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Specialty spotlight – rehabilitation medicine

Hear Dr Meena Nayar and Professor Lynne Turner-Stokes discuss what rehabilitation medicine involves, what it takes to be successful in the specialty, and why it is so rewarding. 

Introduction to rehabilitation medicine

Rehabilitation medicine is a young specialty focused on the management of complex disability. It offers an opportunity of working with patients who have complex difficulties and, with other professionals, seeing them through to a good outcome for both themselves and their families.

Rehabilitation medicine offers continuity, teamwork and the opportunity of bringing together scientific and humanistic aspects of medicine in a secondary care environment. These can range from major trauma centres and hyperacute rehabilitation units to continuing care and community facilities, but all require a firm grounding in neurology, internal and musculoskeletal medicine complemented by excellent problem solving and communication skills.

It is attractive to physicians who wish to practise whole person rather than system specific medicine, and who wish to reduce the impact of disability on human flourishing. It is enjoyable work, with less out-of-hours commitment than many physicianly specialties, and it is possible to practise this specialty successfully working part time.

Specialist registrar’s view

Rehabilitation medicine brings together aspects from areas I found interesting during my core medical training: neurology, stroke medicine and elderly care. Each day I am able to work as part of a multidisciplinary team and treat a wide variety of patients with complex medical diagnoses. Through their longer length of stay in hospital, I also have the opportunity to get to know patients on a personal level as well as understanding their illnesses, disabilities and how it affects their daily life.

Rehabilitation medicine is an exciting, innovative and constantly evolving speciality. Through rehabilitation medicine, trainees will get exposure to a wide-range of patient care that allows them to build skills across many different disciplines. There are also opportunities for research and development, as well as acute/chronic management and inpatient/community work.

Dr Meena Nayar, specialist registrar in rehabilitation medicine and national trainee representative, British Society of Rehabilitation Medicine.

Training and working in rehabilitation medicine

Rehabilitation medicine resources

RCP resources

Historical highlights from the library, archive and museum collection

Rehabilitation in Britain arose out of physical medicine and was initially part of rheumatology.  George Mackenzie Cochrane (1929-2003) believed that rehabilitation medicine needed to be established as a separate specialty. He represented rehabilitation when the British Society for Rheumatology and Rehabilitation and the Heberden Society considered the future of these specialties in 1983. Cochrane become the first Chairman of the British Society of Rehabilitation Medicine (BSRM), which was then called the Medical Disability Society (MDS). The rheumatologists formed the British Society for Rheumatology (BSR).

Earlier in his career, Dr Cochrane set up the first National Rehabilitation Demonstration Centre at Derbyshire Royal Infirmary. There he established a bio-engineering laboratory to produce customised equipment for disabled adults and children with members of the former Institute for Consumer Ergonomics at Loughborough University. In 1980, he moved to the Mary Marlborough Lodge, a 21-bed rehabilitation unit for people with a severe disability. Dr Cochrane established strong links with specialist clinical units, orthopaedic colleagues and Oxford University engineers, to meet the specialist needs of patients. A George Cochrane elective prize in rehabilitation medicine was set up in his name at King’s College Medical School, London.

The RCP library catalogue contains a recording of an interview with Dr Virginia Camp. She was a consultant in rheumatology and rehabilitation in the Amersham and High Wycombe districts where she built a department including inpatient beds and a hydrotherapy and acupuncture service from scratch. After retiring she worked for 5 years as a disability assessor.

A great number of rare books in the library collections concern the diagnosis and treatment of paralysis. In particular, a number of tracts from the mid-to-late 18th century describe the effectiveness of bathing in warm mineral baths for people affected by paralysis. The physician Rice Charleton (1710–1789) settled in Bath and analysed the water there, concluding that sulphur was responsible for its curative properties.