Benefits of a Physical Therapy Residency and Fellowship Program

Written by Ashley K. Oyakawa, PT, DPT, OCS, CSCS

If you're a new grad physical therapist or someone who is thinking about going into the field, here's a short blog on my experience going through residency and fellowship programs. I hope it gives you a little bit of insight and helps you decide whether taking that next step to a residency or fellowship is right for you! 

Did you know, a physical therapist completes a total of three years of schooling or a total of eight semesters to achieve their Doctorate in Physical Therapy (DPT)?

Following graduation, he or she will take the National Physical Therapy Examination (NPTE) to assess entry-level knowledge, skills and abilities along with a jurisprudence examination for specific state laws and rules.  As newly licensed physical therapist, he or she must decide if they will immediate enter the work force or apply for a residency.  The American Board of Physical Therapy Residency and Fellowship Education (ABPTRFE) defines a residency as the following, “… a post-professional planned learning experience comprised of a curriculum encompassing the essential knowledge, skills, and responsibilities of an advanced physical therapist within a defined area of practice”.¹ Most residencies and fellowships are a year in length that address the following domains of competence: knowledge for practice, inquiry skills, clinical skills, clinical reasoning, systems-based practice, communication, and professionalism.²

Sounds pretty solid, right? 

I thought so – so it was decided, I was applying.  When I told my friends and family that I was applying into a residency program, they literally said to me, “Ash, are you crazy?  You have already done three additional years of school and you are going to do another one?  Haven’t you had enough school?”.  To which I smiled and responded, “Yes, yes, and no”.  

I remember when I got the decision because it was the dead of winter in Omaha, Nebraska and I was doing a workout in my room.  I was accepted!  I was absolutely beyond ecstatic that the happy tears began to flow.  So, I packed my bags, drove across the country to sunny Los Angeles, California in my tiny baby Civic packed to the brim.  As much as I was excited to finally not be landlocked, this was not the time for play.  My cohort and I had a jam-packed year ahead of us.  Along with working 20-40 hours in the clinic, we had 20 weekends of classes, weekly prep forms, research projects, community service, and quarterly testing.  Needless to say, we were busy bees!  Do I regret it?  Absolutely not.  

During the residency, I was exposed to the concept of movement science and was strongly influenced by my mentor, Francisco dela Cruz.  I was moved – for lack of a better term – by his ability to assess, diagnose, and treat with his visual observation.  As I began to incorporate movement science, I noticed a significant functional change with my patients that made a more efficient clinician.  This was the beginning of my journey towards becoming a physical therapist with a specialty in movement science or a movement specialist.  

Fast forward a few months: graduated from the residency program and passed my Orthopedic Certified Specialist (OCS) examination.  After this, I thought that I was done with school because, quite frankly, I was burnt out.  Burnout is an all too real occurrence that occurs in any profession.  Professional burnout can be defined as “syndrome of emotional exhaustion, depersonalization, and reduced personal accomplishment”.³  I felt embarrassed and questioned my resolve personally and professionally.  It was my decision to complete a residency and yet there I was doubting my abilities and my motivation.   

Fast forward a few years, complete 180-degree switch.  I decided to apply to the Azusa Pacific University Clinical Fellowship in Movement and Performance!  Here is what happened: I became hungry again for more knowledge and skills – I took a few years to apply what I gained in residency and my drive and passion reignited.  I chose this fellowship for multiple reasons.  The clinical faculty have extensive clinical experience, mentoring skills, and knowledge that I aspire towards.  The curriculum has an emphasis on clinical reasoning, motor control and learning, movement analysis and re-education, and specialty rehabilitation.  This fellowship also has increased classroom learning and practical hands-on experience which promotes advanced clinical reasoning, evidence-based practice, and collaborative patient care.  In an article by Redeghero et al, concludes that physical therapists with fellowship training achieved improved functional outcomes in a lower number of visits.⁴

In my opinion, the most valuable experience was the mentorship during both programs.  At first, I was worried about mentoring because I thought the mentor would try to prove how much smarter they are and humiliate the resident.  However, I was fortunate enough to have a wonderful mentor, Francisco, who was patient and nurturing.  I also had Francisco as my mentor during the fellowship program.  During our first mentoring session, I was extremely nervous – I was thinking what if I did not improve three years after our last mentoring session, would he be disappointed?  Sigh of relief, I did improve, phew!  In addition to Francisco, I was also mentored by the brilliant Clare Frank and amazing Kathy Kumagai-Shimamura.  What I thoroughly appreciated during mentoring was that it was a collaborative approach and the clinical pearls are something that you can never get elsewhere.  Not only did the fellowship improve my clinical skills, but it also expanded and refined my communication skills with patients, patient’s family, other physical therapists and healthcare professionals.  As my years of experience racked up, I realized that everyone communicates differently, and it is my job to navigate that.  

In February of this year, I completed and graduated from the fellowship program.  What a whirlwind of a year it was!  Do I regret it? Absolutely not.  Upon reflection, this has been one of the most eye-opening and influential years of my physical therapy career.  If I could, I would do it all over again.  But I think Clare, Kathy, and Francisco have had enough of me ;)  To be honest, not only have I grown professionally, but I have also grown as a person.  A person that I am extremely proud of: I have become more emotionally mature, composed, patient, and confident.   

I would like to give my heartfelt thanks to my mentors: Francisco dela Cruz, Clare Frank, and Kathy Kumagai-Shimamura.  I would also like to give a huge shoutout to my cohort: Victoria Grey, Jonathan Dickey, and Carlos Roel.  All the shenanigans throughout this year would not have been possible without you! 

Ashley graduated from Creighton University in 2015 with her Doctorate of Physical Therapy. Ashley completed the Kaiser Southern California Orthopedic Residency program in 2017 and recently completed the Azusa Pacific University Movement System Fellowship program to advance clinical reasoning and knowledge. She is an Orthopedic Certified Specialist (OCS) from the American Board of Physical Therapy Specialists and a Certified Strength and Conditioning Specialist (CSCS) from the National Strength and Conditioning Association. 

1. Gardner K. About Residencies. ABPTRFE. http://www.abptrfe.org/ForParticipants/AboutResidencies/. Accessed June 26, 2020.
2.  Furze JA, Tichenor CJ, Fisher BE, Jensen GM, Rapport MJ. Physical Therapy Residency and Fellowship Education: Reflections on the Past, Present, and Future. Phys Ther. 2016;96(7):949-960. doi:10.2522/ptj.20150473
3. Pustułka-Piwnik U, Ryn ZJ, Krzywoszański Ł, Stożek J. Burnout syndrome in physical therapists – Demographic and organizational factors. Medycyna Pracy. 2014;65(4):453-462. doi:10.13075/mp.5893.00038.
4. Rodeghero J, Wang YC, Flynn T, Cleland JA, Wainner RS, Whitman JM. The impact of physical therapy residency or fellowship education on clinical outcomes for patients with musculoskeletal conditions. J Orthop Sports Phys Ther. 2015;45(2):86-96. doi:10.2519/jospt.2015.5255