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Residency Reflections: One Year Later

It has now been a year since I graduated from the residency program, and as I reflect on the last two years since I began as a neophyte resident, what I realize is that the residency program was so much more than just a fast track to proficiency.  My experiences in the program not only allowed me to develop a firm knowledge base, but they also helped me to cultivate a network, prepared me for the Neurologic Clinical Specialist (NCS) exam, and instilled in me a strong sense of confidence as a neurologic clinical practitioner.  Let me elaborate:

  • Knowledge Base: One of the things I most appreciated in the program was being able to work in various settings along the continuum of care.  This exposed me to a wide variety of patient diagnoses.  From glioblastomas to ALS to Bell’s palsy, and everything in between, there was something new and different to grapple with every week.  Within the residency program, we were fortunate enough to have weekly mentoring sessions.  And as someone who always wanted to be ready with an answer, sometimes I dreaded these sessions because I knew that I was going to be asked questions that would stump me.  But you know what?  That’s how I learned.  Being asked “why” and “how” and “what do you think” over and over really got me to think differently about what was going on with my patients.  Eventually I stopped taking things at face value and started to look beneath the surface – why was my patient presenting like this?  What could be contributing to his impairments?  Where is the lesion and what does that mean for the patient’s presentation?  I still don’t always have the answers (does anyone?) but I have learned to think differently to come up with viable hypotheses.
  • Network:  Because of the many diverse experiences I had during the residency program, I couldn’t help but build relationships within the neuro PT community.  This has been quite a boon because upon completion of the residency, I took a job where I was the only neuro PT on staff.  Rather than feel like an island among a sea of predominantly ortho therapists, I have a wonderful network of resources that I can call upon if I ever feel stumped or if I wanted to run ideas by someone.  Since completing the residency, I have been pleasantly surprised to come across familiar and friendly faces at continuing education events.  It has made me appreciate how small the world of neuro PT truly is, and how important it is to get and stay connected with others within this community.
  • NCS Exam Preparation: For those people who have sat through the NCS exam, I don’t need to tell you that the exam is brutal.  For everyone else, the NCS exam is a mental marathon that leaves your head spinning such that you are convinced beyond a shadow of a doubt that you have failed.  One of the things that struck me as I struggled to prepare for this exam is that there is no real guide. There is a suggested list of dozens of articles, and there is a Description of Specialty Practice, which when combined basically amounts to someone telling you “Know everything.”  So where do you start studying?  For me, I started by finding a study buddy, conveniently from the new neuro PT network!  From there, I tried to tackle subjects both broad and deep, brushing up on whatever topics seemed less familiar to me.  I had a unique situation while I was preparing for this exam.  I was a new mother to infant twins, which meant I was in a state of sheer exhaustion and sleep deprivation at all times in the four months leading up to the exam.  I worried and worried that my exam preparation would not be enough, that I would have essentially flushed over $1,000 down the drain by attempting to take this exam while I was simultaneously figuring out how to be a parent.  When I walked out of the exam room last March, my fears were somewhat assuaged.   The questions on the test seemed so random to me that I realized it wouldn’t have mattered if I had studied anymore because I probably would have studied the wrong things.  What really mattered was my clinical judgment.  That didn’t come from months of attempting to study in a severely sleep deprived state.  No, that came from a year of dedicated subject matter immersion during the residency.  In that year, I learned how to analyze clinical situations from simple to complex, and that was the best exam preparation.  Now that I hold the NCS designation, I can fully appreciate the credibility that it gives me among my patients – helping them to develop a sense of trust in my ability to provide appropriate care.
  • Confidence:  Doing something new for the first time can be scary.  During the residency program, there were lots of anxiety provoking firsts.  I had my first formal mentorship, taught my first graduate school class, and my first continuing education class.  We had four different rotations so I had four different “first days” with new colleagues and different processes to follow.  Just as I was getting comfortable in one setting, it was time to move onto the next.  But I appreciated each new experience for the growth and learning that it afforded.  As I had more and more successful patient and provider interactions and as my knowledge base grew, so too did my confidence.  Remember how I said before that I took a job where I was the only neuro PT on staff?  That would never have happened if I didn’t have the confidence in my own skills, abilities, knowledge and network to be successful.  Now I feel proud to be the subject matter expert on all things neuro in my department, and gratified when I can be a resource for my colleagues and clients alike.

In retrospect, I grew so much, bother personally and professionally, during my time in the residency program.  The residency gave me a solid foundation for my PT career, and I can’t even imagine what my career would look like today had I not completed the residency…certainly, I would not hold my NCS designation, and probably I would not have the same degree of confidence, knowledge base or network that I have been able to develop within the program.  I am grateful for how it has shaped me thus far, and I look forward to staying connected with residency faculty and alumni in the years to come.

 

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