To Residency or Mentorship: That Is The Question!
3rd YEAR STUDENTS AND NEW GRADS!
Yes, YOU!
How many of you have gone back and forth in your head about whether or not to go the residency route after graduation? I am going to bet that the majority of you have wrestled with this and I am hoping that today’s blog will help turn some inner turmoil into a calm weighing of options.
This month we are incredibly fortunate to be featuring TWO new grad PT’s that have shared some of their insights and recent experiences with me regarding the paths of residency and free mentorship. I also completed a residency immediately after graduation and am able to provide some guidance here as well. I know that so many of you reading this are students and new grads and I really want to ensure that what we provide you is truly valuable, not just fun to read (though that is a hopeful bonus =)).
So let’s meet the contributors! First up is Leda McDaniel, PT, DPT who some of you may recognize, as she was one of our early Podcast guests. Leda is a new grad who is currently completing an orthopedic residency at Emory University in Atlanta, GA. Then we’ve got Trace McClintock, PT, DPT who is also a new grad and who completed the Level Up free mentorship. He is now practicing at a VA hospital in central Texas. Leda writes for her own blog and Trace is a founder of and on the team for the Ducklegs Podcast and Whiskey Docs Podcast. DO check these high achieving new grads out!
PREFACE: I asked Leda and Trace to answer a handful of questions about their experiences in their respective post grad educational endeavors. I am going to do my best to moderate this discussion to really drive home some major takeaways from this insightful conversation.
Okay let’s dig in…
First and foremost, I want you to reflect and find out what your WHY is for considering a residency and/or formal mentoring post- graduation. I’m talkin’ about your deeper WHY; not just the “well, I really feel like I need more in-depth guidance and practice as I start my career,” or “I want to gain experience and improve my skills faster than I would without a residency or mentor.”
Those are solid reasons, but I challenge you to go a bit beneath the surface here...WHY do you crave that guidance? Everyone’s reason here will be different, but it often hovers around the feelings of uncertainty, lack of confidence, fear of doing harm, and discomfort with having no experience.
I GET IT. I’ve been there. And that is why I place such an emphasis on asking yourself this question because I was guilty of choosing to do a residency for the wrong reason (at least in retrospect).
I wanted to “gain 3-5 years of experience in 1 year.” What I learned the hard way is that I needed 3-5 years of experience to gain 3-5 years of experience.- New Grad Steph Allen
DISCLAIMER: This is NOT to say that I do not value having gone through a residency- it was a great experience, I learned a TON, and had a phenomenal mentor.
This is all just to say that knowing your true motivation for opting to do a residency and/or free mentorship will be instrumental in helping you choose the best fit for you.
Now into the meat and potatoes…
1. Specifics of programs you are looking into: What are you looking to get out of residency or mentorship?
Leda: “structured mentoring time, a diverse caseload, and teaching opportunities.”
Trace: “Free admission, minimal time commitment outside of clinical work, and a strong group mindset focused on growth and development.” 
These are pretty starkly different priorities, and again, why I stress the importance of looking inward first and thinking “Hey- what are my non-negotiables? What do I really need as staples in whatever program I decide to go with?” You may surprise yourself, but it will be worth the extra brain power!
*For more specifics on the actual residency application process, feel free to reach out to Leda, and for more specifics on applying for a free mentorship like The Level Up initiative feel free to reach out to Trace or myself, as well as check out our application HERE.
2. What are some of the things you disliked about your program or that you wished you had considered prior to applying/starting?
Leda: “Having different faculty [members] teaching courses makes for a
good mix of diverse perspectives, but also means that some courses are better than
others due to quality of [each] faculty member. I tend to question material that is
skewed patho-anatomically for diagnosis and treatment given what we know about
pain contributors and complex neuromodulatory processes that are NOT purely
structural! I felt like this was not emphasized enough in certain courses of our
residency program.”
Leda brings up a really unique, yet important consideration, as it is often difficult to know much beyond WHAT the curriculum is. You have very little knowledge of HOW it will be presented, what nuances may be weaved in, which concepts are emphasized or which “undertones” will be expressed. The best thing you can do is respectfully ask! If not of the director of the program, perhaps ask the resident before you/current resident/s, other staff PT’s on site, etc. I have been told by more than one mentor to always ask to spend some time IN the clinic setting, interacting with the PT’s, instructors, and patients. This goes for any interview: residency, full time job, teaching position, etc.
Trace: “I wish there were more clinical examples.” 
Trace made a REALLY good point here as well; he was a mentee in the very early stages of the Level Up mentorship program and, as with any program in its infancy, there was much room for improvement. That is absolutely a consideration for residency AND mentorship: how long has this operation been operating? What are the graduates of the program saying? Is it a situation where you want to gain some clinic experience as this program evolves and apply next year? ALL valid considerations.
Trace: “Sometimes you may not be sure of what exactly you will be getting
from a mentorship group so it is very important to find a mentor whose overall ethos is
comparable to yours.”
This is also a great point: despite having a clearly defined curriculum, mentorship has some “wiggle room,” so the bottom line here is to make sure that your values align with said mentorship/mentor so that unstructured learning is valuable and productive.
OKAY OKAY… I know. You want to hear more about the WHAT. What did these two feel like they got out of each program and was there anything left to be desired? Let’s see!
3. General pro’s and cons:
Leda: “The teaching opportunities, guided mentorship and diverse patient population were great, but the commute was awful and stressful.”
Trace: “Great networking, personal growth and improved patient/client
communication skills, though no added credentials or letters after your name upon
completion.”
This is a big “it depends” moment. If part of your professional growth or career plan involves becoming highly credentialed in order to be considered for a smaller niche of job opportunities, then free mentorship may NOT be for you. If the things Trace mentioned are of higher value to you, then as a new grad, you may opt for the cheaper mentorship and get everything out of it you are seeking (and we hope even more than you expected with us!).
4. What is one major takeaway that has greatly impacted your way of practicing, and that you did not expect to experience?
Leda: “Exposure to and learning novel therapeutic exercise and manual therapy techniques and being able to integrate this into patient care IMMEDIATELY!.”
Trace: “Decreasing the amount of nocebic language used in the clinic. Once
challenged to become self-aware of [my use of] various nocebic phrases, I realized that,
unintentionally, I was confirming patient biases about their injuries instead of taking
the time to educate them.
Again, pretty stark difference here, but not one necessarily better than the other depending on your WHY. I have my own biases that I am fully aware of, but that is not for me to place here and sway anyone any which way 🤓
5. What is one major takeaway that has greatly impacted your personal development, and that you did not expect to experience?
Leda: ”...I am learning to be less overly head-strong and feeling the need to be “right”
or to inject my beliefs about [things like] pain science into treatments...There are a
variety of ways to treat and evaluate that are evidence-supported and effective that we
can offer and the diversity here partially reflects acknowledging the unique personality
and delivery style of the PT as well as the needs of the patient. I am now more
comfortable acknowledging that I am not my mentor. I have a unique perspective and
am constantly learning and striving to be a better PT, but now feel that I have a better
ability to embrace my unique style of delivery and preferences for certain treatments that fit my own delivery models.”
Trace: “The self reflection aspect and communication involved in our
mentorship program had a much larger impact on my personal life than my clinical life
...Sometimes I think we can get comfortable in our lives and lack of communication
because things aren’t blowing up in our face. However, being self-aware enough to
identify the problem before it causes an issue is a skill most are missing.”
What Leda and Trace mention here- being comfortable with uncertainty and with being wrong, appreciating other ways of doing things, reflecting on your own strengths and weaknesses, realizing the importance of communication skills- are all HUGELY emphasized in the Level Up mentorship, probably more so than other mentorships or residencies. We believe that personal development cannot be ignored in the process of professional development because we are human and we work with humans. We feel that bettering ourselves trickles down into all of our interactions with and decisions regarding our patients and clients and that this will complement and enhance clinical reasoning skills vs. detract from them.
6. In a strictly clinical sense, do you feel that this residency made you a better clinician/physical therapist? And how?
Leda: “Yes; I believe that the didactic coursework and structured self-reflection
and self-evaluation that residency demands has really pushed me to plan and JUSTIFY
my examination and treatment techniques (in the context of best available evidence) to
a greater extent than I otherwise would have. It has really kept me accountable in
asking WHY I am practicing in the ways that I am and being open to changing my
methods based on what I am learning.”
Trace: “Yes; Improving patient buy-in, growing my ability to connect with patients, and
becoming aware of my language has for sure had a positive impact on my clinical practice.” 
I LOVE this. Both Trace and Leda feel that their experience has made them a better clinician.This speaks to the value in ALL learning. That doesn’t mean that everything you learn should be taken at face value or as gospel; quite frankly, it means the opposite. Learning and building a really solid knowledge base is a prerequisite for being able to critically think, to discriminate between and apply new knowledge and to confidently move forward in the direction of being just a little bit LESS wrong than you were before.
For some, this path forward begins with residency; for others, it begins with mentorship; and for others still, it is neither. But regardless of which path one takes, having humility, maintaining integrity, embracing uncertainty, staying hungry to learn, and finding some form of informal mentorship is going to lead to you becoming a damn good clinician and human.
7. Are you getting any training in the “human side” of PT or “soft skills” as they apply to PT? If so, what is the content you are learning?
Leda: “Not yet, hope to!”
Trace: “This was the main focus of Level Up. Trying to improve your soft skills
and making connections with your patients plays such a large role in clinical outcomes.
Just seeing research that supports this was amazing. While I have always known that
the soft skills are much more difficult to teach, it was fantastic to see research and
other professionals working through similar issues in clinic.”
I realize that this is by no means an exhaustive list of questions that you may have about the residency vs. mentorship debate, but I do believe that this will be extremely helpful for those toying with this decision to hear. I wish I had had someone to guide me and provide some of this information as I weighed my options after graduation.
In addition, I hope that this sparks some good conversation and reflection, and that this sets the stage for asking yourself more questions and being more introspective in the future. Reflection and introspection have been two of the most beneficial behavior changes I have made over the years and I cannot recommend these as “habits” enough.
Please, PLEASE! If you have any more questions, concerns, ideas or issues with anything that we shared today, do not hesitate to reach out. And, if you know anyone who you think would benefit from hearing this, share it with them or direct them here.
And lastly...have faith in your ability to assess your options and recognize that there really aren’t any “right” or “wrong” answers and that we are all just making the best, most informed decisions that we can. Let's go!
“Excellence is a continuous process and not an accident.”- Abdul Kalam