Well, I am about 2 months into my orthopaedic residency here at Scottsdale Healthcare and it has been quite an experience. Not only am I learning an incredible amount, but the area is beautiful as well. Starting off my first couple weeks, I was eased into the practice with a lighter caseload as I learned the ropes to documenting here. We started off our first day after orientation going through the EMR, so that we could find our way through the system. As helpful as it was, the best way to learn that sort of thing is to actually do it over and over again. The lower patient number each day initially was definitely beneficial while I was trying to become more efficient documenting. Once I had adapted to the EMR, my caseload was increased to that of the other physical therapists. We typically treat 1-on-1 with about 8 patients a day (depending on how many hours you work). I enjoy this individualized care so I can continually assess my patients and adjust any faults with their mechanics when performing exercises. It also allows more time for manual therapy if appropriate for that particular patient. As with any clinic, there can be fluctuating patient populations which may lead to "down time." Whenever I have no patient or paperwork to do, I'm able to observe one of the other clinicians. The benefit of being able to observe different PTs cannot be overstated. Everyone has their own "style" of care, so I can continuously become a little more rounded with my clinical reasoning.
Probably the thing that stood out to me the most thus far has been the mentoring. Each week, I get 4 - 8 hours of 1-on-1 mentoring with a clinician that has both OCS and FAAOMPT credentialing, along with dry needling certification. We work side by side when treating or evaluating patients and in our breaks discuss other patient cases. During PT school, I rarely had any patients that I found too difficult. Here, it seems like every other patient is extremely challenging or with atypical presentations. The ability to schedule these patients for my mentoring hours allows me to build upon my reasoning after working with my mentor and is definitely one of the highlights of residencies in my opinion.
Another component of residencies is class work. Thus far, we have had 4 classes: residency overview/subjective interview, clinical reasoning/evidence-based practice, medical screening, and sacroiliac joint. The sacroiliac joint lecture was just this past week and is the first of all our lectures on the joints (we have lectures every other week). We have initial readings to do for each topic: the APTA monographs. These include readings on both non-surgical and surgical coverage of each joint based on the most recent evidence. The lectures then are created by our faculty and are followed up by lab, where we go over examination techniques, exercises, and extensive manual techniques. I feel like my PT school did a very good job covering the SIJ joint, but my confidence in treating and assessing the SIJ after that lecture and lab increased dramatically. The individual focus and conversational discussion of the material likely played a significant role. I am looking forward to covering the rest of the body.
Some additional components of the residency that have begun include additional course work and case study presentation. Throughout the year I am required to present 3 interesting cases or cases where I implemented interesting techniques to my co-workers, along with the current evidence on the subject. Something that I have enjoyed particularly with this residency has been their appreciation of continuing education. As the hospital hosts some courses, we have the opportunity to attend for free. They are paying for my attendance at the AzPTA fall conference next weekend and have been extremely accommodating with allowing me to design my schedule so that I may attend other courses as well. I can't believe 2 months are already gone, but it should be a fun remaining 10 months! If you have any questions about the residency, feel free to ask.