Christina Gomez, PT, DPT, OCS, SCS, FAAOMPT, CSCS is the Coordinator for Houston Methodist Sugar Land’s orthopedic physical therapy residency program and a Lead faculty mentor for the Institute for Athlete Regeneration sports and orthopedic manual fellowship program. She is currently pursuing a PhD in Physical Therapy from Texas Woman’s University. She is fellowship and residency-trained in orthopedic manual physical therapy and board-certified in orthopedic and sports physical therapy. Christina, a former high-level gymnast, is originally from Albuquerque, New Mexico, and graduated with her Doctor of Physical Therapy from the University of New Mexico. Christina is on the Orthopedic Section’s Independent Study Course advisory panel, on the Communication committee for the Residency and Fellowship Education SIG for the Education Section, and holds the position of Second Vice Co-Chair in the Southeastern District of the Texas Physical Therapy Association (TPTA). Christina is a member of the APTA’s Orthopedic, Sports, and Education sections, AAOMPT, and the TPTA. Her interests include rehabilitation of the aesthetic athlete and the psychosocial aspects of injury.
What inspired you to pursue fellowship training?
After graduating from my DPT program, I spent the better part of two years trying to find the missing piece in my patient care. I began my career in the pediatric setting and soon realized that the setting was not fulfilling in the way that I had dreamed during school. I switched to an outpatient orthopedic setting, and for a short time, was much happier. Eventually, I realized that it wasn’t the setting that made me unhappy; it was my clinical reasoning skills. This realization was disheartening. I couldn’t even confidently say that I was in the right career.
In an attempt to improve my clinical reasoning, I attended APTA’s Combined Sections Meeting in Chicago. It was here that I learned about residency and fellowship programs. I cannot express how much relief I felt that there was an answer to my worries. Two weeks later, I submitted my application to Houston Methodist Sugar Land’s orthopedic residency program and its director, Toko Nguyen. Upon receiving Toko’s offer to join their 2012 residency cohort, I realized that the bewildered feeling I felt all too often was finally going to end. I could breathe again.
Once the program began, I found myself surrounded by a highly skilled residency faculty. Toko and his team of FAAOMPT specialists were brilliant. I had so many revelations, so many light bulbs turn on, that I never wanted the experience to end. When I learned of Toko’s new fellowship program, the Institute for Athlete Regeneration (IAR), I did not hesitate to apply. Two more years of learning from Toko and my mentors, Ben Renfrow and Marie Charpentier, meant that my advanced residency knowledge would grow into expert-level fellowship skills. Little did I know that my clinical reasoning ability, manual intervention skills, evaluation process, and professional behaviors would develop beyond those initial expectations.
What fellowship program did you attend and why?
I attended the Institute for Athlete Regeneration (IAR) Fellowship in Sports and Orthopedic Manual Therapy. I chose this program for a multitude of reasons. I wanted to gain knowledge in movement science and advanced manual therapy. Developing my understanding of sports rehabilitation and the intricate differences of exercise prescription between athletes and the general orthopedic population was also important to me.
However, at the top of my list were Toko, Ben and Marie. Having been mentored by the three of them, I had first-hand experience of the IAR faculty’s drive to educate others, their attention to detail, and their in-depth understanding of sports and orthopedic manual therapy. If I may suggest one thing for those interested in residency or fellowship training, research their faculty. The people who will teach you, mentor you, and ensure your growth should be highly qualified and invested in you. Learning from the three of them challenged me in ways I never expected. I grew because of their efforts and investment in me as a person and as a clinician. They understood my strengths and weaknesses so they could tailor my fellowship training to meet my needs. Without a doubt, I would never have received the fantastic education that I received from IAR if I had chosen another program. It was the best decision of my career.
What did your fellowship program entail (as far as specific training, etc.)?
I always compare my transition from residency to IAR as being similar to moving from high school to college. The weekend classes in IAR were full of discussion and lab experiences. There is a lecture component, but it tends to be more interactive, so it never felt like I spent the weekend in a classroom. After most lectures, we would have a practical component, introducing us to new manual interventions, refining our evaluation skills, and improving our understanding of exercise prescription.
The focus on movement system impairments, manual therapy, and clinical reasoning truly helped me become efficient and effective in my patient care. I now look at movement differently, which allows me to educate and prescribe exercises specific to individual patients. I greatly appreciate that I not only learned all aspects of orthopedic physical therapy, but IAR went above and beyond to teach us rehabilitation for a more active population. The differences in the care of athletes from the orthopedic population are much larger than I had realized.
In addition to the above aspects of the program, the faculty also focused on developing our leadership skills. They actively sought out speaking engagements or opportunities to be involved in committees or SIGs for the fellows-in-training. Also, all graduates can become mentors for other cohorts of the fellowship.
Mentoring was my favorite part of the fellowship. Each mentoring session pushed me outside of my comfort zone and taught me how to self-reflect. My clinical reasoning, which had originally been so disheartening, was now thorough and sound. In an area where I once felt stuck, I now felt capable.
Are you trained in any specific areas of manual therapy (e.g., Maitland, McKenzie, etc.)? If so, why did you choose that area?
One of my favorite aspects of IAR is that it does not isolate its teachings to one philosophy. You learn manual therapy techniques from several areas, along with mobilizations with movement, neuromobilizations, and muscle energy techniques. You gain an understanding of several different techniques so you can choose the best intervention for each patient. They teach you how to make each manual treatment specific to the individual, determine effectiveness of that intervention, and then to prescribe exercises that complement your manual therapy. They also teach how the choice of manual therapy techniques should differ between the general orthopedic population, the overhead athlete, the aesthetic athlete, etc. The clinical reasoning behind the manual technique is more important to them than just teaching specific interventions.
What advice would you give to new grads aspiring to pursue residency/fellowship training?
(I fully recognize that I am about to sound like Baz Lurhmann in his song titled “Everybody’s Free (To Wear Sunscreen).”)
Take full advantage of every opportunity. Seek out new opportunities. Be persistent. Recognize that challenge prefaces growth. Be open-minded. Every person can teach you something. Keep learning. Always. Keep reading. Read outside of the world of physical therapy. Be patient. Growth does not happen overnight. Build a network outside of your friends and immediate colleagues. Physical therapy is more gray than black and white. Express gratitude. Work hard. Have fun. And, most of all, enjoy the ride.
I highly recommend pursuing residency and fellowship to all clinicians, even those who are beyond what is considered a new graduate. The initial time and expense is exponentially recovered after graduation from the program. By taking full advantage of the opportunities and mentorship available in post-professional education, the number of doors that will open are countless. Because of IAR, doors are still opening for me.