Mapping the Practice Landscape of Physical Medicine and Rehabilitation in India: A Descriptive Cross-sectional Study

Abstract Background: Physical medicine and rehabilitation (PMR) is a relatively untapped speciality in India even though it was initiated in 1955. With the approach of biopsychosocial, the field treats chronic conditions, pain, musculoskeletal disorders and neurological disorders, in contrast to disease-oriented medical fields. Objectives: The research was intended to determine the distribution of the number of practicing physiatrists in India and their concentration; to record the subspeciality domains that have developed during the last 7 decades. Methodology: A cross-sectional survey was developed among the practicing physiatrist in India using the network of the Indian Association of Physical Medicine and Rehabilitation. The information was gathered through a four-question survey on a Google Forms questionnaire and distributed through WhatsApp groups and direct contacts. The survey measured practice location, work setting as well as subspeciality domains of practice. Results: Twenty three states and union territories have provided 345 responses, that is about 35% of registered physiatrists in India. The maximum number of respondents was exhibited in Kerala ( n = 123, 35.7%), Tamil Nadu ( n = 41, 11.9%) and Karnataka ( n = 39, 11.3%). Most of them worked in government (53%), and 47% worked in a private/independent arrangement. The most common areas of practice were pain and musculoskeletal rehabilitation, then neurorehabilitation, spinal cord injury rehabilitation, rheumatology and paediatric rehabilitation. The new areas were cancer rehabilitation, burn care, hyperbaric oxygen therapy, applications of the virtual reality and the clinics of diabetic foot. Conclusion: It is a groundbreaking study that presents the first nationwide mapping of PMR practice in India and shows that there are notable geographical inequalities and concentration within domains. There is a critical shortage of workforce in the field, which has 40 PMR residency programmes in the whole country, and a population of more than 1.4 billion, with an estimated 789 registered physiatrists. The results reveal the critical necessity of raising awareness, developing training opportunities and institutionalising the use of PMR in the regular medical education.