PHYSICAL MED & REHABILITATION PROFILE

Transcription

1 PHYSICAL MED & REHABILITATION PROFILE Physical medicine & rehabilitation (also known as physiatry) is concerned with the comprehensive diagnosis, medical management and rehabilitation of people of all ages with neuromusculoskeletal disorders and associated disabilities. Physical medicine & rehabilitation (PM & R) requires expertise in many areas and offers good research opportunities. It is a broad, team oriented field with a variety of practices to choose from including pediatric rehabilitation, orthopedic rehabilitation, electrodiagnosis and sports medicine. These physicians treat the whole person by considering the physical and psychosocial aspects of a patient s diagnosis, basing evaluations on both neurological and musculoskeletal factors. A high degree of patient contact and long term care are common. To be a competent specialist in PM & R, a physician must be capable of assuming a consultant s role in the specialty. The physician must acquire a working knowledge of the specialty, including its foundations in the basic medical sciences and research.

2 Upon completing medical school, in order to become certified in PM & R requires a further 5 years of Royal College approved residency training. This period must include: 1 year of basic clinical training to be completed within the first 18 months of residency consisting of: 6 months in internal medicine, which must include at least 3 months of general internal medicine (clinical teaching unit (CTU) or its equivalent); 2 months in surgery consisting of 1 month in two of the following: general surgery, neurosurgery, orthopedic surgery, plastic surgery, urology or vascular surgery; 4 months training consisting of 1 month in four of the following: anesthesiology, critical care medicine, diagnostic radiology, elective, emergency medicine, family medicine, geriatrics, palliative care, pediatrics, and psychiatry; 9 months residency training to include 3 months each of rheumatology, neurology and orthopedic surgery; 36 months residency training in core physical medicine & rehabilitation including time in cardiac and/or respiratory rehabilitation and residency training in each of the rehabilitation of persons with amputation (including prosthetics and orthotics), cerebrovascular disease, spinal cord disorders and acquired brain disorders. For further training requirements go to: Canadian Association of Physical Medicine & Rehabilitation

3 Number of physicians and physicians/100,000 population for Physical Med & Rehabilitation in Canada, 2013 Province/Territory Physicians Phys/100K pop n Newfoundland/Labrador Prince Edward Island Nova Scotia New Brunswick Quebec Ontario Manitoba Saskatchewan Alberta British Columbia Territories CANADA Source: 2013 CMA Masterfile

4 1.3 Physicians/100,000 population for Physical Med & Rehabilitation Canada, 1995 to Phys/100,000 pop n Source: CMA Masterfile

5 Physical Med & Rehabilitation by gender and year, Canada, 1995 to Total Males Females Source: CMA Masterfile

6 Physical Med & Rehabilitation by age and gender Canada 2013 Gender Age group Males Females < to to to Unknown Source: 2013 CMA Masterfile

7 Physical Med & Rehabilitation by age and gender Canada 2013 < to to to Unknown age Male Female Source: 2013 CMA Masterfile

8 Main Work Setting of Physical Med & Rehabilitation Canada, 2013 Private office/clinic 43% Acad H Sc Centre 20% Other 13% Non AHSC teach hosp 6% Admin office Community Clinic 2% 1% Other 13% 0% 10% 20% 30% 40% 50% Source: 2013 National Physician Survey. CFPC, CMA, Royal College

9 Practice Organization of Physical Med & Rehabilitation Canada, 2013 Solo Group Interprofessional Source: 2013 National Physician Survey. CFPC, CMA, Royal College

10 Hours worked per week (excluding on call) by Physical Med & Rehabilitation Canada, 2013 Activity Hours worked per week Direct patient care without teaching component 25.0 Direct patient care with teaching component 7.0 Teaching without patient care 1.5 Indirect patient care 7.0 Health facility committees 1.1 Administration 3.9 Research 2.3 Managing practice 2.8 Continued professional development 3.7 Other 2.6 TOTAL HOURS PER WEEK 56.7 Source: 2013 National Physician Survey. CFPC, CMA, Royal College

11 Remuneration for Physical Med & Rehabilitation Canada, 2013 Primary payment method 1 Average gross clinical earnings for Int Med & subspecialties in 2010/11 (those earning at least $60,000) = $261, % + fee for service 90%+ salary 90%+ other* Blended NR Average percent overhead reported by all medical specialists in 2010 = 20% 3 * Other includes capitation, sessional, contract and other methods 1 National Physician Survey, 2013, CFPC, CMA, Royal College 2 National Physician Database, 2010/11, CIHI 3 National Physician Survey, 2010, CFPC, CMA, Royal College

12 Satisfaction in Physical Med & Rehabilitation Canada, 2013 Balance of personal & professional commitments 2% 19% 25% 37% 18% Current professional life 2% 5% 11% 54% 29% 0% 20% 40% 60% 80% 100% NR Very dissatisfied Dissatisfied Neutral Satisfied Very satisfied Source: 2013 National Physician Survey. CFPC, CMA, Royal College

13 Total and Ministry funded postgraduate MD trainees in 2012/13 Physical Med & Rehabilitation Faculty of Medicine Ministry funded Total Faculty of Medicine Ministry funded Total MUN McMaster U Dalhousie U 5 5 UWO 6 7 U Laval NOSM U Sherbrooke U Manitoba 5 8 U Montréal U Sask 9 9 McGill U U Alberta U Ottawa U Calgary Queens U 2 2 UBC U Toronto Canada Source: 2012/13 Annual Census of Post MD Trainees, CAPER

14 First year and exiting postgraduate MD trainees in 2012/13 Physical Medicine & Rehabilitation Female Male IMG GCMS 0 First year Exits from postgrad 0 First year Postgrad exits Source: 2012/13 Annual Census of Post MD Trainees, CAPER

15 Postgraduate MD trainees in 2012/13 Physical Medicine & Rehabilitation Total of 24 first year Physical Medicine & Rehabilitation trainees representing 22% of all Physical Medicine & Rehabilitation trainees. Total of 128 Physical Medicine & Rehabilitation trainees representing 1% of all Ministry funded trainees. Total of 5 visa trainees in Physical Medicine & Rehabilitation. Total of 24 Physical Medicine & Rehabilitation trainees completed postgraduate training in Source: 2012/13 Annual Census of Post MD Trainees, CAPER

16 Location of 2011 Postgraduate MD exits in 2013 Physical Medicine & Rehabilitation Of the 20 exits in 2011, all were known to be practising in Canada Source: 2012/13 Annual Census of Post MD Trainees, CAPER

17 Stress associated with finding employment at end of residency FM resident 7% 43% 42% 8% Other spec res 6% 20% 50% 25% 0% 20% 40% 60% 80% 100% NR/NA Not stressful Somewhat stressful Very stressful Source: 2012 National Physician Survey of residents. CFPC, CMA, Royal College

18 Number of Physical Med & Rehabilitation who retired during THREE year period of 2010 to < to to to Males Females Total Source: CMA Masterfile year over year comparisons Note: Retired is based on giving up licence and is therefore excludes those who have retired from clinical practice but are still licensed; it includes physicians who have temporarily given up their licence but may return to practice at a later date.

19 Percentage of Physical Med & Rehabilitation who are Royal College, CFPC or CMQ certified in Canada, % 90% 80% 70% 60% 50% 40% 30% 20% 10% 0% 91% 16% 12% 7% Royal College CFPC CMQ Outside Canada Note: Subset of those who reported a certification. Physicians could indicate more than one certification body. Source: 2013 National Physician Survey. CFPC, CMA, Royal College

20 Links to the organizations supplying information for this document National Physician Survey Canadian Medical Association Association of Faculties of Medicine of Canada Royal College of Physicians and Surgeons of Canada College of Family Physicians of Canada Canadian Institute for Health Information