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Is A Residency Program Right For You? by Stephanie Palacios, SPT

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As graduation approaches, you might have some burning questions that you want answered about residency programs...

Should I do a residency straight out of school or wait at least a year? Does pursuing a residency increase my chance of employment? What if I’m not interested in the research or academic side of residency and I just want quality mentorship? What should I look for in a residency program? And finally, what can I do to make myself a competitive applicant?

To answer these questions, I consulted dozens of physical therapists. Some of these therapists are current residents, others have completed their residencies, and some of them are clinical directors who earned certification specializations with or without having done a residency. In addition, I did some research on my own about various programs in the surrounding area, and I collected information from a webinar about residency programs by residency director, Dr. Elise Ruckert.

What if I don’t know if I want to do a residency program in general?

If you are uncertain about whether you should do a residency in general, make sure that you are certain that you want to work in the field prior to applying. While getting a residency can give you a few more letters behind your name, this should not be the main reason that you are seeking a residency. You can still earn a certification specialization without it by working in that field and taking the exam afterwards. In this case, you may want to start off working first to be sure that that is the specialty that you want to pursue. It is not uncommon for therapists to change specialties early on, and even later on, in their careers.

Should I apply to start right after PT school or wait for at least a year?

Residency programs are very time-consuming and demand on average about 60 hours worth of time for clinical, didactic, research, and even community service work. Therefore, if you are already feeling burnt out from PT school, going straight into a residency program may be difficult to manage. Dr. Rickert suggests waiting to apply if this is the case. In a residency program, you will be extremely accountable for your own progression, which will require a lot of mental energy and stamina. Waiting can also be beneficial because you will gain clinical expertise and acquired skills that you can bring into the residency program. You can bring with you the skill of already knowing how to function independently as a therapist. Therefore, it’ll be easier for you take on those extra responsibilities as a resident without having to learn the entire clinician process at the same time. On the other hand, if you do not feel burnt out from PT school, and you feel like you can continue straight into student mode, residency straight out of school may work out in your favor. You might want to talk to your CIs and touch bases with them about how you have progressed in your internships if you feel like you can handle that level of responsibility. Also, be sure to look into costs associated with a residency program prior to making this decision (see next question below for more details).

What should I look for in a residency program? What if I’m not into research or teaching?

Residency programs differ in several ways. For example, some programs are associated with a university so you may have the opportunity to teach PT students. Other programs are affiliated with research institutions, so there might be a heavier focus on research. And then, there’s the added complexity that some programs are offered through a company, so a company might help pay for your residency program. And if you are thinking of doing a fellowship further down the line, know that only certain residencies approved by the ABPTRFE will be accepted by fellowship programs. Therefore, it is important for you take into consideration all of these factors and ask your program directors about these details.

Another big factor involved in making this decision is finances. Some residency programs will ask you to pay for tuition, but they will offer you entry-level salary (in case you’re curious, $4,000 for in-state tuition is relatively common). Others will offer you a set percentage of an entry-level salary as a stipend. In some cases, the stipend may be relatively lower than is considered comfortable for some entry-level therapists given the pressure that comes with having to pay for loans straight out of school. If you really want to maximize your savings, you could seek a program that is associated with a company and find out if the company will pay for it. However, some of these programs will require you to work for that company for a certain time period before and/or after your residency. This can be beneficial if you love the company and feel like you already have good support from the staff. On the other hand, this may or may not limit your growth if you want to expand and learn techniques and treatment approaches from other therapists and facilities. 

Most importantly, make sure that the program is in line with your own personal interests. Where will you do your rotations? Will there be inpatient and outpatient exposure or just one? Some programs will offer three or four different settings. Also, what are the mentors like at that program? Ask questions like: Are the mentors’ specialties in line with your interests? How long have their mentors been in the program? How long have they been treating?

Finally, what is their mentorship like in general? Some residency programs do not provide much mentorship. Stray away from programs that treat you like you are just another body, and want to use you for cheap labor. Just like with job searching, you want to look for a residency program in which the people that are there now (residents) or used to be there (previous residents) can provide you with feedback about the program. Be sure to ask your residency program director about contact information, so that you can get in touch with current and previous residents to answer these questions.

What can I do to maximize my chances of getting accepted into a residency program? 

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Believe it or not, residency programs do not focus on GPA as heavily as you will see with PT school admissions departments. It is still important for you to have good grades to demonstrate that you can pass the certification exam. However, residency programs care a lot more about how well-rounded you are and how prepared you are for the program. Like employers, residency programs want to see how well you can sell yourself and demonstrate that your interests are in line with their program. Did you do some tutoring or volunteering or research while in PT school? Perhaps you led a camp for children with disabilities or maybe you were a graduate TA. Can you show that you are a self-directed person through your experiences with your internships? Maybe you took on the initiative of doing an in-service for your clinic or you held leadership positions while you were in PT school. Residency programs are a huge commitment. Therefore, future residents should show that they will are capable of taking the lead and going after their own learning opportunities with recent related school or work experiences.


Will a residency improve my chance of employment? Can I still get good mentorship without it?

Residency will generally give you an advantage over other entry-level therapists since you will have additional training and a higher competency than your fellow cohorts. The therapists that did a residency program straight out of PT school felt like they had this advantage and do not regret doing their residencies. However, a residency program will not give you a significantly higher salary, so most people do not do a residency for financial gain. It may be something you want to consider for career advancement, to gain more responsibility in your own clinic, or to pursue a higher position in the future. 

Furthermore, you do NOT need to get a residency to get great mentorship right out of PT school.

Regardless of whether or not you choose to do a mentorship, seek a clinic or hospital that provides excellent mentorship. Entry-level therapists informed me that the most important factor to consider right out of school is mentorship. Even if you are offered more money at one clinic, having good mentorship has been deemed more valuable in terms of bridging the gap between school and working independently as a therapist. In addition, you can get mentorship outside of your own clinic from other therapists in the field. I have met a few clinical directors/experienced therapists who will provide mentorship for orthopedic physical therapists at a very reasonable hourly price. Hospitals will also offer clinical ladders for clinicians that are interested in a specific area of physical therapy and want a structured mentorship that is going to be provided by the hospital. In fact, you can also check out your own APTA section for mentorship options. As a neuro junkie, I looked into the neuro section of the APTA and found that the the Academy of Neurologic Physical Therapy offers a clinical mentorship program. If you are a member, you can request mentorship with an expert in clinical practice, research, teaching, and/or education (see link below).

Finally,  an overarching theme I noticed across my interviews is that a residency will not replace the skill that you will get from exposure to your ideal patient population. In fact, every physical therapist I have spoken to has stated that you finally start to feel more confident once you have treated for a few years. So regardless of which path you choose out of school, some of that knowledge will eventually come with time. Stay ambitious and go after your dreams. Needless to say, you will all be great therapists someday. 

Here’s the link if you’re interested in the APTA's neurologic mentorship program: http://www.neuropt.org/professional-resources/mentorship  

And this is the link for Dr. Rickert’s webinar about residency programs (it's 1hr 20mins) : http://www.neuropt.org/professional-resources/neurologic-residency/is-a-residency-program-right-for-me
 

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