Clinical specialty area: Pain Science

Years in specialty practice area: 17

Areas of Professional interest: Long-standing neuropathic pain

Hobbies:  Pole vault coach for the University of Alberta

What did you find most rewarding about the Specialty Program?

I was very happy to be pressed for reasonable answers regarding my clinical decision making.

I was also happy to speak to like-minded practitioners and have the opportunity to be asked by them to look deeper into literature reviews, use of outcome measures, treatment choices and program planning. 

What were your reasons for applying to the Program?

My initial reason was purely for professional development. There is simply no other way to be evaluated by your peers in a way that so acutely fosters self-reflection. It provided me with exactly what I wanted and a whole lot more. 

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

Physiotherapy will continue to be seen as a lead provider of health care options that are non-surgical and non-pharmaceutical by nature. We will have the opportunity to shine as the provider of interventions that are catered to the optimal function of the healthy body instead of our current model of attempting to alter the structure and function of our bodies through medications and surgeries.  

What impact do you think specialization will have on your specialty area?

Specialization will raise the bar of expectation and professionalism in the study and delivery of  interventions that positively impact pain complaints. I also foresee that specialization will empower physiotherapists to be focused in this area as a vocational destination of choice. 

What is the value of the specialty program to candidates?

I think that the biggest value for candidates is in being put under the microscope. This program will challenge you to bound forward in your own self-reflection, learning, planning and understanding of your specialty area. It will force you to analyze everything from the courses you have taken to the papers that you read, the outcome that you choose and the model of therapy that you provide. No rock remains unturned in this self-reflection and, through the process, you become a better therapist.  

Have you used your specialist network and if so how?

I have expanded my list of trusted professionals that I call upon regularly when planning my interventions. I have made new contacts from Vancouver to Halifax and even right here at home. We discuss outcome measures, CBT-inspired interventions, interpretation of literature and many other things. 

What are important things to consider for those who are interested in pursuing their clinical specialty?

The process is rigorous. It is not merely a submission of a CV and a couple short essays. If you are interested in a challenge, you will find it here. On the flip side, I can simply state that you will not find a more effective way of advancing your clinical skills and decision-making without doing a PhD.  

What new skills or enhanced skills did you obtain going through the specialty process?
One of my colleagues told me that I think differently now. Not in an overwhelming way, but in a more analytical way. He pointed out that I now criticize literature on the basis of its details (such as exclusion criteria) instead of cruising through the abstracts. He also said that the process has set-off an explosion of finely directed energy. I feel like I did when I graduated, thirsty for information, answers, deeper questions and I feel more rounded as a practitioner. In the end, the direct answer is that I am much more focused on models of care instead of techniques.    

What advice would you give to applicants going through the specialty process?

Don’t think to much, go after it now. There is no better time. Like Morgan Freeman said in Shawshank redemption: “You gotta get busy living, or get busy dyin”. Without challenging yourself to grow, you will stagnate. To me, that is professional death.  

What impact has the specialization designation had on you and your career?

I have found a greater need for acuity. I assume less and probe deeper. I assume that I am wrong before I allow myself to suggest that I am right. I am a more critical thinker but at the same time offer my clients more options for therapy and referrals that will advance their understanding of their body. I have also become more diligent about engaging in professional development and knowledge translation. Instead of stating that I wish there was x, y, and z, available for physiotherapy, now I act on the thought and produce opportunities for me and others in my profession to share information and grow.  

How did you become interested in Pain Science?

I took a course in GunnIMS in the 90’s and was interested in how and why the technique was so effective in advancing stale cases of pain. At the time I worked at the Misericordia Hospital providing general PT services. After taking the course, I moved on to a Medical clinic that specialized in chronic pain. I provided a PT perspective on movement and education working hand in hand with the physician and psychologist. During this time I also worked part-time at a psychology clinic that concentrated in part on EMG biofeedback. Within a couple years I wanted the freedom to create a program and teamed up with a senior physical therapist named Ian Sim. He and I started CSA Physiotherapy with the intent of concentrating our efforts on neuropathic pain.

What made you choose Physiotherapy as a lifelong career?

That’s easy. I was in a motor cycle accident a couple weeks after competing in Olympic trials in pole vault. I spent 2 years on crutches and was horrified at the lack of direction for movement and rehab. My experiences both in the hospital and in clinics made me realize that the services offered to people in my situation were simply lacking. I was too high-functioning for a hospital-based program, too low-functioning to properly do it on my own and my physician said that he didn’t believe in physiotherapy. That was enough to make me interested.  

Education

Concordia College Bachelor of Science (1987-91) 

University of Alberta  Bachelor of Science, Physical Therapy (1991-96)                

Current Work and Role

I work full-time at CSA Physiotherapy on 51st ave. I am a senior clinician and help mentor at this site. My role is 100% chronic or complex pain at this site and my interventions include CBT strategies and GunnIMS needling.  

Emailcorychoma@me.com

Onlinewww.csaphysio.ca