Characterization of Physical Medicine and Rehabilitation residency training sites in Peru: An overview of resources, rotations, and positions

Background: The increase in interest in physical medicine and rehabilitation (PM&R) among physicians has not always been accompanied by an improvement in the quality of the residency training sites (RTS), especially in Latin America. To our knowledge, there are no publications that have specifically analyzed the PM&R RTS in Peru. The aim of the study is to characterize the PM&R RTS in Peru. Methods: Cross-sectional study performed between May 2023 and May 2024. Resources, rotations, and positions data were obtained from the RTS websites, through consultation with Delegados MFyR Peru 2023, and from the National Medical Residency Council of Peru website, respectively. Rotations that RTS were expected to have were specified by International Society of PM&R (ISPRM) in 2019. Data analysis was performed using Stata v17. Results: 21 out of the 23 PM&R RTS were fully characterized. Of the total, 73.9% were in Lima. No RTS included more than 50% of the rotations specified in the ISPRM standards. Only 6, 5, and 1 RTS had musculoskeletal ultrasound, electrodiagnostic medicine, and sensory conditions rotations, respectively. From 2019 to 2023, 268 residency positions were offered for the 23 RTS, and 88.5% were offered in RTS from Lima. There was a positive association between higher scores for entering PM&R residency and a greater number of rotations across RTS. Conclusions: Most RTS did not include all the rotations specified in ISPRM standards, with the most concerning gaps in ultrasound, electrodiagnostic medicine, and sensory conditions, among others. Most RTS and residency positions offered were in Lima. These findings confirm the need to increase the number of rotations in all RTS, as well as to decentralize them to offer more positions outside of Lima.