How Residency & Mentorship Shape Top Physical Therapists

[00:00:00] clinicians have ideas that they have the opportunity to discuss with researchers and kind of be more collaborative to move our profession forward.

[00:00:08] A lot of my ideas for like case studies have come from just conversations at conferences.

[00:00:13] Up next we have the pleasure of speaking with someone who's not only dedicated to advancing her own clinical skills,

[00:00:18] but is also shaping the next generation of orthopedic manual therapists.

[00:00:23] Dr. Amber Custode is a fellow of AOMT and serves as the Orthopedic Residency Program Coordinator

[00:00:28] for Brooks Rehabilitation in Orlando, Florida.

[00:00:31] She brings a lifelong learning mindset to her work, mentoring residents, contributing to research,

[00:00:38] and restoring patients' quality of life through her own hands-on care.

[00:00:41] In our conversation today, we'll explore Amber's journey from residency to fellowship,

[00:00:46] how she balances clinical practice with mentorship,

[00:00:49] and her insights into the biggest opportunities in orthopedic manual therapy today.

[00:00:54] We'll also hear her thoughts on how to better translate research into everyday clinical practice.

[00:01:00] This is Hands On, Hands Off.

[00:01:11] Amber, welcome to the show.

[00:01:12] Thank you. Thank you for having me.

[00:01:13] How's your AOMT 2024 conference experience so far as we just kicked off this morning really?

[00:01:18] Great. Super excited for what's to come really.

[00:01:21] Alright, and your quick background is, you're at Brooks right now and what do you get to do there?

[00:01:26] So, right now I have the opportunity to be the program coordinator of the orthopedic residency down here in Orlando.

[00:01:33] So, I kind of spend half of my time with patient care, which is awesome.

[00:01:37] But then I also get to spend time, of course, with mentoring the resident, teaching,

[00:01:42] doing some kind of program development.

[00:01:44] We're rather new, so it's our second year down here in Orlando.

[00:01:47] But our Jacksonville residency has been there for 17 years, I believe.

[00:01:51] Yeah. So, I host my own podcast. Today we're on the AMT podcast, but I host my own.

[00:01:56] And I started mine when I was a student.

[00:01:57] And my episode number one, we've done more than 1600 episodes.

[00:02:00] Episode number one was, what the heck's a residency and fellowship?

[00:02:03] Because I was a second year student, I started to hear about those things,

[00:02:06] but still had sort of no idea of what I was getting into.

[00:02:09] You've done both.

[00:02:10] You've done residency, you've done fellowship.

[00:02:12] What first inspired you to sort of go through those trainings?

[00:02:15] And how have they shaped your approach to patient care and clinical reasoning up until now?

[00:02:20] Yeah. So, I think a couple things come to mind.

[00:02:23] First of all, I had the opportunity to have some really good mentors in PT school

[00:02:26] that kind of opened my mind up to like what residencies,

[00:02:31] not really fellowships at that point in time,

[00:02:32] but what like specialization would do in terms of opportunities and practice later on.

[00:02:38] And so, that kind of opened my mind up into like orthopedics.

[00:02:41] I knew I wanted to specialize or at least kind of do orthopedics.

[00:02:46] So, I felt like kind of with their mentorship that that was really the best avenue was a residency.

[00:02:52] And you know, I just really like upon graduation wanted to make sure that I had a really solid foundation

[00:02:57] to build upon with clinical reasoning and technical skills.

[00:03:01] And so again, I felt like residency was the best avenue for that.

[00:03:05] I didn't really ever picture myself going into fellowship.

[00:03:09] But once I got down here to Brooks and really I credit it to the mentors and the faculty at Brooks,

[00:03:16] that like I felt like doing residency wasn't the only step.

[00:03:21] It was only kind of part of the story.

[00:03:23] So, from there kind of halfway through my residency is when I realized that there was so much more to know in terms of being a PT,

[00:03:29] but also just to learn about the profession and what more there was to the profession.

[00:03:33] That's what really led me to kind of get into fellowship.

[00:03:37] And then, I mean from there, I thought I would go back up to New York and keep practicing.

[00:03:43] But again, I had the opportunity to take the role as orthopedic residency coordinator down here.

[00:03:48] So, to your second part of the question is it opened up opportunities to continue to further my practice and patient care,

[00:03:54] but also share my knowledge with those that share a similar passion as me.

[00:03:58] Yeah. And you kept going because now you're on the other side of the coin.

[00:04:00] Exactly.

[00:04:00] You've climbed the mountain and then you're on the other side,

[00:04:02] which is you are sure in new people who were in a similar space in their life.

[00:04:07] Exactly.

[00:04:07] That you were.

[00:04:08] So, walk me through your role like as program residency program coordinator,

[00:04:12] in their books like inside look into residency programs.

[00:04:14] Like what are you looking for maybe in a resident as well?

[00:04:17] How does someone know they're a good candidate to be a resident?

[00:04:20] I think, of course, just like being curious, keeping an open mind,

[00:04:25] being able to like be comfortable with being uncomfortable.

[00:04:28] You hear that a lot.

[00:04:30] But I think like that's what allows for growth.

[00:04:32] So, someone that's willing to kind of take a challenge is definitely a big part

[00:04:37] because we can teach technical skills,

[00:04:39] but if someone's not interested in, you know, learning more, being curious, asking questions,

[00:04:44] then that's kind of a barrier.

[00:04:46] You can't instill that in someone.

[00:04:47] Exactly.

[00:04:47] You're either curious or you're not.

[00:04:48] Exactly.

[00:04:48] It's either in your operating system or it's not.

[00:04:51] Yeah.

[00:04:52] So, that's what I would say is we're looking forward.

[00:04:54] How do you tease that out?

[00:04:55] Because on an interview, of course, they're going to be prepared for that question

[00:04:57] because they've listened to this podcast, right?

[00:04:59] So like, okay, got it.

[00:05:00] Make sure that they know I'm curious.

[00:05:02] Yeah.

[00:05:03] But how do you tease that out?

[00:05:05] Yeah.

[00:05:06] So, I think, I mean, the application kind of gives us a better idea too of like how well

[00:05:11] rounded the applicant is.

[00:05:13] So, that helps to feed into it as well.

[00:05:16] But we do kind of live interviews and I think where you get to see like some questions that

[00:05:22] they might ask after we ask questions that kind of helps us gauge whether they have curiosity

[00:05:27] or are they just there to kind of provide you with answers, you know?

[00:05:31] I always say an interview, job interview, anything like that is a two-way thing.

[00:05:35] Exactly.

[00:05:35] You shouldn't have that one question at the end when, do you have any questions?

[00:05:39] Here's my one question that I showed that I was prepared.

[00:05:42] This really should be a information exchange, right?

[00:05:46] That really is what the definition of an interview is.

[00:05:48] Yeah.

[00:05:48] Because we're investing time into them but they're investing a lot of time into us as

[00:05:52] the program as well.

[00:05:53] So, absolutely a two-way street.

[00:05:54] Very much so.

[00:05:55] So, now you still, you mentor residents all while still treating patients.

[00:05:58] Another cool mix of what you get to do at your job.

[00:06:01] How do you strike a balance or how do you find a balance between those two important roles

[00:06:04] and what do you find most rewarding about mentoring the next generation of orthopedic manual therapists?

[00:06:09] Yeah, I think I do have a good mix between how much time I get to spend in the clinic

[00:06:14] and I think knowing that I am at the end of the day also trying to share my knowledge

[00:06:20] with the current residents is it just makes me more motivated to continue to learn.

[00:06:25] I mean, we hear massive adaptive learner being talked about so much and so I think that that's really just the key

[00:06:31] is I want to make sure that I'm the best I can be to my patients, number one, but then also the resident

[00:06:36] because they're going to be one.

[00:06:38] I want to provide them with the opportunities that kind of residency and fellowship has provided with me.

[00:06:43] Is there a fun moment in the last couple of months that you've had or an interaction with a student that maybe felt really rewarding?

[00:06:48] Like, you know, I see the light, saw the light bulb go on or this was a, this block has been overcome

[00:06:54] or something that comes to mind with a real student?

[00:06:56] Yeah.

[00:06:57] So student, yes, actually I have a student right now and so he, I've seen kind of his interest in residency

[00:07:04] kind of grow throughout his clinical and I think that that's just been some of the conversations that we've had

[00:07:09] and some of the manual techniques that I've been able to teach him and it's just, again,

[00:07:13] there's so much they don't know that they don't know at that point and so I think as part of residency

[00:07:18] but also as his CI is just to kind of show him how much more is out there so that he can be excited to kind of go on

[00:07:26] and seek for their opportunities to specialize.

[00:07:28] Alright, so on top of everything else that we've talked about you doing, you also love translating research into practice.

[00:07:33] I mean, there's a good balance between education and what you do with students as well as your own practice.

[00:07:39] Share how your approach of integrating the latest evidence in clinical work

[00:07:42] and what advice would you have for clinicians who are trying to stay current but might find it challenging

[00:07:47] because life happens.

[00:07:49] Yeah, so kind of how I mean I've done it is honestly a lot of my ideas for like case studies have come from just conversations at conferences

[00:07:58] and so and I've had the opportunity to work with some really great researchers at Brooks

[00:08:02] and we have a collaboration with University of Florida so some of those reach researchers as well

[00:08:08] and so I've had the opportunity to present at a lot of conferences and I love it from that aspect

[00:08:13] but I also think sometimes researchers are a little bit intimidated to talk or excuse me clinic

[00:08:18] clinicians are a little bit intimidated to talk to researchers about ideas.

[00:08:22] So I think that I don't know what that would look like but just trying to bridge the gap to make sure that we're more collaborative

[00:08:29] and some of researchers if they are excuse me clinicians have ideas that they have the opportunity to discuss with researchers

[00:08:38] and kind of be more collaborative to move our profession forward.

[00:08:41] Yeah, so get past that. They're not going to bite.

[00:08:43] Yeah.

[00:08:44] Probably, right?

[00:08:45] Definitely not.

[00:08:45] Let's talk about future. What do you see as the biggest opportunities in physical therapy in the profession right now

[00:08:52] especially in the world of orthopedic manual therapy?

[00:08:54] What excites you in the next three, five, seven years that you can't wait to see how it unfolds?

[00:08:58] I think, I mean that's definitely a challenging question. I would say that really just trying to invest more in our early professionals

[00:09:07] and just beyond like if they're going into presidency and or fellowship

[00:09:11] but there's so many great people in our profession that can continue to act as mentors to early professionals

[00:09:17] and I think that again just collaborating more to kind of make sure that we're moving our profession in the right way.

[00:09:25] All right, last thing we do on the show, I call it the parting shot.

[00:09:28] Okay.

[00:09:29] What's something you'd want to leave with the audience? Mic drop moments, soapbox statements,

[00:09:32] is there something you, is there something you repeat over and over again to your students

[00:09:36] because you're just like I really want to make sure they get this?

[00:09:38] What comes to mind as we wrap up this little talk?

[00:09:40] I would say kind of the underlying theme that I kind of started with is just stay curious and stay humble

[00:09:45] because we all can learn from each other.

[00:09:48] So.

[00:09:48] And you can put stay curious on a bumper sticker or t-shirt.

[00:09:51] Sure.

[00:09:52] It's easy to remember.

[00:09:53] Yeah.

[00:09:54] Amber, appreciate your time here at AM 2024.

[00:09:56] Thank you so much.

[00:09:57] Thank you for all that you do for our profession.

[00:09:59] Thank you.