Intern Year (PGY-1)
PGY-1 is fully incorporated into Albany Medical College’s Internal Medicine Residency Program. Residents attend all Internal Medicine educational experiences, including morning report, didactics, team-based learning exercises, and Grand Rounds. The schedule is at the discretion of the Internal Medicine program, but in the past has included:
- 12-14 weeks of elective rotations. This may include Rheumatology, Neurology, Sports Medicine, Radiology, or another specialty; a maximum of four weeks can be done in inpatient or outpatient PM&R.
- 23-27 weeks of Medicine floors, divided between Albany Medical Center and the Albany Stratton VA Hospital.
- 6-7 weeks of night float, divided between Albany Medical Center and the Albany Stratton VA Hospital.
- 3-4 weeks of dream team, the Albany Medical Center admitting service, from 6 p.m. to midnight.
- 4 weeks of vacation.
PGY-2
Residents spend 10 months of their PGY-2 at Sunnyview Rehabilitation Hospital where they learn to care for hospital patients with functional impairments stemming from a wide variety of conditions, including orthopedic fractures, multiple trauma, general deconditioning after prolonged hospitalization, post-organ transplants, and spinal disorders. There are dedicated inpatient rotations for spinal cord injury (three months), traumatic brain injury (two months), stroke/amputee (four months), and orthopedics (one month). Residents become well-versed and familiar with each member’s role in the rehabilitation team, while developing and utilizing the skills needed to organize and coordinate the team for optimal patient rehabilitation. Residents also learn to manage medical issues and understand how these issues may impact a patient’s rehab potential. They receive broad exposure to diverse therapy modalities, including our EKSO and ReWalk wearable robotic exoskeletons, advanced functional stimulation systems Xcite and RT300, and the InMotion robot. PGY-2 residents also spend two months in an outpatient PM&R clinic.
PGY-3
PGY-3 residents spend one month each focused on outpatient rehab, consults/rehab, musculoskeletal ultrasound, spine, prosthetics/orthotics, specialty rehab, consults/selective, and an elective. Two months each are devoted to electromyography (EMG) and at the Sunnyview Rehabilitation Center (pediatrics/TBI).
PGY-4
PGY-4 residents spend two months each focused on outpatient rehab and consults/selective, and one month each devoted to consults/rehab, musculoskeletal ultrasound, spine, prosthetics/orthotics, EMG, interdisciplinary pediatrics, specialty rehab, and an elective.
Training Highlights
Musculoskeletal Ultrasound
Residents perform diagnostic ultrasound evaluations, with increasing responsibility, to diagnose a variety of musculoskeletal and peripheral nerve conditions. This clinical experience complements the skill set built throughout the year from the didactic ultrasound curriculum, including six joint-specific ultrasound workshops, lecture reviews of anatomy and scanning technique, practice scanning, two cadaver injection labs, and peer teaching opportunities. Residents also participate in ultrasound-guided interventions, including guided peripheral joint, tendon, and nerve injections.
Electromyography (EMG)
During EMG training in PGY-3 and PGY-4, residents work one-to-one with four four or more board-certified electrodiagnosticians. Opportunities for additional studies at the New York State Department of Corrections and elective rotations with PM&R private practice or Neurology are also available. Our goal is for each resident to achieve at least 300 EMGs during residency training. Since 2003, two of our residents have received the top score in the U.S. on the American Board of Electrodiagnostic Medicine exam.
Chemodenervation
Residents typically perform at least 300 chemodenervation procedures during residency, including adult and pediatric injections. Injections in outpatient settings take place at Albany Medical Center clinics and the Center for Disability Services; injections are also given in the operating room setting to patients under anesthesia.
Patient Safety and Clinical Competency Center (PSCCC) & Cadaver Lab
There are two sessions per academic year in the Patient Safety and Clinical Competency Center, with a clinical case involving standardized patients in the fall, and a mock oral examination in the spring. Residents learn musculoskeletal anatomy in the cadaver lab in partnership with Orthopedics. Practical sessions with “lightly” (methanol) embalmed cadavers include upper extremity and lower extremity sessions to practice ultrasound-guided peripheral joint injections, and multiple sessions to practice fluoroscopy-guided epidural injections, sacroiliac (SI) joint injections, and facet injections.
Didactic Program Schedule
The didactic program is organized and directed by the chief residents. All residents assigned to Albany Medical Center and the Albany Stratton VA Hospital meet every Wednesday from 1 – 4 p.m. It is mandatory that all residents attend; it is protected time. The didactic program is organized as follows:
Core Curriculum
Lectures are correlated with a chapter from the textbook Physical Medicine and Rehabilitation by Randall Braddom. Residents are assigned a chapter to read each week, then the chapter is presented in an attending-led discussion that focuses on the key points and clinical pearls. Residents are expected to be prepared to discuss the chapter information with the attendings. Each chapter and topic is covered at least twice during a resident’s three years.
Anatomy
The formal anatomy course takes place in July, August, and September. For the third hour of didactics each week, the residents and attendings meet in the Albany Medical College anatomy lab to discuss previously dissected anatomy, including muscles and their origins, actions, insertions, and innovations as well as pertinent clinical correlations.
Journal Club
Once a month, a resident presents two or three articles on a topic of their choice for discussion and critique.
Ultrasound
Six three-hour, joint-specific ultrasound modules are covered each year. Two residents learn the material during the two weeks prior to the session so they can teach the other residents and medical students during the session. There are various opportunities for the residents to practice ultrasound-guided injections, including two sessions yearly in the minimally embalmed cadaver lab.
Assessment
Residents take the PM&R self-assessment exam and electrodiagnostic self-assessment exam each year. We also host a Mock Oral Board Exam in our Patient Safety and Clinical Competency Center (PSCCC) yearly to help residents and recent graduates prepare for the Oral Board Exam. We also participate in yearly standardized patient cases in the PSCCC. Preparation for the Oral Board Exam also occurs one to two times per year, utilizing the Albany Medical College standardized patients and PSCCC.
Grand Rounds
Held several times a year, these are presented by both attendings and residents.
Miscellaneous
Guest speakers give hands-on lectures on topics such as orthotics/prosthetics and wheelchairs, and guest attendings speak about EMG topics. The attending physicians meet regularly with the residents to discuss patients and pertinent clinical topics. All clinical activities of the residents are supervised by the faculty. Daily rounds are expected to be interactive and instructive.
Research Initiatives
Current research projects include:
- Impact of adaptive gaming on quality of life and social interaction
- Assessment of resident understanding of the role of skilled rehabilitation services and patient mobility in the acute care setting
- Implementing a high intensity gait training program for stroke patients in the inpatient rehabilitation unit (Sunnyview)
- Impact of adding physiatry residents to care team on patient and staff satisfaction scores on an inpatient rehabilitation unit (Sunnyview)
Past projects include:
- Impact of regional PM&R symposium on medical students’ interest in PM&R and improving medical school support for career in PM&R
- Evaluation of the role of H wave modulation on spasticity management (in partnership with Wadsworth Center for Neuroadaptive Technologies)
- Use of Cialis to promote chronic wound healing
- Measuring fatigue in paraspinal muscles of a nubian goat (grant-funded, collaborative project with the Department of Biomechanics of Rensselaer Polytechnic Institute)