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.
Competence Based Curricula and Assessment - StRs (for trainees who commenced training from 1 August 2007 to present)
There are two versions of curricula for this training period:
StRs who commenced training between 1st August 2007 and 3rd August 2010 will follow the 2007 version of their specialty curriculum and the 2007 Generic curriculum. Please see the 2007 Curriculum section of this webpage.
StRs who commenced training from 4th August 2010 onwards will use the 2010 version of their specialty curriculum. There is no need to follow the previously known ‘Generic curriculum' as this has now been embedded into the specialty curriculum. Please see the 2010 Curriculum section of this webpage.
2010 Curriculum
The Joint Royal Colleges of Physicians Training Board (JRCPTB) is pleased to announce the
2010 Rehabilitation Medicine curriculum which has been reviewed and rewritten to:
- meet the GMC's 6 new standards as detailed in their Standards for Curricula and Assessment systems
- keep up to date with medical advances and changes in the service and training
- incorporate the framework documents produced by the Academy of Medical Royal Colleges (AoMRC) detailing Common, Medical Leadership and Health Inequality competencies
- include 5 new assessment methods (Case Conference Assessment Tool, Case Based Discussion, Patient Survey, Teaching Observation and Audit Assessment).
This new curriculum has improved content, design and usability compared to its predecessors, and reflects a great deal of hard work and time expended by specialty curriculum groups. This curriculum will become the training manual for all trainees entering ST3 from 4th August 2010.
For further information on the 2010 curriculum it is recommended that you read the Quick Start Curriculum Guide.
If you have any queries or problems regarding the 2010 curriculum please email ptb@jrcptb.org.uk.
Core Training Programmes
Entry into Rehabilitation Medicine training is possible following successful completion of both a foundation programme and a core training programme.
There are 4 core training programmes for Rehabilitation Medicine training:
- Core Medical Training (CMT)
- Core Surgical Training
- Core Psychiatry Training
- GP Training
Assessment
The following methods are used as part of the integrated assessment system:
- Knowledge Based Assessment - The small size of the specialty means that it is not feasible to run a full specialty certificate examination to assess knowledge. The specialty is currently planning to pilot a formative knowledge-based assessment method and, if successful, it is intended that this method will be used in the future - details to follow.
- Workplace-based assessments
The assessment blueprint, which is embedded in the clinical syllabus, shows the possible methods that can be used to assess each of the competencies in the curriculum. Trainees and trainers should refer to the blueprint 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 ARCP Decision Aid. It is not expected that all competencies will be assessed by all methods, rather that there will be a sampling of competencies within a variety of settings, both within formal and workplace-based assessment, from which overall competence acquisition has to be determined.
The diagram below describes the training pathway:
Please view the 2010 curriculum for Rehabilitation Medicine for full details on the training routes and selection criteria.
Entry into Rehabilitation Medicine training is possible following successful completion of both a Foundation Programme and a core training programme.
Please view the 2007 curriculum for Rehabilitation Medicine for full details on the training routes and selection criteria.
Assessment
The assessment blueprints show the possible methods that can be used to assess each of the competencies 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 ARCP/RITA Decision Aid. It is not expected that all competencies will be assessed by all methods, rather that there will be a sampling of competencies within a variety of settings, both within formal and workplace-based assessment, from which overall competence acquisition has to be determined.
Further information on the various methods of assessment can be viewed in the Assessment section of this website.
The diagram below describes the training pathway in general terms.
Competence Based Curricula - SpR (for trainees who commenced training between 1 Jan 2003 and 31 July 2007)
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 - SpR (for trainees who commenced training before 1 Jan 2003)
The curricula for trainees enrolling pre 01/01/03 are no longer available on the website but can be obtained by request to ptb@jrcptb.org.uk.