Residency Program Produces National Leaders in Rehabilitation Medicine

As one of the leading rehabilitation organizations in the United States according to U.S. News and World Report, TIRR Memorial Hermann maintains a strong commitment to educating the clinicians of the future, across multiple subspecialties.

Each year, more than 20 residents and fellows in fields such as physical medicine and rehabilitation (PM&R), neuropsychology, spinal cord injury medicine, brain injury medicine, neurologic physical therapy, speech language pathology and occupational therapy graduate from TIRR Memorial Hermann−based programs and begin their careers as professionals, either within Memorial Hermann or at other health systems across the country.

This means that the approaches and philosophies ingrained at TIRR Memorial Hermann have been adopted and adapted at similar institutions across the country, says Gerard E. Francisco, MD, chief medical officer at TIRR Memorial Hermann.

“Through coursework and working alongside our top health care professionals, our residents and fellows are truly prepared for a career in rehabilitation medicine, and many of them become leaders in the field,” Dr. Francisco says. “At TIRR Memorial Hermann, we treat some of the most complex cases, and this experience and knowledge only helps residents and fellows as they advance in their profession.”

Here is a look at two alumni of the residency program at TIRR Memorial Hermann: Miguel Xavier Escalón, MD, MPH, FAAPMR, who graduated in 2013, and Rajeev Kanaiyalal Patel, MD, who completed the program in 1999.

New York State of Mind

After completing his residency in PM&R at TIRR Memorial Hermann, Dr. Escalón came to New York City with his wife, who was matched there for her own residency.

Starting at Mount Sinai Health System in the summer of 2013, Dr. Escalón has been the vice chair of the Department of Rehabilitation and Human Performance at Mount Sinai since 2019. He’s also a professor of rehabilitation and human performance and the director of Graduate Medical Education for PM&R at the Icahn School of Medicine at Mount Sinai, also in New York City, and serves as the director of the Critical Care Rehabilitation Institute and director of Brain Injury Medicine for the health system.

Dr. Escalón, a College Station, Texas, native, credits his time at TIRR Memorial Hermann, where he was a resident from 2010 through 2013, with preparing him for these leadership roles at a large health system with an outstanding reputation.

“TIRR Memorial Hermann is an amazing hospital. The one thing I learned there and tried to carry forward is to really see the whole patient like a rehabilitation medicine doctor,” he explains. “What I mean by that is that, in this specialty, we really need to assess a patient’s history, their diagnosis and potential prognosis in a short period of time, so that we can optimize their care. The analogy I like to use is that this role is almost like that of an NFL quarterback, who has to see and process things on the field quickly, before he can make, what in the context of the game, is an important decision. For many of our patients who are dealing with trauma or severe injury, they rely on us to do essentially the same thing, because that’s what’s going to lead us to positive outcomes.” Another aspect of his time at TIRR Memorial Hermann that has stayed with Dr. Escalón is TIRR Memorial Hermann’s “truly multidisciplinary” approach to care, one that engages specialists ranging from physiatrists, such as himself, to nurses and physical and occupational therapists. “That teamwork is so key,” he notes. “At TIRR Memorial Hermann, you can truly see all those professionals working in concert. Everyone has a high-level understanding of what’s needed for every patient.”

The work of TIRR Memorial Hermann with organizations that help patients re-engage with their communities at the end of their treatment journey is another element that he tried to bring with him to Mount Sinai, although it is a bit more challenging in New York City, he admits. “TIRR Memorial Hermann does a great job of that, and it’s so important,” he adds. “Frankly, there are few places you can send someone where you can feel confident that they’re going to get the best care possible. In PM&R, TIRR Memorial Hermann is one of those places, and that’s one reason it’s appealing to go there from a training perspective.”

Building a Program at the University of Rochester

Dr. Patel also counts the Mount Sinai Health System as part of his career trajectory. After leaving TIRR Memorial Hermann in 1999, he did an interventional spine fellowship at the University of Pennsylvania Health System in Philadelphia. From there, he worked briefly in PM&R at Mount Sinai before being recruited to the University of Rochester Medical Center (URMC), initially in the Department of Orthopedics.

After 17 years in the Department of Orthopedics, the dean and CEO of URMC asked Dr. Patel to transition into and assume the role of Chair of the Department of PM&R, which underwent significant changes under the guidance of three national consultants engaged by URMC. One of those consultants was Dr. Francisco.

“As a Chair candidate external to the Department of PM&R but internal to URMC, I was a known entity in a lot of different ways,” recalls Dr. Patel, who recently signed for his second five-year term as Chair of the Department of PM&R for the health system and a professor in the discipline at the University of Rochester’s School of Medicine. “URMC has really made a commitment to elevating PM&R and developing a nationally recognized program.”

Under his leadership since 2018, the faculty of the updated PM&R department has grown exponentially, and its residency program has also doubled in size per year over that same period. Additionally, Dr. Patel and his team have seen great facility growth with the completion of a new musculoskeletal facility and new brain injury and neuro-rehab units.

“We’re doing amazing things, and none of these facilities and programs existed prior to my taking over as chair.”

Dr. Patel describes his time in the residency program at TIRR Memorial Hermann, from 1996 through 1999, as “foundational” to his current role.

“In addition to everything I learned about physiatry at TIRR Memorial Hermann, I also learned about all the subspecialties in PM&R and how they should integrate to optimize patient care,” he notes. “That understanding of everyone’s role, from specialists to therapists, has been fundamental to my helping to build the program here.”

Dr. Patel is still planning for more growth by increasing the team of specialists in size and scope and adding specialists in brain injury, cancer and pediatric rehabilitation medicine. He and his colleagues also hope to open a new outpatient neuro-rehabilitation institute. “One of the many things I learned at TIRR Memorial Hermann is what a nationally recognized program, with multiple affiliate hospitals and subspecialty service lines in a large academic medical center, could look like,” Dr. Patel notes. “That’s what I’m trying to bring [to URMC].”