Semiannual Summaries

Hear from our residents as they have completed half of their respective year. Check back around June for further updates!

FIRST HALF OF PGY-4 YEAR

At this point in the year, I'm beginning to feel excitement for the next step in my training mixed with the first twinges of what it will be like to miss everyone here at Michigan. I've definitely met a lot of great people on this leg of my journey and it will be tough to leave these relationships behind in July when I begin fellowship at Ohio State University in Addiction Medicine.

Right now I am trying to make the most of what is left of my senior year. There is still a lot to learn. I'm trying to absorb as much as I can clinically and academically while balancing study time with some really cool extracurricular activities. I just finished another manuscript to submit for publication. I have two additional research projects that are still ongoing but making progress. I hope to finish both prior to graduation. I'm collaborating with my co-resident Steve Pirnie, PGY-II and our faculty mentor Dr. Danko to start the Michigan Medicine PM&R podcast. Finally, I'm working with Harris Imam, PGY-III and our faculty mentors Dr. Chiodo and Dr. Claflin in an effort to update our official unit policy on venous thromboembolism prophylaxis. For me as a senior wrapping up my last year at Michigan it is incredibly meaningful to be a part of these projects that I hope will leave a lasting impact after I am gone.  

Trent Hall, DO

As I sit here putting down my thoughts regarding my fourth and last year of residency, I kind of feel as though this is like putting together a Christmas card, only without the pictures of the kids and dog which inevitably always livens up the card a bit. Oh well, hopefully you can make do with just the typed words.

My fourth year has so far been a wonderful time to grow both as a clinician as well as a leader. I have had the incredible opportunity to serve as a co-chief with my fantastic and much more detail oriented co-resident Elisabeth Acker. Serving as a chief resident has certainly been a busy role which has challenged my leadership skills while offering me insight into the academic administrative structure, both of which will undoubtedly serve me well as I prepare to transition out of residency soon. Elisabeth and I have been able to help create and usher in a new 6 week foundations educational didactics block, helped guide our program’s transition to a new inpatient service line model, and helped shape a new didactics feedback system. This, along with the usual duties (ie. Scheduling, leading the retreat, etc) has provided us with more than enough work to keep us out of trouble. The experience has been a tremendous, and much of that is due to the incredible residency team that we have. Most everyone has been willing to pitch in on different projects while being engaged team members throughout the year. Our PGY-3 class has served as wonderful role models to our incoming twos and our PGY-2 class has absolutely crushed their first year here. That certainly has made for some happy chiefs as their self-sufficiency has eased our load tremendously.

As for me personally, I found out a few months ago that I will be completing a fellowship in Spinal Cord Injury here at the University of Michigan. Fellowship applications went out this summer and I was able to interview with numerous wonderful programs at ASCIP in New Orleans this past September. I truly appreciated the experience of meeting some of the top clinicians in the Spinal Cord Injury field as I was absolutely blown away by their generosity, knowledge base, and sense of comradery. It was a great opportunity to build some professional bridges which I hope to venture across in my near future.

For now, I will look forward to continuing to grown as a clinician over my last six months. I will have the opportunity to help guide the new chiefs (to be elected in the next few months), learn from the great Dr. Brian Kelly (O&P), while sharpening my procedural skills during my two elective months that I still have at my disposal. All of this, while starting to dabble in the job market. The end…or beginning…is drawing near. Exciting times.

Cory Wernimont, MD 

FIRST HALF OF PGY-3 YEAR

Spending the early months of my PGY3 year in EMG completely changed my residency experience.  I enjoyed becoming proficient at doing daily procedures and correlating my physical exam findings with definitive findings on nerve conduction and needle EMG.  I also realized how painful the procedure is!  While it was trying to watch myself inflict pain for the good of the diagnosis, it was rewarding to give patients answers, oftentimes better than we can offer in the clinic. Working with Dr. Richarsdson, Spires, Laidlaw, Chiodo, DiPonio, Hearn, and Schott was such a fun time. I learned so much while laughing and had a great time.

Meanwhile, I’ve been planning to apply for sports medicine fellowships at the end of this year.  I enjoyed EMG so much, that I’m even looking at how much EMG is offered in sports fellowships.  

Kimbie Casten, MD

I really enjoyed the broad depth of experiences that we get here.  We have a great balance of inpatient and outpatient experiences. We have significant autonomy and choosing what clinics we can work in, especially if we take advantage of our research, elective, and jeopardy months. As a whole, faculties in the program are open to feedback and changes continue to be made. We have a graded supervision where we have is much supervision as we needed beginning, with a great balance of autonomy that only continues to grow as time progresses. If she makes the time you have significant opportunity for procedures and learning especially in the areas of electrodiagnostics. we have the opportunity to independently take a history, examination, perform nerve conduction studies, and needle electromyography on patients with a variety of disorders such as carpal tunnel syndrome, ulnar neuropathy, radiculopathy, distal symmetric polyneuropathy of multiple etiologies, and other compression type mono-neuropathies or transections following trauma. while working with a neurologist we also have the opportunity to see many varieties of neuromuscular disorders such as ALS, myasthenia gravis, varying types of myopathies, and hereditary neuropathies.  This gives us a great opportunity to see and understand nearly any type of pathophysiology if we choose to continue to perform such studies independently after graduation. There are adequate didactic sessions specifically focused on electrodiagnostics where we focused on the theory and practice of planning and interpreting an electrodiagnostic examination, even in rare cases. Some of this is at the level of neuromuscular fellows while some his basic enough for someone who has had no experience with EMG. Fellow residents are all down to earth. Fellow residents are also very supportive of all activities such as learning, patient care, and research. Many residents even spend their off time together doing recreational activities such as floating down the river, enjoying new breweries, and trivia.

Josh Startup, MD

FIRST HALF OF PGY-2 YEAR

The first year of PM&R, the second year of residency, is definitely a BIG adjustment, but an awesome one!

Intern year is spent toiling through various specialties, gleaning all the outside information/experience that you can in preparation for your ultimate career (i.e. acute and chronic management of various medical issues [pertinent to life on inpatient rehabilitation], identifying the "sick" vs "not sick" patient [helpful for decisions regarding the medical stability of a patient to participate in rehab], developing some basic procedural skills [sterile technique, ultrasound] and much more). 

PGY-2 year then shifts your clinical lens to that of a rehabilitation physician, an adjacent but vastly different vantage point than any other! As a PM&R resident, your time is spent learning the key components of a comprehensive functional assessment and treatment plan for a variety of patient populations (including those with traumatic brain injury, stroke, cancer, general medical complexity, spinal cord injury, congenital derangements, chronic pain and musculoskeletal ailments). 

It feels incredible to finally immerse yourself in your chosen specialty, albeit at times frustrating as the learning curve can feel a bit steep. Believe me though, we all progress faster and in greater magnitude than we ever expect! 

Your call nights, however sleepless, do in fact build your confidence in medical decision making and provide important experiences you would otherwise miss. Our inpatient service months (during which we take call) are then balanced by a lighter load on outpatient rotations, where you have more time to study but also to enjoy time with your family and co-residents. 

Some of my most favorite memories of this year are those I spent with my new residency family. We had a blast during board game nights after journal club at Dr. Hearn's, our friendsgiving feast at Stephen's, our Christmas cookie decorating day at Snacks' and our restaurant excursions in the foodie city of Ann Arbor. We make a point of getting together regularly, to relax & because we just genuinely like each other.

In PM&R, we are fervently dedicated to improving the quality of life of our patients and advancing our field, but the importance of self-care and life outside of work is not lost on us. You've picked a wonderful specialty filled with inspiring stories and hope; congratulations and welcome aboard!

Laura Bridges, DO