Rehabilitation medicine

Rehabilitation medicine focuses on reducing disability and enabling people with disabilities to fulfil their potential, as well as managing their medical conditions. Rehabilitation medicine doctors deal with patients who have limb loss, musculoskeletal and neurological conditions. Rehabilitation is not necessarily about making people better but helping them to live with their condition and to become as independent as their condition allows. Even simple changes can make a difference to the lives of patients. Doctors in this specialty look after patients in rehabilitation or spinal injuries units, run outpatient clinics and see people in the community. Inpatients include those who have had strokes or sustained head injuries, and patients with multiple sclerosis and other progressive diseases. Outpatient clinics serve patients with a variety of conditions. For example, doctors may administer botulinum toxin injections to patients with spasticity, run a clinic for young people with physical disabilities or see people who have limb loss.

The realities of rehabilitation medicine

Some people think that doctors in rehabilitation medicine only deal with older people but patients can be of any age. It is not yet recognised as a paediatric specialty but you could be dealing with patients as young as 16. The best bits about working in rehabilitation medicine are seeing a patient do something they couldn’t do before or helping a patient to come to terms with their condition so they can get on with their life. Working with upset and angry relatives can be difficult as they often don’t understand that the rehabilitation process can take time and are having to come to terms with a life-changing condition in their relative.

Getting into rehabilitation medicine

To work in rehabilitation medicine you need a good grounding in general medicine as you see a diverse range of patients. Other useful areas to provide experience include neurology, rheumatology, neurosurgery, psychiatry, general practice and care of the elderly. If you want to find out more about the specialty, talk to someone practising rehabilitation medicine. Spend some time on a good specialist rehabilitation unit. Speak to some patients with a long-term neurological condition such as multiple sclerosis or a stroke, to see if you feel that your particular personal and medical strengths would be suited to helping such patients gain more independence and autonomy. If you’re the sort of person who needs instant gratification then it’s not the specialty for you. Similarly if you think that patients can only be helped with medication and operations it probably isn’t the right specialty for you – rehabilitation medicine is more for people who see medicine as an art as well as a science.

Dr Margaret Phillips (MD MRCP) is an honorary consultant and associate professor in rehabilitation medicine at Derby Hospitals’ Foundation Trust and the University of Nottingham.