Physical Medicine and Rehabilitation

Physical medicine and rehabilitation, also referred to as rehabilitation medicine or physiatry, is the primary medical specialty concerned with evaluating, diagnosing, and treating patients with disabling conditions that involve the musculoskeletal, neurological, cardiovascular, or other body systems. There are physicians in the fields orthopedic surgery and neurology who have received rehabilitation training. The primary focus of rehabilitation medicine is on maximal restoration of physical, psychological, social, and vocational function and on evaluation of pain. For diagnosis and evaluation, a physician may include the techniques of electromyography and electrodiagnosis as supplements to the standard history and physical, X-ray, and laboratory examinations. In addition to traditional treatment modes, specialists in rehabilitation medicine may use therapeutic exercise, prosthetics, orthotics, and mechanical and electrical devices. Physiatrists are certified by the American Board of Physical Medicine and Rehabilitation through the administration of written and oral examinations that assess candidate performance in basic sciences and clinical aspects of rehabilitation practice. Upon approval of the application and the candidate's successful completion of the examinations, the board grants a certificate to the candidate. The recipient of the certificate is known as a certificant or a diplomate of the American Board of Physical Medicine and Rehabilitation. In addition, an application and examination process are being developed for certification of special qualifications in spinal cord injury medicine.

The specialty of physical medicine and rehabilitation has 79 accredited residency programs. In 1994-1995 the training programs offered 1,313 residency positions, and 1,277 (97 percent) of these were filled. The board has given written and oral examinations annually since 1947 and has certified 4,940 physicians as diplomates; 2,562 of these have been certified in the past 10 years, with 298 certified in 1995.

Rehabilitation Engineering

Although the baccalaureate degree is most common in engineering practice, many engineers obtain master's degrees after they go into practice in order to specialize or to change career directions. Practicing biomedical engineers frequently have master's degrees. The doctorate has become more prevalent in engineering since the late 1950s and is still regarded as a research degree although that view has changed somewhat over the last few years as persons with doctoral degrees have become involved at decision-making levels related to development, implementation, or acquisition of new technologies. Engineering schools still empha-



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