To Residency or not to Residency?

This is probably one of the most common questions that myself and the other founders of the NeuroCollaborative hear. The short answer is YES! The long answer is that there are many factors to consider when deciding to do a residency. Even if a residency ends up not being the right choice for you, I will give you insider information so you can implement many of the same learning opportunities into your personal career development!


Let me back up for a second though, in case you aren’t familiar with Physical Therapy Residencies. In the Physical Therapy field, a residency is not required as part of the education, but are an option for those who would like to further their education and experience in a certain specialty area. Orthopedic PT residencies were some of the earliest, and they are probably still the most prolific. When I did the Neurologic PT residency in 2007-2008, there were only a few Neuro residencies and now there are 38 accredited programs across the country! There are programs in Acute Care, Women’s Health, Pediatrics, Sports, Geriatrics, Cardiovascular & Pulmonary. It is said that a residency program (~1 year) will progress your practice about 5 years compared to a typical setting.


I am very fortunate to have experienced a residency first hand. I completed the University of Southern California/Rancho Los Amigos Neurologic Residency in 2008. It was definitely the best decision I could have made to propel my career forward. I am where I am today because of doing the residency. As part of the residency we took the first LSVT BIG course that Dr. Becky Farley taught, she has been an amazing mentor and friend to me and help shapes my ideas of what is possible because she has been working “outside the box” as long as I have known her. Dr. Beth Fisher is another fantastic mentor and friend. I have been fortunate to have many amazing opportunities to work on different projects with her. The education you receive in the residency will change your clinical skills, but the connections you make with other professionals will change your life.


I learned so much during the residency and its only because of the residency that the network of my mentors and colleagues in Southern California is impressive in its depth and breath. I am inspired on a weekly basis by what my colleagues do in the clinic and for the profession.


For anyone considering a residency I would highly recommend it, however, there are a couple factors to consider when deciding if a residency is right for you.


What is your goal for doing the residency? What are your career goals? Do you want to be the best clinician possible? Do you want to teach or get involved in research projects?


These are definitely questions that you want to ask yourself, and make sure that completing a residency is the best experience to help you achieve your goals. If you wonder if a residency will help you reach your goals, hop into our Facebook group and let us know what you are thinking! We’d be happy to give some advice as to the best experiences to help you achieve your goals. Once you have decided that a residency is the right experience for you, there are a few other details to consider.


One is location, as most residencies need to be done in person. First question: is there a residency in your area? There is also a residency that can be done from anywhere through EIM and the NeuroRecovery Training Institute.


If there isn’t a residency in your city, is there a residency in a city in a location that you'd be willing to move to for a period of time or that you're interested in moving to?

Here is the list of all accredited residencies.


One important thing to consider is location, another important thing to to consider is timing. I completed a residency right after Physical Therapy School. I would say the optimal time to do a residency is a couple years after physical therapy school. It is very challenging to have your first job be a residency program. I would say it is ideal to get some clinical experience and get more comfortable with patient care and a little more efficient with things like your notes and documentation prior to completing the residency. I think that you can get the most out of a residency with a couple years of experience, however the caveat there is that doing a residency will likely be a lower yearly salary which can be challenging. If you work for a couple years at a full-time rate and then have to reduce your salary that can be a challenging transition. For that reason, the transition is easier if you go from Physical Therapy school to residency and then continuing working afterwards


So you have decided a residency is right for you, there is a location you are interested in, and you figured out the time is NOW! Wonderful! Good luck in your application process, and again, feel free to come over to the Facebook group for some ideas and inspiration about interviews for a residency.


I would also like us all to think outside the box, and if a residency isn’t right for you, for whatever reason, how can you get some of the same amazing learning experiences?  Let’s discuss some of the components of residency program and then discuss how you could implement some of these experiences into your own career development.


With most residencies, the primary goal is improved clinical skills. Again, I'm speaking about my experience and each residency is a little bit different in terms of how they're set up. In my experience in the USC residency we were in the clinic 24 hours a week. 20 of those we were treating independently and four of those hours per week were seeing patients with a mentor present.


To improve your skills working with patients and clients with neurologic conditions-you need to see them! Maybe that is already the clinical setting that you're working on, or maybe you need to carve out that neuro niche, and check out one of our earlier videos to see how to do that.


Next you'll need some mentorship, so look in your local community. Are there any neurologic physical therapists who you could work with? Be flexible! You may need to go and spend time some time with them in their clinic or maybe they will be able to come and work with you in your location. If you have difficulty finding someone in person there are options for online and virtual mentoring! I would definitely make sure that you are on Twitter, there is a lot of informal mentoring and conversations that happened on Twitter as well as just introductions to people who you may reach out to and have a phone conversation or video chat. Facebook is another great way to meet people and you might meet someone who can be your mentor over long distance. This is something the NeuroCollaborative is definitely planning on doing in the future as well so keep so keep us in mind for future mentoring. Make sure to sign up on our email list to hear any updates! APTAs neurologic Academy of Physical Therapy also has a mentorship program.


The first component is clinical experience and mentoring time. The second component is continuing education. I would say the educational aspect of residencies is extremely important. You learn a lot in PT school, but the learning must continue, especially if you want to specialize in Neuro! You can put together a good curriculum for yourself through continuing education courses, webinars and selected reading. The APTA and the Academy of Neurologic Physical Therapy sponsors many good courses. You might have to do some traveling to attend these courses, but the content and networking opportunities make it well worth it. I would recommend making a list of the content you would like to cover and give yourself a timeline (the benefit to non-residency learning is you have more control over the schedule!). Maybe you set a goal of accomplishing these courses in the next 2 years. List the courses you are interested in taking and see what they look like on a schedule. Certain courses may be offered only a couple times a year, and others may be offered more regularly. You can take all of this into consideration when scheduling your education. If you have any questions about good continuing education courses to take please ask us about it in the Facebook group. In addition to the founders of the NeuroCollaborative, there are many others who will have good recommendations for the courses they found most beneficial!


The third component of many residencies is teaching. In addition to learning a lot, teaching is a great way to solidify that learning and help progress the field of physical therapy. You might even find that teaching is something you really enjoy doing and would be a good part of your professional life. In my experience, may PT programs are always looking for faculty at some level. They may need TAs for labs, or they might bring in outside lecturers for certain content. You can contact local PT and PTA programs. If there aren’t any programs in your area, you could even consider seeing what colleges and universities are in your area and if they have a pre-physical therapy program. If you specialize with a certain population or treatment type, you may eventually enjoy teaching continuing education courses!


The fourth component is completing a research project. This project can vary a lot depending on your program and what current research projects are. At USC the projects have varied from a case study to a case series or completing work on a large research study during the timeframe of the residency. It is easy to be ambitious and want to develop and implement a research project, just to discover that this is nearly impossible to complete in a year! So, make sure to take the time to choose the right type of project as part of your residency. If you're not doing a residency there are many ways to get involved in research. I would recommend contacting your local universities, physical therapy programs, also any kinesiology programs or motor control programs to see about getting involved in research. Even if you don’t have a local PT program, there could be a relevant motor control program with a masters and/or PhD. Those programs are often doing very similar research. You could see if they need any help in their lab, your participation may start with volunteering your time or they may have paid positions to help with collecting data. It can also be a very good connection to develop because you may be seeing patients in the community who could participate in these studies, and you could help with recruiting. Building these connections can lead to many opportunities down the road! You might even find that at some point you can be a site for research in the community.


The fifth and final component of the residency at USC, is a spending time with Neurologist in the clinic. I would expect that this would be a component for most residencies. We spent half a day per week in the Neurologists office, and sometimes got to attend rounds with them in the hospital. This was a great part of the residency, we got to spend time with different neurologist in different specialty areas like Movement disorders and Neuromuscular diagnosis. For the most part we were listened observed, and learned quietly. You can learn so much from observing a neurologist while they complete their testing and make diagnosis and also see how they approach treatment for these individuals with neurologic diagnosis. You might also find though, that you are a great resource for the neurologist and patient. You can answer questions about physical therapy, what it might include and even simple questions about insurance coverage. At USC, many of the patients came from outside the local area, and we would also help them find a Neuro PT in their area. I think the Neurologists and patients benefited quite a big from having us in the office too! I learned so much from the neurologists, which even though we do not provide medical treatment, really informs my PT treatment, and allows me to understand a lot more about how my patients are doing as it relates to their medications.


Wow, there is still so much more to cover! We might have to have a part two to continue the discussion. I hope this has given you an idea good idea of whether or not a residency is the right decision for you. I hope you also can see how many options there are for obtaining some of the same learning experiences without completing a formal residency.


Please let us know if you have any questions, or have other topics you would like us to discuss in our FB lives or blog!


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I’m excited to continue to learn and grow with all of you!