Interest in manual medicine among residents in physical medicine and rehabilitation: The need for increased instruction

Manual medicine is an important part of the practice of physical medicine and rehabilitation (PM and R). Using a two-part questionnaire, we surveyed PM and R residents to determine their level of interest in manual medicine, their attitudes about this type of treatment, and the amount of formal training in manual medicine offered in PM and R residencies. Questionnaires were sent to all 75 PM and R residency training programs. Responses were received from 470 residents (41.6%) of 1126 potential respondents; this represented 55 (73%) of the programs surveyed. Of the 470 respondents, 363 (77.2%) believed that manual medicine should be a part of PM and R, 386 (82.1%) wanted more training in manual medicine, 389 (82.8%) believed that manual medicine is useful in the treatment of back/neck pain, and 392 (83.4%) would refer patients for manual medicine treatment. However, only 124 (27.3%) were receiving formal instruction in manual medicine during their PM and R residency training. Most of the 305 respondents who had received some exposure to manual medicine had done so through conferences (88.7%) and independent reading (66.9%). The results of this survey of PM and R residents demonstrate both a widespread interest in the use of manual medicine and an unmet desire for more instruction. Educational experiences in manual medicine should be provided so that, as residents become practicing physiatrists, they can either utilize this form of treatment or appropriately refer patients to other practitioners.