The Physiatrists’ Crucial Role in the Development and Implementation of a Longitudinal Musculoskeletal Physical Examination Curriculum in a Medical School

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Abstract

The musculoskeletal physical examination (MSK PE) is a critical clinical skill that should be mastered by all medical students. The authors believe that physiatrists should have a crucial role in undergraduate musculoskeletal education. This article outlines the successful integration of an MSK PE curriculum taught by physiatrists into the first 2 yrs of medical school. During year 1, a basic MSK PE is taught concomitantly with the human anatomy course and focuses on anatomical correlation with physical examination maneuvers. In year 2, the MSK PE is taught concomitantly with the musculoskeletal didactic block. Special musculoskeletal tests, basic neurologic evaluation, and case correlation are also added to expand on the examination skills learned in the first year. At the end of the second year and before beginning third-year clinical rotations, students take a practical test to demonstrate their competency in the MSK PE. The authors believe that an important component of their MSK PE educational sessions is a low student-to-instructor ratio (4:1), with ample hands-on supervision of physical examination skills practice. Residents in the Department of Physical Medicine and Rehabilitation assist with the teaching. With their intensive training and clinical experience in musculoskeletal medicine, physiatric staff and residents are ideal faculty for teaching the MSK PE. The authors are hopeful that this article encourages other physiatrists to construct similar programs aimed to develop MSK PE skills in medical students.

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