Harris Health: First 3 months

People always say that time goes by faster as you age, but I had never really thought about the truth of his statement until this year. When I was a student, time seemed to have no relevance. School was a protective bubble from reality. Now that I am working and have the freedom to create my own schedule, my scope of time has changed. It is hard for me to grasp that I have already been at the Harris Health System for 3 months. I am not sure if the time has gone so fast because of the hard work and long hours or simply because it has been a fun adventure. I am going to sum up my experiences thus far in 3 words: Challenging, Mentorship, and Growth. 

Challenging: Being part of any Orthopedic Residency program is challenging (as it should be). It is a 1-yr program that prepares someone to take a Specialty Examination. If it was not difficult, I would be questioning why I was there. But the intensity of the Harris Health Residency has been unique. I was always considered a fairly competent PT student from my clinical instructors. When first arriving at Harris Health, regardless of my clinical competence, I had to overcome the barriers of working with a complex patient population. Since I work at the county hospital, many of my patients speak Spanish as their primary language (I do not speak Spanish). They come from low socioeconomic backgrounds and have little health awareness. Little health awareness+ Low socioeconomic status + multiple comorbidities= Chronic pain. Regardless, I spent the first few weeks understanding my environment and learning how to treat this special population. As I was trying to keep my head above water in the clinic, I was also taking 3 didactic modules: Foundational Sciences, Sports/ Exercise Prescription, and Research. My residency director, Dana Tew, places these 3 modules first because of the high importance placed on differential diagnosis and understanding how to read the literature. All 3 modules were incredible learning experiences and each discussed their respective topics in much more detail than I received in PT school. The other aspect that makes Harris Health challenging (and awesome) is that everyone else in the clinic is much more intelligent than you. In the clinic gym, I am practicing around 6 or 7 OCS and FAAOMPTs. This combination of specialty degrees exists in ~1% of all physical therapists. Having a handful of them practicing next to you and mentoring you is unheard of (literally there are only a few other clinics in the entire country with this level of specialization). Every clinician is working towards or has achieved specialization.

Mentorship: Mentorship is the #1 thing that separates a residency program from any typical first job. At Harris Health we receive a minimum of 5 mentor hours per week. I switch mentors every 10-12 weeks to learn different skills and see different practice styles. Essentially, they watch me treat a patient and provide critical feedback on how to become a more efficient practitioner. Aside from improving my treatment style, the mentors have also helped advance my manual techniques. If a patient does not show up to their appointment, we drop the books and practice techniques. These practice sessions have really helped hone my palpation skills and improve my diagnostic abilities. It is these 1-on-1 sessions that have helped my clinical skills the most. 

Growth: It is often hard to detect change in your practice or personal growth unless you take a moment to reflect on where you once were. Coming out of PT school, I knew a little on a bunch of subjects. Translating that into practice, my evaluations were all over the place. I wanted to know every impairment and practice every test. One way the residency has helped me grow is in my efficiency. For example, if a patient demonstrates a positive Trendelenburg during a gait assessment, there is no need to test their posterior gluteus medius strength. They have already demonstrated weakness during a functional test. The art of observation is such a simple skill that is constantly overlooked. Taking a step back from your patient and looking at their injury in the context of their life will do great things for your treatment session and expectations for achieving goals. I would definitely not call myself an expert, but I am getting much better at synthesizing this information and diagnosing accordingly.     

In summary, my first 3 months have been great. As with anything in life, the amount of hard work and dedication you put into something will correlate with how much you receive in the end. To anyone who is on the fence about pursuing a residency, I highly recommend it. If a challenging experiences, Mentorship, and Professional Growth are things you are interested in, check out the Harris Health System Residency. Applications are due Feb. 1, 2014.   
      
-Jim

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