Guest Post: Why I Chose Residency | Modern Manual Therapy Blog

Guest Post: Why I Chose Residency

A fellow blogger and PT in Social Medial @cinema_air on twitter recently wrote a guest post for my blog. I asked him a while back why he chose residency, and what follows is his answer.

Thank you Dr. E for inviting me to guest-post on your blog. The topic is Physical Therapy Residency; why I decided to take this route, and thoughts on why you should as well.

I’m currently an Orthopedic Manual Physical Therapy resident. It’s been a great experience so far, and my effectiveness as a clinician has noticeably sharpened. I would recommend this route to any Physical Therapist interested in enhancing their skills in the clinic. Also, it helps to have a year or so under your belt prior to the residency.

The benefits of a residency are no less than three-fold. Primo, the feedback is priceless. This built-in mechanism will accelerate your learning process, thereby shortening your learning curve by piggybacking on your mentor’s experience and expertise. Secundo, this leverage is further amplified by the fact that mistakes are expected (and allowed) without risk of major losses during the learning process. Check your pride at the door and embrace small failures. Lucky for you, the payoff is rather asymmetrical in that you are fast-tracked in terms of clinical effectiveness, while your mentor sacrificed his or her time to help you achieve your goals. Knowing this, you better sell the interview (more on that below). Tertio, the extra-curricular benefits; the soft skills. These include becoming more adept at handling staff, teaching, and/or participating in the company’s growing process. This encapsulates, essentially, everything you didn’t learn in PT school.

The reason I decided to take on a residency was the self-recognition of shortcomings and inefficiencies during my early years as a PT. These inefficiencies fell into 2 general categories:

1. Clinical ineffectiveness - applying what I already knew didn’t yield results that I expected. Holes were sinking my clinical craft. I attempted to plug these holes via various Continuing Education courses screening for models of treatment that fit my needs. Once I found it, a deeper exploration of the subject matter began in earnest. That’s when I discovered and committed to the residency option.

2. Professional dissatisfaction - Positive patient outcomes yield a sense of accomplishment by impacting meaningful change in his or her life. Inconsistent patient outcomes combined with a sense of stalled progression as a PT necessitated a push. I found this push en route to discovering residency. The growth through this period has been incredible, and I look forward to further advancement.

As you, the astute reader, are well aware of the difference between knowing and doing, there lies another layer beneath this level of awareness - the difference between trying and doing. (This would be the perfect spot for one of Yoda’s popular quotes, but if you’re reading this, then it just crossed your mind.) A residency pushes you to “do” more than just “try.” You get the duplex benefits of both levels of understanding and application; not only will you increase and strengthen your knowledge base, but you will also develop a meaningful practical application of this knowledge.

There are a growing number and variety of physical therapy residencies. Choosing among them can feel like walking down the cereal aisle, leaving you riddled with indecision. Here are two filters that may help you decide which residency to pursue:

1. Cognitive Curiosity - does it make sense? Can you follow the logic behind the model of treatment? Does it make you want to know more and be more? Does it fit your long term plans?

2. Clinical Confirmation - Apply the concepts in the clinic. Does the model work? If not, then are the results better or worse than your prior model of treatment? Could it be user error? I confirmed this for myself by shadowing a couple PT’s who practice using the treatment model I would soon pursue. And yes, it was user error; having someone point out better ways of accomplishing treatment goals makes a huge difference.

So, you’ve decided on a treatment model and are determined to do a residency. Next step is the interview. Remember, the interview is a two-way street; not only are you being interviewed, but you are also interviewing your potential future mentor. The environment - including clinical set-up, staff, etc. - can impact your learning experience. Take the time to explore the facility by spending at least 2 days at the facility prior to committing. This will give you a feel for not just the working atmosphere, but also the hard and soft bonds between employees. Is the environment right for you?

And of course, your future mentor must be someone whom you admire and with whom you can build an efficient working relationship. After all, you’ll soon spend no less than 30% of your day with this individual! And more importantly, remember that you may be competing with other applicants. Bring more to the table than your diploma and a smile; take time to learn as much as you can about the company and figure out ways to contribute to their growth. Help others achieve their goals, and they’ll help you achieve yours.

I love metaphors, so I’ll recap this post using one - learning to ride a motorcycle. You’ve just watched “Long Way Round” and are now inspired to become a motorcyclist. As an aspiring motorcyclist, having just completed your 3-day training course, you hit the road on your new (or new to you!) motorcycle. The combination of excitement and challenge is thrilling. Your handling improves, and serpentine roads become pure magnetic joy. Some time goes by before you recall the original reason for becoming a motorcyclist, “Long Way Round”... but there’s a huge difference between riding on smooth paved roads and unpaved terrains. Decision-time: teach yourself off-road skills, risking not just potentially wasted time, but serious injury, or learn from someone who know what he or she is doing? Hit with this spark of wisdom you train with the best you can find. That was 3 years ago. Today you’re more than just another motorcyclist. Equipped with new perspective and humble confidence, you’re out making new tracks. Happy riding!

Real Name: Cinema... sorry not giving this away :)

Quick Bio: After graduating from University of St. Augustine, he earned his Manual Therapy Certification and practiced in an outpatient clinic in the Midwest. He continues to pursue his interests in manual therapy through an OMPT residency, also located in the Midwest. He enjoys learning from those who have walked the path before him, and loves exploring new ways to experience the world around him. Physical Therapy is an art & science that he believes has the potential to make impactful and positive change in our society. You can find out more through his blog: or contact him on twitter @Cinema_air

Edit - I am farily certain Cinema is a real person and a PT to boot. Personally, I read his post using the voice of The Architect from the Matrix movies in my head.

Keeping It Eclectic...


  1. Both my fiance and I are undertaking orthopedic residency education a couple years post-graduation; it really does help make us better at "doing". We are happy to see other PT's promoting it. Our profession will benefit from quality PT's who can provide good outcomes especially in direct access roles! Thanks for sharing!

  2. Good for you guys! Received an email from EIM asking for more options for residents from their faculty. That is great news that larger facilities and hospitals spots for residents and possible future employees are being filled! Exciting times and great for both our profession and consumer's health!

  3. What if instead of all these residencies and fellowships, PT schools taught you what you needed to know? I just opened my own practice, but I couldn't have done it without spending thousands of dollars on con ed over the past 2 years. I'm also trying home care per diem work, and these fields are entirely different. It's part of our "brand issue." People see us in their homes and in hospitals walking with their parents and then wonder why they see us for back pain instead of chiros.

    These are different fields requiring different skills and, in my opinion, different schools. I am no more qualified for home care, snf, or inpatient than they are to come and treat my patients. Our time in school would be better spent learning how to be good at what we are actually going to do instead of learning how to pass a test. School is too expensive for our field to be so expansive and yield a graduation tool set which includes being good enough to "not hurt anyone (this was thrown around often)."

  4. I agree, but when I hear course instructors who went to school in Canada say mckenzie, maitland, mulligan, and manipulation was their ortho education I wonder what we are doing over here.