RESIDENCIES FOR NEW DPT GRADS FROM CLINIC OWNERS PERSPECTIVE

Residencies seem to the hot topic now that I have entered the third and final year of my DPT program. Residencies are designed to help build a specialization as well as foster mentorship and increase clinical reasoning skills. If completing an APTA accredited residency you are eligible to take the OCS, NCS or other specialization designation test sooner. (More details about that here.) Deciding to pursue a residency after graduating from a DPT program is a big undertaking and should be well researched and understood by the student. You can find a great comprehensive list of residencies in different areas of specialization here. The point of this post is not to discuss to many different kinds of residency models but instead to discuss some topics that #DPTstudents should be aware of before diving head first into post DPT residency.

Let me start with a little background on why I decided to ask clinic owners or hiring managers their thoughts on residencies. I was discussing the many options of post DPT graduation residencies with my husband. With a confused look on his face he said, “I don’t understand. You will have just finished 3 years of a doctorate program but you need to do a year or longer residency to land a job that would pay you exactly the same as if you hadn’t done the residency?”  I wasn’t sure how to answer his question. Would I make more if I did a residency? Would I be a better candidate or would I just be considered a silly new grad who happens to be more in debt? Would an employer be willing to help me pay for it? (Please note that there are residencies that pay you as a full time employee and incorporate mentoring hours and clinical hours. In my case, I want to stay in Colorado so I have only been looking into distance based residency programs with weekend hands-on intensives. I also want to begin my career where I  plan to live for the foreseeable future just as a personal choice. Ok, back to the topic!)

I made a short survey and with the power of Twitter I was able to get 35 clinic owners or hiring managers to complete the survey and many offered additional comments. The n=35 is not statistically significant but I think it gives a good insight regardless. This is what they had to say.

Question 1: Does completing a residency increase a new grads chance of being hired?

YES. 66.6% said yes, 33.3% said no. Many of the comments that accompanied this question stated that a residency provides more experience and mentoring (read: “less needy”) and therefor the student would be perceived as a better candidate. However, some of the comments were not along these lines such as “I would not give a residency grad higher priority than I would to a well-informed, motivated and articulate new DPT who has not gone through a residency.”

Question 2: Is the salary higher for a residency grad vs a new DPT grad?

You have a 50/50 shot at making more money as a residency grad. The results were split right down the middle (one person did not answer this question). Many of the comments on this question stated that just because a new PT graduated from a residency program does not mean they are able to bill the patient more for their time. One commenter stated that often times residency grads request a higher salary but the skills they bring have not brought extra value to the clinic. This owner/ hiring manager states “you have to look at what type of value/niche the potential PTs residency brings to the practice and community. We pay people based on the individual value they bring.” It’s all about value.

Question 3: As an employer, do you offer any assistance for an employee wanting to complete a residency?

I was really surprised by the answers and comments on this question. The majority (50%) do not offer any assistance on continuing education including a residency, 30% offer some continuing education budget, and 20% of the respondents host a residency in their clinic. Many of the comments posted on this question simply stated that as a small private practice, this is too big of a financial burden to provide a continuing education budget. One responder said they would support an employee wanting to pursue a residency but there would be pay back stipulations if a certain time commitment of employment was not met.

Question 4: Do you have any other thoughts you would like to share regarding new DPT grads exploring residency programs?

I will let these comments speak for themselves:

I think that we do our profession harm if we imply a residency is the only way to specialize. I think it’s great that it’s an option, but it’s too soon (at least in women’s health) to determine a good cost-benefit analysis.

Therapists who complete the residency programs may have didactic knowledge, however the clinical translation is a value lost on my practice. I would suggest a 2-3 year level of experience prior to attending a residency as a criteria, a new grad is a new grad- residency or otherwise.

I encourage new grads to do a residency is they have the financial means. If they don’t, then I think they should think twice

I think it’s a great idea to explore a residency if you can support yourself on a potential lower salary for awhile.

I think a residency is a fantastic thing to do for the motivated individual to take their practice to the highest level. However, I do not believe that increased pay or anything to that effect should be the motivating factor to pursue a residency.

If you are in a position to attend one, great. The mentoring and experience should be beneficial. But do not think that it is the only path to excellence. As an employer, I would prefer a keen, passionate and well informed new grad over one who has been groomed to follow outdated paradigms and has become a follower of any one particular technique (i.e. McKenzie, Paris or Dry Needling). I much prefer a strong critical thinker who is willing to apply uncomfortable truths about research and evidence into the practice of PT. I do not see this push in residency programs so far.

I found the results and comments posted on my little research study to be very eye opening. I hope this helps you put things into perspective as it did for me. Attending a residency can be very beneficial in many ways, but think twice and ask many questions before jumping in as a residency is not the only way to success.

13 Replies to “RESIDENCIES FOR NEW DPT GRADS FROM CLINIC OWNERS PERSPECTIVE”

  1. Hi,
    You provided some great information here regarding residencies. As a graduate of a residency, clinical faculty in a residency, and adjunct faculty in a DPT program, I am obviously biased, but I think in addition to the above there are some other factors to put into the decision. Your questions above address money and jobs. Coming out of PT school, these are obviously important questions as most will have mounting debt and want to be able to pay it off and have a decent quality of life as well. One thing that all new grads need to consider is the amount of mentoring they will get in any new job, residency or not. Most of my students graduate and go straight into the job force. I keep in touch with many of them and they frequently complain that they do not have adequate mentoring in their first couple of years. This is either due to being in clinics that have no time for it or potentially working in clinics where the clinicians have not kept up with changes in the profession , such that the student is coming out of school with more knowledge than those they are working with. If you graduate and are never challenged in your knowledge and skill level, you will have a harder time moving from a novice clinician to an expert. One of the reasons I chose to do a residency was that I wanted to make sure that I was seeing what I was supposed to be seeing and that my reasoning was challenged by those who had more experience than me (confirmation bias is quite easy if the only person you have to bounce ideas off is yourself!). Good luck with your future endeavors and continue to strive to be the best for yourself and your patients!

    1. Hi Ben!

      I agree with you 110%. I think the mentoring that comes with a residency is unparalleled and that should be a huge consideration when making the decision to apply to residency programs. I think if a new grad is very self motivated and seeks outside mentorship as well as challenges themselves, they can be successful without having to complete a residency. The opposite is also true- not every residency grad will continue to seek mentorship and challenge themselves once the program is over. The decision to pursue a residency is personal for each student and should include several different factors. The main point I wanted to stress in this article is that a residency may not be the right choice for everyone- especially if a student’s motivating factors include an increase in pay.

      Thanks for commenting and offering your perspective!

  2. Great article, I loved the section at the end talking about being a well rounded PT and using many approaches to treatment (ie: muscle energy, manual, dry needling etc). It’s important to have any array of treatment methods and being well informed from our current research!

    1. Hi Chad! Thanks! Yes, it is very important to be open minded instead of pigeonholed into one method.

  3. Hello,
    Great insight into the question of a residency. One thing that I would add to the discussion is that most new graduates have such a limited exposure to the different areas of physical therapy it might be better to get into a general PT position first and get to actually know more about each area prior to deciding. I worked in a critical access rural hospital for a year after I graduated, best decision I ever made. I originally wanted to do primarily neuro but my experience guided me to military direct access and emergency room work. Ended up with an OCS and FAAOMPT instead of a NCS. My advice, make sure you know what you want before you specialize, then go for it,
    Rich

  4. I appreciate the comments on the salary in this post as well, as many tend to “avoid” that topic, I had the pleasure of talking to a clinical director and asked him that exact question worded as: “When looking at 2 candidates, one DPT, and one DPT,OCS, would you weigh more towards the OCS candidate and provide more of a salary bump?”, He essentially responded that if that DPT,OCS candidate could bring more value to the clinic (IE more referrals, community engagement), that said candidate may be worth ~5-6K more. Obviously a residency and choosing a specialty is not purely financial, but it was otherwise interesting. Did you find any information about comparing residency programs that are distance based (such as EIM), compared to academic based, related to program quality, and amount of mentorship provided?

    1. Chad- I did not find out any information regarding the different types of residencies from a clinical manager perspective, although that would be very interesting. I have done extensive research for my own personal information and I lean heavily towards a distance based program for a few reasons. The main reason being that my husband and I are very happy in Denver and don’t want to leave but another strong reason is that I want to be in the workforce, with a full caseload, while pursuing a residency. This model works for me personally because I am a self learner and would be able to keep up with the didactic work available online but I will still get mentoring and hands-on experience. I feel that way by the time I am finished with the residency I will also have 1.5 yrs of “real word” PT experience under my belt and will not have to look for a job. The biggest downfall to the distance based is that I will be most likely paying for it out of pocket. I also see many benefits of university based residencies with the main one being you get a salary and in most cases help teach the DPT students and teaching is a great way to test your knowledge. To me, the downfall w/ a university based residency is that once it is over you have to find employment and demonstrate the value that the residency has brought t your skill set. Just my opinion though! Choosing a residency program is very personal and students may choose one or another based on several different factors. What are your thoughts?

  5. I definitely agree with you that the distance learning options are viable for students that don’t have the opportunity to move, but I am curious about some of the programs setup. For example, are the distance options you are considering allow you to engage in the didactic portion of the residency and simultaneously work at a clinic full-time? From what I understand you have to setup an agreement with a specific clinic and work with a mentor from said clinic, as well as working on the online classwork, is that correct? I also agree with your thoughts about a university based residency program, but I also see it as a way to say “I did an ortho residency through such and such”, but the cost associated with these programs are generally ~$10,000+ which is crazy taking into account the amount of loans from the DPT. In either case, distance or not, I think that a residency will allow for great post-DPT mentorship and gives an edge to new graduates that want to be board certified specialists early in their career. Strictly financially speaking, working for $20-30K directly after graduation and paying $10K for a residency is quite a hefty financial burden, and I don’t completely agree with such a low pay aspect of residencies, but it will hopefully increase your clinical expertise and open up new doors in the future!

    1. The program setup at the two that I am leaning towards are set up in such that I can work in whatever clinic I want but I have to have an OCS as a mentor (does not need to work at the clinic, but that would be preferable for me!). What is kind of crazy is that there are no clinics in Denver or Boulder that actually host a residency from what I could find!

      The cost is certainly a concern because as well as the price of tuition, I will have to pay to travel to weekend intensives a few times so that adds a considerable cost as well.

  6. That is crazy, I would think that w/ the high concentration of PTs in CO as a whole there would be some type of clinical-driven or university driven residency program, best of luck with you decision!

  7. Wow, great post! Admittedly I skimmed it but still lots of great insight into residencies.
    I checked out PT+ but o you have any other recommendations for prospects searching for residencies, like a resource or tool to connect and find residency opportunities?

    Thanks!

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