What made you decide to pursue fellowship training?
I decided while in my DPT program that I wanted to be a fellow in AAOMPT. Initially, my biggest influence and inspiration for this was my professor, David Morrisette, because of his passion and skill that was evident from our first day of instruction with him. Then, in my second year of school, I attended the AAOMPT conference in Charlotte, NC and was a ‘patient’ for the challenge exam (which I believe was the last year AAOMPT allowed therapists to ‘challenge’ and pass a rigorous examination to become a fellow… now, you have to graduate from an accredited program). Seeing the skill/knowledge of the examiners and those being examined was even more inspiration! Lastly, I think ultimately what drove me to seek fellowship training was that I would get frustrated with myself if I didn’t have the knowledge or skills to help my patients.
What fellowship program did you attend and why?
I attended the Institute of Physical Art’s fellowship program. The main reason for that was that I had completed my residency program with them as well and saw the uniqueness and power behind their Functional Manual Therapy philosophy and approach. To me, it had a unique system to assess and treat any type of patient that came into the clinic, and could offer them a way to enhance their function no matter what their diagnosis/problems were.
What did your fellowship program entail (as far as specific training, etc…)?
Our program worked on many different aspects to mold us into a highly skilled therapist. Our patient population involved a lot of complex, chronic musculoskeletal/orthopaedic and some neurologic patients. So, we were mentored heavily on aspects such as: taking an in-depth and effective subjective history; identifying the main culprit for the patient’s symptoms or dysfunctions; clinical reasoning for those difficult/complex patients that had not improved as much with ‘traditional’ medicine/chiropractic/physical therapy; manipulation of the spine and peripheral joints; visceral manipulation from a more direct technique aspect; and for me, I also wanted mentoring on PNF (who better to mentor you than one of Maggie Knott’s main protégés!). One of the nice things about our program was that our mentors took into account what we as fellows-in-training wanted to get better at personally, but also worked tirelessly on our weaknesses to make us the best clinicians that we could be (sometimes that would be things as simple as how we interacted with different patients versus only clinical skills).
Are you trained in any specific areas of manual therapy (i.e. Maitland, McKenzie, etc…), if so, why did you choose that area?
I believe I’m well trained in the Functional Manual Therapy approach as my residency and fellowship training was in that, and I’m also an instructor for multiple courses with the Institute of Physical Art. Also, I’m almost complete with coursework and certification to the highest level of the North American Institute of Orthopedic Manual Therapy (NAIOMT). To me, the IPA and NAIOMT are two great organizations that complement each other so well to make a therapist extremely well rounded to be able to best help all patients (not to say that other systems are not).
In my view, NAIOMT does very well with teaching functional anatomy and biomechanics to make our clinical reasoning and manual treatments more effective; highly reliant on instructing clinical reasoning from the most simple/basic patient to the most complex patient you could think of; and learning how to be safe with our patients and knowing pathology/diseases well enough to recognize when a patient is not appropriate for physical therapy (more so than what we are routinely instructed within our entry-level programs).
The Institute of Physical Art’s Functional Manual Therapy approach was something I gravitated toward immediately out of graduate school because they were so different than the ‘usual’ manual physical therapy I had been exposed to. There were so many new things to assess and treat that I hadn’t thought about before, and everything was highly effective at getting immediate results with patients. That was very attractive to me as a new grad, as I noted before, when I would get frustrated with the feeling that I wasn’t doing enough for my patients.
What advice would you give to new grads aspiring to pursue residency/fellowship training?
Take continuing education! There are plenty of wonderful organizations out there with different philosophies or approaches to treat our patients/clients.
Not every approach or philosophy may fit with you, and that’s okay! Find a system that you like, that makes sense to you, and that resonates with you and continue with their curriculum. That way, you gain confidence and skills quickly and have a framework to effectively assess and treat your patients with.
To me, having that framework or system gives us a lens through which we view all of our patients. That doesn’t mean you can’t be eclectic and incorporate other systems within your treatment approach; but for a new grad, we want to be better clinicians… fast! After you’ve gone through those organized forms of learning (residency/fellowship), continue to learn, push yourself, and branch out and work on your weaknesses. That way, by the time your career is over, you can see that you’ve done everything you can to help your patients, and that you are as well-rounded as you could be.
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