What is the Regis DPT Interview Like?

Name: Monika Teter, Class of 2019
Hometown: Los Alamos, NM
Undergrad: Colorado State University
Fun Fact: I had a 5th wisdom tooth that had to be removed in 5th grade!

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            We all remember sitting down for hours at a time: filling out PT school applications, finally hitting the daunting submit button, and then that overwhelming joy we felt when we got our first interview invitation. I can’t believe my interview experience was already a year ago! The entire application process is a rollercoaster of emotions, but my experience with Regis’ interview put my nerves at ease and stood out from the rest of the schools I applied to. From the moment I stepped onto campus that snowy Monday afternoon, I felt a sense of belonging that I hadn’t felt at any other school. The interview process exposed unique facets of Regis’ program including the sense of community, the school’s dedication to the PT field, supportive faculty and students, unique involvement opportunities, and the program’s adaptability to unpredictable situations.

            My interview at Regis was one of the most memorable of my interviews—not only because of the people I met and conversations I had, but because of the blizzard that ensued that day. Though Regis provided the option to do a phone interview if we thought it was too dangerous to travel, I decided to attend the interview anyway since I was in Colorado at the time. I braved the drive from Fort Collins to Denver in my suit and red plaid snow boots armed with four-wheel drive and going over potential interview questions in my head. I was unbelievably nervous! The storm inevitably resulted in the early closure of campus and a shortened interview day. This could have caused mass chaos, but I was impressed by the adaptability of the Regis PT community to expedite the interview process without jeopardizing our time and experience. The organizers made sure every applicant had a fair chance regardless of the barrier Mother Nature concocted. They were able to calmly adapt to an unpredictable situation, which is a valuable skill in this field. Additionally, the current Regis PT students offered up their homes for interviewees to stay until they were able to safely get home. This kindness expressed by current students and the flexibility of the program spoke volumes to me, and I knew this was a program I wanted to be a part of.

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Enjoying the CO sunshine on days off!

            Weather aside, the interview process was a wonderful representation of the program. I was able to get a sense that this was a PT family and everyone was here to support each other. The students spoke nothing but good things regarding the faculty, and I understood why when I met several of them. Each and every one of the faculty radiated dedication to the field as they talked about their passions and areas of research during the faculty-interviewee mixer. We talked about the Peru trip Heidi was preparing to take students to as part of their global immersions trip. We chatted with Marcia and learned about her breadth of research in leadership, clinical development, and management of neurological disorders. I talked with Larisa in my interview regarding my love for volunteering and how the service learning here at Regis would fill that particular passion in my life. Talking to the faculty here at Regis was surprisingly easy in the stressful environment interviews can create. They were attentive and were interested in getting to know me as a person deeper than just my academic accomplishments.

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My mentor, grand-mentor and me at the welcome BBQ

          Regis also wanted to give us a peak at what our daily lives would look like as a PT student by taking us into the anatomy lab and having us sit in on a class. I remember walking into the anatomy lab where students talked about their experiences with cadavers as they pointed out structures on the brains. We also had the opportunity to participate in a postural assessment and wheelchair transfer lab in PT Exam. I remember looking at the students in awe thinking that I would hopefully one day be doing the exact same lab. These two unique experiences set Regis apart, and I was sold!

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Some of us first years enjoying our day off

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9thHealth Fair for Service Learning

         I went home that day bubbling with excitement. I had found my ideal program that matched my values, and I was hopeful they saw something in me that would complement their program. The day I got my acceptance letter, I was elated to call Regis my home. I have become part of a class full of brilliant minds and kind souls. These incredible people push me to be better, to stay that extra hour after class, to help maintain my sanity by going on a hike, and keep me motivated during hectic weeks. I have made some incredible friendships and have had some amazing experiences so far.

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Friendsgiving with the PT Fam!

         There are several wonderful programs out there, but something resonated with me the day I left the interview at Regis. It is truly an amazing community composed of unique perspectives nestled in the most supportive environment. I am happy to call Regis my home and my PT family.

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The Professional Ceremony inducts us into the Regis DPT program at the beginning of the semester.

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Our anatomy lab group–celebrating the end of the semester at the Nutcracker!

Physical Therapy Classification and Payment System: a Discussion with Lindsay Still

 

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Blogger: Katie Baratta

My name is Katie Baratta and I just graduated from the Regis University School of Physical Therapy. I had the opportunity to spend two weeks at the APTA doing a student internship. I was able to talk to many different members of the APTA, attend the Federal Advocacy Forum, and learn more about what the APTA has been doing to move our profession forward. I’ve written a series of essays about my experiences here at the Association.

Interview with Lindsay Still, Senior Payment Specialist

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I talked with Lindsay Still, a Senior Payment Specialist, and she explained the current state of the PTCPS.  Read a summary of our interview below!

Overview

The Physical Therapy Classification and Payment System (PTCPS) is an ongoing initiative that was developed as an alternative to the current, fee-for-service codes—ones that easily fail to capture the true value of what PTs do—and instead particularly account for the complexity and skill of clinical expertise required for patients with more involved presentations. It also incorporates the use of standardized outcome measures. PTCPS would include a single CPT (Current Procedural Technology) code for the entire treatment session versus the assortment of 15-minute unit codes that we’re used to today.

The system has gone through multiple iterations in the past several years, and was developed by the APTA in collaboration with a specialty work group within the AMA (American Medical Association) involving members from the professional organizations of OTs, massage therapists, athletic trainers, speech-language pathologists, chiropractors, psychologists, optometrists, podiatrists, physiatrists, neurologists, orthopedic surgeons, osteopathic physicians, and representatives of CMS (Centers for Medicare & Medicaid Services).

Structure of the new coding system

Under the new system, there would be three new evaluation codes that puts a patient into an initial category of lower, moderate, or higher complexity. Certain documentation criteria (e.g. under patient history, presentation, or plan of care) would determine which of the three eval codes you would select. For example, the number of comorbidities for a given patient would play a role in the eval code selection. There would also be a single code for any re-eval visit.

As currently structured, the proposed PTCPS would also incorporate five treatment codes, based on the overall complexity of the patient’s presentation and treatments. These codes, much like our current CPT code for evals (97001 Physical Therapy Evaluation), would not have a set time frame or number of units associated with it. However, treatment billed under the lowest complexity code would likely be much shorter than a treatment session under the highest complexity code, and the reimbursements would reflect this fact.

Implementation

In 2014, pilot testing of the new system was performed with PTs using the new system to code/bill for hypothetical patients, as well as using the new system to code the treatments of actual patients previously coded with the existing system. This testing occurred in various care settings. Overall, the clinicians were very consistent in their ability to categorize patients with the new initial eval codes. However, for the intervention codes, the pilot clinicians were only able to consistently categorize those patients with the least complex and most complex presentations. There was significant disagreement between PTs in regards to cases that fell within the different “moderate” treatment categories.

The definitions and valuation of the proposed eval codes were reviewed and approved by the RUC (Relative Value Scale Update Committee) and will now require CMS approval. Lindsay is hopeful that CMS will accept the new eval codes, as they will be budget-neutral. In August of 2016, CMS will release the 2017 Medicare Physician Fee Schedule Final Rule; this should include the new PT evaluation and reevaluation codes. The new codes will go live on January 1, 2017. PTs will have three brand-new CPT codes to replace the current 97001 Physical Therapy Evaluation. The APTA will provide training and support to clinicians during the time leading up to the release of the new eval codes.

Impediments to the impending treatment code change

The new treatment codes will require further review and refinement, given their inconsistency of use during the pilot testing. This will likely be an interactive process, and not without controversy from the perspective of payers (insurance companies). In the meantime, the RUC has requested a “backup plan” to address ten CPT codes commonly used by PTs which have been identified as “potentially misvalued codes,” most of which PTs probably use frequently:

  • 97032 attended electrical stimulation
  • 97035 ultrasound
  • 97110 therapeutic exercise
  • 97112 neuromuscular reeducation
  • 97113 aquatic therapy with therapeutic exercise
  • 97116 gait training
  • 97140 manual therapy
  • 97530 therapeutic activities
  • 97535 self care home management training
  • G0283 unattended electrical stimulation (non-wound)

These codes are flagged  because they represent a high reimbursement rate and have not been assessed since 1994.

As a result, the APTA is currently redirecting efforts to provide replacements to those 10 codes rather than waiting for the codes to be reevaluated for us. The new treatment codes the APTA envisions to replace them with would be procedure-based: you would still bill in 15-minute increments. However, they would be streamlined; there would be fewer codes, and the codes would reflect the types of treatment PTs currently perform in practice (as opposed to focusing on what treatments PTs may have historically performed).

Future of the proposed treatment codes

The more general patient- and value-based treatment codes initially envisioned by the APTA are still in the works, but Lindsay foresees a longer process before fruition: it will require all parties to agree on a coding system that accurately and cost-effectively describes the type of treatments that PTs perform for patients. This includes the third-party payers who generally prefer the current setup of treatment codes based on billable units. The current coding system is easy to monitor for abuse or overuse of treatments.

I asked Lindsay if she saw outcome measures as one way of giving insurance companies some power to track the value of treatments under the proposed system. While they wouldn’t be able to screen specific procedures in the same way that they are able to under the current system, they would be able to, for example, monitor whether the progress of a “low complexity” patient was lagging behind what would be expected given that patient’s presentation.

She agreed that this could work in theory, but felt that we still have a long way to go in terms of standardization of outcome data across the spectrum of patient presentation. This is one of the reasons the PT Outcomes Registry will be so important! These two issues truly are intertwined in the future of value-based billing for PT services.

For more information, visit: http://www.apta.org/PTCPS and check out the Timeline for payment reform.

From Practicing Clinician to APTA Employee: an Interview with Anne Reicherter

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Blogger: Katie Baratta

My name is Katie Baratta and I just graduated from the Regis University School of Physical Therapy. I had the opportunity to spend two weeks at the APTA doing a student internship. I was able to talk to many different members of the APTA, attend the Federal Advocacy Forum, and learn more about what the APTA has been doing to move our profession forward. I’ve written a series of essays about my experiences here at the Association.

Interview with Anne Reicherter PT, DPT, PhD, OCS, CHES

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What do you do at the APTA?

Anne was hired by the APTA last spring (2015) and works as a Senior Practice Specialist. In this position, she oversees the PTnow website, which provides practicing therapists with tools for evidence-based practice and includes access to current research and other clinical resources. A good portion of her workweek is dedicated to improving the services offered by PTnow* and working to facilitate access and utilization by APTA members.

Practice Specialists at the APTA are all licensed PTs and also work as consultants on whichever issues are current hot topics regarding our scope of practice. For example, dry needling is currently being discussed and spinal manipulation has been a historically important issue.  As one of the few PTs on staff at the APTA, Anne and her colleagues in the Practice Department review products created by the APTA marketing team or other departments prior to publication to ensure that they are accurate from a clinical and research perspective. She says she will sometimes look at a photo and say that “a PT wouldn’t perform that intervention,” or  that they “wouldn’t stand that far from the patient.” Another current project of Anne’s is a collaboration with APTA researchers on an article for the Journal of Health Policy and Administration about obesity. One of her other areas of focus is the importance of work-life balance within the profession.

How did you come to work at the APTA?

Anne graduated with a BS in Physical Therapy at University of Pittsburgh and then worked in a mixed inpatient and outpatient setting at a hospital. She describes that this was fairly common at the time, and that–with few exceptions–PTs were given a lot of autonomy from their referring providers, and that there was not yet a fee-for-service model at the HMO for which she worked. After ten years in that setting, she wanted to progress her career and knowledge, so she attended night school to obtain her Masters of Health Education. In subsequent years she held a variety of jobs in the educational setting (working for Howard University in DC and the University of Maryland, Baltimore) as well as in other clinical settings, including orthopedics and home health. During this time, she obtained her PhD in Educational Psychology, as well as her transitional DPT. She has also performed some educational consulting for various DPT programs.

The position at the APTA for a PT Practice Specialist opened up at the same time that Anne was searching for something more. She wanted a job that fit with her interests and values: the ability to participate in  writing and publishing, advancing the profession through APTA initiatives, and expanding her own knowledge made the job an excellent fit. She says that these meaningful components–including continuing education–were built into her practice as a new clinician (for example, if there was a “lunch and learn” on a given day, the clinicians would leave a bit early that day), as well as into her work as faculty. Today, however, there is an increased emphasis on productivity and fee-for-service; thus, there is limited time and resources allocated to the pursuit of continuing education that distinguish us as professionals. Anne described the difference between professionals and technicians: professionals design a plan of care and add value to the system with professional discernment, and technicians simply deliver a procedure. To maintain the high expectations set of PTs as professionals, most PTs today must spend time beyond their paid workweek to pursue continuing education, APTA involvement, and evidence-based practice.

Where do we plan to see change in the typical PT’s work-life balance?

Anne replied that one of the biggest initiatives currently is the push to change from a billing system with a procedural focus (for example, billing for “therapeutic exercises” x15 min or “therapeutic ultrasound” x15 min) to one based on value. Current reimbursement accounts merely for the delivery of a procedure or modality for a set unit of time, but it does not account for our clinical judgement as professionals. I’ll go more into this initiative in next week’s blog post.

Any advice for new clinicians starting out in their career?

Anne’s advice to new graduates is to consider whether a job or position allows for and encourages professional development: do they fund continuing education? Do they have on-site mentoring programs you can participate in? She also advises new graduates to not allow mentoring to be limited to colleagues within your particular clinical setting but to continue to seek out a supportive network of clinicians for support as you begin to navigate your professional career.

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*PTnow is a valuable resource for us, as new clinicians, to perform literature searches after graduation (as we’ll no longer have access to the school’s library search function) as well as to access clinical reviews, clinical practice guidelines, and clinical summaries prepared by respected experts within the field of physical therapy.

If you haven’t visited the website, you should definitely check it out: ptnow.org

 

Commuting to Class: Meet Leigh Dugan

Name: Leigh Dugan

Hometown: Boston, Massachusetts

Undergrad: University of Massachusetts Amherst

Fun Fact: My husband is in the military and we have moved 4 times in 2 years!!

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Hi, Class of 2019! Congratulations on your acceptance to the Regis DPT program; you will not regret your decision to come here. So, now that you have made the choice to make Denver, CO your home, the next step is deciding where to live. Most of you will live close by, so getting to school will not be a problem. However, there may be a few of you that do not have the luxury to live that close for whatever reason. This was the situation that I found myself in a year ago when I decided to go to Regis in the fall. My family could not relocate to Denver and I made the decision to commute from Colorado Springs each day—a 140-mile roundtrip journey on each side of an 8-5pm class day.

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Leigh, Taylor and Amanada enjoying some time off of school

I decided to write this blog post because I wish that I had been able to talk to someone to tell me that yes, it is possible and yes, it will be tough. If this is something you are trying to figure out before beginning PT school in August, here are a few tips that I would love to share with you to hopefully make your decision easier:

  1. The commute IS indeed possible and was actually quite relaxing after a long school day.
  2. Take the time during your drive to decompress. Sometimes, I would sit in absolute silence and take the time to relax and reflect on the day. It is a good excuse to truly do nothing.
  3. Be prepared to not have much of a life. When you drive for 3 hours each day, most of your free time is devoted to studying. I wish I could say that there wasn’t much work outside of school in the first year, but that is not the case. Be prepared to spend a few hours after class each day doing school work or studying.
  4. To add to the above comment, you have to really make an effort to balance fun times and studying in your free time. This is so important for anyone in PT school to ensure that you keep your sanity!
  5. Group projects can be tough to coordinate, but all of my classmates took into consideration my commute and it worked out fine.
  6. Find a good podcast that is “mindless.” After a long day of learning, you will want something that is entertaining but isn’t taxing on your mind.
  7. Waze, the traffic app, will be your best friend.
  8. You will figure out the best times to leave your house in order to dodge traffic. I really learned to take advantage of the extra time I had at school before and after class to get work done so I wouldn’t have to do it at home.
  9. It is tough to miss out on all of the fun activities after class. A lot of times, my classmates would go out to concerts or for drinks on weekends and it would be hard to miss these moments. Make an effort to still engage with your class! I never regretted spending the night on a couch so I could join in on the fun :).
  10. Do not be afraid to ask for help from your classmates. You will find that everyone in your class is on the same team and they truly want to help. I would not have survived without them!
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Brunch after second semester finals

Feel free to email me if you have any specific questions on commuting or any questions at all about Regis! Congratulations again on your acceptance to Regis!

Blogger: Leigh Dugan, ldugan@regis.edu

APTA Tuesday: Meet Katie Baratta

Meet Katie Baratta, new Regis DPT graduate! Katie participated in an American Physical Therapy Association internship in Washington, D.C. during her final year at Regis.  Check in every Tuesday this summer to hear about her experience and to learn more about the legislation and politics behind all things physical therapy.

Name: Katherine “Katie” Baratta

Undergrad: Rensselaer Polytechnic Institute

Hometown: Boston/Belmont, MA

Fun Fact: I worked for 5 years as a transportation engineering consultant and am the second of six kids!

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Where did you do your last two clinicals?

CE III at St Joseph’s hospital in Denver, acute care, ICU, cardiac care, and CF floors.

CE IV at Denver VA primarily outpatient ortho with emphasis on manual therapy

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How did you get interested in advocacy and how has Regis furthered your interests?

I applied for the APTA internship for two reasons: one relating to learning to better serve patients I will serve as a Doctor of Physical Therapy, and the second pertaining to learning more about the role of Physical Therapy as a profession in the state in which I will practice.

In regards to my future patients, I foresee myself working a significant percentage of my caseload with patients who have considerable needs, vulnerabilities, and/or economic disadvantages—that is what motivates me to put 100% effort into what I’m doing. I know I’ll do everything within my power to provide the best care I possibly can for these patients. However, I also know that there are greater systemic forces at play which can limit any effort I make as an individual practitioner. In order to address these larger issues, I have a duty to advocate as a healthcare professional. Prior to the APTA internship, I didn’t possess a solid understanding of the ways the APTA, as an organization, interfaces with the government and how the political process can be a tool for large-scale change in the healthcare arena. This internship allowed me to observe and participate in this process. It gave me a more nuanced understanding of politics: I now both understand politics in terms of government and politics in terms of group and power dynamics and how these social factors relate to getting things accomplished. So now, as a new graduate, I can bring this understanding back to my individual patients as I push for large-scale changes in the realm of availability of care, funding, and specific physical therapy services.

The second reason I was interested in this internship had to do with the role of the APTA in Massachusetts. According to the APTA state rankings, my home state (and where I eventually see myself practicing) ranked last in APTA involvement in 2014. This is an area of opportunity for the profession. Massachusetts (and Boston) is a leader in many aspects of healthcare. I saw the APTA internship as preparation for increasing the presence of the APTA and the profession of physical therapy in Massachusetts.

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Where are you heading with your career?

My path thus far in life has been winding and full of surprises, and I am sure my future will be as well!

I tremendously enjoyed my work during CE IV at the VA. I found a group of people I connected well with—both the patient population and the rehab team, overall. It was my first true manual/outpatient rotation. By the end of it, I really felt I was starting to get the hang of how to integrate manual skills with tailored exercise prescription for a patient’s short- and long-term function.

I find the role of the nervous system in pain—particularly persistent pain—to be fascinating, and I think that it’s an area that we as DPTs can serve, push the envelope, and dig deeper into understanding.  I see the solution to be very intertwined with integrating exercise, mental and emotional health, and our toolbox of manual skills.

Beyond the practice setting, I envision myself tying in some of the skills I developed in my prior career. I have an extensive background in data analysis, grant writing, and drafting reports on alternatives analysis; essentially, I have experience in demonstrating the “value” of something to decision-makers (including those who provide funding).

One of PT’s biggest issues is lack of PR. Nobody understands or sees our value. Word of mouth is clearly some of the greatest PR, particularly when attracting new patients to an outpatient clinic. But, when there are larger factors at play beyond an individual patient’s choice—when it comes down to hospital policy or insurance policy—we need to speak in the language that those controlling funding allocation understand: numbers (particularly numbers with dollar signs in front of them!).

So, I see utilizing the skills I’ve developed in my past career into my current practice and will be able to demonstrate the value of physical therapy for both patient outcomes and overall costs. There’s a tremendous need for widespread change to healthcare and to PT access and I am excited to be a part of that change!

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Tune in next week to read Katie’s take on direct access barriers and initiatives to direct access.

Stress Decompression with the 2nd Year Regis DPT Students

After a long week of studying, practicing skills, and being evaluated for skill competency, what better way is there to decompress than pounding it out? After such a stressful week some may have wanted to pound their head against their desk, but second-year student Morgan Pearson had a different idea. During this Thursday’s lunch break, a classroom turned into an exercise studio as Morgan led 15 classmates in a POUND fitness class. This cardio workout incorporates numerous whole-body strengthening exercises such as squats, lunges, jumps, and abdominal crunches–all while pounding drum sticks to the beat of the music.12915268_10154141123068278_1424337970_o

I must admit, at first sight, I was unconvinced that everyone would stay in-sync with their drumsticks. But I was proven wrong when, after just 18 minutes, Morgan whole-heartedly exclaimed, “Yes!! We sound like we are in a band!” Needless to say, students caught on very quickly to Morgan’s encouraging and tough class. They even cheered for one last song towards the end of the workout. After class, second-year student Christy Houk joyfully stated, “Every single muscle fiber in my body is burning!”

Morgan plans to lead classes every Thursday at lunch in Claver Hall room 410 for the remainder of the semester. So come one, come all, and be ready to sweat, burn, and POUND out your stressors! You might just learn some new exercises for your future patients, too!

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Blogger: Lindsay Mayors

Taking a gap year before Regis PT school: Meet Mason Hill

Name: Mason Hill

Hometown: Tacoma, WA

Undergrad: California Lutheran University

Fun Fact: I think I have a cold.

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Congratulations are in order! You’ve completed the long and arduous process of applying to and interviewing for a position in a top-ranked physical therapy school. You should feel a genuine sense of accomplishment for being considered to be a part of the Regis DPT program.

This post is for the candidates that will unfortunately not be receiving a letter of acceptance this year.

When I first applied to PT programs I felt relatively good about my chances of acceptance. I had a strong resume and GPA, would be published in multiple scientific journals before graduation, and had just received the American Kinesiology Association Undergraduate Scholar award.

That being said, I failed to even receive an invitation to interview at my top choice, Regis University.

I did, however, gain acceptance to a program that shall remain nameless, and one which I knew very little about.  I started doing my research on the university’s staff, mission, and facilities and was not pleased with what I saw. I had been working toward PT school since I was 16, and I felt a considerable amount of pressure to accept the position.

After a long conversation with a current student of that program, I came to the conclusion that I would reject the position and reapply to my top choices the following year; it was far and away the best decision that I have ever made.

The odds are good that if you, the reader, were invited to interview at Regis, you have been accepted to some other program. I do not write this to discourage you from attending said program, but to encourage you to follow your intuition and reassure you that waiting another year and once again dealing with the dreaded PTCAS is not the end of the world. You’ve got plenty of options.

Here’s what my gap year looked like at a glance:

After crunching the numbers I decided that going to the UK for a MSc  program would not be financially feasible; so, after graduating college, I packed my bags to head home to Tacoma, WA to plot my next move. During those first few months at home I turned my attention to PT in developing countries.  After doing a bit of research into disability rates and the prevalence of physiotherapists in the developing world, I was hooked. Within a few weeks I was headed to Tijuana, where I spent the next two months volunteering in various clinics and at a school for children with special needs. During those two months I reapplied to Regis, was granted an interview, and made plans for my next trip to work for 4 months in a physiotherapy clinic in the Kingdom of Swaziland.

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When it came time to answer that all important question “what have you done to improve your application?”, I had too much material to work with. The beautiful thing is that not only was that year spent out of the classroom the most enriching and transformative time of my life, but it also enabled me to gain access to what I believe is the program that is best-suited to serve me as a student of physical therapy.

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If you are faced with a year away from academia (by choice or not), it will undoubtedly look different than mine. Just know that you can do with it whatever you like. (Personally I would suggest a bit of solo travel to a foreign country. In my opinion there is no better form of education.) However you decide to spend the next year, be sure to take the opportunity to grow as a person and future clinician.

If you have any questions about how I was able to fund my year of travel/volunteering, how to make connections and find opportunities in other countries, or anything really, feel free to contact me at hillmasond@gmail.com.