Exploring PM&R interest and resources among osteopathic medical students: bridging educational gaps

Physical Medicine & Rehabilitation (PM&R) has traditionally had strong representation from Doctors of Osteopathic Medicine (DOs), most recently filling 40.2 % of all postgraduate year 1 (PGY-1) positions in the 2024 residency match. However, significant variability exists in PM&R exposure across the 42 accredited osteopathic medical schools.

This study explores how osteopathic students develop an interest in PM&R and assesses the availability of related institutional resources.

A cross-sectional survey was distributed to osteopathic students through the American Osteopathic College of Physical Medicine & Rehabilitation (AOCPMR) listserv and its affiliated channels from February to April 2024. The University of Kentucky Institutional Review Board (IRB) deemed this study "Not Human Research" (NHR), exempting it from IRB review. The survey included short-answer, yes/no, and multiple-choice questions addressing premedical exposure, institutional resources, mentorship, and research opportunities. Seventy-three respondents from 24 osteopathic schools (57 % institutional representation) participated, with 38 in pre-clerkship and 35 in clerkship years. Chi-squared analyses and Fisher's exact tests were performed to examine the associations between institutional resources and student outcomes.

Previous PM&R knowledge before matriculation was present in 60.3 % of respondents. Interest sources included premedical experiences (22.2 %), school faculty (20.8 %), mentors (12.5 %), social media (13.9 %), and shadowing (9.7 %). Most respondents (93.2 %) reported having a PM&R interest group at their school; however, only 58.9 % had access to PM&R-trained faculty, and only 28.8 % reported formal PM&R educational experiences. Additional resource opportunities were identified: 30.1 % of students reported difficulty accessing PM&R alumni and 52.1 % indicated that their school provides no resources for early away rotations. No significant associations were found between PM&R-trained faculty presence and student engagement outcomes including mentorship acquisition (69.8 % vs. 67.9 %, p=0.865), conference attendance (32.6 % vs. 53.6 %, p=0.126), national organization membership (86.0 % vs. 89.3 %, p=1.000), or PM&R-specific research participation (32.6 % vs. 46.4 %, p=0.239). Clerkship students demonstrated significantly higher conference attendance (65.7 % vs. 15.8 %, p<0.001), PM&R research participation (62.9 % vs. 13.2 %, p<0.001), and mentor acquisition (80.0 % vs. 55.3 %, p=0.025) compared to preclerkship students. Financial and logistical barriers further limit student engagement, with 72.7 % of nonconference attendees citing cost and 61.4 % citing travel as primary obstacles.

Despite growing interest in PM&R among osteopathic students, differences exist in institutional resources and opportunities. Clerkship year was the strongest driver of student engagement, with clerkship students significantly more likely to attend conferences, participate in PM&R research, and acquire mentors compared to preclerkship students. Notably, formal curricula had minimal influence on initial interest (8.2 %) compared to premedical experiences (21.9 %), underscoring the need for standardized resources that capture and sustain student interest earlier in the medical school timeline. Standardizing access to PM&R-related resources across osteopathic schools could enhance student engagement and better prepare future physiatrists. As PM&R continues to attract DO applicants, schools should invest in PM&R educational opportunities to maintain strong osteopathic representation in the specialty.