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Why I Chose To Do A Residency

First and foremost, I’m new to this whole blogging, so bare with me.  Anyway, my name is Joe O and I graduated with my DPT from Stockton University in 2013.  I was recently offered a position as an orthopedic resident at the University of North Carolina.

So lets go back to where it all started.

While in PT school, I attended CSM in Minneapolis and learned what a residency was and the basic components involved in a residency.  After that conference, I knew I wanted to do a residency once I completed PT school.  As school progressed and graduation came closer, I still really I wanted to do a residency.  However, as graduation came and went and I was more focused on passing my boards, the last thing on my mind was a residency.  After passing boards, I decided to go into the work force and put all this great knowledge to use.  I figured if I could get a mentor, do I really need to take a pay cut and participate in a residency.  Plus, the thought of paying my loans was weighing heavy on my mind and wallet…

So I started working in an outpatient PT facility, which was PT owned.  When I first started out, everything was great!  I was learning a lot, getting great mentoring, and was finally helping people move and feel better!  However as time went on, my mentoring decreased and practice became more about the bottom line and productivity.  Now don’t get me wrong, I totally agree with needing to be productive at work and meeting a certain standard because at the end of the day, it is a business and I get that.  In my head though, I’m still growing and learning as a clinician and my priority is to not only help people get back to their lives but to improve my skills and knowledge as a clinician.  Unfortunately, time continued on and my mentoring never got back to the level I would have preferred.

During this time, I have been listening to podcasts including The School of Greatness with Lewis Howes, PT Pintcast, Therapy Insiders, plus many others.  In various podcasts by the aforementioned shows, a fire was reignited inside of me, the same fire that was burning when I went to CSM in Minneapolis.  Through those podcasts, as well as support from friends and family, I decided to revisit my goal of participating in a residency.

I immediately started searching for orthopedic residencies through the ABPTRFE website.  I found about 14 residencies that interested me and researched every single one as best as I could.  Obviously something that is a requirement of all residencies is mentorship, which is the number one thing that I was looking for.  I wasn’t necessarily looking for anything specific for my residency to have such as manual therapy focus or spine focus, because I just wanted a residency that would give me a good overall and comprehensive skill set in orthopedics.

After researching thoroughly, I came to my top five choices with UNC being number one.  The things that attracted me to UNC were numerous.  First, UNC Health Care is ranked #2 for primary care in the state of North Carolina.  Second, the DPT faculty at UNC are well known and world renown for the teaching, practice, and research (look them up, it’s incredible).  The UNC DPT and orthopedic residency philosophies were very similar in that they want to practice with the most recent evidence, give back to their community, and preach excellence in practice.  Lastly, they have options for an elective while you’re a resident so if you wanted to go into research, teaching, work with UE athletes, or be manual based, etc., it’s all an option as long as it is well within reason and a mentor is willing to help.  I’m skipping ahead a little right now, but after getting a tour of their clinics, especially the ambulatory care center, there is such a broad range of conditions you can see as well a very diverse community that I will be working with, which was super attractive for broadening my skill set.  So luckily at that time, the application for UNC was still open and I could meet the deadline. (Depending on the residency timeline, applications for some may be closed as they may not be accepting residents, for example nine months from now)

Once I knew I was going to apply to UNC, there were various items that they required, in addition to what ABPTRFE required, so that my application would be complete.  It’s nice that the ABPTRFE site is well laid out and user friendly, however if you do have any problems/questions you can always contact them, as their customer service was pretty quick.  Also, feel free to reach out and ask questions to the residency director about the program or supplemental application items, which I had done during the process.  Some items that were needed for the application were: basic background information, verification from school that I graduated, plus my transcripts, three letters of reference, and three essays.  I worked frantically to get everything completed in time so that I could meet my deadline.

After about 2-3 weeks of waiting in anticipation, I had learned that I had gotten an interview with UNC!  At the time I was super excited and then my nerves set in because I needed to go down to Chapel Hill put it all on the line to reach my goal.  After knowing that I landed the interview, I began to research questions that may be asked during an interview for residency.  In my research, it was pretty much all related to medical residency, but the good thing is that most, if not all, potential questions I found are relatable to PT.  I started to prepare general answers for the most basic of questions that I could be asked on my interview.  I didn’t want to memorize anything specifically because you don’t want to sound robotic when you’re at your interview.  Through my research and talking with many people, I learned the best thing that you can do is BE YOURSELF!  I also did a lot of research on UNC itself, UNC Health Care (which the residency is associated with), the UNC DPT program, the PT professors, and the mentors within the residency.  As the interview date got closer, I scheduled a mock residency interview with career services at Stockton to help prepare me for the situation.  In addition to all of this I continued to listen to inspirational and motivational podcasts.  I also watched various TED talks for motivation and for tips on interviewing.

I flew down to Chapel Hill a day before my interview and got acquainted with the area.  I made sure that I knew the route I needed to take and how long it would take me to get to my destination.  On interview day, I put on my Sunday best and made my way to the clinic.  On my way there, I did my normal routine that I do to get me pumped up and in the zone, listen to some serious bass pumping hip-hop.  I also listened to a two minute speech by Steve Weatherford, whom I find to be super motivating and inspiring.  When I got to the clinic and while I waited, I got to meet the other candidates interviewing for a position as well.  Once we were all there, we received a tour of the clinic and then were transported by one of the mentors to campus.  Once on campus, we received a tour of the ambulatory care center and the PT classrooms.  After that, we broke up for interviews.  I had two separate interviews with two interviewers in each.  After those interviews, my clinical thinking skills were tested with a case study.

That was it!  Once I was done I felt like a huge a weight was lifted off my shoulders.  We then got to meet and talk with current residents have a private Q&A session about the residency and life during the residency.  After being dropped off at the original clinic, the director told us that we would hear back probably in about two weeks regarding the position.  I flew back home after taking a few more days in Chapel Hill and Durham, soaking in the southern hospitality.  Which if you have never been in the south, southern hospitality is real and it is absolutely awesome!  Anyway, I flew back home and was waiting in anticipation.  Luckily for me, I was given a call about two days later saying that I was being offered a position as an orthopedic resident at the University of North Carolina!!  I was beyond excited and thrilled knowing that everything I had done was worth it and that I was gonna be able to achieve a goal that I set for myself about 4-5 years earlier.

This is part one of this blog post as I hope to update everyone about the residency once I start!  I am also contemplating starting my own blog about the residency and everything about it while I’m going through it.  As noted earlier, there is not much out there on PT residency and I’m hoping to be able to document my experience and give people an idea as to what it is really like.  Also as mentioned before, this is my first ever blog post, so I hope it was enjoyable, somewhat comprehensible, and that you got something out of it.  Please feel free to ask me any questions through this post or through Twitter, my handle is @orbonacle.

About Joe:

I graduated from Stockton University in 2011 with my B.S. in Biology and in 2013 with my DPT.  Most recently I have been certified as a Certified Strength and Conditioning Specialist (CSCS) through the National Strength and Conditioning Association.  I have been working in orthopedic PT since graduating and have seen an array of orthopedic cases.  I have a love of helping people feel and move better.  I also have a strong love for sports medicine and athletes of all types.  I begin my orthopedic residency in January 2017 and I can’t wait!  As mentioned I am looking at starting my own blog about the residency itself, leadership, motivation, and other PT matters.  I am currently taking suggestions regarding the title of my blog.  You can follow me @orbonacle at pretty much all social media outlets.

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What I learned at CSM 2016 is…

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I just attended my first American Physical Therapy Association (APTA) Combined Sections Meeting (CSM) this year.   I am fortunate enough to have been allowed time off from my current clinical experience to attend this event;  my clinic as well as my CI are absolutely amazing!  My CI fully supported me going to this event as she had an overwhelming positive experience when she attended while she was in school.  Thanks so much!

For those of you who have never attended one before, this is THE conference to go to for those in the physical therapy profession whether you are a PT, PTA or a student.  I believe this one was the biggest thus far with a whopping 11,000 people attending this year! Holy cow!

I flew out early so I could sightsee, meet people and settle in without being in a rush; plus I had to be there early for our volunteer orientation on what else?… how to scan people into their sessions – super fun right?  I reserved a place on Airbnb for the conference, which was super convenient for me and my roommates in which we only spent $100 each for 5 nights.

When I arrived at the place, I was greeted by one of the owners and their dogs.  It was my first time doing Airbnb and I was pleasantly surprised.  The couple that owned the place are really nice and the place we stayed matched with their personality.  I was properly greeted by their two lovely dogs

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Later that night, one of my roommates flew in and of course we have to experience the In and Out Burger. Yum!

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I am fortunate enough to network with some really cool PTs and #DPTstudent beforehand on Twitter so I was able to hang out with a couple before everyone else flew in the next day.  I had so much fun getting to hang with some big names in the Twitter world.  I got to reunite with Sarah Haag (@SarahHaagPT) the day I flew in, which was awesome!  I got to talk shop with Sarah, her business partner Sandy Hilton (@SandyHiltonPT) and a bunch of their colleagues.  Sarah apparently likes to introduce me to her friends as the “Famous @MarkyKev on Twitter” because she says to me, “you’re kind of a big deal now on Twitter.”

The next day was just as exciting as I got to have lunch with the famous Ben Fung (@DrBenFung) and Gene Shirokobrod (@therapyinsiders) at Earl of Sandwich in Downtown Disney.  

The next few days were a whirlwind of adventure.  It was literally nonstop action where I would wake up early, get to the convention center, do my volunteer shift, sit in on sessions and/or meet with my Twitter friends in real life, wander the exhibit hall, eat, drink, sleep and repeat.  It went by so fast; to think I spent a whole five days here in California! Honestly, I think the flight over to California from New Jersey felt longer.  I guess time flies when you’re having fun.

During the times that I wasn’t scanning people into their sessions or listening in on talks, I was networking and talking with professionals and students.  It was great to finally put a face to a name that I only knew from Twitter.  It was so cool to be approached by people and have them ask, “You look familiar, are you Mark from Twitter?”  I mean, how cool is that?!  I even had a fellow student come up to me thanking me for  my blog posts; heck, I didn’t even know people read my stuff.  He thanked me for inspiring him with my blog posts to keep writing for his blog.  That’s an amazing feeling to know how much of a positive influence you can have outside of the clinic.

I talked to so many people throughout this conference that I actually lost my voice and sound like a prepubescent boy with my voice cracking every 5 seconds; my friends during the last days of CSM can attest to that.

The one thing I learned during my time at CSM was not during an educational session, but when I was interacting with people in our very own profession.  Every PT I got to interact with, I felt like I talked them to death #SorryNotSorry and picked their brains with so many questions I had.  It was really heartwarming, as cheesy as this sounds, to hear so many words of support and encouragement from all the PTs I have talked with at CSM.  The massive amounts of positive vibes has definitely recharged me to not only return to my clinical affiliation in full gear, but also to have something to look forward to after graduation; having an opportunity to call these people my colleagues and getting to learn and pick the brains of some of the brightest and coolest people in the profession.

“Jobs don’t care about what school you went to or your test grades”  – Monique Caruth (@mjcDPT)

As you probably already know, I’m currently in my clinical affiliation which happens to be at a Level II Trauma Center; so I’m seeing everything under the sun from strokes, gunshot wounds and motor vehicle accidents.  It’s really challenging as a student because these are medically complex cases, but on the other hand it’s a really awesome experience; very few, if any, of my classmates are getting the same experience that I’m getting.  That being said, I had second thoughts on what I wanted to pursue after graduation;  I had a new found interest in Acute Care, specifically trauma ICU because of my time at this clinical affiliation.

“. . . re: trauma hospital… you are LEAGUES ahead” – Ben Fung referring to my clinical placement at a Trauma Hospital.

I was really torn about deciding Acute Care vs a Sports oriented outpatient clinic for my last clinical affiliation; and seriously debating on whether I wanted to pursue a sports residency after graduation.  I think attending CSM re-kindled the fire and passion I had for sports PT and sports performance.  I talked to some bright minds in the profession which gave me some perspective on the future.  The one big piece of advice came from my talk with Kyle Ridgeway (@Dr_Ridge_DPT).  He gave me some interesting insight and thoughts on directing my path as a future Physical Therapist.

“No matter which path you choose, you can’t go wrong.  That’s the beauty of our profession.”

Some advice for those who are attending conferences

Get yourself on twitter!

  • Twitter seems confusing, but once you get the hang of it, it’s simple and addicting.  I remember Jess Schwartz (@DPT2Go) say to me “I remember when you just started on Twitter and to see you all grown up now is amazing.”  You’d be surprised what social media can do for you.  I’ve made so many connections on twitter that when the time came to coming to CSM, it was just a matter of meeting each other. . . with hugs especially if you meet Ann Wendel (@PranaPT) for the first time.  

Bring a power pack for your mobile devices!

  • If you’re like me and always on twitter, your phone is going to die fast!  Bring something at least rated 4,000 mAh.  Plus, you’ll be using your phone to snap photos, text, and checking out the sessions with the official CSM app.  

Bring a decently sized backpack

  • Remember you’re allowed two carry-on items; one for the overhead bin and one for underneath the seat in front of you.  Personally, I like only traveling with carry-on luggage.  It’s easier to tote around a backpack to carry every day items like a jacket/sweatshirt, snacks, charger and all the free swag you’ll accumulate during your time at the conference.  I personally recommend the GoRuck GR1 and their Civvy kit.  They look cool, but also are really tough and functional.  Plus they’re made in America #Merica.  

Bring snacks!

  • Food will be seriously overpriced at the conventions especially at the hotels.  Bring something to nibble on in between sessions to get you fueled and ready to go.  

Put yourself out there and talk to people!

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  • Personally, I’m a really introverted person.  I find it very difficult to put myself out there to complete strangers.  But if you don’t ask, the answers will always be no.  You never know who you will meet and the new opportunities that could come from just introducing yourself to someone.  Remember, most PT’s have been in your shoes before and are more than willing to pay it forward and help you out.  

 

Look to help cut the costs

  • I didn’t want to spend a ton of money on flying out here for the conference.  Look up ways to help cut the costs.  Look for scholarships both private and if your school offers some.  Try to look for alternative places to stay like AirBnb and splitting the rent with people you networked with on Twitter (Use this link to save $20 off)  Volunteer!  APTA has volunteer opportunities for students during conferences that reimburse all if not most of the registration fee.  I highly recommend that if you’re interested, make sure you try and sign up the day that they open because they go FAST.  I was fortunate enough to be selected as one this year.

Wear comfy shoes

  • You will be walking A LOT.  I felt like Forrest Gump at the end of his run…

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Suck it up

  • This leads to my next suggestion; don’t to bed early.  Sure, there will be educational sessions during the day, but the real magic happens during the late night where you truly get to meet and talk to people. This is where you network! Remember, you never know who you’ll meet.  You’ll have plenty of time to sleep on the flight back!

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Choose, but choose wisely

  • My suggestion to choosing what sessions is to pick something you’ve never learned but are interested in.  For example, there were a lot of ACL talks, but since I’m a student, most of the information we already learned about in school.  I was a little bored.  If you do choose something that you never heard about and are interested, you’ll be more engaged in listening instead of snoozing off and trying to find another session to hop in on.

In conclusion…

So far, this has been the most exciting experience in my physical therapy career (you know, besides that feeling when you get that acceptance letter to PT school – I don’t think anything will ever top that… errr maybe passing the boards? haha).  I’ve met so many awesome people during my time at CSM and I would highly recommend for professionals and students who are on the fence about going, to go.  So what are you waiting for? Start planning! I promise you won’t regret it!

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Some memories of all the new friends I made during CSM; It was a pleasure to meet you all!

The Struggles of Being a Small Physical Therapist

Dr. Jennifer Palmer

No, this isn’t Elite Daily or Buzzfeed. I’m not going to tell you the 37 reasons why being a physical therapist is “THE BEST” while using completely opinionated rationales.

This blog post, however, is based off of my opinion as well as from my not-very-extensive-but-still-valid experience of how being a smaller person has affected how I treat patients, how I treat colleagues, and how I have overcome others’ opinions of what smaller people CAN do in this field. Just FYI – I’m a 5’2″ petite girl.

To get you in the right mindset and to help you understand where I’m coming from (especially if you’re a normal sized human being)… Let me first give you a few quotes that have stuck in my head and/or are repeated on a constant basis from either patients, patients’ visitors, nursing staff, and/or other health professionals:
1) “You can’t lift me, you’re the size of my thigh.”

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Clinical Experience from the DPT Student Point of View

Thank you to everyone who responded to the survey I put forth on social media about your clinical experiences.  I apologize again for the sheer length and amount of open ended questions the survey included.  I really do appreciate your honest feedback.  It is my hope that it will help students who are about to embark on their next clinical affiliation.  Just remember, you are not alone in this endeavor!

These are direct quotations from the survey.  Some changes and edits were made such as spelling corrections or shortened to reduce redundancy.

What we look for in a clinical instructor

wanting to be a CI for the student to learn not just for the student to do all the work”

“Someone who is genuinely interested in teaching because he/she wants to better the PT profession.”

Approachable”

Positive, encouraging”

A CI that will tell me what they expect from me, demonstrate new skills, give me space to treat my own patients but still be available if I have questions”

reasonable caseload to allow teaching time”

I like it when they take time to regularly talk with me about how I am doing and my goals and what they would like to see me doing better with as a student. I like it when we work together to gradually increase my independence as a clinician instead of just throwing me in there when I don’t feel comfortable. I also like it when they respond to clinical questions with other questions that help to guide my thinking”

A good CI is one that has the ability to let go of their patients and allow the student to take a forward role as appropriate for the student’s education to that point. The CI should always be available for questions, and should regularly question why they student treats the way they choose to.”

Flexible on teaching style”

willingness to let me jump in and discuss treatment options with me.”

Good communication”

setting mini goals with the student so that both are on the same page with the student’s performance, strengths, weaknesses”

Flexible on teaching style. . . also willing to let you learn from them and not rely solely on what you are bringing to the clinical”

Someone who challenges me as a student in order for me to develop my clinical decision making skills”

“Someone who takes time to give the student feedback, both positive and negative.”

Someone who keeps eye contact with their patients, and remembers they are human beings in need of expert healthcare.”

Someone who is a lifelong learner.”

What we look for in a clinical experience

Interdisciplinary exposure”

Opportunities specific to the setting”

Being in a setting that is not high pressure for productivity”

“Good work environment: approachable and helpful coworkers, an aim for learning not just productivity, application of evidence based practice”

other therapists that I can work in close proximity with so I can learn from multiple styles.”

Variety in case load, independence to choose treatments”

I think that the CI can make or break the clinical experience”

“Good CIs are hard to come by, from what I hear.”

Having good communication and the site appreciating the student and vice versa. – Feedback and communication are key.”

What we liked about our clinical instructors

day one we discussed how I best learn”

Went above and beyond and spent extra time with me”

“. . . honest yet respectful feedback”

My last CI found my weak spots and pushed me to improve them”

helped me become me as a clinician rather than a carbon copy of themselves”

We also set weekly goals and had a quick mini-meeting every week to discuss progress thus far, what to work on, etc.”

Gauges my skill and comfort levels before exposing me to new situations”

What we didn’t like about our clinical instructors

No feedback.”

I learned close to nothing, never observed her treat, had to base my sessions on what I knew coming in and what I found through research”

Her feedback is inconsistent, one day she says she wants one thing and the next day it’s completely opposite”

I did not like it when my CI did not have a plan or clear expectations for me or had difficulty allowing me to participate fully.”

“. . . not being organized”

“. . . my way or the highway type”

What we liked about our clinical experience

It was so nice to get into the field, talk with patients, use critical thinking skills.”

I learned about things in the clinic that I have yet to learn in the classroom, which will set me up for success in the classroom later.”

Humility of staff to acknowledge that we do our best but that we are always … Always. Learning”

Variety of patient population, ability to shadow other clinicians or disciplines, earned independence”

Because of the high patient volume, I learned time management and efficiency, as well as how to treat acute injuries,”

What we didn’t like about our clinical experience

Having my CI look over my shoulder all the time.”

Overly concerned with productivity”

I just wish I had a better CI. My expectations were too high going in, which made it a worse experience.”

Didn’t learn much”

sometimes the hours have been difficult or what seemed to me to be excessively long (52+ hours/week)”

If you could go back in time and give yourself advice for clinic, what would you say?

Be more vocal about the extra opportunities you would like to see.”

Take advantage of every learning opportunity and have confidence in the skills and knowledge I received in PT school.”

Communication with your CI is key to having a good clinical experience, no matter the CI’s level of expertise.”

Stay flexible, ask more questions, and don’t be scared when I get asked questions. If you’re using x technique to treat you should know why.”

Be confident!”

Talk to my school clin Ed advisor about problematic relationship issue with CI. Early. Don’t wait and think it will sort out”

Seek feedback from your CI regularly about what you could have done differently or better.”

Have more confidence. You know more than you think you do.”

“Relax. Always try to learn from each day. Reflect on paper”

“Relax and ask questions when you have them, remember this is your time to learn not to just show what you know”

What strategies did you use in clinical? 

Talking with CI, making sure there is open communication and trust”

Daily meeting/discussion about patients and plan for sessions, weekly checkpoints on good, bad and need for improvement and setting weekly goals”

We [CI and student] also discuss documentation before locking notes”

Goal settings weekly, strengths and weaknesses”

How did you manage stress during clinical? 

With CI and other staff”

Exercise!”

made time to hang out with classmates.”

Prioritize as best as I can between clinic and home life”

“. . . prayer”

“Alcohol”

“Reflection/journal writing”

How did you manage setbacks and/or lack of progress in clinic? 

Feedback and communication with my CI

Discuss with my CI on how I can improve.”

Either spent extra time preparing, or readjusted my goals if it was clear they weren’t going to be met in this setting”

Pick something that I’m lacking and make every treatment or whatever about improving one thing.”

Patience knowing that I am learning every day even if I do not realize it at the time”

Goal setting with CI helps.”

Did you feel your didactic coursework prepared you for clinic? 

Yes. We have a great professor who has taught me how to think critically, which is exactly what I needed to be doing in the clinic. Rarely did we have a “textbook patient,” so I had to critically think about what the patient in front of me needed.”

Partially. I had the basic information I needed to start the rotation from my classes. However, for me, the actual hands on experience is way easier to retain all of the information we learn in the classroom.”

Yes and no. I was not prepared for dealing with discharging patients to hospice or losing them to death. My CI was great at helping me cope with the death of patients and helped me realize it is something commonly seen in the skilled setting.”

Yes as best as they could. Nothing is as clear cut as it is in the classroom, and the professors give a bunch of resources and try to have a good discussion about the topic, but you won’t know until they are in front of you.”

Do you feel the CPI adequately evaluates your performance? Why or why not?

“No. CPI is very subjective and not a great evaluation of the whole experience. It is a good tool but should not be the sole evaluator of the clinical experience.”

The CPI is repetitively and lengthy. I think it could be shortened and still do a sufficient job of evaluating performance.”

Yes it is thorough, hits most areas, and has an easy to use grading system”

No. It’s too long and repetitive. The comments are more appropriate for performance than the grading scale”

What could be done to improve the CPI? 

“More free box writing such as strengths, weaknesses and further study needed”

“Get rid of the grading scale, make it shorter”

“The individual PT program should do site calls or visits to thoroughly eval their students.”

A sliding scale just doesn’t seem to work well for some categories. I think it works for things like examination, or diagnosis because it depends on how much help you need in that area but things like “professional behavior” don’t really make sense on the scale. I mean, why would you need help being professional with complex patients but not simple ones? It just doesn’t really work in my opinion.”

Any comments or advice you would give students heading into their next clinical?

Be confident in yourself, you know more than you think! Don’t be afraid to ask questions, that’s why you’re there! Try and experience as many different things as you can”

Reflect! Write a short synopsis for each day”

Prepare beforehand. Ask your CI what you should brush up on before you head out.”

Open communication is key. If don’t have it with CI… Talk with school early and often. Clinical is stressful enough without having a CI who stresses you out.”

Keep an open mind and be prepared to get out of your comfort zone. You may have to change a few adult “briefs” or clean up a patient after an accident– treat every patient as if they were your parents or grandparents :)”

“Good luck! Enjoy it and learn!!”

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Inspiration to be an Athletic Trainer

Athletic Training and Fitness

I have a football coach who tells me all the time “I don’t know why anybody would want to be a (athletic) trainer. Y’all are always getting abused and working a ton for little pay!” Sometimes I think about that. Why do we do it? Why do we put up with coaches and parents always harassing us?

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