USC Sports Residency Update: Learning to assess your weaknesses and learning the value of experience

As this incredible experience in USC's sports residency is coming to a close in a little over one month from now, I've done much reflecting lately.  One year ago I was graduating from PT school and today I am treating high school, college, and professional athletes.  A lot has changed from a personal and professional perspective.  Going into the sports residency I had many expectations and opinions on what I thought I would get out of it.  What I envisioned was much different then what has truly transpired.  

The most important thing I have learned this year is to constantly assess, reflect, and expand on each and every patient case.  Whats the pain generating structure? What is contributing to that? Whats the most important contributing structure? How did you verify one vs the other? What treatment intervention will you choose and is that the most appropriate/best intervention and why? How did you measure if there was a change?  Are you reassessing every session? Are you making a change every session? If your patient is not progressing have you expended every possible reason why?  

These are the daily thoughts I am challenged to think about with every patient.  The residency has flipped my thought process completely.  School gave me a very basic foundation, but it couldn't give me the clinical reasoning development that a residency could.  It's not just clinical reasoning though, its manual therapy skills as well.  Is my body placement the MOST optimal? Am I being lazy and not using a belt to get the perfect stabilization? Am I using a wedge under the scapula for shoulder mobs? Am I measuring well? Is the manual therapy selection (assessment or intervention) the very best I can use right now for this patient?  Why? What makes it the most appropriate?  

Lastly, I think what is often confused is the word "experience".  Just because someone has years of experience does not mean that experience has been "good" experience.  On the flip side, just because one goes though a residency and gains additional experiences doesn't mean they are better than someone five years out.  I hear that all the time, a residency gets you five years of experience in one year.  Well, thats not necessarily true.  The intention is to advance your experience in a particular subspecialty faster and more focused than a non-resident, thats all.  Every person will be different.  Do I have more experience treating athletes that I would have in an outpatient orthopedic group? Yes, thats without a doubt.  Training room at the high school, college, and professional level every week, clinic time with weekend warriors, high school, college and professional athletes, and observation/co-treating with mentors in the clinic, USC, and private practices has given me opportunities that I wouldn't have been able to replicate without the residency.  The point is that whatever your experience is, make the most of it.  If you feel like you're weak in one area go out and find a way to improve that area.  There are manual therapy courses and fellowships, sports physical therapy conferences (TCC),  residencies and fellowships, online blogs and webinars, and more.  Follow the top PT's in the area you want to be in and pay attention to what they are following, conferences they are going too, and places they have worked.  Take advantage of the situation you have and keep moving forward!

- Brian

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