabilitation. This includes establishing a diagnosis and prognosis, appropriate medical management of disease, health promotion and prevention of secondary damage and complications. They use specific diagnostic assessment tools and carry out treatments including pharmacological, physical, technical, educational and vocational interventions. Because of their comprehensive training, they are best placed to be responsible for the activities of the multidisciplinary team in order to achieve optimal outcomes in the treatment of the whole patient.

Is it affiliated with other specialties?

Rehabilitation Medicine Physicians work closely with a range of doctors from other specialties including healthcare for the elderly, stroke physicians, neurologists and neurosurgeons, spinal surgeons and paediatricians.

Where are Rehabilitation Medicine Physicians based?

Rehabilitation medicine consultants work in various facilities from acute care units to community settings.

Why would Rehabilitation Medicine be an attractive option for trainees?

Rehabilitation medicine will be attractive to those doctors who enjoy working in a multidisciplinary setting to ameliorate the impact of disability on people's everyday lives. Rehabilitation medicine physicians will support patients and their families through periods of change and need to be skilled in managing the physical, emotional and behavioural aspects of disabling illness. Many of the patients have recently had significant trauma, stroke, or neurosurgery and confidence in dealing with a wide range of diagnoses and ill patients is essential.  Rehabilitation is an attractive career option for those who wish to enjoy flexibility in their training or ultimate career post in terms of hours and work commitment.  The absence of acute medical and on-call commitments allows time to pursue research, non-clinical and managerial roles. Many consultants develop an interest in medico-legal work.

How big the specialty is anticipated to be in the future

There are currently 173 consultants in rehabilitation, with 36 trainees.  There is a commitment from the BSRM to work to increase these numbers, and initiatives like the NSF for long-term neurological conditions recognize the need for expertise in rehabilitation.

How the training fits in with MMC

Speciality training in rehabilitation medicine starts at ST3.  The curriculum follows completion of core training (core medical training – CMT; basic neuroscience training – BNT; acute care common stem - ACCS), although if vacancies arise trainees from surgical, and other backgrounds are welcome to apply.

Updated Feb 07

Due to regular revisions, arising from changes in the training environment and the requirements of the PMETB, the JRCPTB are currently running various curricula for trainees in each specialty.  All relevant curricula are listed at the bottom of this page under Documents.  Use the filter option on the right-hand side, together with the guidance notes below,  to help you select the correct document.  In summary:

• If you are a run-through (Specialty Registrar [StR]) trainee, you will follow the curricula tagged as ST3+

• If you are an ‘old style’ SpR, you are following the curricula tagged as SpR

• If you enrolled prior to 01/01/03, you will be following the original curricula which are no longer available for download, see note below

 
Competence Based Curricula – StRs

PMETB has received the assessment system (blueprint and RITA/ARCP grid) for Rehabiliation Medicine and this has been approved. 

The assessment blueprints show the possible methods that can be used to assess each of the competences in the curriculum. Trainees and trainers should refer to the blueprints for guidance on the appropriate assessment methods for each aspect of the curriculum, and so plan the training programme according to the criteria set by the RITA Decision Aid. It is not expected that all competences will be assessed by all methods, rather that there will be a sampling of competences within a variety of settings, both within formal and workplace-based assessment, from which overall competence acquisition has to be determined.

 Acute care common stem (Medicine) trainees will also follow the ACCS training manual.

Competence based curricula – SpR (for trainees enrolling after 1 Jan 2003)

The JCHMT introduced revised curricula for all the medical specialties together with a generic curriculum that applied to all trainees back in 2003. These are competence-based and set out the knowledge, skills and attitudes to be acquired by trainees before they may be awarded a CCT. 

Curricula (for trainees enrolling before 1 Jan 2003)