Response To Post About Residencies From A Clinic Owner's Perspective

Last week, PT Think Tank put up a post about how clinic owners view residency grads and incorporate the added training into their job offers. This was an excellent topic to present as many do not consider potential employers' opinions when deciding on whether or not to pursue a residency. While the interest in residencies appears to be increasing from a new grad perspective, many employers continue to be unaware of the benefits of a residency or why one would actually consider pursuing one.

What many do not realize is that we graduate physical therapy school as generalists. We know a little bit about many different areas, but are in no way experts in any specific area. That doesn't mean we graduate incompetent, but we definitely have an inexperienced aspect to our care. While many are aware that residencies contain many different components such as additional didactic/clinical work, mentoring hours, etc., they are unaware of the impact this plays on the "experience" of a PT. A residency allows one to gain specialized training in one specific area. This immediately separates the typical "new grad" from a "residency grad," or even a PT 1 year out of school. A residency basically allows you to accumulate the experience at a higher rate compared to just regular practice. This is possible because of the accelerated development of clinical reasoning. That is not to say that a residency is necessary. I know plenty of individuals who are driven sufficiently to become an expert clinician where that residency is not required...but it doesn't hurt.

I was asked in an interview why the employer should hire me (1 year out of PT school and a residency graduate) instead of a clinician with 10 years experience. I simply explained just because a PT has been practicing for a decade, it doesn't mean they are any more competent than a new grad. We know plenty of 10-year PT's who still use ultrasound and hot packs regularly. Sometimes years of practice does not correlate with improved clinical skills rather more time to form improper habits. As a residency graduate, one must be careful of potential employers and their value of residency training. If an employer does not understand the value of having highly trained clinicians on staff, that says quite a few things about the philosophy of that work place. A clinic that is looking to hire any warm body has no interest in providing quality care. With skilled clinicians, patients will have improved outcomes, resulting in word of mouth referrals and desired care. My mentor is one of the few Fellows of Manual Therapy in the state and repeatedly has referrals specifically directed towards him. This is becoming increasingly important as health care is moving towards a quality/outcomes driven reimbursement model.

Should a residency grad have increased pay? Absolutely. Most clinics pay based on experience, not skill. This is unfortunate as there are just as easily bad "experienced" clinicians that have been doing the same thing for 20 years as there are bad new grads. Experience does not guarantee quality. The way I approached this topic in interviews was I listed the average salary for PT's in my area. I then gave a number above that as I felt a residency program develops above-average PT's, justifying the above-average pay. Depending on the setting you are looking to practice, you will have a various amount of influence in this area. Some settings have so many qualified applicants that you may have little bargaining power. In other places, you will have a big say due to your added training.

In summary, you are going to hear a variety of opinions in regards to the value of residency training from clinic owners. Answers may vary from seeing residency training as a deficit to only hiring residency graduates. An employers view on residency training says a lot about what they think about continuing education and providing quality care. While you may be an "above average" clinician following residency graduation, that does not guarantee increased pay (due to supply and demand), so I would not pursue a residency for the financial reasons. However, if you are interested in growing as a clinician, a residency, fellowship, or some other advanced training program may be for you.

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