Victoria Galante graduated from Oakland University in Rochester, Michigan and earned both a Bachelor’s of Arts in Psychology (1973) and Bachelor’s of Science in Physical Therapy (1984). In 1994, she completed her first introduction to manual therapy through Tim Fearon’s Year-long Manual Therapy Course which was taught by Barbara Stevens and Margaret Anderson. In 1997, Victoria earned her Advanced Masters Degree in Orthopaedic Manual Therapy from the Ola Grimsby Institute. Victoria earned her Certification in Spinal Manipulation and Certification in Dry Needling from the Spinal Manipulation Institute. In 2013, Victoria completed all the requirements to earn her Diploma in Osteopractic. Most recently, Victoria completed her Fellowship training in Orthopaedic Manual Therapy through the American Academy of Manipulative Therapy (2014). For the past 32 years, Victoria has been practicing physical therapy in a variety of settings. Early in her career, she worked in inpatient and outpatient neuro-rehabilitation, and later transitioned to full-time outpatient orthopaedics and part-time Emergency Department physical therapy coverage. Victoria has served on the Arizona Physical Therapy Association (AzPTA) Continuing Education Committee (CEU) for the past 17 years and has served as the AzPTA CEU Committee Chair for the past 5 years. Additionally, Victoria has made five trips to Port de Paix, Haiti with Phoenix Rising for Haiti to bring orthopaedic physical therapy care to the poorest country in the western hemisphere. Presently, Victoria is completing her transitional doctorate degree in physical therapy (tDPT) through the College of Saint Scholastica in Duluth, Minnesota.
What made you decide to pursue fellowship training?
It has always been my career long goal to pursue fellowship training, but I had to put my fellowship goals on hold for about 12 years because both of my parents were aging and I was caring for them. I decided to pursue fellowship training to improve my thrust and non-thrust manual skills, gain greater understanding of evidence-based practice, improve my clinical reasoning skills, and improve my patient outcomes.
What fellowship program did you attend and why?
I attended the American Academy of Manipulative Therapy Fellowship in Orthopaedic Manual Physical Therapy. I started taking spinal manipulation courses from the Spinal Manipulation Institute under Dr. James Dunning. I was very impressed with the enthusiasm and the commitment of Dr. Dunning to teaching physical therapists exceptional skills in spinal manipulation as well as the evidence to support the practice of spinal manipulation. I could also feel the serious commitment that Dr. Dunning possessed to move the physical therapy profession forward. I later met Dr. Ray Butts who is an incredible speaker and instructor for the Spinal Manipulation Institute and coordinator of the AAMT Fellowship program. From that moment on, I knew if Dr. Dunning ever started a fellowship program, I wanted to be a part of it.
What did your fellowship program entail (as far as specific training, etc…) ?
Without going into too much detail, the AAMT Fellowship program is a one year program. It consists of three one week intensives in Columbia, South Carolina. Course work includes earning certification in spinal manipulation and dry needling via comprehensive oral, written, and practical examination, extremity manipulation, spinal and extremity mobilization, instrument assisted soft tissue mobilization, biopsychosocial and pharmaceutical aspects of pain management, differential diagnosis and multimodal management of upper and lower extremity pain syndromes of spinal origin, emerging technologies in physical therapy [wireless EMG, functional MRI (fMRI), transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), diagnostic ultrasound (DU)], biostatistics for clinical research, grant writing and publication, clinical research design and methodology, manual therapy in developing nations and underserved populations, clinical reasoning for the management of vestibular disorders, applied musculoskeletal anatomy with cadavers and neuromusculoskeletal imaging, There are bi-monthly journal article review with homework questions and two annual blog posts. Additionally, there are requirements to be a teaching assistant in all the spinal manipulation and dry needling courses. Each fellow-in-training (FIT) must complete 1) 310 mentor accessible hours, 2) 20 mentor-FIT observation, patient discussion, and technique practice, 3) 40 mentor-FIT practice hours with peers, mentors, or staff, and 4) 110 mentor-FIT 1:1 patient treatment hours. Additionally, a lecture and lab teaching presentation must be completed by the FIT. Lastly, a publishable quality capstone project must be completed. My capstone project was entitled Electro-Dry Needling Versus Conventional Physical Therapy In Patients With Knee Osteoarthritis – A Randomized Clinical Trial. To deem the AAMT Fellowship program as rigorous would be a huge understatement. I can definitely say that it was a transformative experience for my professional career and well worth the blood, sweat, and tears that went into completing this excellent AAMT Fellowship experience.
Are you trained in any specific areas of manual therapy (i.e. Maitland, McKenzie, etc…) and if so why did you choose that area?
I earned an Advanced Master’s Degree in Orthopaedic Manual Therapy from the Ola Grimsby Institute. I chose to do this residency program early in my career because I recognized that I had gaps in my learning and I needed better manual therapy skills and improved clinical reasoning skills. Keith Kocher, PT, MOMT, FAAOMPT was my instructor and my mentor and Laura Markey, PT, DPT, FAAOMPT was the assistant instructor and my mentor in the OGI residency program. Both Keith and Laura were instrumental in my development of my manual therapy skills through their excellent instruction, valuable feedback, and kindness and patience. Brad Jordan was my examiner during my final oral practical exam in Salt Lake City. I was saddened to learn of his passing recently. Keith, Laura, and Brad were instrumental in developing my confidence and skills in manual therapy. All in all, the OGI residency program delivers the goods.
I am also trained in the Maitland approach through Tim Fearon’s year long Manual Therapy Course. I was instructed by Barbara Stevens and Margaret Anderson. Both these women were instrumental in teaching me to use my hands and instilling the love of manual therapy and excellent clinical reasoning early in my career.
I am certified in spinal manipulation therapy (Cert. SMT) through the Spinal Manipulation Institute /American Academy of Manipulative Therapy. I had approached a physical therapist who was performing spinal manipulation during my first trip to Haiti and asked him where he learned to manipulate the spine. He mentioned taking courses from Dr. James Dunning. I was enrolled in SMT-1 in Dallas, Texas three weeks after returning from Haiti. I found Dr. Dunning to be an outstanding lecturer and exceptional instructor of spinal manipulation. The skills I learned through these courses toward attaining my certification in spinal manipulation is the main reason I have enjoyed so much clinical and teaching success as well as personal career growth and satisfaction.
Coinciding with the completion of the AAMT Fellowship I also earned my Diploma in Osteopractic. Like the term Manual Therapist, Osteopractor is not a new or separate profession, but simply represents physical therapists or medical doctors that have completed an evidence-based post-graduate training program in the use of high-velocity low-amplitude thrust manipulation and dry needling for the diagnosis and treatment of neuromusculoskeletal conditions of the spine and extremities.
What advice would you give new grads aspiring to pursue residency/fellowship training?
First of all, I would recommend that all new grads who are contemplating residency or fellowship do a “gut” check. Make sure you are in a place in your life in which you can be fully immersed in the rigors of a residency or fellowship program. Make sure you’ve got the support of your significant other and family. Make sure they fully understand the rigors of the training you are contemplating doing. Also, make sure they understand the tuition and travel expenses that will be incurred as part of residency or fellowship training.
Secondly, make sure you are comfortable being critiqued by instructors and mentors. This is crucial and the road to rapidly growing and rapidly developing your manual therapy and clinical reasoning skills. This experience can be daunting and extremely humbling. Make sure you are able to handle constructive feedback and that you are comfortable with practicing self-reflection (metacognition). This is the road to rapid progression and growth in a residency or fellowship program.
Thirdly, talk to graduates of different residency and fellowship programs. Find out their opinion of the program they graduated from. Reach out to the director of the residency or fellowship programs you are interested in applying to. Make sure the program that you are interested in aligns with your personal goals for growth in the profession.
Lastly, get on social media and start making connections with engaged, enthusiastic, forward thinking physical therapists from all over the world. Twitter has a very lively physical therapy community. You can learn about the latest research, upcoming great courses, and informative podcasts of areas of interest in physical therapy. It is a great, supportive learning environment. Please follow me on Twitter at @VictoriaGalante.