What medical doctors and medical students know about physical medicine and rehabilitation: a survey from Central Europe

BACKGROUND: Physical and rehabilitation medicine (PRM) is a relatively new and dynamically developing branch of the contemporary medicine. The unique role of PRM is bridging pure clinical outcomes with overall functional improvement. The concepts of disability and rehabilitation may be difficult to comprehend by medical students (MS) and Non-PRM specialists (NPRMS). AIM: The aim of this study was to assess the level of knowledge of NPRMS and MS regarding the role of PRM in health care systems in Poland, Hungary and Croatia. DESIGN: Cross-sectional observational study. SETTING: Anonymous questionnaire distributed in Hungarian, Polish and Croatian universities. RESULTS: Knowledge of definitions of a person with disability and PRM was poor (MS: 58% and 35%, NPRMS: 39% and 30%, PRMT: 72% and 62%). Prevalence of disability was correctly estimated by 58% of MS and 62% of doctors. 76% of MS, 72% of NPRMS and 99% of PRMT perceived PRM as a basic medical specialty. Leading role of PRM physician in comprehensive management of patients with stroke, multiple injury, spinal cord injury and congenital limb defect was perceived respectively by 42%, 49%, 53% and 64% of respondents. Functional statement as an important criterion in referring a patient for rehabilitation was perceived by 48% of NPRMS. Inadequate perception of the PRM role in health care system results from the lack of unified programme and scope of PRM in under- and postgraduate medical education, inappropriate allocation of funds in public PRM services, and claims of certain paramedical professions to extend their qualifications over interventions assigned to PRM doctors. CONCLUSIONS. Low knowledge of PRM among all studied groups testifies to the inadequacy of education of the medical community in rehabilitation.