Clinical specialty area: Musculoskeletal

Years in specialty practice area: 25

Areas of interest: MDT spine and extremities, mild-moderate OA hip and knees

What did you find most challenging about the program?

For me, the most challenging parts of the program were getting my CV in order, deciding what types of cases to present, and how to write them up in a way that would make sense to the assessors.

Could I present my clinical reasoning in a way that made sense to them? Would they think I was crazy if I did not assess and treat the same way that they did?

I learned that the assessors are interested in understanding why you did what you did, not the details of which techniques you chose. They want to see a differential diagnostic and clinical reasoning process that is well described and built on a broad base of knowledge, understanding of the evidence, and clinical experience. Most of all, I learned that what I had to offer did measure up!  How nerve raking it can be to put oneself “out there” in this way, but I’m glad I didn’t talk myself out of it.

This is not about how many courses you have attended, nor the letters behind your name – that is only a small piece of it.

Where do you hope to see the profession in 25 years?

My hope is that we will see a lively within-profession referral system focused on achieving the best possible outcomes for patients. We will know our own strengths but we will also have a network of PT specialists whom we can refer challenging patients to on a regular basis.

Today, patient referral is not common so we lose them to other professions. My hope is that PTs will see referral as an opportunity for learning. We can be reassured that we’ve made sound clinical decisions by seeking a second opinion or we can learn new ideas to use for similar patients in the future.

What advice can you offer physiotherapists who are considering the program?

Contemplate all the competencies listed. This is not about how many courses you have attended, nor the letters behind your name – that is only a small piece of it. Ask yourself if your experience will be able to speak to all nine competencies or if there are areas you can further develop.

Also, don’t necessarily present cases where the results were magical; present cases that really made you think and feel differently and changed the way you practice. Be prepared to share your thinking process and feelings that caused you to act differently than the average PT would act. Reflect on how these experiences changed your practice, and how you shared this experience with colleagues.  

What’s the best advice you ever received?

“Remember, we are here for the patient” was something I heard from Robin McKenzie (1931-2013). I have heard this statement from him in a number of contexts, and I really think that ultimately it is patients who will benefit from the specialization process.