Gary is a 2002 graduate from the Texas Tech University Health Sciences Center (TTUHSC) where he earned his Masters in Physical Therapy. He began his manual therapy training with the North American Institute for Orthopaedic Manual Therapy (NAIOMT) in 2005, becoming a Certified Orthopaedic Manipulative Therapists (COMT) in 2010. Graduating from the NAIOMT Fellowship Program, he was recognized as a Fellow in the American Academy of Orthopaedic Manual Physical Therapists (FAAOMPT) in 2010. His fellowship project entitled Medical Diagnosis of Cubital Tunnel Syndrome Ameliorated with Thrust Manipulation of the Elbow and Carpals was published in the Journal of Manual and Manipulative Therapy in 2012. Gary is a guest Faculty for NAIOMT, teaching Dry Needling. Most recently he became a Board Certified Orthopaedic Specialist (OCS) in 2016.
He graduated with his Doctor of Science (ScD) in Physical Therapy through TTUHSC in 2015 and is currently an Assistant Professor in the Doctor of Physical Therapy Program at TTUHSC where he teaches Musculoskeletal PT Practice, History & Systems Screening and Differential Diagnosis. Additionally he is the faculty liason for the Student Orthopaedic Manual Physical Therapy Association (SOMPTA), the AAOMPT Local sSIG. His research interests revolve around accuracy and safety of dry needling, clinical reasoning and manual therapy mechanism.
What inspired you to pursue fellowship training?
Ultimately, the desire for clinical excellence and being able to provide for my patients was my main motivation to pursue fellowship training. As a new graduate I often felt lost and confused with more complicated patients. Nothing frustrated me more than not being able to help my patients. I was blessed to have Michael Lucido, PT, DPT, OCS, FAAOMPT, who provided mentoring within our company, take me under his wing. He was able to make complicated clinical scenarios seem so simple and straight forward with a logical approach to clinical reasoning. He was the first clinician to show me the fruit of a fellowship program and I quickly realized that in order for me to become the clinician I desired to be, pursuing fellowship training was the only route to get there.
What fellowship program did you attend and why?
I chose The North American Institute of Orthopaedic Manual Therapy (NAIOMT) in part due to Michael Lucido’s influence in my clinical practice, but also their emphasis on clinical reasoning and mentoring. NAIOMT presented a very logical and methodical approach which meshed well with my style of learning and personality. NAIOMT was well established in Dallas by the time I began their coursework and consequently, there was a solid network of clinicians that were able to serve as mentors, leading small study groups to help facilitate a deeper understanding of concepts and work through difficult clinical case.
What did your fellowship program entail (as far as specific training, etc.)?
The crux of the fellowship program was the 1:1 clinical hours with my fellowship instructors. In a word, invaluable! In addition, I had to go through all of the NAIOMT curriculum and complete 2 oral practical examinations to demonstrate clinical reasoning, differential diagnosis and psychomotor skills. I then had the opportunity to go through the curriculum again as a lab assistant. In order to meet all of the required hours for graduation NAIOMT encouraged me to take outside courses in order to get exposed to other areas to become a more well-rounded clinician. Finally, I had to complete a fellowship project, which, for me, ended up being a case study that was ultimately published in The Journal of Manual and Manipulative Therapy.
Are you trained in any specific areas of manual therapy (e.g., Maitland, McKenzie, etc.)? If so, why did you choose that area?
NAIOMT draws from a lot of influences. Maitland, Cyriax, Kaltenborn, Evjenth, McKenzie, etc. In fact, some of my instructors were not only influenced by, but also trained directly with the aforementioned clinicians. This really underscores the importance of recognizing and assimilating the strong points of so many influential clinicians in an attempt to be well rounded and familiar with various philosophies of manual therapy.
What advice would you give to new grads aspiring to pursue residency/fellowship training?
There’s a lot of cliché things I could say, but I would emphasize 3 pieces of wisdom that were given to me early in my career that have always resonated with me.
- Get comfortable feeling uncomfortable. A fellowship program is about growth. If you’re not pushing the boundaries of your comfort zone, you’re not growing. Fellowship training is about becoming a lifelong learner, not about getting alphabet soup after your name.
2. No one has all the answers. We all have our biases, i.e. treatment techniques, philosophies, etc, but if you think one specific residency or fellowship will give you all the answers you’ll ever need, you’re fooling yourself. That type of belief causes you to walk around with blinders on. We need to be very introspective and be able to assess where our weak areas are and then actively pursue how we can improve that weak area.
3. Question everything…….and be prepared to be questioned yourself. In other words, don’t take everything you consume at face value and don’t take being questioned personally. In order for orthopaedic manual physical therapy to continue to grow and advance, we have to be just as comfortable questioning long held ideas or philosophies as we are about having our own ideas and philosophies questioned. If done out of respect and simple inquisitiveness, we can spark some very productive discussions and realize there is much more common ground than some want to admit.