Fellowship Corner: Evidence in Motion Orthopaedic Manual Physical Therapy Fellowship

Today we will be bringing you two different perspectives. The first part will be questions answered by the Director of EIM’s OMPT Fellowship, Dr. Julie Whitman.

The second part will be questions answered by two fellows, Dr. Derek Clewley and Dr. Mark Shepherd, that graduated from EIM’s OMPT fellowship program and Dr. Visnja King, a current FiT of the program.

Part 1

What makes your Fellowship unique?

  • Unmatched, World class faculty– Our faculty are clinician scientists and in many cases, practice owners who mastered the rare and difficult combination of teaching, practicing and conducting publishable research. Our faculty consists of master clinicians, such as Barb Stevens, Tim Fearon, John Sievert, Britt Smith, Louie Puentadura and others who each have more than 30 years of experience; distinguished researchers such as Julie Whitman, Tim Flynn, Paul Mintken, Bob Boyles and others; and the next wave of cutting edge professionals such as Mark Shepherd, Jeff Moore, Ron Masri, Tom Denninger, Derek Clewley, Casey Unverzagt, Kristin Carpenter, Ben Morgan, Joe Signorino, and more.
  • Convenience- Hybrid learning model that allows you to participate regardless of where you live in the US. We have 13 locations around the country in key geographic markets where we teach the hands on training labs. So, no matter where you are, you are either a short plane flight or drive from the nearest weekend location.
  • Relationships and our stakeholders – EIM partners with more than 75 companies and has built a vast community of evidence-based practitioners, high quality employers and prospective employees and is closely associated with many of the best academic programs and other key groups in the physical therapy profession. The extensive community that has formed around EIM provides a best practice environment for prospective fellows-in-training to receive the highest caliber of training and become distinguished leaders in evidence-based orthopaedic and manual physical therapy practice and education.
  • Mentorship and Role-modeling–  You will not only learn evidence-based physical therapy, but you will see it modeled throughout the program from clinical scientist faculty who are global leaders in the profession.
  • Learn to teach – One of the unique features of our program is that we mentor you to teach in a hybrid learning platform. As you matriculate through the EIM program, you will complete five teaching practicum courses. EIM hires back >75% of its graduates into teaching opportunities upon graduation, in both entry-level or post-professional adjunct and lead teaching roles. The opportunities to continue engagement and to continue growth are endless.
  • Timely access- Our Orthopedic Manual Therapy Fellowship program currently have a four start dates per year with classes starting in January, March, July and September.

What would you consider the strengths of your program?

  • Learn where you live, work where you choose, and maintain a full time clinical job (and salary!)
  • Hands on experience –  Live onsite weekends required delivered at a a variety of locations throughout the US.
  • Un-paralleled professional networking- Job opportunities with EIM Partner organizations nation-wide willing to support EIM training through financial and mentorship support
  • An adult learning model that optimizes didactic learning by integrating scholarship with leveraged online platforms and technological innovation.  Clinical skill development and tailored mentorship that fosters critical thinking is provided in a variety of ways, including frequent virtual grand rounds, discussion threads, virtual live case presentation/oral defense, and weekend lab intensive engagements. Additional mentorship time is arranged locally by the fellow-in-training and allows necessary 1:1 time with an FAAOMPT clinical mentor.

What are the appropriate steps for the application process?

  • All applicants must have successfully completed an APTA-accredited professional physical therapy curriculum, have a current license to practice physical therapy (not under suspension, revocation, probationary status or subject to disciplinary proceedings or injury), be an active member of APTA and have a current CPR certification. Other program specific requirements can be found at http://www.evidenceinmotion.com/educational-offerings/
  • Apply Online at www.evidenceinmotion.com
  • Required documents: License, CPR Card, Liability Insurance, APTA membership, two letters of recommendation. Starting Jan 1st, 2019, applicants must have the OCS credential.

What makes focused learning within a fellowship worth pursuing?

  • The Fellowship program is designed to graduate clinician scientists skilled in the evidence-based integration of thrust and non-thrust mobilization/manipulation and other manual techniques into the overall care of patients with musculoskeletal conditions. We seek to produce highly skilled autonomous practitioners who are reflective, empathetic, critical thinkers and lifelong learners. Fellowship graduates will represent the best clinicians in the physical therapy profession, equipped to teach and mentor residents, clinicians and students, as well as to lead in management of musculoskeletal disorders in multi-disciplinary environments. From a survey conducted in 2017 of all EIM Fellowship gradates at the time (77):
  • Graduates are heavily involved in clinical practice, teaching, research and professional scholarship
  • Graduates rated the impact of fellowship training on self-perception as a professional at 10.7 out of 11
  • Graduates rate their ability to achieve optimal outcomes and to treat efficiently on average were 10.5 and 10.4, respectively
  • Graduates rate their ability in clinical reasoning in the areas of patient history, physical exam, interventions and discharge planning at >10 on an 11-point liker scale
  • Graduates rate technical performance of manual therapies, exercise, and patient education: 9.6 -10.4 out of 11 points.
  • 76% of graduates were involved in research activities while in fellowship or since fellowship training.
  • 81% of graduates were involved in professional scholarly work including: platform presentations at professional conferences 32%; poster presentations at professional conferences 31%; development of curricula in first- or post-professional PT education 40%; and development of materials for online and onsite courses 57%
  • Graduates have also been invited speakers at a national level meeting 20%; invited speaker at a district or state meeting 37%; lead instructor of a first- or post-professional PT education program 43%; lead instructor of a continuing education seminar 53%.
  • Graduates reported that fellowship allowed them to increase total gross incomes an average of $9560 through either raises, career advancement or adjunct teaching opportunities

What do you look for when you are reviewing application materials?

We are looking for motivated, high-quality physical therapists to enter the EIM Fellowship Programs who are hungry to grow professionally and looking to change their clinical behavior based on current best evidence as well as emerging evidence.  We especially welcome those who have board certification (required starting January 2019), or those who are eligible to take their board examinations and who want to sub-specialize in manual physical therapy.

What is your advice to a student who is seriously interested in pursuing a fellowship?

There are some key considerations in this decision.  First, it must be evidence-based, in actuality and not merely in name…dogma and personality driven programs are to be avoided and you need not apply. Second, the program should be of reasonable cost (including all fees as well as the need to relocate, work, etc) and needs to be flexible with regard to your timetable and life.  Third, it should help connect you with a professional community that facilitates your growth after the program and helps open doors beyond graduation. Fourth, plan out what you wish to accomplish after fellowship and make sure the organization you are training with can support these goals. Finally, talk with program graduates and faculty to be sure that these are the type of professionals that you want to work with upon graduation. The relationships that you develop in your program will last a lifetime, so carefully select your “tribe” to match your personal and professional values and goals. The EIM program has over 90 graduates as of Jan 2018, so we are happy to connect you with these individuals to discuss the benefits of our program.

If you are not eligible for our fellowship (do not have your OCS) but you are dedicated to achieving your FAAOMPT status, you may want to consider EIM’s Manual Therapy Certification Pre-Fellowship program as a stepping stone to the fellowship program. This program allows learners to take the EIM course foundational courses and fellowship level topic courses (Pain Sciences, Professionalism, Advanced EBP, Mechanisms of MT, and Writing Case Reports/Case Studies) and apply these credits to the EIM fellowship within two years. This is often a great option for newer graduates or those not in a position to make as large of a financial commitment up front, as well as for those who need to lengthen the overall timeline to complete fellowship requirements due to personal and/or professional life requirements.

Get on-line to review and seriously consider our curriculum and our faculty. We are confident that you cannot find another program with EIM’s caliber of leaders, learners, and partners that will foster your growth while in the program, and that will continue to nurture your development after graduation.

What additional opportunities do fellows pursue after their training?

  • Many of our Fellow graduates go on to pursue teaching opportunities (clinical and didactic), as well as research involvement and legislative efforts.  Most graduates also continue with EIM in various teaching roles, both post-professionally and in entry-level education with EIM’s partners in South College and Baylor University.
  • Many of our graduates report expanded opportunities within their companies for leading educational training.
  • Many students graduating from PT school who choose EIM take advantage of employment opportunities with EIM Network Partners who pay for half or in some cases all of their fellowship program training costs as well as support them throughout the course of their program.

Part 2

Dr. Derek Clewley PT, DPT, OCS, FAAOMPT; abbreviated as DC  

Dr. Mark Shepherd PT, DPT, OCS, FAAOMPT; abbreviated as MS

Dr. Visnja King PT, DPT, OCS, MTC; abbreviated as VK

What are the key advantages or strengths of the EIM OMPT Fellowship?

  • VK: The clinical reasoning, mentorship, and high calibur faculty that are always available and willing to help you find your true path in your career are some of the biggest reasons I chose EIM’s fellowship.  The intense mentorship and time spent on hands-on skills development with other fellows-in-training only lead by some of the most gifted in the profession has drastically changed my skill level in a very short amount of time.  Something that I found unique was the use of videos of our evaluations in our specific clinical reasoning courses. This was the most “hands on” way that we could be taught through the virtual world. It also aided in teaching you how to give and take constructive feedback as well as be humble.  The quantity of time and effort that the clinical reasoning faculty put in to analyze your clinical reasoning and guide you in the right direction to make true changes in your clinical practice was an invaluable experience that was all made possible by the hybrid learning model.
  • MS:  The culture of EIM’s program is what sticks out to me.  We all got very close as a cohort. After reviewing each other’s cases over months at a time, we become quite vulnerable and this allows for a greater bond with each other.  Many folks say that hybrid environments don’t allow for connection, I completely disagree. I to this day have very strong friendships with those that were in the program who came from all parts of the country.
  • DC: Couple of additions – large network of PTs with diverse backgrounds, a curriculum that adapts and is nimble, especially in a progressive professional and healthcare environment. 

Can you discuss the clinical reasoning training that is included in the EIM curriculum?

  • MS: EIM’s fellowship improves your skill with manual therapy, but the key feature of the fellowship was the focus on clinical reasoning above all else.  The program has a virtual rounds where master clinicians like Barb Stevens and Jason Steere guide you through a very structured reasoning approach that identifies your biases and puts the patient first in an evidence-informed way.  I loved that we had true “clinical-coal faces” leading this as they were folks who were in the clinic day in day out and trained with some of the manual therapy experts such as Geoff Maitland. Each week of the course we would review, critique and reflect on video recorded cases — these are real cases that we record in the clinic.  Not only do we get feedback from our course faculty, but from our peers. This training is over 12 months! One can see how this type of training can hone in your reasoning skills.
  • VK: The clinical reasoning is based around the patient response model and learning to analyze all of your hypotheses while being aware of your biases to ensure that the patient is addressed as a whole.  It is all made possible by the utilization of videos for real time visualization of FiT current practice. We incorporate the evidence learned from the management courses, but the model allows you to apply any of your prior training for treatment.  Learning through breaking down of your thought process and the why you chose to do what you do.
  • DC:  Eclectic and evolutionary.  As a member of the first cohort, I would say that without a doubt our clinical reasoning has always been eclectic.  But, what I have also witnessed is that the clinical reasoning evolves specific to what is available in the literature, and seen in clinical practice.

What opportunities have become available to you due to your professional network developed in the program?

  • DC: More than ever imagined.  After fellowship, I was able to take a role on as a residency program director for a ground up residency.  I also started PhD training (and recently finished) because of the research stimulation I received in fellowship.  I have moved into academia as an assistant professor at Duke, in large part because of my experience with EIM.
  • MS:  Teaching at various entry level DPT programs.  I was able to be involved in the Low Back Pain Clinical Practice Guideline manuscript write-up.  This allowed me to break into both the teaching and research market – things that I was not able to get into through my clinical job.
  • VK: I had the unique opportunity to work at the University of Pittsburgh Physical Therapy Research Clinic for 2.5 years which exposed me heavily to the research and evidence based world.  Exposure to the the incredible faculty of EIM also gave me the opportunity to teaching assist in con-ed weekend courses both with EIM and with the Institute of Clinical Excellence, become an adjunct instructor at University of Pittsburgh and Chatham University DPT program in the MSK courses.  EIM has done an incredible job of grooming its’ FITs to become better instructors as they incorporate becoming a teaching assistant in nearly every course within the program allowing you to interact with your peers and learn how to navigate teaching a variety of individuals. I also had an opportunity to assist in writing an update for Travell and Simons alongside Tim Flynn and Derek Clewley.  Finally, fellowship fueled my confidence, knowledge, and the drive to open my own clinic in the last year of fellowship with my husband. Many fellows and FITs provided me with the guidance and advice towards private practice from those who have done so before me.

When you were considering manual therapy fellowship training, what factors in a program were most important to you, and did EIM satisfy that need?

  • DC comments
    • EIM satisfied my goals, and then some.  
    • Convenience
    • Learning from the experts
    • Hands on skills
    • Building relationships with others
    • Teaching opportunities
    • High level mentorship (clinical and otherwise)
  • VK:  EIM has beyond exceeded all of my expectations and goals.  Those within fellowship have made an impact in my both my professional and personal life and have become like family.  I wanted the ability to complete fellowship from a distance while maintaining my current location and work schedule. The significant amount of time in labs both weekend intensives and fellows only weekend intensives to hone hands on skills and receive feedback from some of the best hands out there was another huge driver of my choice into the program.  Also the teaching opportunities and mentorship by some of the best out there was something that I have been seeking since PT school and EIM had the ability to provide that.
  • MS:  I wanted to work and train from those putting out the latest evidence.  EIM had folks at all levels that were involved in research of manual therapy.  EIM went above and beyond my expectations – primarily with the focus on reasoning.  This has allowed me to be a confident clinician and helped identify my biases so that I can stay true to the patient vs. treating the way I like to treat.

One of the advantages to a hybrid learning design (which combines in-person mentorship and lab sessions, virtual meetings and discussions, and both synchronous and asynchronous online coursework) is that the fellow-in-training can continue to pursue other personal and professional goals. Were you truly able to juggle personal and professional lives alongside the fellowship program as is advertised?

  • DC: Worked as a clinic director, had my first born, promotion within organization as well as took on numerous advocacy roles for our profession
  • VK: I was able to work as a full time clinician and then transitioned to a research PT job full time while maintaining part time clinic work as well 9-12 hrs a week.  My husband was also able to go through a fellowship at same time. We also had the opportunity to open our own clinic together. Throughout all of this i was also able to spend many weekends traveling and assisting in other con-ed courses in addition to mentorship and the EIM weekends.
  • MS:  I worked as a full time clinician, got married, moved and took on national organizational roles as well as adjunct teaching at various schools.  If I were not able to partake in a hybrid learning model, this would have been much more challenging to do. Quite honestly, if I didn’t have the ability to do this hybrid model, I would not have been able to pursue fellowship in the first place.

The EIM OMPT program states that they promote both clinical expertise and professional leadership.  Do you feel that upon graduation you are indeed prepared and ready to step into beginning leadership roles?

  • DC – Yes, and I felt that way even before graduation.  
  • VK– Yes, the set up of the program teaches you leadership and gives you the skills and confidence in both areas.  
  • MS:  Absolutely, we are primed for this from the start.  With great exemplars from program faculty, we were able to step into roles well.
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