PMR Occup Med Rotation
PM&R Residency Program Manual
PM&R Resident Rotation Descriptions
PM&R Occupational Medicine & Outpatient Musculoskeletal Medicine
– Dr. David S. Rubendall
This rotation offers general musculoskeletal medicine with an emphasis on manual medicine and osteopathic manipulation, Worker’s Compensation, and clinic-based non-spinal procedures to the PM&R resident. Residents will see a wide variety of musculoskeletal patients and develop a broad array of musculoskeletal skills. They will learn how to provide outpatient care for spinal patients, sports-related injuries, and conditions requiring manual medicine. They will also gain an understanding of Worker’s Compensation patients and types of cases.
Residents will have the opportunity to work with UVA-WorkMed, a comprehensive occupational health and wellness program dedicated to improving health, productivity and morale among employees. UVA-WorkMed provides services that benefit both the employee and the employer. They provide an array of Health and Wellness programs such as Personal Wellness, Nutrition Counseling, Cardiovascular Health, and Basic Life Support. They also provide comprehensive management and treatment of work-related injuries, using a proven, outcomes-based model to assist the employee to safely return to work as soon as possible. UVA-WorkMed provides comprehensive occupational health services, such as blood and body fluid exposure treatment, infectious disease exposure evaluations, immunizations, flu shots, and more. They also offer an array of employment services including BAT screenings, MRO services, and employee physical exams.
Goals and Objectives: The Resident has the opportunity to learn about and gain experience with:
- Pre-employment physicals and pre-employment job screening.
- Drug screening.
- Worker’s Comp injury management and case management.
- Annual health surveillance and physicals.
- Fitness for duty exams, light or restricted work duty evaluations and permanent impairment.
- Independent Medical Exams, Impairment Ratings, and Functional Capacity Exams
- Work hardening programs.
- The use of standardized measures to direct workers toward new jobs compatible with their abilities.
- NIOSH Guidelines and requirements for the work environment, individual jobs, and material handling.
- OSHA standards and guidelines enforcement.
- Treatment of the injured worker: initial treatment, follow-up treatments, chronic treatment and case closure, maximal medical improvement.
- Low back pain and the disabled worker: heavy lifting/maximal safe lift-weight/maximal permissible lift-weight, lifting technique, strength, vibration.
- Cumulative trauma disorders – CTS, lateral epicondylitis, RTC, wrist and hand tendonitis, neck and shoulder pain.
- Trauma and the injured worker- lacerations, contusions, sprains/strains, crush injuries, falls.
- History and physical for the injured worker including length of time on job; history of injury; have other workers been injured in the same job?; pre-morbid level of conditioning; previous history of injury and recovery times; nature of job, repetitive stresses, sustained loads, breaks, job satisfaction, relationships with supervisor and co-workers.
- Facilitators that hasten return to work, and causes of recidivism among injured workers.
- Case management and the best ways to control costs.