Didactic vs. Clinical Emphasis in PT School

[CBAforPT]

I am considering two PT schools that will both take the same length of time but put different emphasis their didactic and clinical portions. One program (EWU) has 35 weeks of clinical experiences (1 5-week and 3 10-week clinicals) but a strong, well-established didactic portion. The other program (RMUoHP) is newer and has fewer classes/credits, but has 51 weeks of clinical experiences (1 6-week and 3 15-week clinicals) with some online classes during the clinical portion.

I fell in love with EWU's program and how passionate everyone there was about the program and so my husband and I have been moving heaven and earth to make it work, but I am concerned that I am over-blowing the benefits of its didactic portion. RMUoHP will be much simpler for my husband and I, and the net costs of attending the two schools will end up being about the same.

All other differences in the two schools set aside, which is more important to have: a strong didactic and theoretical background or the extra practical experiences and connections that come with clinical experiences.

I haven't seen a lot about this on the forums so any opinions on the matter would be welcome.

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[kcrat21]

If it were my choice, I would choose the school with more clinical time. That's where you learn the most as far as patient interaction and putting that didactic stuff into real practice goes. Yea, practicing your skills on your super-fit, non-impaired classmates in the controlled classroom environment is all well and good, but nothing beats working day-in and day-out with patients with dementia who won't cooperate with your manual muscle testing, and who live alone and fall down all the time and refuse to use an assistive device because they're "fine", etc.

You will learn all the same didactic stuff no matter what school you go to, it's the clinical time that really matters.

My school sets aside the entire last year of our program strictly for clinical experiences. So we get all of our didactic work over with in the first two years....wouldn't change it for the world. I've grown so much as a clinician in the last year and I feel really confident having an entire consecutive year of clinic under my belt as I enter the work force...just my opinion!

 

[DjT3kN]

I feel that the extra clinical experience will be most valuable to preparing you as a skilled clinician, especially shortly after PT school. Having more clinical experience will enable you to immerse yourself fully into the PT environment and real hands-on experience.

As mentioned above, didactic is great but you'll get to use your didactic information in the clinical setting. I agree with the above post.

 

[DesertPT]

@kcrat21 Don't you think by the last couple months of that 51 weeks PT students would feel like they were just paying to work for free?

 

[DjT3kN]

@kcrat21 Don't you think by the last couple months of that 51 weeks PT students would feel like they were just paying to work for free?

I'm not answering for kcrat but in my opinion, maybe.... however, the clinical setting is where you can find mistakes in the way you practice and fix them prior to ACTUALLY practicing as a licensed PT. By understanding your limits and flaws, will you only get better and further yourself as a skilled clinician. Just my two cents....

 

[starrsgirl]

My only reservation here is that although the one school offers more clinicals, it is not another clinical experience. It's just longer at each place. From my talks with upperclassmen at various schools, many students feel like they max out a clinical by about 10-12 weeks. So more clinicals is good in theory but it depends on the setting.

 

[kcrat21]

My only reservation here is that although the one school offers more clinicals, it is not another clinical experience. It's just longer at each place. From my talks with upperclassmen at various schools, many students feel like they max out a clinical by about 10-12 weeks. So more clinicals is good in theory but it depends on the setting.

If someone truly believes that they have "maxed out" a clinical experience at 10-12 weeks then they are doing their CIs and everyone else working in that setting a disservice. You honestly think you can learn everything there is to know about a particular setting and implement that knowledge consistently while maintaining productivity and efficiently documenting in 10-12 weeks? If I worked in those particular settings and heard someone say that about what I do for my living, I'd lose my mind. You don't max anything out in 10-12 weeks, you just stop caring because you're ready to move on and get one step closer to graduation. There is always something new to learn and implement and 10-12 weeks isn't long enough. I spent SIX MONTHS working in outpatient neuro and while I LOVE it, it took me a long time to get even close to comfortable and really feel productive. Also, just ask any number of the new grads who spend their ENTIRE first year just getting acclimated and used to working in a setting before settling in and REALLY getting things done in a way that they are comfortable and efficient in doing...So no, I don't agree with that statement at all. If you're bored in a setting, that's entirely on you, but don't kid yourself into thinking its because you maxed anything out. (and when I say "you" I mean it generally, not you, specifically, @starrsgirl)

@kcrat21 Don't you think by the last couple months of that 51 weeks PT students would feel like they were just paying to work for free?

I think that clinicals are what you make of them. If you hate the setting and are just trying to get it over with and move on, then yea, you're going to feel like free labor. As I said before, I spent six months in outpatient neuro. My mentor was amazing. Even at the end of my six months we were seeing patients together and bouncing ideas off of each other. I never for a second felt like free labor. I felt like I was getting a guided learning experience which is exactly what I wanted and needed considering I wanted to work in a neuro setting. The clinical I just finished was 12 weeks in an inpatient setting working with trauma and general surgery patients, and while I had my own caseload throughout the majority of this clinical, my CI was always there to read my notes and ask me thought-provoking questions about my patients and my rationale for different treatments and discharge planning. Again, I felt like I was getting a guided learning experience but with more autonomy. Independence does not equal free labor, it just means that your CI trusts that you aren't going to kill someone when they're not around.

 

[DesertPT]

Your not just being there for free though, you are literally paying hundreds of dollars a week to be there, and the clinic never sees a dime of that money.

I guess it's just the schools way of spreading the cost out over three years rather than having to charge more for the first two

How about we make school 6 months shorter and you get all that neuro training while actually getting paid something as a resident? Pt school is supposed to give you basic skills in as broad of a generalist way as possible. Having a 6 month internship that you had to pay for is kind of a bum deal in a way.

 

[vnroobee]

You will learn all the same didactic stuff no matter what school you go to, it's the clinical time that really matters.

 

[kcrat21]

How about we make school 6 months shorter and you get all that neuro training while actually getting paid something as a resident?

Oh lord, don't even get me started on residencies straight out of school. Do you honestly think that after a single year of working as a clinician you could/should be considered an EXPERT in a specific aspect of PT? As I said in my last post, it takes new grads several months to even get acclimated to being in the work force. As a resident, you don't get to feel comfortable ever. Every 12 weeks you are rotating to a new setting. You have teaching and research duties, so at many sites you are only a part-time clinician. And you get paid crap without benefits...so I see no benefit to the learner in any way to be honest. Yea, you get the instant gratification of being "certified" after just one year, but is it really more beneficial to your patients to call yourself an expert in something that you're probably not really an expert in? It's just another couple of letters to put after your name at that point. My neuro CI has been working in neuro for 20 years, she doesn't have her NCS, and I would consider her an expert. As long as this current residency model stands, I'll be working toward getting my NCS by grinding it out in the clinic, taking CEUs, and then sitting for the exam when I'm ready, hopefully with 3-5 years of experience under my belt.

So, yea, it sucks that we have to pay to do our clinical training, but most health professions do, its not new to PT. MDs pay to go to school and do clinical affiliations just like we do, but then their residencies are 3-5 years. I don't think PT school needs to be shorter, I feel comfortable with my level of knowledge and experience after 3 years. And making it shorter to start a paid residency isn't the answer unless that residency is 2-3 years and pays better...

 

[DesertPT]

Do you honestly think that after a single year of working as a clinician you could/should be considered an EXPERT in a specific aspect of PT?

No. I said nothing of the kind, you just made that up.

New neurosurgery attendings aren't necessarily considered experts by their peers after a 7 year residency either. What's your point?

I also didn't say anything about the NCS, which you are oddly critical of considering it is a pretty widely respected certification. Again, what's your point?

Of course doctors also do rotations in medical school, but they aren't 6 months. Again, what's your point?

My point is that perhaps students would receive equal and probably more thorough training and benefit their financial situation by doing a residency in a specialty rather than by doing a relatively long internship in a specialty as a paying student. It's just a philosophical thought I was intending to put out there for discussion. I did not make any claims about the nature of residencies or really about anything else you addressed.

 

[DjT3kN]

I believe this is all preference.... personally, I'd rather get more clinical experience rather than didactic emphasis. My goal is to be a traveling PT for the first 4 years of practice right after the NPTE. I want to travel and learn to be a highly competent and efficient clinician associated with most settings, then decide which specific field I want to settle in afterwards.
On the other hand, there are others that want to do research and/or teach.... with that being said, didactic emphasis can prove to be useful compared to clinical experience.

In essence, it depends solely on the individual and their ultimate goal as a licensed PT. Just my two cents again... but it sounding more like a nickel to me. Har har har! *I know my jokes suck, deal with it... or do you want to fight about it and I'll rehab you afterwards*

 

[kcrat21]

@DesertPT, I mean "you", generally. Not you, specifically. Take it easy.

I think that residencies are a waste of time and money. I've had a lot of time to research them in my three years and was seriously considering it at one point. I have no problems with the certifications themselves, just the current system by which they are being obtained. I only bring up the NCS because its what I'm interested in personally. And last I checked, "Neuro Certified Specialist" implied expertise. You brought up a subject I am passionate about, so I gave you my opinion. If you didn't want it, sorry.

Yes, "philosophically" it would have been great to have been paid for my six months. Then again, it would be great to get paid for doing basically anything, ever. So what's your point? I enjoyed what I did for six months and learned a lot. Its the nature of the PT school beast (and basically every other school, as well). Get over it.

Also, there are residencies that require you to pay for them, and you get paid crap. So I think that maybe it evens out in the grand scheme of things. I'd rather work and get paid an actual salary and then just take the exam. I'll have more experience than someone who did a one year residency and the same certification, and I got paid a normal salary while doing it, without also having to jump through the research/teaching hoops.

 

[ptisfun2]

I am considering two PT schools that will both take the same length of time but put different emphasis their didactic and clinical portions. One program (EWU) has 35 weeks of clinical experiences (1 5-week and 3 10-week clinicals) but a strong, well-established didactic portion. The other program (RMUoHP) is newer and has fewer classes/credits, but has 51 weeks of clinical experiences (1 6-week and 3 15-week clinicals) with some online classes during the clinical portion.

I fell in love with EWU's program and how passionate everyone there was about the program and so my husband and I have been moving heaven and earth to make it work, but I am concerned that I am over-blowing the benefits of its didactic portion. RMUoHP will be much simpler for my husband and I, and the net costs of attending the two schools will end up being about the same.

All other differences in the two schools set aside, which is more important to have: a strong didactic and theoretical background or the extra practical experiences and connections that come with clinical experiences.

I haven't seen a lot about this on the forums so any opinions on the matter would be welcome.

I do not know what RMUoHP is, but EWU is a good school. I think I would select it based on that (and the fact that I have not heard of the other one). It has an excellent reputation, solid curriculum. I do not work there, go there, or know anything about it other than the quality of the faculty, the curriculum, and my interaction with some of the graduates. I work close enough that it is considered a 'peer institution' (i.e., who the University compares our performance to). But it may also depend on where you want to live when you are done. Although many applicants and students espouse on this site that the school doesn't matter, I think that is a bit simplistic. I work at a PT school in a state with a few other schools. We are one of the 1st in the state, which means a larger alumni network, both within the state and regionally. So when a rotation gets cancelled at the last minute and the ACCE is scrambling, clinicians will work with us more than other schools in the state since they are alumni. Same thing happens when PT students graduate and go looking for a job. Networking of all types, but especially alumni can be quite powerful. We cultivate a strong alumni network, and are proud of the ties with our clinical partners. But if you don't know where you want to live upon graduation, and don't care about your job too much (and just want a paycheck, which is totally cool), then pick what you jibe with. Perfect NPTE scores and faculty and setting means nothing if you do not jibe with the institution and program. In closing, remember, PT schools know more about PT education than most others. I will try not to rant here (and not directed to you particularly, but more generally), but the program knows more about what a PT needs to learn and know than you do. PT school has a specific focus and purpose, and you will not get nearly all of your learning in 2 - 3 years of PT school. If so, we are in BIG trouble as a profession.

 

[ptisfun2]

My only reservation here is that although the one school offers more clinicals, it is not another clinical experience. It's just longer at each place. From my talks with upperclassmen at various schools, many students feel like they max out a clinical by about 10-12 weeks. So more clinicals is good in theory but it depends on the setting.

Oh this would be so fantastic if a student said this to an ACCE...or faculty member....or clinical faculty. So fantastic! Admission could be charged to watch the response.

 

[ptisfun2]

@DesertPT, I mean "you", generally. Not you, specifically. Take it easy.

I think that residencies are a waste of time and money.

I think they can be. Or they can be fantastic. Residencies are just so varied now, that it requires a lot of in-depth poking around to see what (if any) residency is going to give YOU specifically what YOU want and need. Even more variable for fellowships. But there are some good ones out there that I have seen.

 

[tweaze]

My only reservation here is that although the one school offers more clinicals, it is not another clinical experience. It's just longer at each place. From my talks with upperclassmen at various schools, many students feel like they max out a clinical by about 10-12 weeks. So more clinicals is good in theory but it depends on the setting.

Oh this would be so fantastic if a student said this to an ACCE...or faculty member....or clinical faculty. So fantastic! Admission could be charged to watch the response.

I heard this at a Q&A session with students at one school. The school in question had moved to shorter clinical experiences, and many of the students stated they got diminishing returns after 10 weeks or so anyways.

I have visited EWU, and would have loved to attend there. I was very impressed with the faculty I met and the resources available to each student. I didn't even apply, as did not have enough of the prereqs completed. I don't know much about the other school, but it sounds like more clinical time is what you make of it. Where are you planning to live long term after school? Utah or Washington?

 

[DesertPT]

Although many applicants and students espouse on this site that the school doesn't matter, I think that is a bit simplistic.

I think a lot of time what people mean is that the school doesn't matter as far as going to a little known school will not be likely to leave you unemployed, and the school you attend will probably not impact your salary notably.

I'm glad you pointed this out though. There are definitely benefits to going to a well-established school over a newer/smaller one that are not often pointed out. I interviewed at or visited schools across a broad range of the spectrum, from extremely well-known across the country to virtually unheard of, and I could tell the difference. I think what you mentioned about clinical placement options was probably the most obvious example of the well-established schools really having a leg up on the new ones. And there are certainly other reasons too, this is reminding me of our previous discussion on Dr. Gordon's Mary McMillan lecture.

With that said, I would only choose the well-established school over the lesser-known school if it was cheaper or only slightly more expensive. But a lot of times applicants have two schools to choose from that differ in cost by $40-50,000 or more (the difference between the most and least expensive schools I applied to was $65,000!), and so to me none of the benefits of going to a better-known program would be worth taking on that kind of additional debt.

In my case, for all the schools I applied to there was a perfect inverse relationship between reputation and cost, so it wasn't ever an issue. And in the case of this thread however I image EWU is the cheaper of the two schools in question anyway.

 

[DjT3kN]

I think a lot of time what people mean is that the school doesn't matter as far as going to a little known school will not be likely to leave you unemployed, and the school you attend will probably not impact your salary notably.

I'm glad you pointed this out though. There are definitely benefits to going to a well-established school over a newer/smaller one that are not often pointed out. I interviewed at or visited schools across a broad range of the spectrum, from extremely well-known across the country to virtually unheard of, and I could tell the difference. I think what you mentioned about clinical placement options was probably the most obvious example of the well-established schools really having a leg up on the new ones. And there are certainly other reasons too, this is reminding me of our previous discussion on Dr. Gordon's Mary McMillan lecture.

At the same time though, I would only choose the well-established school over the lesser-known school if it was cheaper or only slightly more expensive. But a lot of times applicants have two schools to choose from that differ in cost by $40-50,000 or more, and so to me none of the benefits of going to a better-known program would be worth taking on that kind of additional debt. In the case of this thread however I image EWU is the cheaper of the two schools in question anyway.

Also, I feel that most aren't taking into account that some schools have a wider variety of clinical placements, as well as more well-established networking ties. This definitely can play a factor for you when looking for employment after the NPTE, not that most of us will be unemployed after the NPTE. However, this could help if you are looking for specific places to work. Who knows, your network could have alumni working there already and can put in a good for you. Maybe a faculty member has ties to a clinic and plays golf with the director/owner of that specific clinic. Every bit does help, in my opinion.

 

[ktachiba]

Also, I feel that most aren't taking into account that some schools have a wider variety of clinical placements, as well as more well-established networking ties. This definitely can play a factor for you when looking for employment after the NPTE, not that most of us will be unemployed after the NPTE. However, this could help if you are looking for specific places to work. Who knows, your network could have alumni working there already and can put in a good for you. Maybe a faculty member has ties to a clinic and plays golf with the director/owner of that specific clinic. Every bit does help, in my opinion.

Definitely agree with this...although UNE isn't a top school according to US News, it has been established for a while (1988 I believe), and has a history of great pass rates. Their faculty seems top notch, and the clinical sites are amazing (Harvard, NYU Medical, TIRR, Spalding). So, I believe there are benefits to going to more established schools if you can do it.

 

[ktachiba]

One of the people I have talked to on the Facebook group page (who is a PT) said that if I can get top notch clinical sites on my resume, it will open the doors for more opportunities come graduation time. This was important cuz I was thinking about going to fun places (like Hawaii or Alaska) for my clinicals, but now I will try my best to get all my clinicals done at top notch universities/hospitals

 

[DjT3kN]

Hawaii sounds awesome.... not sure about Alaska. However, I do want to visit there when I become a traveling PT.

 

[CBAforPT]

Thank you all for the good advice.

I will note that a couple people have mentioned that you learn the same things at all schools...which is true to a point. Every school orients their curriculum to fulfill NPTE requirements, but they also include their own adaptations based on their faculty, whether they are research-based, and what they think will make their students the best PTs. While the basic information may be the same, the quality and the structure of programs are varied. A school's quality may only be differ by 10% (or even 5%) from another school, but it may be the difference between pushing myself to be good enough or pushing myself to be excellent. Just a different perspective…

That being said, I think additional clinical experience will probably be the most productive for me. I have spent a lot of time focusing on being "book-smart" and so I could probably use the real life experiences; as @kcrat21 mentioned, knowing theory is different than knowing how to work in a clinical setting.

I do not know what RMUoHP is, but EWU is a good school. I think I would select it based on that (and the fact that I have not heard of the other one). It has an excellent reputation, solid curriculum. I do not work there, go there, or know anything about it other than the quality of the faculty, the curriculum, and my interaction with some of the graduates. [...] Although many applicants and students espouse on this site that the school doesn't matter, I think that is a bit simplistic.

@ptisfun2 RMUoHP (Rocky Mountain University of Health Professions) is a private school in Provo, UT. It has been offering tDPTs and a couple other post-professional health degrees since 1998, but only started offering an entry level DPT in 2010. I do agree that EWU has a very strong reputation, and was probably the closest fit for me personally, but moving to Spokane from Utah would be difficult for my husband (traveling every other week for his job, possibly forgoing promotions and pay-raises, weakening his work relationships...). Our end goal is to end up in Utah, so RMUoHP will probably serve us best. Thank you again for the advice.