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00:00:10.560Welcome to the APTA Nebraska Podcast, where we dive into the stories, challenges, and innovations shaping physical therapy in our state.
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00:00:18.559We're here to advance, promote, and protect the practice of physical therapy, optimizing the health and quality of life for all Nebraskans.
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00:00:24.719Join us as we connect with experts, share insights, and build community throughout our profession.
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00:00:27.600Welcome back to the APTA Nebraska podcast.
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00:00:36.479My name is Brad Dexter, your host, and today we're going to be talking about one of the biggest decisions a newer physical therapist can make whether to do a residency.
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00:00:39.759So I have three people that have trained a lot of residents between them.
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00:00:43.359Megan Frazy directs the orthopedic residency at UNMC.
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00:00:49.039Heather Knight oversees six accredited residencies at Creighton and directs their neuroresidency.
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00:00:54.799And Sarah Garcia, along with Heidi Rilfs, brings a lot of experience in pediatrics.
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00:00:59.520And Sarah is joining us from the Monroe-Meyer Institute's Pediatric Residency.
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00:01:01.200Welcome to all three of you.
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00:01:02.079Thank you.
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00:01:03.200Thanks for having us.
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00:01:05.040Yeah, glad to have you here.
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00:01:11.280Okay, so just kind of diving into this, I've enjoyed starting with origin stories a little bit.
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00:01:15.280So I just gave a really brief introduction for each of you.
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00:01:27.519I would love to just kind of go around the table, so to say, or around the screen since we're on Zoom, and uh would love for you guys to share a little bit more about yourselves before I dive into some specific questions.
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00:01:29.280So, Heather, I'll start with you.
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00:01:34.879Uh, beyond directing um residency programs at Creighton, can you tell us a little bit more about yourself?
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00:01:37.120Yeah, thanks for having me, Brad.
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00:01:49.760Um I have been a physical therapist for 18 years now, and I actually started my career as a traveling physical therapist because I initially didn't know quite what I wanted to do.
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00:01:55.120And as part of that discernment process, I got out in clinic and realized I had a passion for neuro.
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00:01:58.959And the more you learn, the more you realize you have to learn.
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00:02:07.439I also realized that my clinical experience in neuro gave me a really good background in maybe a snippet of neuro practice.
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00:02:18.159And so I myself started exploring uh neuroresidency back then, which makes me feel slightly old because there were only four in the country at that time.
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00:02:36.479Uh thankfully we have a lot more now, so accessibility is a little bit easier, but um, I made the decision like, why not give it a try and gain some mentorship and really feel like I had a solid foundation across the breadth and depth of neuropractice.
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00:02:43.840So I graduated from Kaiser Permanente Neurorehab residency in 2010.
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00:02:48.719And kind of my passion area is inpatient rehab focused on traumatic brain injury and strokes.
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00:03:00.879I've done a little bit of everything over the years, including outpatient wellness practice now and my current role here, but spent um almost 10 years on inpatient rehab and a TDI team.
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00:03:04.080So that's kind of where my my niche area is, I would say.
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00:03:13.439But currently teach in our adult neuro program or adult curriculum now here at Creighton, in addition to my um residency roles.
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00:03:16.400So just have a passion for teaching and sharing and mentorship.
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00:03:17.280Fantastic.
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00:03:18.240Thanks, Heather.
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00:03:20.080Uh Megan, I'm gonna come over to you next.
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00:03:21.680You want to share a little bit more about yourself?
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00:03:25.199Well, it sounds very similar to Heather, actually.
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00:03:32.240Um, so I am an associate professor at UNMC, and as you mentioned, I'm the director of the orthopedic residency program here.
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00:03:39.039Um I maintain a clinical practice at Nebraska Medicine, which is also where our residents do their clinical work.
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00:03:43.039I graduated from UNMC with my DPT in 2009.
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00:03:47.039But similar to Heather, I didn't really know what I wanted to do yet.
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00:04:03.360I had actually thought ortho was probably my least favorite, if you would have um asked me even halfway through PT school, and when my very last clinical was a outpatient ortho, and I liked it, which confused me because I had liked all my other clinicals.
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00:04:07.599Um, so I also wasn't sure what to do for my real job.
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00:04:16.639Uh so I did traveling PT for a couple of years and was able to dabble in a few different areas and figure out what I really wanted to do.
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00:04:22.639And when I chose outpatient ortho, that's when I also decided that if I was gonna do this, I needed to learn more.
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00:04:28.399And so I did residency and uh fellowship after that to specialize a bit more.
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00:04:34.160What what uh what took you past the residency and into a fellowship?
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00:04:35.920Well, that's a long story.
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00:04:43.199So actually I was going to do a certain residency and then decided that residency in particular probably wasn't the best fit for me.
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00:04:50.480But then in trying to figure out what else to do based on where I was living, there wasn't a fellowship option like in person.
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00:04:57.680Um, anyway, it was suggested to me that I should just do the fellowship, which at that I didn't know that was possible.
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00:04:59.920I thought you had to finish the residency first.
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00:05:07.759Now you do have to specialize first, but at that time you could just complete your specialty before you finished your fellowship.
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00:05:10.879So I went right into my manual therapy fellowship.
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00:05:17.920I'd always been interested in manual therapy and it and it had basically the first half of the fellowship program was the same curriculum as the residency.
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00:05:21.920It was just like a deeper dive for another year and a half, two years.
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00:05:24.079Um, so I went that way.
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00:05:24.959Fantastic.
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00:05:25.920That's a good answer.
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00:05:26.720It's a good answer.
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00:05:30.399And then ended up as a faculty member, which again was not in the plan.
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00:05:36.319So I guess the moral of the story is stay open to opportunities because you never know where you're gonna be.
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00:05:37.279That's great.
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00:05:40.399And Sarah, we'll we'll come over to you next.
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00:05:42.639Um, tell us a little bit more about yourself.
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00:05:45.120Yeah, my story is maybe just a little bit different.
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00:05:48.560I did know when I graduated I really wanted to go into pediatrics.
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00:05:53.759And I am old enough that at that time there were not residencies, they were still kind of talking about them.
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00:06:08.319Um, but I was able to find a job right out of school with some mentorship that got me into pediatrics and then was able to go into a job where I was at children's and really got the opportunity to see all different areas of pediatrics.
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00:06:10.879And as I was there, I always enjoyed teaching.
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00:06:19.680And then when um MMI started their residency program, they asked if we would join them and give them an exportion of acute care.
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00:06:22.879So I was the mentor there for a little bit and was able to be on their faculty.
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00:06:27.839And then when I came to MMI, I remained on the faculty and now I'm the co-director.
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00:06:37.519So I've just always really had a passion for working with pediatrics and helping others to kind of enhance their clinical reasoning and their critical thinking about that too.
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00:06:41.120So it's kind of like Megan said, being open to the opportunities.com.
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00:06:45.839I don't know if I ever expected to be here, but I'm really grateful to be here and excited for the opportunities.
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00:06:56.639Yeah, it's really interesting, you know, talking to younger clinicians, younger uh physical therapists, um, those that are still student physical therapists, and maybe trying to figure out is this something that's worth it for me?
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00:06:58.160Is this the right path for me?
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00:07:01.279I'm hearing each of you kind of uh communicate.
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00:07:02.879There was a nonlinear path.
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00:07:13.199It was kind of it took some winding roads in different directions before you maybe landed um in a residency or at least Sarah, in your case, you didn't you didn't even do a residency, right?
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00:07:18.720You just had some great mentorship in the job and and now you're uh involved and engaged in a residency program, right?
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00:07:19.759Yeah, exactly.
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00:07:29.279And I think that was just really being intentional about finding mentors that could help me to continue to grow in my own clinical thinking and you know, looking at what the evidence is.
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00:07:34.160So it definitely wasn't a plan, but um seeking out that mentorship has been super helpful.
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00:07:37.839And I feel like just my career itself has been a residency program in some ways.
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00:07:39.279All right, excellent.
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00:07:42.800We're gonna shift into uh residency 101.
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00:07:43.279All right.
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00:07:45.519So, Megan, I'm gonna just start with you.
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00:07:51.600We've we've gotten some of the language in your answers already, but can you just tell us what is a residency?
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00:07:58.639Um, if if students or prospective um clinicians want to go into a residency, how is that different from a fellowship?
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00:08:00.720Um, so maybe let's just start there.
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00:08:17.759Yeah, so both residencies and fellowships are structured learning experiences that have like a minimum number of hours for didactic work and one-on-one mentoring, especially if they're an accredited program, the accrediting body makes sure that everyone has kind of the same minimum standards.
00:08:18.079 -->
00:08:24.800Residencies are designed to develop clinical specialty in an area and ultimately pass that specialty exam.
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00:08:30.879So if it's an orthopedics to be an orthopedic specialist, neuropediatrics, um, same thing.
00:08:31.040 -->
00:08:37.360So they're often geared more towards early career PTs, but as we mentioned, you don't have to do it right out of school.
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00:08:47.039Um, Heather and I didn't, several other a couple other faculty and um UNMC faculty uh didn't do it right out of school and did it after a few years of practice.
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00:08:56.320So either way, but if you do know, like Sarah did, if you know what you want to specialize in, you can do it right out of school and get that early jump start.
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00:09:02.639Um fellowships are designed to develop sub-specialties.
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00:09:12.879So after you've gotten your specialty, after you are an orthopedic or neuro or pediatric specialist, you can then do a fellowship to sub have a sub-specialty.
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00:09:20.879So in the area of orthopedics that I'm more familiar with, there's some sub-specialties such as manual therapy, performing arts, foot and ankle, and spine.
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00:09:22.000So those are just examples.
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00:09:27.279So you need to kind of get your specialty first, and then it's a deeper dive into that sub-specialty.
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00:09:35.519But they all have one-on-one mentoring where a mentor is watching you practice, it's carved out time, generally weekly throughout that year.
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00:09:38.960Heather, I'm gonna come over your direction.
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00:09:46.960So you're um directing the neural residency program at Creighton, but you also kind of have your hands in a number of other residency programs as well.
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00:09:53.600So just to throw out some specific numbers here, there's really two routes to ultimately sitting for a specialist exam.
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00:09:58.720Megan's talking about specialties, right, um, versus subspecialties.
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00:10:07.360Um, so sitting for that specialist exam requires 2,000 hours of direct care in the specialty or an accredited residency.
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00:10:12.000Why would someone pick the residency route when they could just go to work?
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00:10:14.480Yeah, thanks for that question, Brad.
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00:10:18.000I we get that a lot actually from our learners too.
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00:10:25.840So the residency is really intended to speed up that process to specialization.
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00:10:33.039And so back to what Megan was talking about as to why maybe somebody might do a residency early on in their career.
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00:10:57.120And that's because it is meant to help kind of speed up getting you that really relevant information, that experience, and structured mentorship that helps really advance your clinical reasoning skills, your ability to manage dynamic uh situations in the clinic and kind of springboard you into that advanced practice, if you will.
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00:11:02.720So the residencies are structured to help prepare you for that certification exam.
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00:11:10.879We have residency um guidelines that help us kind of make sure we're covering specific topics.
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00:11:15.360So I think a residency, you can think about it as being a funnel.
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00:11:28.639It funnels you a lot of resources, a lot of high-level information that if you go the non-residency route, you really have to be that independent learner that's gathering and going out and getting those resources on your own.
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00:11:31.120The residency is gonna funnel that to you.
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00:11:42.000It's gonna challenge you to dig into the evidence, and then you're gonna have that structured mentorship alongside that didactic curriculum to help you think about how you can apply it in practice.
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00:11:47.039So it's really meant to be a um a springboard and kind of speed up that process.
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00:11:55.120When you do apply, you get to nicely check the box too, because if you graduate from a residency program, that program is guaranteed.
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00:11:57.840You've met all the requirements to sit for the exam.
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00:12:01.440I think the the word I keep hearing from you guys is structured.
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00:12:18.720Uh so you've you've in a residency program, you've um you've done the work, you've put in the work of laying out all of the material, structuring the time, structuring the mentorship uh in order to get someone to that final point of um being able to sit for specialty exam.
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00:12:22.639I'm I'm curious, uh, and any of you can speak to this.
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00:12:31.120Do you have do you have stories from previous residents that have communicated, you know, I this was really valuable for me.
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00:12:36.080When I got out of the clinic, I just I felt like I could kind of I had everything organized in my mind.
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00:12:39.200I I felt more confident treating my patients.
00:12:39.279 -->
00:12:44.639I can you guys speak to any of that from the experiences you've had with uh residents in the past?
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00:12:50.159Uh I'll jump in, but others feel free to um add additional thoughts.
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00:12:54.399I do think we very much get a lot of feedback about the growth and confidence.
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00:13:05.279And we see that even within that residency year of just building confidence, of knowing where to start with really complex patients and or complex scenarios.
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00:13:12.000Um and so I do think there's a lot of growth in the confidence area, although that might be the hardest one to measure.
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00:13:24.799So uh when we think about outcomes, that's not necessarily always what we're we're specifically targeting, but anecdotally we hear that often from our graduates and in our graduate surveys.
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00:13:38.159And I think some of it is just knowing where to start in those tough situations, where as a new grad, without without the the there's informal mentorship, but without kind of a structured process, you're kind of figuring it out on your own as you go.
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00:13:45.200And so um I think that is in hindsight as somebody who experienced that um myself.
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00:13:50.559I found a lot of benefit in just having that ability to know where to start with those tough situations.
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00:13:52.000I would agree.
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00:14:01.600I think the feedback we often get is similar, and that yes, you can technically sit for your specialty exam with on and just study on your own, right?
00:14:01.679 -->
00:14:07.200You can go work a full-time job, study nights and weekends, you could pass your exam.
00:14:07.679 -->
00:14:08.480And that's great.
00:14:08.720 -->
00:14:14.240You've probably gained more knowledge, you've kind of focused, you've made yourself focus on that for a bit.
00:14:14.399 -->
00:14:18.480Um, but ultimately the specialty that means you can pass an exam.
00:14:18.639 -->
00:14:21.840Does that carry over to actual changes in your treatment?
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00:14:25.200Maybe, and some people, and other people not, right?
00:14:25.279 -->
00:14:33.679They still struggle with um accurately reflecting on or translating that information into the clinic.
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00:14:42.080They can, you know, maybe spit out all the facts and they understand the clinical practice guidelines, but can they actually translate that into patient care?
00:14:42.320 -->
00:14:49.440So I think what we often hear from residents is it's yes, I wanted to pass my board exam, but I could have done that on my own.
00:14:49.600 -->
00:14:59.600The piece that was really valuable was the mentoring piece and getting feedback and maybe all of those things that you're blind to that you're not even aware you're doing.
00:14:59.679 -->
00:15:10.799Like you don't know what some of like maybe your body language is um doing, or I don't know, your clinical reasoning, just blind spots that you might have.
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00:15:16.000Um, that studying on its own is not going to help me necessarily.
00:15:16.159 -->
00:15:18.960So I think that's what we often hear is it's that mentoring piece.
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00:15:26.080Yes, it's great that they feel more prepared to pass their board exam, but it's not just studying, because you could ultimately do that on your own.
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00:15:35.360Yeah, I would just add simply, I think it gives them a framework to take the knowledge and the evidence that they have and being able to translate that into practice.
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00:15:37.600Well said, Sarah.
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00:15:38.159Yeah.
00:15:38.799 -->
00:15:49.200I I asked the question because I I know that I've had a conversation within the last year with a younger clinician who mentioned some of the same things that you guys are saying, right?
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00:16:11.840So when he was comparing himself, and I was just doing some mentoring with him, as he compared himself with um one of his colleagues who had gone through a residency program, he just felt like his thoughts were a little more scrambled, um, didn't have the same level of mentoring, didn't have the same um uh just didn't feel like he was at the same place from a clinical reasoning standpoint as that colleague was.
00:16:12.000 -->
00:16:17.039And so um, you know, he maybe just realized it may just take me a little longer.
00:16:17.200 -->
00:16:21.840I need some help on the structured learning side of things, the structured mentorship side of things.
00:16:21.919 -->
00:16:27.919So just I wanted your guys' perspective on that, because uh you've probably seen that quite a bit from your students too.
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00:16:32.559Uh Megan, I want to dive in just a little bit more since you were um talking here.
00:16:32.639 -->
00:16:39.519Uh I want to dive a little more into how the week actually flows within a residency program.
00:16:39.679 -->
00:16:44.320I'm sure this is different, Sarah and Heather, in your programs to some extent too.
00:16:44.399 -->
00:16:45.919So feel free to chime in.
00:16:46.080 -->
00:16:50.080Megan, I know some of the numbers from the orthopedic residency program here.
00:16:50.240 -->
00:16:58.559You're looking at roughly 300 hours of didactic work, 1,500 hours in the clinic, and at least 150 hours of one-on-one mentoring.
00:16:58.879 -->
00:17:01.279How does that actually flow over the course of the week?
00:17:01.440 -->
00:17:02.399I'll let you speak to that.
00:17:02.480 -->
00:17:06.799And then Heather, Sarah, if you guys want to jump in with your own uh thoughts, that'd be great too.
00:17:07.039 -->
00:17:11.759Yeah, so those basic numbers, that's kind of the set standard for accredited programs.
00:17:11.920 -->
00:17:16.559So we have to have at least 300 hours of didactic, 1500 hours in the clinic.
00:17:16.720 -->
00:17:20.240Of those clinic hours, at least 150 are one-on-one mentoring.
00:17:20.319 -->
00:17:21.440So you got those right.
00:17:21.599 -->
00:17:27.039Um, I would say most of our programs here are somewhat similar, but again, chime in if they're not.
00:17:27.200 -->
00:17:31.200But we can also mention there are other models out there that might vary.
00:17:31.440 -->
00:17:36.640Most residencies pro residency programs, though, are right about a year in length.
00:17:36.799 -->
00:17:50.480Um, we have a little bit of built-in overlap, so our outgoing residents can take over or help transition the incoming residents so it's not an abrupt stop, but they're about a year long.
00:17:50.640 -->
00:18:04.480Um, so over that year, if you divide that out, our residents, and I believe Creighton and MMIs are similar, they're in the clinic about 30 hours a week seeing patients, um, and not kind of 40.
00:18:04.640 -->
00:18:09.440Um, so that leaves a little bit more time for their didactic work and other experiences.
00:18:09.519 -->
00:18:21.680So that 300 hours, if you divide that out over a year, it averages about six hours a week, but that can vary from week to week or month to month depending on the program and how they structure some chunk, like weekends.
00:18:21.759 -->
00:18:24.480If it's a hybrid program, they come in and do a full weekend or something.
00:18:24.640 -->
00:18:28.240Ours is kind of spread out more consistently.
00:18:28.559 -->
00:18:37.279Um, many programs, I know Creighton and UNMC also have their residents help in as lab assistants in the DPT program.
00:18:37.440 -->
00:18:41.839So the residents get a little opportunity to teach and kind of review those basic skills.
00:18:42.079 -->
00:18:48.400I think if you can teach a skill, you're often more comfortable um doing it or you feel more confident.
00:18:48.720 -->
00:18:58.079And then they do a little bit of scholarly activity, um, some independent didactic work and then some in-person didactic work reviewing skills.
00:18:58.240 -->
00:19:03.680And then we have them do some other experiences like spending time with our orthopedic and sports physicians.
00:19:03.920 -->
00:19:07.839Um they can spend time with our sports PTs.
00:19:07.920 -->
00:19:13.519We do some coverage in town with Union Omaha and Love Volleyball and some high school athletics.
00:19:13.599 -->
00:19:21.759But in general, most residency programs, I would say it's about 30 hours a week if it's more of an on-site program like ours.
00:19:21.839 -->
00:19:28.880Or again, there are hybrid programs or models where you will work a full-time job and then you do all of that didactic work nights and weekends.
00:19:29.039 -->
00:19:31.279So you just have to compare the model.
00:19:31.680 -->
00:19:33.039Yeah, I'll jump in next.
00:19:33.200 -->
00:19:46.319Um, and maybe putting my post-professional education hat on that spans across all six programs because they all meet those requirements that you highlighted, but they have different requirements within the specialty programs.
00:19:46.480 -->
00:19:50.880So we have description of residency practice for each specialty area.
00:19:51.039 -->
00:20:03.359And so that does a little bit change how some of them are structured on the clinical practice side because there are different levels of care that are required of the different um practice settings.
00:20:03.519 -->
00:20:06.400And so I'll let Sarah talk to some of that a little bit later.
00:20:06.480 -->
00:20:08.799Related to PEADs is one of the most complex ones.
00:20:08.960 -->
00:20:12.960But um, neuro, for example, covers inpatient rehab, acute care, and outpatient.
00:20:13.119 -->
00:20:18.319So that kind of and like neuropatients are not really able to come in at 7 a.m.
00:20:18.480 -->
00:20:21.759all the time because it takes them, there's transportation challenges and things like that.
00:20:21.839 -->
00:20:26.079So there's just like different demands on the practice areas that structure some of that.
00:20:26.240 -->
00:20:31.440But very similarly, they all spend about 30 hours in clinical practice a week.
00:20:31.519 -->
00:20:41.279Um, but some of them are switching, like clinic in the morning, coming to Creighton in the afternoon, so that we can have them be in clinic when the patients are available in clinic.
00:20:41.359 -->
00:20:47.359Um, and then I think of that like I call it Creighton time, but it's really academic learning time.
00:20:47.680 -->
00:20:55.200It kind of funnels all the other things that we think either support reinforcement of the knowledge or application of the knowledge.
00:20:55.279 -->
00:21:01.599And that can be teaching, research, service, and then their own didactic modules that we do.
00:21:01.759 -->
00:21:10.079We have a common curriculum, so there's um an interprofessional opportunity there where all of our residents and we have three OT fellowship programs too.
00:21:10.160 -->
00:21:23.440They come together and do some work together, present cases, that reflective process that happens as a part of that reflection on cases is really dynamic and I think a fun part of a residency program too.
00:21:23.599 -->
00:21:27.920So that's maybe some um that's for us woven in there.
00:21:28.079 -->
00:21:35.759And then the teaching aspect um occurs in labs mostly, but there are some opportunities in in lectures and then in services in the clinics.
00:21:35.839 -->
00:21:47.359So thinking about all types of teaching, I think is um back to what Megan mentioned, just reinforcing you have to know the content really well to teach others and share your clinical reasoning process.
00:21:47.519 -->
00:21:49.119So that's woven in in different ways.
00:21:49.200 -->
00:21:59.200And I would just maybe sprinkle in when maybe you're considering residencies, choosing a program that you feel like meets your professional development goals, right?
00:21:59.359 -->
00:22:07.680And so Will help you develop in the way that you want to develop out because we really look for residents that kind of we want to be able to get you where you want to be.
00:22:07.839 -->
00:22:14.319So maybe I'll hand it over to Sarah to comment more on the dynamics of the practice settings.
00:22:14.880 -->
00:22:16.720Yeah, so Heather is correct.
00:22:16.799 -->
00:22:26.000For pediatrics, there is a requirement of having so many hours in each five different pediatric settings built within your residency program, and that there's a minimum.
00:22:26.079 -->
00:22:29.680And so each program can kind of distribute that a little bit differently.
00:22:29.839 -->
00:22:38.480So you have to have some time in school based, some time in early intervention, some time in acute care, some time in um NICU, and some time in outpatient.
00:22:38.559 -->
00:22:42.319And so how you do that can kind of look different.
00:22:42.559 -->
00:22:44.960Um and so we have a structure.
00:22:45.039 -->
00:22:51.839We also, what is maybe a little bit different about our residents is that they are um taking part in our LIND program.
00:22:52.240 -->
00:23:01.039And so they're a trainee in that program alongside being in our residency throughout the whole year, and that just stands for leadership education and neurodevelopmental and related disorders.
00:23:01.200 -->
00:23:15.920And really the goal of that program, there are 60 programs across the country, is to develop and train individuals that are able to improve the health and well-being being of individuals with um individual or with disabilities.
00:23:16.079 -->
00:23:26.720And so it's nice because they're part of another cohort, they're working together, they also have that opportunity to work with lots of different disciplines and understand how we can all work together as part of that team.
00:23:26.960 -->
00:23:38.960And it's also really nice because they have opportunities to learn about cultural competence, health disparities, and then they're able to do some advocacy in action by taking trips to Lincoln and Washington, DC.
00:23:39.279 -->
00:23:45.039And also a part of that is doing a scholarly research project and presenting that as part of the whole LIN cohort.
00:23:45.200 -->
00:23:50.480So I think, yeah, every specialty and every program looks a little different, how they meet those requirements.
00:23:50.559 -->
00:23:52.000Um, and I would agree with Heather.
00:23:52.079 -->
00:23:56.319Then looking at those programs, what are your goals and kind of what do you hope to get out of it?
00:23:56.400 -->
00:24:00.559And how can that program kind of help you learn what you want to learn in that year?
00:24:00.960 -->
00:24:03.920Because it a Heather, did you want to say something else?
00:24:04.400 -->
00:24:05.039Yeah, sorry.
00:24:05.119 -->
00:24:06.000I just wanted to circle.
00:24:06.160 -->
00:24:11.519Well, I had an afterthought about our sports specialty friends for those who might be considering sports.
00:24:11.680 -->
00:24:18.160They do have a little bit of an extra requirement, so um related to on-field training.
00:24:18.319 -->
00:24:24.559So they actually have 200 additional hours that are required related to on-field sports management.
00:24:24.720 -->
00:24:42.559And so just as we're thinking about the programs, those folks who are interested in sports are very passionate and just know that you're signing up for that like extra learning opportunity related to on-field coverage, um, and that they do go above and beyond what the others do related to that specific requirement.
00:24:42.640 -->
00:24:45.200Um, so I thought I should add that back in.
00:24:45.359 -->
00:24:46.079Sorry.
00:24:47.039 -->
00:24:56.640You guys holistically kind of did a great job of just discussing what residents are going to experience in respective residency programs, right?
00:24:56.720 -->
00:25:01.279And and how it's not just about the clinical reasoning or clinical skills.
00:25:01.440 -->
00:25:04.640Um, you're you're building more into them, right?
00:25:04.799 -->
00:25:12.640Um can you guys talk a little more specifically about what mentoring looks like within a residency program?
00:25:12.960 -->
00:25:29.920I'm asking that question because I've had some other conversations and even done some podcasts recently with people that are thinking about mentoring within the clinic and trying to build out programs in those ways to make sure that it's not just, hey, go talk to Joe over in the corner when he has five minutes available, right?
00:25:30.240 -->
00:25:35.359So can you guys be a little more specific about what mentoring looks like in a residency program?
00:25:35.759 -->
00:25:38.480I can start, but Heather, yeah, jump in.
00:25:38.720 -->
00:25:46.880Um, yes, because I've heard that too, where you know, new grads or are some of our students are saying, Well, this clinic is telling me they're gonna mentor me.
00:25:46.960 -->
00:25:50.559And I think it's trying to find out like what is that definition of mentoring?
00:25:50.799 -->
00:25:58.960Um, some it is just, oh, I'm gonna partner you with your mentor and you know, good luck, ask questions at lunch or something, or whenever you can catch them.
00:25:59.119 -->
00:26:10.880Others do have a more structured program, but it's often more like lunch webinars or things, and it's not usually someone watching you with patients because that's lost productivity.
00:26:10.960 -->
00:26:15.039And most clinics aren't willing to do that on a consistent basis.
00:26:15.200 -->
00:26:27.440So in a residency program, again, most of that required mentoring time has to be what they define as one-on-one, which means the resident is leading the treatment and the mentor is observing.
00:26:27.759 -->
00:26:33.920And generally, the mentor is letting the resident lead the session, they're not taking over.
00:26:34.160 -->
00:26:43.920Um, obviously, that depends on the situation and the skill of the resident, and maybe they'll jump in and just ask a couple questions or prompts as appropriate.
00:26:44.000 -->
00:26:48.000They try not to take over and then kind of give their feedback after the fact.
00:26:48.160 -->
00:26:52.400So that's the other thing, and I'll let the others chime in on how theirs are structured.
00:26:52.640 -->
00:27:00.400So, generally in a year-long on-site residency program, you get three to four hours a week of mentoring.
00:27:00.720 -->
00:27:15.519What we do is the first 30 minutes is our like prep time where the resident gets to give a rundown of their patients and see like if there's any questions they have for their mentors or areas they really want to focus on.
00:27:15.759 -->
00:27:20.880Then they'll see those patients for two, two and a half hours, depending on the session that day.
00:27:21.039 -->
00:27:26.000The mentors present, again, observing, maybe asking a few questions or prompts.
00:27:26.160 -->
00:27:50.160And then there's at least 30 minutes at the end for a debrief where there's dedicated, you know, time to give feedback, um, develop that clinical reasoning rather than just, well, you have three hours of mentoring, but you're booked with patients that whole time, and now your your mentor has to run off to see a patient, and you have to run off to see another patient, and you don't actually have time to give feedback.
00:27:50.319 -->
00:27:57.519So kind of asking how that is structured is helpful, but there's dedicated time for actual conversation and debrief.
00:27:57.599 -->
00:28:01.279And obviously, then if there's like a cancellation or a no-show, you've got even more time to practice.
00:28:01.359 -->
00:28:07.359But we try to build that in in case that doesn't happen, that there's still that dedicated time.
00:28:07.519 -->
00:28:15.599So, again, if you're looking at a job that maybe says they have mentorship, that's great, but maybe just look at like what does that actually look like?
00:28:15.759 -->
00:28:26.319How often is it you might be learning really valuable things, but it's still not the same as someone observing you and challenging you in clinical practice?
00:28:26.640 -->
00:28:37.519Yeah, I would underscore the one-on-one overpatient care opportunities within the residency program and having a trained mentor.
00:28:37.680 -->
00:29:01.279So and that's also something maybe to ask when you're exploring programs because different programs recruit mentors and train mentors differently, but having somebody who's trained to probe and guide your clinical reasoning so that you're growing your thought process is very much a foundational component within residency education.
00:29:01.759 -->
00:29:33.759And the structured part of that that Megan was describing, where there's this pre-brief direct observation of your interaction with the patient, because you can tell your perspective to a mentor who wasn't there, but back to the thought of like, were there gaps or things I didn't see or didn't understand, having that experienced person in the room to interpret some of that or bring in additional context can be so valuable in understanding the big picture or other opportunities that you just may not know on your own, right?
00:29:34.000 -->
00:29:49.519So um, and then that reflective process, trying to um have the debrief afterwards, but you know, some programs and most of ours have a written reflection as part of our mentorship form so that you're continuing to reflect on that and how can I learn and grow.
00:29:49.759 -->
00:29:55.359I'll also add that it's also about pulling in the best evidence too.
00:29:55.680 -->
00:30:03.359So not only what did I do with this patient in this moment, but should there be other evidence I'm considering or resources that I didn't know about?
00:30:03.519 -->
00:30:07.440And can they funnel like our mentors funnel the residents that way?
00:30:07.759 -->
00:30:12.559And finally, I had a really good example of just this is the structured minimum.
00:30:12.799 -->
00:30:14.799150 hours is the structured minimum.
00:30:14.880 -->
00:30:18.000Our residents get so much more mentoring beyond that.
00:30:18.160 -->
00:30:20.000Um, some of them from team mentors.
00:30:20.240 -->
00:30:22.960We had a resident ask about what can I count the mentoring hours?
00:30:23.119 -->
00:30:28.160I'm meeting with this OT, and she's giving me such good feedback on our patient that we're sharing.
00:30:28.319 -->
00:30:29.440And that is great.
00:30:29.599 -->
00:30:38.000We do we value that, but that is separate from what a structured residency program offers by a licensed physical therapist.
00:30:38.160 -->
00:30:46.559And so um, you know, our residents get a lot of mentorship and guidance from experienced people, both on the academic side and in their teams in the clinic.
00:30:46.720 -->
00:30:53.359Um, so it's not they get mentorship in so many ways, but the structured mentorship is really what is protected.
00:30:53.519 -->
00:30:53.920Yeah.
00:30:54.240 -->
00:30:55.920Yeah, and I don't know that I have a lot to add.
00:30:56.079 -->
00:30:58.559I think that's all, you know, great information.
00:30:58.720 -->
00:31:09.279But I think also just thinking about the fact that, you know, that when that mentorship is happening, it's not a just about, well, you did this right or you did this or you should try this.
00:31:09.359 -->
00:31:13.680It's really enhancing their ability to think critically about like, well, why did I do that?
00:31:13.759 -->
00:31:16.240If I thought that went well, why did it go well?
00:31:16.400 -->
00:31:24.079So also that mentoring is really deepening their understanding of why they're doing what they're doing versus just getting an answer to their question.
00:31:24.480 -->
00:31:24.799Yeah.
00:31:25.039 -->
00:31:41.759Develop their ability to, once they're done with residency, have that voice in their head to continually refine and reflect, even when someone's not there to, as Sarah said, it's not just pointing out like you did this right, you did this wrong, but figuring out the why behind it.
00:31:42.000 -->
00:31:42.720I like that.
00:31:43.359 -->
00:31:46.960I'm I'm gonna try to recap some of the things that I just heard you guys say.
00:31:47.039 -->
00:31:52.160So fill in the blanks if if uh excuse me, if I'm missing something.
00:31:52.400 -->
00:32:21.200Uh so in terms of just thinking about from your all's perspective as the mentors uh within some of these residency programs, you want that time to be structured, you want it to be intentional, um, you want it to be reflective and not necessarily just one-way reflect, like not just the resident reflecting, but you're even modeling that reflection in front of them or doing it alongside of them at the same time.
00:32:21.440 -->
00:32:39.680You're exploring literature together, you're maybe challenging one another's thought processes, but it's it's a lot of side by side as you do this, not you know, uh resident goes and does their thing and then comes back and then goes back out again and comes comes back to you.
00:32:39.920 -->
00:32:40.559Is that accurate?
00:32:40.640 -->
00:32:42.000And what am I missing?
00:32:43.200 -->
00:32:45.200Nailed it, mic drop, okay.
00:32:45.279 -->
00:32:46.559I'm getting head nods.
00:32:46.720 -->
00:32:47.200Love it.
00:32:47.359 -->
00:32:48.400That's wonderful.
00:32:48.640 -->
00:32:52.880Okay, so I'm I'm a little bit interested uh just to ask a question.
00:32:53.119 -->
00:33:03.519You know, when a when a resident starts in a program and they get about a month into it, what's the thing that you guys find surprises them the most about their residency program?
00:33:03.839 -->
00:33:11.200I imagine, I mean, just like anytime you start something new, it's a little overwhelming at first, but you get a month in, what's the thing that surprises them the most?
00:33:11.839 -->
00:33:20.880I think what seems like for our residents to be the most surprising is because we they are in multiple different settings doing lots of different didactic work.
00:33:21.039 -->
00:33:25.200Um, they've come from a program where they had to be pretty organized generally.
00:33:25.279 -->
00:33:29.359You know, they've just come from PT school, they've had to be organized to be successful.
00:33:29.519 -->
00:33:39.599And I think sometimes it surprises them how that organization needs to change to help them to really be an independent learner and to kind of meet all the demands of the residency.
00:33:39.759 -->
00:33:42.400Sometimes that can be a little surprising for them.
00:33:42.720 -->
00:33:55.440I think I would add, and I would I would agree with that, about just kind of there's a transition to post-professional programs, just like I think a lot of our learners transition going from undergrad to graduate programs.
00:33:55.519 -->
00:34:00.079So it's just kind of getting your feet wet and figuring out your process.
00:34:00.240 -->
00:34:09.039But if I had to narrow it down to something that maybe surprised them, and not that they're not aware they're going to be doing it in advance, like we're very clear about all the things they'll be doing.
00:34:09.119 -->
00:34:18.800But once you're in the lived experience of the dynamic nature of the residency programs, it I think it's just how many different roles they hold.
00:34:19.039 -->
00:34:27.599Um, knowing they're a PT in the clinic, they're um they have a mentee mentee mentor, excuse me, mentee-mentor relationship.
00:34:27.840 -->
00:34:33.360They have a little bit of an educator type of role in teaching in labs.
00:34:33.760 -->
00:34:40.320Um, they have an advocacy role, like thinking about for my patients, what does the patient need?
00:34:40.400 -->
00:34:41.920And they're learning that health system.
00:34:42.079 -->
00:34:49.039So I think that the residency gives them really good opportunities to see all the different roles that we hold as physical therapists.
00:34:49.199 -->
00:34:54.559And I think that first month they kind of learned to embrace that and um really grow into that.
00:34:54.639 -->
00:34:58.480But I think it's kind of surprising once you're living it and we're like, yeah, you're doing it.
00:34:58.639 -->
00:35:04.320And it's that moment of just kind of helping them embrace some of that dynamic challenge of a residency program.
00:35:04.800 -->
00:35:16.000Heather, I'm gonna stick with you for a moment because one of the things that you mentioned in some of our you know, prep materials ahead of this podcast was just that there's five different traits of successful residents.
00:35:16.079 -->
00:35:24.079Uh, one of those is open to feedback and then teachable, critical thinker, accountable, and reflective.
00:35:24.239 -->
00:35:26.480So can you maybe just speak a little bit more?
00:35:26.639 -->
00:35:28.400I feel like this is building off of what you're just saying.
00:35:28.559 -->
00:35:37.199Can you speak a little bit more to each one of those things and maybe paint this picture for how residents can be successful uh within their residency programs too?
00:35:38.239 -->
00:35:42.960Yeah, well, I think they kind of all flow into each other a little bit.
00:35:43.039 -->
00:35:57.920Um, but when I think about a resident who really thrives in that dynamic residency environment, um, having that open openness to feedback and that flexible mindset is really important because you're getting a lot of feedback.
00:35:58.079 -->
00:36:05.920And then we also really want the residents to take that feedback, reflect on it, and make change in practice, right?
00:36:06.079 -->
00:36:17.519So um, and that's where being dynamic and have that flexible mindset kind of I think falls into the being teachable and working together and being willing to change what you're doing.
00:36:17.679 -->
00:36:21.280Behavior change is hard, even for really experienced therapists, right?
00:36:21.360 -->
00:36:25.199So it's just going into it with that mindset of I'm gonna get a lot of feedback.
00:36:25.280 -->
00:36:27.039Um, I'm also gonna give a lot of feedback.
00:36:27.199 -->
00:36:29.199So that's a little bit of that accountability piece.
00:36:29.280 -->
00:36:34.960It goes both ways, but they got to embrace the different roles that we hold as physical therapists.
00:36:35.039 -->
00:36:40.239And so some of that accountability and we keep each other accountable in the program.
00:36:40.400 -->
00:36:43.519That's part of the benefit of I think the structured residency program.
00:36:43.599 -->
00:36:55.679It builds in some of that accountability, but um, we really, you know, look for those residents who are striving to be lifelong learners and can build out that critical thinking, clinical reasoning.
00:36:55.840 -->
00:37:03.599So yeah, just embracing those, coming into the program with that mindset can be so valuable in optimizing your time in a residency.
00:37:03.920 -->
00:37:04.719Okay, it's great.
00:37:04.960 -->
00:37:09.119Megan, you talked a little bit about um thinking back to your origin story.
00:37:09.199 -->
00:37:18.480You talked in some of our prep materials just about the fact that um imposter syndrome and learning when to ask for help were things that were hard for you early on.
00:37:18.639 -->
00:37:21.119How did residency help you with that?
00:37:21.199 -->
00:37:24.639And how do you see it maybe helping newer grads as well?
00:37:26.239 -->
00:37:36.079Yeah, I think again, as a newer grad, if you're thrown into a busy clinical environment, you're expected to be highly productive.
00:37:36.320 -->
00:37:40.239Um it can be, first of all, you have to know what you don't know.
00:37:40.400 -->
00:37:42.480You have to even recognize that you have a question.
00:37:42.639 -->
00:37:46.320Sometimes we're blind to the fact that we don't know that.
00:37:46.639 -->
00:37:53.519But sometimes it's glaringly obvious and you you understand that you're not where you want to be, but you're not sure how to get there.
00:37:53.599 -->
00:37:58.880And that I think that disconnect, well, that can lead to imposter syndrome, but it also can lead to burnout.
00:37:59.039 -->
00:38:20.639I think that's what that kind of I think talk about like moral injury when we think about burnout, and that is often when like you know the level of care you want to be providing, but you feel like you're not able to provide that for whatever reason, whether that's your own skills, whether that's the the productivity pressures or whatever it is, um, and that can become kind of overwhelming and frustrating for people.
00:38:20.719 -->
00:38:23.360And then I think that often leads to burnout.
00:38:23.440 -->
00:38:33.840And I actually just saw a study at a little conference I was at a week or two ago, and they cited that mentorship can help reduce some of that burnout.
00:38:33.920 -->
00:38:36.400And so I was like, yes, this is what we've been saying forever.
00:38:36.559 -->
00:38:46.719Um, but I think that that structure gives you permission, not only permission, but it actively requires you to reflect and ask questions.
00:38:46.880 -->
00:38:56.480Not only like, oh, go and ask Joe in the corner a question, like someone's giving you permission to ask, but you're like, well, he's trying to get his documentation done.
00:38:56.559 -->
00:38:57.760He's got to get home to his kids.
00:38:57.840 -->
00:39:00.480I don't want to bother him, I don't want to look stupid, right?
00:39:00.559 -->
00:39:08.239There's all of these like hesitations, but in the residency, it's you are required to do this, and we want you to do it.
00:39:08.400 -->
00:39:12.960Um and we don't expect you to come in being perfect.
00:39:13.119 -->
00:39:14.239Like that's fine.
00:39:14.400 -->
00:39:17.920We want you to see you grow and we're there to help guide you.
00:39:18.000 -->
00:39:21.360So I think just having that permission initially helps a lot.
00:39:21.599 -->
00:39:25.599And then after residency, you hopefully continue that, right?
00:39:25.679 -->
00:39:38.960You continue um either asking yourself those questions, challenging yourself, reflecting on your on your own, or then being more comfortable having those conversations with your coworkers and things.
00:39:39.119 -->
00:39:39.519I don't know.
00:39:39.840 -->
00:39:41.119I feel like I was rambling.
00:39:41.440 -->
00:39:43.039Heather and Sarah chime in.
00:39:43.840 -->
00:39:54.960Yeah, no, I think just uh like what Megan said, I think that it just gives you that opportunity to ask questions because I think we know we learn best when we don't have the answer and it doesn't go the way that we want it to.
00:39:55.119 -->
00:40:01.840And so um, I think that's what a residency is nice because you sh you're not expected to have an answer.
00:40:02.000 -->
00:40:04.239And hopefully that's really clear to all residents.
00:40:04.320 -->
00:40:07.039Like that's not our goal, is you're getting to this point.
00:40:07.280 -->
00:40:10.400We just want to see you grow as a clinician throughout the year.
00:40:11.039 -->
00:40:11.360Okay.
00:40:12.159 -->
00:40:12.639All right.
00:40:12.719 -->
00:40:17.119So I want to get into the question that you know inevitably comes.
00:40:17.360 -->
00:40:20.000Uh can I afford to do this?
00:40:20.239 -->
00:40:22.480Is it worth it in the end?
00:40:22.639 -->
00:40:22.960Right.
00:40:23.360 -->
00:40:25.599Uh, Megan, I'll start with you here.
00:40:26.000 -->
00:40:37.280Um, I think the numbers that you've shared with me are that you know, residents often will earn about 80% of a comparable PT salary with benefits, no tuition.
00:40:37.440 -->
00:40:41.760How do you talk to a student who's staring down loan payments coming?
00:40:42.719 -->
00:40:44.639Yeah, that's always a point of discussion.
00:40:44.719 -->
00:40:47.039And again, we've mentioned there are other models out there.
00:40:47.199 -->
00:40:54.719There are models where you can have your full-time job, get a full salary, but then you turn around and pay tuition for a residency program.
00:40:54.800 -->
00:40:58.480Um, so some of that, you just have to do that math in what works better for you.
00:40:58.719 -->
00:41:05.679In our program, yeah, it's 80% of a comparable salary, but as we've mentioned, the residents are only in the clinic 30 hours a week.
00:41:05.840 -->
00:41:08.639So they're only generating revenue for 30 hours a week.
00:41:08.800 -->
00:41:17.840So you can't expect a full salary when you're only seeing patients for about a 0.75, you know, 75% of a full salary.
00:41:18.000 -->
00:41:30.000So if you're comparing a job offer for 40 hours a week to a residency salary for 30 hours a week, you need to just say, well, what would that job pay me if I was only going to work there for 30 hours a week?
00:41:30.079 -->
00:41:32.239And that's a little bit better comparison.
00:41:32.480 -->
00:41:38.719The salary is then slightly reduced, generally because of tuition, or you know, we don't charge tuition.
00:41:38.800 -->
00:41:39.679So some programs do.
00:41:39.840 -->
00:41:43.760Some programs you'll take your full salary, then you turn around and pay tuition.
00:41:44.000 -->
00:41:46.880Ours, we just take the tuition off.
00:41:47.199 -->
00:41:50.239So you're not paid as much and you don't pay as many taxes.
00:41:50.320 -->
00:41:51.760You're maybe in a lower tax bracket.
00:41:51.840 -->
00:41:52.880So there's a benefit.
00:41:53.119 -->
00:41:55.280Um, so I think you just have to think about that.
00:41:55.360 -->
00:41:58.960We've actually honestly, because that has been a struggle the last few years.
00:41:59.119 -->
00:42:04.000People are the job market's so good, and these new grads are getting offered great salaries.
00:42:04.159 -->
00:42:07.119So it's a hard decision.
00:42:07.199 -->
00:42:09.920And so we've honestly looked at, well, what could we do?
00:42:10.079 -->
00:42:14.960We could just have our residents see patients 40 hours a week, and then I could pay them more.
00:42:15.119 -->
00:42:27.360But when I've talked to prospective residents about that, they don't love that idea either because they want the work-life balance and they want the time to study and they want the time to go do all of these other great experiences with the physicians and um teaching.
00:42:27.679 -->
00:42:29.199So it's a trade-off.
00:42:29.280 -->
00:42:36.960If you want that balance, you're not going to get a full salary, or you can go get a job, work a full salary, pay tuition.
00:42:37.119 -->
00:42:38.239So that's the trade.
00:42:38.320 -->
00:42:41.039You just have to think about it, it's one year of your life.
00:42:41.280 -->
00:42:53.440Um, the other thing, and I think we'll maybe mention some of the evidence shows that those who are board certified early in their career do earn more, up to$6,000 a year, like that's an average.
00:42:53.760 -->
00:42:56.800So it might pay off more in the future, right?
00:42:56.880 -->
00:43:08.800You you're more likely to get leadership jobs in the future, you're more likely to maybe um, you know, beat someone out for that job offer or negotiate a raise because you do have that certification.
00:43:08.960 -->
00:43:17.679So um, and then there's the non-financial benefits that we've talked about, like if it improves your confidence, if it helps reduce burnout, like that's worth something.
00:43:17.920 -->
00:43:19.360It's worth a lot, I think.
00:43:19.519 -->
00:43:21.519But yeah, the finances always come up.
00:43:21.760 -->
00:43:36.880If I can add, I would um reinforce too that if you have access to a financial advisor, financial aid, it might be worth consulting with them about like the repayment options that are open to you.
00:43:37.119 -->
00:43:42.239And I know there's been a lot of changes recently, so it's best just to go to the experts, I would say.
00:43:42.480 -->
00:43:48.559But you know, you don't necessarily have to delay education, if you will.
00:43:48.719 -->
00:43:58.960Um, there are income based repayment options that might help reduce the payment while you're getting the reduced salary and it kind of scales your payment to your salary range.
00:43:59.039 -->
00:44:06.480Um, there are Also, other repayment options that are worth considering if they stick around, like the public service loan forgiveness program.
00:44:06.800 -->
00:44:12.400You might find a residency program that is a qualifying employer if you plan to go on that track.
00:44:12.559 -->
00:44:15.440So again, those things are ever evolving.
00:44:15.519 -->
00:44:22.159So go to the expert, but it's worth your time if you if you are feeling driven to do a residency program.
00:44:22.400 -->
00:44:31.280I would say don't let money be the barrier, but kind of look at your options and be financially savvy, I would say, as you pursue that opportunity.
00:44:31.519 -->
00:44:37.679So, and I just maybe springboard off of what Megan said about the different opportunities that maybe come out of residency.
00:44:37.840 -->
00:44:59.280I'll say that a non-financial benefit that I felt like was a benefit to me was just feeling like I grew in my PT skills in a variety of ways that as life evolves, and you know, if you're hitting a phase where, like, man, I feel like I'm in a rut, can I, can I, you know, volunteer for something service-oriented?
00:44:59.440 -->
00:45:13.760It made me feel like I had the skills to say yes to different program improvement projects within my organization and or you know, sign up for things on the organization level, like JPTA Nebraska or Academy of NeuroPT.
00:45:13.840 -->
00:45:17.599Like I felt like I could step out and connect in different ways within the profession.
00:45:17.760 -->
00:45:22.320And I also gave me flexibility to like think about different roles I might hold.
00:45:22.480 -->
00:45:30.159This is also how I ended up in education of like, you know, life changes and you have kids, and do you need something that fits different?
00:45:30.400 -->
00:45:33.039Um, you know, you have a partner who makes benefits.
00:45:33.280 -->
00:45:38.800Can you work different jobs that puts together PRN and or other roles that you like to hold?
00:45:38.880 -->
00:45:58.079Like that, even though I didn't pursue all of those, I think feeling like you have the ability opens up doors that maybe you you don't anticipate existing when you first pursue a residency, but that's just a non-financial benefit that I I personally experienced and think I've seen a number of residents experience over the course of their careers.
00:45:58.559 -->
00:45:59.360That's great.
00:45:59.599 -->
00:46:00.480That's great.
00:46:00.719 -->
00:46:03.760Um, Heather, I know we're gonna lose you here shortly.
00:46:03.920 -->
00:46:07.760So I would love to just kind of uh switch gears real quickly.
00:46:07.920 -->
00:46:16.800So um if if there's some kind of a match process, how can a new grad be competitive when it comes to applying for residencies?
00:46:18.000 -->
00:46:24.800Yeah, well, um interestingly, a match process is just how the program matches with a resident.
00:46:24.880 -->
00:46:41.199And it's a more structured process for matching applicants with the program, as opposed to a program that has more of a traditional interview application type of process, and you individually kind of apply to each program separately, and it's not on the all on the same time frame.
00:46:41.440 -->
00:46:43.519A match really has a structured time frame.
00:46:43.840 -->
00:47:00.400So I said, I in my mind, regardless of which process you're going for for application to a residency program, kind of thinking about pursuing opportunities that help you confirm that this is the area of practice you really want to specialize in so that you can speak to it.
00:47:00.480 -->
00:47:04.880Like, yes, I'm excited and passionate about it because I've done X, Y, and Z.
00:47:04.960 -->
00:47:21.280It's not necessarily checking off a box, but it's being able to speak to understand why you're passionate about that area of practice and you've explored that, you've gone through that discernment because residencies are busy and they can be really fun, busy because you love the area of practice.
00:47:21.360 -->
00:47:30.480But if you go into it because you feel like you have to, it's gonna be a heavy year because you're just doing work that you maybe aren't passionate about.
00:47:30.559 -->
00:47:34.639And we want those people to feel passionate about what they're doing in the residencies.
00:47:34.880 -->
00:47:40.880So that's my two cents, but others feel free to like add to that message.
00:47:41.199 -->
00:47:47.119Yeah, we have had a match, we've done the math program for several years now, um, through the pediatric section.
00:47:47.199 -->
00:47:58.480And I think it actually benefits both the resident and the program because it does allow for just you to say who are you, who is your first pick, each of you.
00:47:58.639 -->
00:48:06.480And it seems like across our section, our specialty, it's allowed people to really get their first picks more often.
00:48:06.719 -->
00:48:14.159So um it could seem more intimidating, but I think in the long run, it really does um help out.
00:48:14.559 -->
00:48:15.760Thank you, Sarah.
00:48:16.079 -->
00:48:18.960Heather, we're gonna say our goodbye to you real quick.
00:48:19.119 -->
00:48:25.039Uh so thanks for joining us, and we're gonna wrap up our conversation as you um after you leave, I suppose.
00:48:25.360 -->
00:48:26.559Well, thanks for having me.
00:48:26.719 -->
00:48:30.320I appreciate your time and interest in residency programs.
00:48:30.480 -->
00:48:31.519So have a great day.
00:48:31.840 -->
00:48:32.079Yep.
00:48:32.239 -->
00:48:32.800See ya.
00:48:33.039 -->
00:48:33.519All right.
00:48:33.679 -->
00:48:47.920So, Megan, Sarah, um, I would just ask you guys if students are on clinical rotations um in their final year of PT school, what should they really be investigating to figure out whether or not a residency is right for them?
00:48:48.239 -->
00:49:02.400I think if you are a student and you really feel called that you want to be in a certain specialty, that it really would behoove you to look at the different residency programs, kind of as Heather mentioned, what does each program offer those settings?
00:49:02.559 -->
00:49:04.719Is it what your career goals are?
00:49:05.039 -->
00:49:24.239And if they all line up, it does give you just a really nice year of structured mentorship that hopefully should, as we've kind of talked about all along, take you, allow you to take your knowledge, translate it into practice, be more confident, and hopefully kind of take your career to the next step a little bit faster.
00:49:24.480 -->
00:49:25.360Yeah, I would agree.
00:49:25.440 -->
00:49:30.480I think just first, as it's already been mentioned, like what area do you want to specialize in?
00:49:30.639 -->
00:49:33.920And if you do feel pretty confident, um, go for it.
00:49:34.079 -->
00:49:37.119If not, then maybe it's not the best choice right now.
00:49:37.280 -->
00:49:41.199And as we talked about, figure that out, and then you can do it in a couple of years.
00:49:41.280 -->
00:49:42.880Like that's also an option.
00:49:43.119 -->
00:49:47.920But if you know, it's often kind of an easier transition to do out of school.
00:49:48.079 -->
00:49:53.360You're already not used to making a full salary or you're used to studying, there's a little structure there.
00:49:53.599 -->
00:50:02.159I think the other part is those skills we've talked about or those traits that we're looking for, is like ask yourself, are you a motivated, self-directed learner?
00:50:02.400 -->
00:50:07.760Residency is not getting lectured at as much as DPT school.
00:50:07.840 -->
00:50:11.760It's more um adult learner um focused.
00:50:11.840 -->
00:50:27.519And so you've got to kind of, yes, there's a curriculum, there's certain required maybe readings or uh materials, but we also expect you to kind of go to the literature and and ask questions and seek things out more actively and not have to be kind of told what to do constantly.
00:50:27.679 -->
00:50:34.320So be an honest, you know, reflection of do you feel like you're up for that?
00:50:34.400 -->
00:50:36.320Um, and again, are you open to feedback?
00:50:36.400 -->
00:50:37.840Do you have that growth mindset?
00:50:38.000 -->
00:50:42.400How do you um how did you receive feedback on your clinical rotations?
00:50:42.480 -->
00:50:48.480Like just kind of honestly reflect on um how that has gone for you.
00:50:48.559 -->
00:50:51.599And then as already mentioned, just what are your goals beyond specialization?
00:50:51.679 -->
00:51:07.599Because some clinicals or some residencies, excuse me, are focused purely in the clinic realm and others, as some of ours, have more of that maybe teaching component, maybe a scholarly activity, maybe more time with other professionals like physicians that others don't offer.
00:51:07.679 -->
00:51:12.159So, what do you want to get out of residency beyond just the clinic side?
00:51:12.320 -->
00:51:14.320And then look at those things.
00:51:15.039 -->
00:51:15.519All right.
00:51:15.679 -->
00:51:20.320Before I start to wrap us up, I just want to close with any odds and ends.
00:51:20.400 -->
00:51:26.400So is there anything that we haven't talked about, we haven't covered that you guys would love for our listeners to know?
00:51:26.719 -->
00:51:31.119I think I recently, one of our third-year students was asking a question.
00:51:31.199 -->
00:51:38.639So I posed it to our residents of, you know, compared to the workload in DPT school, what does residency feel like?
00:51:38.880 -->
00:51:48.960And at least at this point in the year, the residents both felt like it was much more manageable, even though it seems like, well, I'm in the clinic and now I have to study and I have to teach.
00:51:49.199 -->
00:52:02.320Um, at least in again, our programs that are all about 30 hours a week, so they've got some of that time, but also the the reading they are doing and the studying they are doing is now focused in an area they're interested in.
00:52:02.400 -->
00:52:03.360So also think about that.
00:52:03.440 -->
00:52:19.599And there's less juggling of in DPT school, you've got maybe five different courses, you're trying to remember neuro, and then the next day you've got cardio, and then you've got ortho, and you're trying to juggle all that in your brain, um, where residency, all the curriculum is kind of focused in that one area.
00:52:19.679 -->
00:52:23.199And so it's also interesting and it's what they want to spend their time on.
00:52:23.440 -->
00:52:33.519So, yes, it's work, and yes, it is more than just kind of your standard 40-hour job, but I think it's um something they signed up for.
00:52:33.599 -->
00:52:36.320Um, but they also felt like it was very manageable.
00:52:36.400 -->
00:52:41.119So I guess I'll just put that little plug in there since I got that information from the residents.
00:52:41.679 -->
00:52:47.360And I would just say we have talked a lot about how residency programs are structured and there's a framework.
00:52:47.440 -->
00:52:59.199Um, but don't be afraid to, if you're interested in a residency, if you have like even within that specialty a certain special interest area, often residencies can kind of help tailor their program to that.
00:52:59.280 -->
00:53:05.840So don't be afraid to mention that it's not, even though there's a lot of structure and framework, it doesn't have to be a one size fits all.
00:53:06.239 -->
00:53:07.679That's a great point, Sarah.
00:53:07.760 -->
00:53:15.280I I'm at UNMC our program, because we often get people who are on the fence of do I do an ortho residency or do I do a sports residency?
00:53:15.519 -->
00:53:26.960As Heather mentioned before, the sports residency does have 200 extra hours, kind of that extra requirement, which, if that's what you want to do, again, think about what do you want your career to look like for the next five or 10 years.
00:53:27.199 -->
00:53:29.360That might be exactly what you want to do.
00:53:29.599 -->
00:53:38.639If not, if you don't really want that venue coverage hour piece of it moving forward, and we have to think about what does it take to maintain each specialty?
00:53:38.880 -->
00:53:49.360So you get your board certification in whatever area, but you have to maintain that in cycles of every three years, and then it's over a full 10-year cycle.
00:53:49.519 -->
00:53:57.199Um, so I would also look into that because there are different requirements to uptake or upkeep, say, a sports residency versus ortho.
00:53:57.599 -->
00:54:03.280So, what some will do is say, well, yeah, I'm gonna do an ortho residency, but I do I'm still interested in sports.
00:54:03.599 -->
00:54:10.480So we'll kind of create like a sports track for our residents if they're really interested in that that goes above and beyond the core curriculum.
00:54:10.559 -->
00:54:20.800Like we've got the base requirements, but as Sarah said, we try to tailor those, you know, if we want them to do a certain number of hours with certain physicians, but which area are they more interested in?
00:54:20.960 -->
00:54:22.320And we can tailor that.
00:54:22.480 -->
00:54:30.079Um, I briefly mentioned at the beginning, we've got some of our PTs that do sports coverage for some of the professional teams and high school teams in the area.
00:54:30.320 -->
00:54:32.159We have a connection with Hutsker Athletics.
00:54:32.239 -->
00:54:38.719So we can take, like, we're not gonna make all of our residents go do those things because it's not part of the core curriculum.
00:54:39.039 -->
00:54:47.360But if they're interested, you know, express those interests to the directors and they can often tailor some of those things for you.
00:54:48.719 -->
00:54:49.440That's great.
00:54:49.599 -->
00:55:00.400Um, Sarah, Megan, thank you guys for just sharing all of this information about your residency programs with our audience, uh, with younger clinicians as well.
00:55:00.639 -->
00:55:07.760Let me just name that UNMC's um application deadline is December 31st this year.
00:55:07.920 -->
00:55:13.199Uh, Monroe Meyer Institute's deadline is January 3rd of 2027.
00:55:13.519 -->
00:55:16.079And Creighton has a couple different deadlines.
00:55:16.239 -->
00:55:23.760So their sports deadline for applications is December 1st, and it's December 14th for all other residencies.
00:55:23.920 -->
00:55:25.760So let's just name that there.
00:55:26.000 -->
00:55:29.519And uh I've been doing this fun thing to wrap up some of these podcasts.
00:55:29.599 -->
00:55:31.360So this is the good life lightning round.
00:55:31.440 -->
00:55:36.480It's just rapid fire questions for you guys, um, and we'll see what comes out of this.
00:55:36.639 -->
00:55:42.239Okay, so uh Sarah, can you give me just one word to describe residency?
00:55:43.039 -->
00:55:45.119I think realistically, intense.
00:55:45.679 -->
00:55:46.320Intense.
00:55:46.480 -->
00:55:47.119Megan?
00:55:47.360 -->
00:55:48.559Uh growth.
00:55:48.880 -->
00:55:49.199Growth.
00:55:49.519 -->
00:55:53.440Okay, both of you now, best piece of advice a mentor ever gave you.
00:55:53.679 -->
00:55:58.559Um mine was we really do learn the most when things don't work out the way that we thought they would.
00:55:59.360 -->
00:56:00.159I like that one.
00:56:00.400 -->
00:56:03.199Mine was never stop questioning and therefore learning.
00:56:03.280 -->
00:56:05.840Like again, just constantly question things.
00:56:06.159 -->
00:56:08.880Okay, favorite Nebraska spot to recharge?
00:56:09.199 -->
00:56:10.559Spot in El Forest.
00:56:10.880 -->
00:56:15.280Mine is Northeast Nebraska, just because I grew up there and it's so peaceful.
00:56:15.599 -->
00:56:15.920All right.
00:56:16.079 -->
00:56:18.400Megan, what's your go-to thing to bake?
00:56:18.960 -->
00:56:21.119Salted chocolate chunk cookies.
00:56:21.840 -->
00:56:23.840Bringing any of those into the office soon?
00:56:24.960 -->
00:56:25.280Yeah.
00:56:27.119 -->
00:56:30.719Uh Sarah, how about a favorite go baby go moment?
00:56:31.440 -->
00:56:41.280You know, my favorite moment is every build when the cut kids come and get their cars and watching them drive for the first time and move on their own for the first time and just that smile on their face.
00:56:41.920 -->
00:56:42.559Love it.
00:56:42.880 -->
00:56:48.000And then last one here, you know you're a Nebraska PT when, fill in the blank.
00:56:48.159 -->
00:56:52.239You get upset when you go to a chain restaurant and they don't offer Dorothy Lynch.
00:56:52.320 -->
00:56:59.039That used to really upset me as a child because it was the only, it was the only dressing I would eat and pizza didn't have it.
00:56:59.840 -->
00:57:00.079Yeah.
00:57:00.159 -->
00:57:06.480And I would say when we're planning events like Go Baby Go, we really do have to plan around Husker football and volleyball games.
00:57:06.880 -->
00:57:09.440That's a that's a real deal, for sure.
00:57:09.679 -->
00:57:10.320For sure.
00:57:10.559 -->
00:57:12.079All right, last question for you guys.
00:57:12.239 -->
00:57:14.480What has APTA Nebraska meant to you?
00:57:14.719 -->
00:57:27.519I've just really valued all the connections and advocacy that the state organization and the national organization can do for us that honestly no one person could achieve on their own.
00:57:27.599 -->
00:57:31.840But I also recognize, again, we've been talking about being reflective and honest with ourselves.
00:57:31.920 -->
00:57:33.440And that is not my skill set.
00:57:33.599 -->
00:57:50.079Um, and so I appreciate that there are people out there that help monitor the legislative side of things and the payment side of things, um, and then use our voices collectively to get a little bit more um probably influence than we could if we were trying to do that individually.
00:57:50.159 -->
00:57:56.559And especially when I was working full-time in the clinic, that's not something we all have the time and energy to do.
00:57:56.639 -->
00:58:00.079And but personally, it's also just the connections I've made.
00:58:00.639 -->
00:58:04.639Yeah, I think I would say a lot of what Megan has said, just the connections I've made.
00:58:04.719 -->
00:58:11.920It's really also offered me opportunities to do things I probably would not have thought that I would have done in lots of different ways.
00:58:12.079 -->
00:58:23.039And then also I think it is so great that they do provide like an annual conference every year that is super affordable and allows us that connection and you know advocacy and networking to occur.
00:58:23.119 -->
00:58:26.719So I think we're really it's a great benefit that we have.
00:58:27.119 -->
00:58:27.679That's great.
00:58:27.840 -->
00:58:30.079Well, Heather signed off already.
00:58:30.159 -->
00:58:31.760She had to run to another meeting.
00:58:31.840 -->
00:58:34.159Uh, but Megan and Sarah, thank you again.
00:58:34.239 -->
00:58:37.760And if you're a student listening, application season is right around the corner.
00:58:37.840 -->
00:58:46.079So make sure that you talk to your clinical instructors, reach out to any of these program directors that you heard on the podcast today, and also ask to talk with current residents.
00:58:46.320 -->
00:58:55.280All of the links for each of the programs are in the show notes, and uh contact information for Sarah, Megan, and Heather are there as well.
00:58:55.440 -->
00:59:00.880Uh thank you both for being here with us again today, and thanks to our audience for listening.
00:59:01.199 -->
00:59:01.840Thank you.
00:59:02.159 -->
00:59:02.960Thanks.
00:59:03.360 -->
00:59:06.480Thanks for tuning in to the APTA Nebraska podcast.
00:59:06.639 -->
00:59:12.880Stay connected with us for more conversations that elevate our profession and improve the lives of Nebraskans.
00:59:13.119 -->
00:59:16.239Don't forget to subscribe, share, and join the discussion.
00:59:16.480 -->
00:59:20.239Because together we're driving the future of physical therapy forward.
