Residency Training: Enhancing your Knowledge and Network

Three years after graduating from PT school, Lauren Waits, PT, DPT, did a geriatric physical therapy residency.  She believes completing a residency was beneficial in advancing her knowledge and skills along with establishing a strong professional network.

My journey to a geriatric residency was not traditional. Completing a residency was not in my professional plan when I graduated from PT school in 2015. From my clinical rotations in school I learned that I enjoyed working with older adults and after graduation I worked as the only PT in a skilled nursing facility (SNF) with a significant long-term care population. I also did PRN at a different SNF that emphasized short term rehab and PRN home health. My PRN jobs brought further variety to my patient caseload and therefore, further breadth of experiences.

As a new grad and the only PT at my full time job that rarely saw other therapists during my PRN opportunities, I sought mentorship outside of the typical face-to-face. I maintained an active APTA membership, utilized their bounty of resources and went to conferences, but still felt disconnected. I had a supportive PTA team who were fantastic clinicians and helped me. Social media sources including Twitter, Facebook, and Geros Health (formerly, Senior Rehab Project) also became a great way to reach out to other Physical Therapists. All of these helped me develop as an early career PT, but I knew I wanted more.

I started considering doing a residency about a year and a half after graduating. I loved working with older adults and patients with neurologic pathologies. The first step was to start my research. There were many questions to which I needed answers: What were the pros and cons to a residency? Geriatrics versus Neurology? What does the future of this profession look like with or without residency training? How does a residency prepare PTs for board certified specialty exams? I spoke with others who completed a residency program and found many resources online, such as http://www.abptrfe.org. After a thorough period of investigating, I decided a geriatric residency was the best choice for me and submitted an application.

In July 2018, I started a one year geriatric residency at the Durham VA Medical Center in Durham, North Carolina. I believe that each residency program is distinctive, and the Durham VA geriatric residency emphasizes interdisciplinary learning along with exposure to unique programs only offered at the VA. The didactic portion of my training included lectures from clinicians and researchers from the VA and Duke Center of Aging. I attended medicine grand rounds and geriatric grand rounds at Duke Medical Center.  I participated in and provided lectures with an interdisciplinary team including geriatric medicine fellows, a geriatric nurse practitioner, geriatric pharmacy residents, and the geriatric mental health occupational therapy fellow.

The multidisciplinary environment carried into many different clinics, including my participation in the Perioperative Optimization of Senior Health Team and the Geriatric Primary Aligned Care Team (GERI-PACT). I was exposed to programs unique to the VA, including home based primary care and GeroFit. The Durham VA residency has each resident rotate through three major settings – acute, outpatient, and subacute. Each setting allows for further development and understanding of the different levels of care and importance of mobility and collaboration throughout this continuum.

A residency not only provides increased depth and breadth of knowledge, it also allows a clinician to develop a robust network of professionals with a wide range of expertise. The VA is known for its teaching and innovative environment and all the professionals I interacted with shared knowledge and wisdom with me. Many of my mentors were board certified specialists in a variety of PT fields or have other specialty certifications. I worked alongside OTs with experience and creativity in areas of specialty practice previously unknown to me. I observed with other professionals and learned more about their role in geriatric care along with sharing how the PT examines and evaluates a patient. A strong professional network is helpful for referrals, difficult patient presentations, and providing for new prospects within our profession. Developing my network opened new professional opportunities that I had not considered previously. An interdisciplinary network advances our profession forward by showcasing our skills and collaborating with others to provide optimal patient care and outcomes.

A residency elevates knowledge and comprehension along with development of a professional network, so why not do a residency? For some reading this, one of the big drawbacks of doing a residency is the decreased compensation potential compared to most full time opportunities in the field. In my opinion, the lower wages during the residency were a worthwhile sacrifice for the knowledge and other tangible benefits I gained. You have to consider it as an investment in yourself.  The decision of when to start a residency is a personal choice and is typically within a 5 year range immediately following PT school. Going into a residency after being a practicing clinician for 3 years was a difficult transition, I was placed back in the trainee role. I had to remind myself that I was not meant to know everything, I was there to learn and develop my skills beyond what PT school taught me. For others, another negative to a residency may be the time commitment. A mentor once told me, “Don’t be afraid of the time it takes to perform a task, the time will pass anyway.” After one year you will look back and not regret your decision to perform a residency program. In July of this year, I was able to reflect and be proud of my decision to get advanced training and become a better clinician in an environment that fostered learning and growth.

For those considering a residency, I recommend you complete research early so you can make an informed decision.  Reach out to program directors and get in touch with current and past residents. One residency may not be a good fit for you, but another may be perfect. As Physical Therapists we are always learning, we should always seek out new knowledge and a community that fosters our best selves. A residency provides mentorship, development of skills, growth in critical thinking, and encourages an interdisciplinary network.

Lauren Waits, PT, DPT                   11/15/2019

 

Additional information and resources:

 

  • Questions to ask a residency program director?
    • How is the residency organized?
      • What are the didactic experiences? How do the didactics vary throughout the year?
      • What is the average schedule for the resident?
    • What settings does the resident have exposure to?
    • How is mentorship provided?
    • What unique experiences are offered?
    • How many previous residents are board certified specialists? What is their (first time) pass rate for those who took the exam?
    • If a resident is not performing up to a specified standard how would the program provide remediation?

 

  • Pros of a Residency
    • Increased knowledge base
    • Advanced critical thinking and skills for a specific area of practice
    • Exposure to new experiences
    • Professional network
    • Potential for Interdisciplinary learning environment
    • Opportunity for new career prospects
  • Cons
    • Compensation
    • Time to complete
    • Locations available
    • Trainee/Learner yet fully licensed
    • Intense schedule

 

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