Residency Corner: Memorial Hermann Orthopedic Residency

Orthopedic Residency Director

Current Residents 
Sienna Kahlden PT, DPT | Ian Aviles PT, DPT

Residency Program Description

Advanced practice: In-person didactic curriculum covering orthopedic and sports content including clinical reasoning, differential diagnosis and advanced manual therapy. We also have content covering imaging, research, strength & conditioning, nutrition, and return to sport guidelines. Residents have access to over 50 advanced clinical specialists who are board-certified in orthopedics and sports and/or manual therapy fellowship trained mentors. Our orthopedic and sports residents work closely together and have the opportunity to collaborate and network with other Texas area programs as well. Being a part of a large hospital system in the largest medical center along with strong external collaborations allows for a greater opportunity and exposure to experiences including return to sport programming with Athlete Training & Health, surgical observation and surgery skills labs with UT Physicians Orthopedic Surgeon Fellows, and working with body region specialty programs within the Memorial Hermann system. Built in time for physician collaboration including mentorship on relationship development makes our residents more marketable and equips them for future inter-professional interactions.

Teaching: The orthopedic residents have clinically relevant teaching opportunities across the Greater Houston Area including leading labs at local DPT and PTA programs, as well as specialty lectures at undergraduate universities and in the community. All of our residents serve as a clinical instructor at the end of the program and receive mentorship on their clinical education skills.

Research: Our residents have a separate research curriculum and are mentored through the creation and implementation of a clinically relevant question from a large data set from one of our specialty programs including our Spine Program, Hip Preservation Program, and Upper Extremity Program. The goal of the research portion is presenting at a national conference and/or publication in a peer reviewed journal. Throughout the residency year the residents will present, and get feedback on, numerous topics to improve public speaking and engagement skills.

Leadership: Our residents participate in our leadership curriculum to establish and hone their professional development plan including skills such as networking, the business of physical therapy, and personal development.

What makes your residency program unique compared to other programs?

Our residency is unique in the design of our cohorts, the opportunities within our pillars, the generational influence it maintains, and the clinical practice structure. Our program continues to grow rapidly in size across the Greater Houston area. Our large hospital system allows our program to house 8 orthopedic residents across 7 clinical sites. All residents meet weekly at a centrally located clinic to partake in didactic modules, research, and collaborative learning experiences. Additionally, the program offers a multitude of opportunities for each of our four pillars: advanced practice, teaching, research, and leadership. Of the ample number of opportunities presented to our orthopedic residents, the most unique experiences include teaching clinically relevant material at a local DPT program, physician collaboration, and venue coverage. Each resident rounds with nearby in-network physicians and surgeons and perform in-house data collection for their research projects during weekly physician collaboration hours. While venue coverage is well established for our sports residents, our orthopedics residents are provided opportunities to participate in event coverage for elite level athletic performance on a local community and citywide scale. Furthermore, our program has mentors with diverse backgrounds and uniquely our program retains a large portion of our residency graduates that pour back into the program. Lastly, our orthopedic residents undergo a ‘site switch’ halfway through the residency. Not only does it provide exposure to new mentors, coworkers, patient demographics, and network referral sources it also refreshes the residents for the second half of residency.

What would you consider the strengths of your program to be?

Memorial Hermann’s Orthopedic Residency Program has a well-established reputation and attained re-accreditation for a term of 10 years by the American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE). Our program’s strengths include a rigorous and comprehensive curriculum, excellence in clinical reasoning, collaboration within a vast network, a large residency cohort, and overlap with the incoming residency class. The keystone of our program’s goals is to instill a strong foundation in clinical reasoning to our residents. This equips them to become specialized clinicians, advocates, innovators, and leaders within our field. Consequently, our graduates have spread out across the country fulfilling roles within our profession ranging from serving on professional sports teams, becoming private practice owners, teaching within DPT programs and becoming faculty and mentors within our own as well as other post graduate educational programs. Furthermore, our highly qualified, well decorated, published, clinically active faculty are second to none and play vital roles within our clinical mentorship model, community partnerships, and professional educational experiences. Our residents are surrounded by an expansive family-like network of clinicians, leaders, researchers, and physicians that provide a paramount support system and create a strong sense of comradery within our team. We have grown from an initial cohort of 2 residents to graduating 8 residents this year over a 7-year period. Although large in number, our program emphasizes an individualized track for each resident to ensure they achieve their own unique aspirations. Our 13-month long program allows our graduating residents to overlap with the incoming cohort. This is a great asset to our onboarding process and ultimately a support system to our new residents. Our program’s notoriety has been marked by the passion and dedication of its residency leadership team, faculty, and residents.

What makes focused learning within a residency worth pursuing?

One of the advantages of our profession is graduating as a ‘generalist’. This allows for self-driven distinction to occur and ultimately to attract therapists to an area of specialization that best suits them. Usually, a predominating reason for pursing a residency includes specialization. Focused learning promotes focused growth and focused growth necessitates focused practice. Once someone has identified a specific niche or specialty within our field, residency provides an accelerated path to attaining the advanced knowledge and skills required to become a master of their craft. Residency takes you beyond the textbook to real time application, feedback, and experience. The learning you undergo naturally occurs within your daily job and exposes you to people with similar passions and interests for built in support along the way. The advantage is that it is a planned and organized way to developing leaders within our profession through a model that instills lifelong learning and ultimately gives back to the profession.

What advice would you give to students that are seriously interested in pursuing residency training?

My best advice for someone who is interested in pursuing a residency is to know the direction you are headed, to understand the process, and to get comfortable with being uncomfortable.

Maybe the path you envision for your career isn’t fully paved yet, but you should be navigating using a map, not wandering aimlessly. Be intentional about the programs you choose to pursue. Stand by your values, both personal and professional, and ensure they align with the goals you have for yourself. You want to guarantee you will be provided the opportunities you need to grow in your areas of interest. Likewise, you should have a well-thought-out reason for why residency is going to get you to your next destination (notice I didn’t say the final destination). Residency is designed to equip you with what you need to overcome any obstacle you may face on your journey to creating your livelihood, long after you are a resident, not to meet self-actualization by the end of it. So, know what you need now and know what you will need later.

Residency isn’t just an opportunity for higher level learning and advanced practice, it’s a lifestyle. A few things to consider: academic stamina, time, finances, and reflexivity. Be honest with yourself about the demands a residency entails because there are other avenues you can take to grow yourself and enhance professional development – you must choose what’s best for you and the stage of life you are in. But if you are still invested here are a few of the rewards: mentorship, specialization, opportunity, marketability, resiliency, and much more.

Lastly, prepare to be vulnerable. If you were ready to tackle what residency has to throw at you then you aren’t in the right place. You will learn to reinforce your strengths, but you will also be faced with an abundant amount of feedback. If I could sum up residency in one word, it would be: growth. The question is, are you comfortable with getting uncomfortable? That’s what you came for, right? Take the leap of faith!

What additional opportunities do your residents pursue after completing their training?

Our graduates go on to explore and pave a wide variety of paths due to the strong foundation they have built within our program that offers not only clinical excellence, but individualization. Our leadership module acts as a springboard and helps residents develop their unique vision for the future. Our orthopedic program has had individuals pursue manual therapy and upper extremity fellowships, become physical therapists and rehabilitation coordinators for professional sports teams, open their own private practices, pursue clinic management positions, teach in DPT programs, and become faculty and mentors within our own as well as other post-doctoral educational programs.

What do you look for in a quality candidate for your residency program?

Intellectual curiosity, resiliency, and flexibility. Due to the multitude of opportunities within our program, each resident will get out of the program what they put in. Having intellectual curiosity allows the resident to dive deeper into the “why” behind not only the course work and hands on skills but also each patient interaction to become a true clinical specialist. The program is vast, fast-paced and immersive which calls for resiliency and flexibility to truly mold each individual into the best version of themselves they can be, professionally and personally, to begin the journey of lifelong learning.

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