Residency training in PT isn’t anything new in our profession. There are well over 150 programs out there and a number of applicants that are looking to progress their professional careers after PT school. Last year, there was a lot of chatter on the idea behind mandatory residencies (read here, here, and here). In late 2017, the APTA Board of Directors modified task force recommendations based on stakeholder feedback and voted to pass these updated recommendations on to another task force (Education Leadership Partnership (ELP)) for consideration and potential action.
It is great to see that there is much talk in our profession now on best practice in PT education (both didactic and clinical) as well as post professional training. The APTA is clearly locked into the idea that residency training will become the norm for most new graduates some time in the future. I believe that this day will soon come, whether mandatory or not, but this thought has me thinking:
Are we prepared for this?
Fruze et al published an outstanding article in 2016 regarding Residency and Fellowship Education: Reflections on the Past, Present, and Future. The article goes into the current state (at least in 2016) of residency and fellowship education and called out several aspects for the future of post-professional training. The authors state that there were 540 individuals admitted into a residency program in 2013 with over 1,400 applicants applying.
This means that less than 50% of applicants get a resident position. I have a hard time believing that over half of these applicants were not qualified. In fact, I worked for a health system that interviewed over 20 applicants for 3 residency spots – most of the time each one had the drive, professionalism and focus to be a successful resident.
The issue I see here is that we have a major bottle neck in the entry-level to resident transition point. Whether people want to admit it or not, 2 year DPT programs are here and here to stay. This will provide the opportunity for more graduates to apply for residencies given that PT school debt won’t be as catastrophic (as compared to 3 years of PT school plus a residency). With more applicants, will we have the capacity to take them?
The only way this can happen is if clinics, health systems, etc. start thinking differently. We need to start looking to the medical model where the attending physician works with several physician fellows, who work and train several physician residents, who work and train several physician interns.
The key factor?
Each person in the “hierarchy” is training more than one other person.
We have to get away from this one-on-one training model that will never meet the needs of resident applicants the future holds. This should change – this needs to change.