Which medical specialties have the best lifestyle

Specialist training in physical and rehabilitative medicine: duration, content, perspectives

Physical and rehabilitation medicine is a particularly versatile area: Here the whole person is the focus, not a single organ or symptom. Further advantages: More time for the patients and a predictable working day.

At a glance: Further training (specialist training) in physical and rehabilitative medicine

  • Definition: Physical and rehabilitative medicine includes secondary prevention, detection, specialist diagnostics, treatment and rehabilitation for diseases, damage and their consequences with the methods of physical therapy, manual therapy, natural healing methods and balneo and climatic therapy as well as the design of the Rehabilitation plan.
  • Duration: The specialist training in physical and rehabilitation medicine lasts 60 months. Of this, 12 months each must be completed in the areas of surgery / neurosurgery and internal medicine / neurology.

  • Number of specialists: There are 2,726 physicians specializing in physical and rehabilitation medicine in Germany. Of these, 1,903 are employed. 782 work as an outpatient, 883 as an inpatient in a clinic, 55 in authorities, corporations and similar institutions.

Specialists in physical and rehabilitative medicine (PRM) help their patients to get back on their feet: sometimes quite literally, sometimes in a figurative sense. Because their job is to support people with acute or chronic pain or functional restrictions in the musculoskeletal system to restore their performance and quality of life as much as possible - for example after an operation or a stroke.

The area of ​​responsibility of the PRM specialists includes, among other things, early rehabilitation (rehabilitative strategy in acute hospitals), post-acute rehabilitation (mainly in rehabilitation clinics) and long-term rehabilitation (mainly outpatient). The rehabilitation of the psyche and advice on a health-conscious lifestyle also play an important role.

PRM specialists are generalists: Young doctors get to know many different diagnostic procedures and therapy methods during their training period. They also have to be familiar with many different specialist areas - from orthopedics to neurology to internal medicine. Because in rehabilitation medicine, patients are diagnosed and treated across disciplines. Differential diagnostics therefore also play a major role here: Often patients with multiple symptoms and complaints with an unclear genesis are discharged from the acute clinic without a clear diagnosis. PRM specialists must therefore recognize the connections and interactions between the various complaints and include them in their therapy concept.

For this reason, this specialist area is particularly interdisciplinary: PRM specialists work closely with general practitioners, other specialists and psychotherapists, but also with physiotherapists, occupational therapists, speech therapists and nursing services. Another plus point: The PRM specialists can take more time for the individual patients, and everyday work in a rehab clinic is much easier to plan than in other medical specialties. This ensures a relatively good work-life balance.

Physical and rehabilitative medicine is an independent medical specialty in all European countries. In Germany there has been a specialist in physiotherapy since 1967 and a specialist in physical and rehabilitative medicine since 1992. According to statistics from the German Medical Association (as of 2019), there are currently 2,695 specialists in physical and rehabilitation medicine across Germany.

Here you will find current vacancies in the field of physical and rehabilitation medicine on aerztestellen.de
 


The advanced training (specialist training) physical and rehabilitative medicine at a glance

The duration of the training

The further training period in physical and rehabilitative medicine is 60 months with a training officer at a training center, of which

  • 12 months must be completed in inpatient acute care in the field of surgery and / or neurosurgery
  • 12 months must be completed in inpatient acute care in the field of internal medicine and / or neurology

Overarching content of the specialist training course in physical and rehabilitative medicine

  • Essential laws, ordinances and guidelines
  • Theory models of functioning, disability and health, e.g. B. International Classification of Functioning, Disability and Health (ICF) and rehabilitation
  • Rehabilitation-specific hygiene measures with special consideration of multi-resistant pathogens
  • Scientifically founded reports (guide number: 10)
  • Participation in multi-professional team meetings (guide number: 50)
  • Rehabilitation-specific aspects of the treatment of patients with cognitive deficits
  • Rehabilitation-specific advice and treatment of addictions

Emergencies

  • Detection and treatment of typical complications in the course of treatment and their prophylaxis

Prevention

  • Prevention of diseases, work-related stress and damage (primary prevention)
  • Prevention of the consequences of illness (secondary prevention)
  • Prevention of restrictions on participation and the need for help or support (tertiary prevention)
  • Preventive medical examinations and advice, including aspects of sports medicine
  • Workplace-oriented advice
  • Advice on help and support needs

Social security systems and supply structures

  • Basic principles of social security, rehabilitation and social medicine
  • Rehabilitation-related control elements in health care and their practical application
  • Basics and methodological principles of rehabilitation and rehabilitation control
  • Medical rehabilitation, in particular types of services, specific rehabilitation offers and procedures and facilities
  • Vocational rehabilitation (benefits for participation in working life) and reintegration
  • School-based educational rehabilitation and services for participation in community life
  • Basics of the transit doctor and types of injuries procedures of the statutory accident insurance
  • Application of models of functioning, disability and health
  • Indication and allocation to the various forms of rehabilitation care (reference number: 50)
  • Indication and initiation of professional and / or job-oriented rehabilitation services (reference number: 20)
  • Indication and advice on services for participation in community life (reference number: 20)
  • Assessment of performance, incapacity for work and reduced earning capacity as well as the need for care (reference number: 100)

Diagnostic measures

  • Differential diagnosis of structural and functional disorders
  • Manual medical examination of complex and individual findings of the movement system, e.g. B. Movement disorders, regional findings, individual findings on joints, muscles, fascial, visceral and neural structures (reference number: 200)
  • Neurological assessment of disorders of the peripheral and central nervous system
  • Indication, implementation and evaluation of apparatus-based diagnostics
  1. EKG
  2. Exercise ECG
  3. Pulmonary function test
  • Sonography of the locomotor organs (guide number: 200)
  • Indication and interpretation of findings from radiological examinations, also from a functional point of view
  • Participation in radiological case discussions (guide number: 50)
  • Stance and gait analysis
  • Orienting psycho-pathological assessment
  • Indication-related evaluation of assessment instruments for self-assessment and external assessment

Diseases and functional disorders

  • Co-treatment and follow-up treatment and rehabilitation of diseases and functional disorders, in particular
  1. Consequences of complicative disease courses
  2. functional, degenerative, inflammatory and metabolic diseases of the musculoskeletal system
  3. Consequences of injuries including multiple trauma, head trauma, cross-sectional lesions
  4. cerebral circulation disorders including stroke
  5. neurodegenerative diseases and peripheral nerve lesions
  6. Diseases of the cardiopulmonary system
  7. Diseases of the vascular system, including the lymphatic system
  8. congenital ailments and consequences of early childhood brain damage
  9. mental and psychosocial illnesses and problem areas

Interventions

  • Method and therapeutic agent, physiological effect and therapeutic effects of physical therapies, e.g. B. Physiotherapy, manual therapy, occupational therapy, sports therapy, massage therapy, electrical and ultrasound therapy, hydrotherapy, thermotherapy, balneotherapy and inhalation therapy
  • Rehabilitation measures such as rehabilitation care, speech therapy, neuropsychology, rehabilitative social work, patient training and information, art and music therapy, accompanying psychotherapeutic procedures, nutritional therapy
  • Indication, initiation and assessment of the course of physical and rehabilitative interventions with curative and rehabilitative objectives (reference number: 100)
  • Interventional methods
  • Diagnostic and therapeutic punctures and injections
  • Manual medical treatment techniques, also in combination with examination techniques
  • Differential indicative provision of aids with orthoses and prostheses, insoles and shoe supplies, rehabilitation technology and compression stockings, mobility aids (guide number: 50)

Early rehabilitation

  • Basics of combined acute and rehabilitation medical treatment
  • Transfer and mobilization concepts
  • Basics of ventilation and ventilation weaning, tracheostoma and secretion management
  • Planning and implementation of early rehabilitation including early rehabilitation complex treatment in a multi-professional team (reference number: 50)
  • Structured monitoring of the early rehabilitation process and transition management
  • Further and follow-up treatment of the illness or injury leading to early rehabilitation, the accompanying illnesses and complications
  • Early rehabilitation assessments (guide number: 50)
  • Dysphagia management
  • Nutritional management
  • Tracheostomy tube supply

Post-acute and follow-up rehabilitation as well as intermittent treatment

  • Rehabilitation diagnostics and assignment
  • Rehabilitation planning and rehabilitative interventions
  • Therapy evaluation and modification
  • Transfer management and socio-medical assessment
  • Planning, coordination and assessment of post-acute rehabilitation and intermittent healing procedures (reference number: 50)

Long-term rehabilitation care and outpatient rehabilitative treatment

  • Long-term rehabilitation and aftercare
  • Selection and initiation of services for participation in the long-term care of people with chronic diseases or disabilities (reference number: 10)
  • Initiation of functional training or rehabilitation sport (reference number: 20)

Conservative and surgical acute care

  • Assistance during operations (guide number: 50)
  • Wound and infection management as well as dressing theory
  • Coagulation management as well as prophylaxis, diagnosis and therapy of thromboses
  • Indication and interpretation of findings from abdominal sonographies, Doppler sonographies of the vessels, echocardiographies, endoscopic procedures
  • Indication and interpretation of findings from electroencephalographs, electromyographies, nerve conduction velocities, evoked potentials
  • Basics of botulinum toxin therapy

Sources: Model further training regulations of the German Medical Association 2018, medical statistics of the German Medical Association 2020, German Society for Physical and Rehabilitative Medicine (www.dgprm.de)
 


Current vacancies in this field:

Resident physician positions in physical and rehabilitative medicine
Specialist positions in physical and rehabilitation medicine