FCPS Training in Physical Medicine and Rehabilitation
The pioneers of Rehabilitation Medicine joined hands to establish a residency programme in Physical Medicine and Rehabilitation (PMR) in the late 1990s. The Departments of PMR at Mayo Hospital Lahore, Jinnah Postgraduate Medical Center (JPMC) Karachi and Armed Forces Institute of Rehabilitation Medicine (AFIRM) Rawalpindi were the first to be recognised for training by the College of Physicians and Surgeon of Pakistan (CPSP) and the first batch of trainees graduated in 2001 to acquire the Fellowship (FCPS) status in PMR. Later, institutes in other provinces were also accredited with the CPSP for PMR residency training. Institute of Physical Medicine and Rehabilitation (IPMR) at Dow University of Health Sciences Karachi is a state of the art rehabilitation center in civil sector which offers various graduate and post graduate training programs. A collaborative training programme between the CPSP and King Fahad Medical City (KFMC) Riyadh, Saudi Arabia, was launched in 2009 and enrolled six trainees in PMR from Pakistan uptil 2016. The programme follows the same curriculum that is implemented in Pakistan as outlined by the CPSP. Children Hospital and Institute of Child Health trained most of the founding civilian fellows in PMR. So far candidates can enroll in PMR training at five different institutions in Pakistan and one institution abroad.
Since PMR is a medical and surgical allied specialty, medical graduates can apply for PMR residency training after passing FCPS I in "Medicine and Allied" or "Surgery and Allied". The curriculum includes one year of training in medical and surgical allied specialties, and three years of extensive inpatient and outpatient rotations in various rehabilitation settings. Training also involves rotations in other accredited rehabilitation facilities to ensure uniformity in training and exposure to practices in both civilian and military sectors. After completion of four years of training and passing the exit exam, physicians are awarded FCPS diploma in PMR. Click here to review the current FCPS curriculum and details about the program.
The academics in PMR have grown much stronger over the last few years especially due to modifications in the CPSP training and examination standards. A unique aspect of PMR training in Pakistan is that despite the fact that PMR community is relatively small, the contribution by physiatrists in research is proportionally comparable with any other medical specialty in Pakistan. This is reflected in the extensive involvement in research by physiatrists who undertake research initiatives during their training. These publications are in addition to the dissertation requirement of FCPS training.
The contributions of AFIRM in academic development of PMR in Pakistan have been remarkable. AFIRM is considered to be one the largest rehabilitation facilities in South Asia and is the best equipped training institute for PMR in the country. A few civilian applicants were also able to complete their FCPS training at AFIRM in recent years. Securing residency position at AIFRM is becoming more competitive. The PMR Department at Mayo Hospital Lahore is the pioneer training programme in the civilian sector. Two physicians who began their residency in PMR at the Mayo Hospital Lahore were selected to continue their FCPS training at King Fahad Medical City (KFMC) Saudi Arabia, out of whom one trainee was able to secure fellowship in the United States based upon his FCPS training. Similarly, three physiatrists who were trained at the Children Hospital Lahore and rotated at Mayo Hospital Lahore served as Consultants in Saudi Arabia. Four FCPS trained physiatrists from the military sector also gained experience in Saudi Arabia and one held supervisor position at KFMC. The Institute of Physical Medicine and Rehabilitation at Dow Universtiy Karachi offers a multidisciplinary model of rehabilitation care and is a the leading academic institute in the region.
Over the years, many physiatrists from AFIRM have undergone advance training at various well-recognised institutions of the world including U.K, U.S, Australia, Italy, Switzerland and Turkey. In 2014, the first international and third national conference of PMR was held under the auspices of Pakistan Society of Physical Medicine and Rehabilitation (PSPMR) at AFIRM, which has opened new horizons for PMR in Pakistan. It was attended by the President of Pakistan and the Chief of Army staff who reinforced the need of development of rehabilitation in both military and civilian populations.
Considering the growing needs of disability care, PMR is the specialty of the future in Pakistan. The unique aspect is that one can choose to practice a wide spectrum of expertise in the specialty which include outpatient practice ranging from musculoskeletal medicine to pain interventions, NCS/EMG to urodynamics, spasticity related procedures to amputee care and so on. There remains a huge need of inpatient physiatrists for spinal cord injuries, brain injuries, stroke rehabilitation, geriatric care, cardiopulmonary and oncological rehab. In Pakistan, where provision of basic healthcare is a challenge, disability care remains underemphasised entity in health sector. The number of qualified Physiatrists in Pakistan are growing gradually. The burden of disability care clearly exceeds the manpower available to manage disability care in Pakistan. FCPS training at various CPSP recognised institutions offer promising training in PMR. The pioneers in this field have been successful in establishing a strong and sustainable framework of PMR in Pakistan. Its integration into undergraduate medical training and the development of PMR departments at major teaching hospitals are the next steps in the growth of this specialty. Currently teaching slots are vacant or are not fully operational due to the lack of available expertise. It is a well-known fact that the specialties of cardiology, paediatrics and oncology gained vast recognition after development of large specialised hospitals such as the Punjab Institute of Cardiology, the Children Hospital Lahore and Shaukat Khanam Memorial Cancer Hospital. Efforts are being made to establish a state-of-the-art rehabilitation institute staffed by locally-trained physiatrists to address the growing need of disability care in Pakistan. It will also help to identify PMR as a distinct specialty in the medical community.For a detailed article published in Journal of Pakistan Medical Association click here
- Residency Currculum
- Recognized Training
- CPSP Academic Council
- Current Residents
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