A very small part of the sports med team at the holiday party

Waiting out in the cold with Danny (co-resident) and his girlfriend Marianne

It’s been 6 months at Gundersen Health Systems sports physical therapy residency, and it’s gone by fast! Feels like just yesterday was my 3000 mile drive from California. Anyhow, the purpose of this post is to let my friends know what I’ve been up to, to help those who are considering a residency, and to let potential applicants know about Gundersen’s program specifically. There’s A LOT of history to Gundersen’s sports residency program which you can find around the web and main site (here). This is merely about my experience. I’ll be breaking it into daily duties, weekly schedule, and annual events.

Daily:

I work about 10-12 hours a day (log shows an average of 60 hours a week), which doesn’t feel long at all with the fun and variety. There is also reading and work outside those documented hours, but I never feel stressed or fun-deprived. Here’s a break down of my daily routine:

• Office Hours
  • Most mornings I have 2-4 hours to work on residency assignments, personal projects, and patient prep. Below are some things I’ve been working on during my morning hours that my past mentors and/or people at Gundersen have enabled me to do. Although 2-4 hours of “free time” may sound like a lot, you could see how time flies:
    • Lecture for 2nd year DPT students at University of Wisconsin La-Crosse: 1 lecture in “Examination and Treatment of Traumatic Knee Injuries” and another co-lecture on “Return to Sport for Lower Extremity Injuries”.
    • Communications Committee work for the American Academy of Sports Physical Therapy (formerly known as the Sports Section of the APTA): I helped plan Teammates at Team Concepts Conference, and am now writing newsletter content and planning Combined Sections Meeting (CSM) events.
    • Several presentations: One main session for CSM (population health and social determinants of health), one for the NSCA Wisconsin State clinic (interprofessional communication in sports performance and medicine), and one for the WPTA regional education series (dual-task and vision training for ACL rehabilitation).
    • Research: We are responsible for an original research project, and I am currently in data collection. In the past I was working on reading background articles, submitting for IRB approval, and doing other prep work.
    • Didactics: Didactics is definitely a strength of our program. Each week we spend 4-hours going over recent and classic articles in sports PT. The readings are daunting at times, so I spent a lot of mornings going over all the articles in order to make the most of the scheduled time.
    • Patient prep: I make a daily layout every morning that goes over programming for all my patients. It makes my patient care hours go smoother, and gives me time to do some critical case reviews rather than rush through a case as the patient comes in.
• Patient Care
  • I see patients from 1:00 pm to 7:00 pm (one hour of it is carved out for documentation), but I’m usually done by 6:00 pm or 6:30 pm. I work with my own PTA, and together we see 10-14 patients in a 5-hour block. Initial evaluations are 60 minutes, and follow ups are 30-minutes (The PTA works with them after I see them for 30 minutes, or we both go back and forth). We get a variety of orthopedic surgical cases and high school/college athletes. I love seeing patients, and try to see as many a day as possible to get my reps in. We’re allowed to open morning hours and lunch hours to see patients if we want.
• Post-operative evals
  • In the morning sometimes patients pop up, and need to be seen by anyone available since they were just in for the post-operative follow ups with their surgeon. The other resident and I are usually free to take them on, and do the eval and treatment. We never feel pressured to do it, and are often eager to take them since it’s more reps. It’s not often many PT’s get to see patients a week after their surgery, and the patients seem to appreciate all the education we provide. Sometimes I feel their pain and objective measures improve with mere education…but that’s for another post.
• Fantasy football: Yes, it’s the season right now, and there’s likely to be long discussions about fantasy football among the staff. I’m a league champion this year!

Weekly

Although the above is my normal daily routine, some mornings are busier than others with other scheduled components.

• Teaching Assistant
  • Twice a week I head over to University of Wisconsin-La Crosse to help teach their DPT class. The first day is a 2-hour lecture course where we can teach as many lectures as we want, but are required to do at least one. As noted above, I did 1.5. The second day is the lab component of their musculoskeletal course for the lower extremity. We assist the professor with special tests, treatment discussion, or whatever the students have to ask.
• Didactics
  • Again, mentioned earlier, we have 4 hours a week of didactics. Each week is a different theme, and we generally spend 2-4 weeks on a body region. I really enjoy these sessions since we interpret classic and new research. There’s never any narrative or bias we get pushed into, it really is about what everyone thinks, and how to make sense of gray areas when integrating research to practice. A lot of it is going over current concepts for post-operative rehab of athletic injuries, and learning the process of how protocols are made.
• Athletic Training Room
  • Once a week I head out to Onalaska High School to help out in the training room. I usually do some screening, quick evals, treatments, and taping. The bulk of the athletes come the first hour, so I get to see 6-8 people within that hour. I love training room days since the kids are a great, and I get to be challenged with the pace. Dustin Billups is my supervising ATC, and has taught me a ton. The documentation is way easier too!
• Coverage
  • We are only required to do sports coverage once a week, but I try to do 2-3 days a week since not many PTs get the opportunity to do sports coverage. So far the sports covered have been professional golf, Division 1 baseball, NAIA collegiate volleyball, Track Wrestling, and high school/middle school sports (football, cross-country, soccer, volleyball, wrestling, and basketball).

• Mentorship
  • Each week we have 4 hours of patient care blocked off where a mentor is with us during our evals and follow-ups. We also case review and debrief before and after. It’s great learning from each mentor since each has there own philosophy and emphasis. Of course, there is always informal mentorship when we can ask for thoughts anytime. We get a new mentor every 8-weeks.

The daily and weekly parts might make things confusing, so here is a picture of a usual week (minus the Saturday coverage which happens maybe only once a month) that might help you visualize it more:

Annually:

This program is seriously amazing! Of course I am bias, but I feel it is one of the most complete programs out there; there’s a reason it’s been going on 2 decades strong. It is worth braving out a year of humid/hot summers and below-0 winters in Wisconsin! Below are some annual events we get to do:

• University of South Dakota
  • This year we spent only a Saturday at USD, but in past years residents have spent 2 days on the campus. Our alumni, Brandon Ness and Hanz Tao, are both faculty and sports physical therapists there. We hang out with them to cover Division 1 football, and also learn about there day-to-day routine and projects. It is jam packed to give us a full perspective in Division 1 sports, but a day simply isn’t enough. It definitely allows us to see if we want to consider Divison 1 sports in the future. Brandon just completed his PhD and Hanz is faculty there, so we also get that perspective as well.
• Howard Head Center in Vail, CO
  • We participate in a residency exchange program where we spend a week with the PT residents at Howard Head and the surgeons at the world-renown Steadman Phillipon Research Institute (SPRI). We get to present, do some patient care, and shadow surgeries and rounds with the medical staff.
• Hosting Howard Head Residents
  • Later in the year, the Howard Head residents come over to Gundersen for a week where we do the same as above. Instead of acute management and snow sport injuries that we go over in Vail, we go over running biomechanics and assessment.
• University of Wisconsin – Madison
  • Dr. Bryan Heiderscheit is running wiz! Everytime I see him talk I learn something new and mind-blowing. We get to spend a full day with him where we hang out in his lab and learn about all things running.
• Mentorship with George Davies
  • George is an amazing human being. The man exemplifies passion, resilience, and high-standards. We begin the first 6 weeks of residency with him as our mentor, and also the last 4-6 weeks of residency as well. It’s great to both begin and end with him because he sets a strong foundation of expectations for the way we approach our careers as we both start our residency, and right as we move on to the future. He paved the way for a lot of sports rehab ideology, so it’s great to hear from the source since things may have gotten misinterpreted along the way.
• Wisconsin NSCA State Clinic
  • I went out on my own to find this opportunity, but my directors were so supportive to allow me the time. I hope this becomes an annual staple to the residency. Tim Suchomel is the director of the Wisconsin NSCA chapter, and I got to hang out with him for a full day at his beautiful campus at Carroll University. Me and my co-resident will be joining strength and conditioning coaches at the conference as well as presenting a main session on the sports medicine education track.
• Coverage Events
  • There are some relatively large events we do each year outside of our typical weekly coverage assignments including some below:
    • LPGA Golf Tournament in Green Bay
    • Track Wrestling Tournament
    • Bi-State Wrestling Tournament
    • Wisconsin Health and Wellness fair
    • NCAA track meets
  • The director and athletic training staff are great. We can reach out to any opportunities outside the residency, and our team supports us 100%. In the past I’ve reached out the X-Games in Minneapolis, Crossfit Games in Madison, and MMA fights in the area. Those didn’t go through because I simply asked too late (3 months before was still too short — be sure to reach out extra early for these things).

• Strength and Conditioning and Nutrition at University of Wisconsin La Crosse
  • We hang out with Dr. Wright and other sports medicine staff for a day at UW-L. They’re a Division 3 program, and we join them right as off-season football training begins.
• Team Concepts Conference
  • Although this isn’t a mandatory part, most residents have gone every year. The programming often helps me stay current on post-operative and acute management of injuries, but I feel it’s important for networking. The first year I went I had a ton of help from residents and fellows for career advice. I think it’s only right I attend it to pay it forward. This was the first year I also took over as the main organizer for the TeamMates event which sets up “rookies” and “captains” for career development and mentorship.

Vanessa Brooks, Wake Forrest Fellow at TeamMates

Rich Westrick, Tactical SIG chair, #3 UFC Strawweight Claudia Gadelha, UFC Rehab Director Heather Linden at TeamMates

Exploring Vegas after the conference with Chris Lefever (Duke Fellow), Emma Taylor and Merritt Walker (MGH/Northeastern restidents)

• Combined Sections Meeting
  • Last year the conference hosted 17,000 PT’s and it’s likely to grow. It is a mental rush and a jam packed conference. I attend main sessions that interest me, however I most enjoy the platform sessions since I feel the “science meets practice” shows me current studies by my peers. I love coming out to support my friends doing talks too; amazing to see them up there and being so successful. I also make sure to spend time outside the conference catching up with friends and local sight-seeing. Evenings are dedicated to helping out with all the AASPT events.
• Physician and Physician Assistant surgery and clinic observation
  • Our MD’s and PA’s are a 10-second walk down the hall from us. We can discuss cases with them anytime throughout the entire year. We also have scheduled time with them to shadow their evals and follow ups, view their surgeries, and some didactics going over radiology. There’s also informal sessions that occur such as exchanging ideas and methods on how we eval certain pathologies. So far I’ve observed a SLAP repair, a hip labral repair, partial excision of a tibia tuberosity, a menisectomy, and a rotator cuff repair. Learning beside them has opened so much perspective on my clinical practice.
• Interviews
  • Don’t sleep on the interviews! Interviews is such a great time to know your colleagues no matter what side of the chair your on. I still chat with many people I interviewed with, and they’re among the coolest, smartest, and funniest people I know. Soon to be on the other side of the interviews, it helps me prepare for what I’d like as a future job from both a setting and culture standpoint.

• Cook-offs
  • So far we had a chili cook off (that was rigged), and an appetizer cook off. I personally love to cook and compete. I didn’t place well, but there’s some drama to it…not like I’m still bitter or anything. Our director, Scott Straker, also has us over for dinner, and he knows how to throw down in the kitchen.

Well, so far that’s my residency for the most part. It’s been an amazing time. Paul Yerhot from Mayo said it best; he mentioned that PT school is hard, but there’s periods of sprinting and then walking for some points, whereas residency is an 12-month sprint. Due to my prior expectations, the variety of my days, and the amazing people around me, I never feel overwhelmed. In fact, I usually feel I should be doing more for them.

I hope this gave readers a good look into work life, and future applicants a good look into the program.

It’s really cold.