PARTICIPATION IN MEDICAL UNDERGRADUATE TRAINING BY THE DEPARTMENT OF REHABILITA TION MEDICINE WILLIBALD NAGLER, M.D., F.A.C.P.* Why Should Rehabilitation Medicine Be Taught! The student of medicine should acquire knowledge about the incidence and nature of the more common disorders of the locomotor system and should become acquainted with the main physical methods used to ameliorate these disorders. Besides drugs or surgery, patients afflicted with such ailments often require exercise therapy, guidance, and sometimes mechanical devices to lead a life of maximal independence from the physical assistance of another person. These disorders are frequently long lasting, and familiarity with them enables the student to gain insight into the effect of these ailments on the patient's attitude toward the family and the community. The special skills which rehabilitation medicine ought to teach are those of the evaluation of the locomotor system. By the nature of its clinical work, rehabilitation medicine lends itself to introducing the student to the particularities of long-term care. Likewise, it can show the part which physical rehabilitation procedures play in limiting disabilities. The future physician should also be introduced to the various techniques used to forestall pulmonary and musculoskeletal complications after surgery or during acute illness. A student will also encounter patients suffering from neuromuscular disorders. From these disorders the necessity of planning for a patient's optimal way of life can be learned. Attitude of the Medical Student toward Medical Rehabilitation In this aspect, a department of rehabilitation medicine has much to offer. The student will become aware that a realistic approach to * Associate professor of medicine, Cornell University Medical College, and head, Department of Rehabilitation Medicine, New York Hospital-Cornell Medical Center, 525 East 68th Street, New York, New York 10021. Perspectives in Biology and Medicine · Spring 1973 | 457 rehabilitation goals has to be adopted to secure some success. A rehabilitation department abounds with possibilities of demonstrating teamwork with physical and occupational therapists, nurses, social workers, orthotists, and bioengineers. The student will encounter rehabilitation care at home, in the hospital, and in the nursing home. The needs and wants of the individual patient can be contrasted with those of the family and the community at large. Awareness of preventive measures which limit and arrest disability can be taught by patient follow-up. Rehabilitation medicine offers many examples for the teaching and practice of pattern recognition, which, in a way, is a computer habit of thought. In addition, rehabilitation medicine is frequently concerned with patients whose disabilities call for an attitude of problem solving, not only by the process of scientific reasoning but as frequently by the balance of probabilities. When Should Rehabilitation Medicine Be Taught? The point of time at which a medical student should be introduced to the clinical practice of rehabilitation medicine is open to debate. Our past educational experience with summer trainees showed that a good anatomical and physiological knowledge is necessary for the student to function effectively as a member of the rehabilitation team and derive some benefit from his participation. To give the student the opportunity to acquire some skill in the evaluation of locomotor disability, a certain period of supervision has to be provided in his curriculum. Frequently more than one body system is involved in patients who require rehabilitation therapy. This calls for, eventually, interdepartmental teaching efforts. Members of other specialty departments may have to be called upon. Rehabilitation also offers many opportunities to apply well-established neurophysiological principles in daily practice, as, for instance, muscle fiber recruitment. During the third and fourth year of the curriculum some provisions ought to be made for faculty members whose sphere of interest is in rehabilitation to offer their views to the future physician. This could be done along with teaching sessions in the various fields of clinical medicine. Rehabilitation medicine is particularly amenable to investigative activities by medical students. Medical personnel below the M.D. and Ph.D. level, as bioengineers, therapists, and social workers, make substantial contributions to the practice of clinical rehabilitation. 458 I Willibald Nagler · Rehabilitation Medicine in Medical Training How Should Rehabilitation Medicine Be Taught? Rehabilitation medicine should be allowed to contribute to the student's education at various times and...