MEDICAL-STUDENT REFERRAL PATTERNS FOR MUSCULOSKELETAL DISORDERS

The purpose of this study was to determine the relationship between me dical student knowledge and exposure to physiatry and the student's re ferral patterns for musculoskeletal disorders. Surveys were mailed to senior medical students at five United States medical schools across t he country with a response rate of 26% (n = 191). Five common musculos keletal and neurologic disorders were presented as clinical vignettes and the student was asked to assume the role of a primary care physici an and refer the patient to one of eight specialists listed. A section to assess the student's subjective overall knowledge and exposure to these fields was also included. Physiatrists received 27% of the refer rals for evaluation and treatment of chronic low-back pain, 3% of the referrals for acute low-back pain, 10% of the referrals for carpal tun nel syndrome, 22% of the referrals for an industrial medicine injury, and 20% of the referrals for a sports medicine injury. The frequency o f physiatry referrals for three of the five cases was significantly co rrelated (P < 0.05) with the student's overall knowledge of physical m edicine and rehabilitation (PM&R). The presence of a department of PM& R at the student's school, however, did not have a significant impact on the rate of referrals. The results indicate that senior medical stu dents referral patterns are strongly influenced by knowledge of PM&R. This suggests that focusing efforts on increasing this awareness may b e an effective means of increasing referrals to physiatry in the futur e.