Rehabilitation medicine provides an opportunity to work in a
multidisciplinary environment and is not only concerned with
physical impairments and disabilities but also with psychological
and social factors. The specialty emerged in response to the needs of those injured in
wartime (particularly following the Second World War) and is now one
of the fastest growing medical specialties in Europe, North America
and Australia.
Rehabilitation specialists collaborate with rehabilitation nurses,
allied health therapists and
other specialists, so you need to work well as part of a team.
Excellent interpersonal and communication skills are required. You
need scientific, evidence-based knowledge as well as the ability to
think creatively and laterally to overcome the challenges associated
with disability and handicap.
A typical day might include conducting ward rounds and outpatient
clinics; reviewing and assessing new referrals; planning and evaluating
rehabilitation programmes for new admissions; holding discussions
with therapists; attending multidisciplinary and family meetings;
preparing reports; liaising with other specialists and
rehabilitation providers and with referrers such as ACC; and
attending to administrative and managerial responsibilities.
New Zealand still lacks a solid rehabilitation medicine
infrastructure. Ideally there should be three or four comprehensive
rehabilitation services within the Auckland region that are headed
by rehabilitation specialists and subscribe to the Australasian Faculty
of Rehabilitation Medicine standards. Given the shortage of
specialists and the heavy workloads of those who are active in the
discipline, it will be a challenge to ensure that all people who
would benefit from rehabilitation services are able to access them.
The volume of patients is ever increasing and many patients are
being transferred from acute settings to rehabilitation units at an
early stage with an emphasis on re-integration back in the
community, vocational activities and return to
work.
You should give serious consideration to pursuing the specialty if
you enjoy clinical medicine and desire to work in a
multidisciplinary environment with long-term follow-up of patients.
It is very rewarding to work with and assist people with
disabilities. There are also excellent employment opportunities and
the job does not entail the stresses associated with more acute
medical subspecialties. Private work opportunities ( mostly ACC
clients and work at private rehab providers) are also available.
There are currently seven rehabilitation centres in New Zealand with
AFRM-approved registrar training programmes. Nationwide there is a
need for more consultants in this discipline so job prospects should
continue. There is also enormous potential to focus
on a particular area such as spinal rehabilitation, amputee and
prosthetic management or pain management.
One contributor commented that it would probably be preferable to
complete vocational training before taking time out, though there is
a part time training option. On call commitment is much less
demanding and could be easily covered from home on the phone.
Rehabilitation medicine is not an acute specialty so the work in
this field is not too stressful. During training a significant
amount of time needs to be devoted to study: the training programme
is demanding and requires support and understanding from families.
Administrative and managerial skills are usually required (and can
take a significant proportion of your working time), although it
will help that training in this area is now included as part of the
AFRM registrar training programme.
The training programme is fairly structured. Each trainee is
closely supervised and progress is monitored by the AFRM Board of
Censors. Weekly tutorials, rotating between RehabPlus and
the Spinal Injury Unit, take place throughout the year. Three
national two day training seminars take place every year at various
rehab centres in New Zealand. These are exam oriented and registrars
find them quite useful.
