Clinical Residency and Fellowship Program Credentialing - Frequently
Asked Questions
What is a clinical residency?
A clinical residency is a planned program of postprofessional
clinical and didactic education for physical therapists that is designed
to significantly advance the physical therapist resident's preparation
as a provider of patient care services in a defined area of clinical
practice. It combines opportunities for ongoing clinical supervision and
mentoring with a theoretical basis for advanced practice and scientific
inquiry.
What is a clinical fellowship?
A clinical fellowship is a planned program of postprofessional
clinical and didactic education for physical therapists who demonstrate
clinical expertise, prior to commencing the program, in a learning
experience in an area of clinical practice related to the practice focus
of the fellowship. (Fellows are frequently post-residency prepared or
board-certified specialists.) A fellowship program must possess a
curriculum that: 1) is focused, with advanced clinical and didactic
instruction within a subspecialty area of practice; 2) is intensive and
includes extensive mentored clinical experience; and, 3) provides a
sufficient and appropriate patient population to create an environment
for advanced clinical skill building.
What is the difference between a residency and a fellowship
program?
A clinical residency program is designed to substantially advance a
resident's expertise in examination, evaluation, diagnosis, prognosis,
intervention, and management of patients in a defined area of clinical
practice (specialty). This focus may also include community service,
patient education, research, and supervision of other health care
providers (professional and technical). Often, the residency experience
prepares an individual to become a board-certified clinical
specialist.
A fellowship program is designed to provide greater depth in a
specialty or subspecialty area than that which is covered in a residency
program. Additionally, applicants of a clinical fellowship program must
be licensed as a physical therapist and possess one or more of the
following qualifications: 1) specialist certification, 2) completion of
a residency in a specialty area, or 3) demonstrable clinical skills
within a particular specialty area.
Lastly, the clinical residency program should be completed within a
minimum of 1,500 hours and in no fewer than nine (9) months and no more
than 36 months. A clinical fellowship program should be completed within
a minimum of 1,000 hours and in no fewer than six (6) months and no more
than 36 months. Programs whose timeframe falls outside of these
parameters will be reviewed on a case-by-case basis.
What is a clinical internship and how is it different from a
residency or fellowship program?
A clinical internship is a clinical education experience that is part
of the requirement for graduation from a physical therapist professional
education program (Degree could be awarded before, during, or after the
internship.). Residency and fellowship programs are post-professional
programs and normally occur after the graduate physical therapist has
obtained clinical experience in the workplace.
How does a residency or fellowship program decide what it will
teach?
Residency and fellowship programs must be based on a recognized
practice analysis to be credentialed by APTA. Such patterning ensures
consistent standards of instruction for prospective residents, their
future employers, and even their future patients. A clinical residency
curriculum may be based on part or all of the most recent
Description of Specialty Practice (DSP) (formerly
Description of Advanced Clinical Practice or DACP) in the
related specialty area (eg, orthopedics, cardiopulmonary, etc.).
For areas of practice where a DACP or DSP does not exist, a practice
analysis must be submitted to the Committee for approval to become the
basis of the curriculum. Guidelines for conducting a practice analysis
are available from the Clinical Residency and Fellowship Program
Credentialing web page.
Because fellowship programs are always in subspecialty areas,
a DACP or DSP is too broad to serve as an acceptable practice analysis.
Therefore, a fellowship program must submit an equally acceptable
practice analysis in the subspecialty.
Will APTA credential clinical residency or fellowship programs in
subspecialty areas or other special interest areas that currently do not
have a specific ABPTS-approved specialty exam, such as Performing Arts
Physical Therapy, Brain Injury, Occupational Health, Neonatal Physical
Therapy, or Foot and Ankle Physical Therapy?
Yes, programs have the option of submitting a curriculum in a
specialty or sub-specialty area, or in other special interest
areas, as long as the curriculum is based on a valid practice analysis.
The curriculum must also have a well-defined, systematic process for
establishing its content validity that describes practice in a defined
area. Residencies may be created in a specialty or subspecialty
area; fellowships should have a curriculum based in one or more
subspecialty areas. Specialized and subspecialized programs must include
postprofessional education and training in the scientific principles
underlying practice applications. In specialty areas where validated
competencies have been identified, the curriculum should be based on
those competencies. In addition, the curriculum should be consistent
with the Guide to Physical Therapist Practice.
What is the acceptable duration of clinical residency or clinical
fellowship?
A clinical residency program should be completed within a minimum of
1500 hours in no fewer than nine (9) months and no more than 36 months.
A clinical fellowship should be completed within a minimum of 1000 hours
in no fewer than six (6) months in duration and no more than 36 months.
Programs whose timeframe falls outside of these parameters will be
reviewed on a case-by-case basis.
Within a program's total hours, how many of these hours should be
devoted to clinical practice?
The amount of time devoted to clinical practice should be determined
according to what is necessary to achieve the Program's curricular
outcomes. For example, programs in orthopaedics allocate approximately
10% of their overall hours to clinical practice.
In addition to determining the appropriate number of practice hours,
the program must also decide how many of these hours will be spent in
one-to-one mentoring. It should be noted that some practice areas, such
as manual therapy fellowships and sports residencies, have additional
requirements for credentialing.
Does successful completion of an APTA-credentialed
postprofessional clinical residency meet the practice eligibility
requirement to sit for the Specialist Certification exam?
Depending on the specialty area, successful completion of a residency
program might fulfill some or all of the minimum practice eligibility
requirements to sit for the specialist certification examination.
However, experience from residencies in which the curriculum plan
reflects only a portion of the DSP will not be considered. For more
information on your specific specialty area requirements, please refer
to APTA's
specialist certification Web page.
How would subspecialty areas develop a curriculum and set up
a clinical residency or fellowship?
First, the program should check for a valid practice analysis that
details the intended subspecialty area. If there is none, the program
must engage in a practice analysis. Contacting the Committee on Clinical
Residency and Fellowship Program Credentialing is a critical first step
to assure that the practice analysis is conducted to meet Committee
requirements. By way of example, suppose an early intervention physical
therapy residency program in pediatrics wanted to develop a curriculum.
The program could use the Pediatric DSP as the basis for the
curriculum. A fellowship program could use an already published and
accepted practice analysis or develop their own practice analysis using
the early intervention component of the pediatric DSP as a guideline.
The fellowship is challenged to focus its curriculum on the proficiency
of advanced clinical and didactic knowledge and skills for clinicians
who already possess specialization.
The terms "practice analysis" and "standardized curriculum" seem
to be recurring themes. Why are they so important?
It is a fundamental consumer protection and payer/policymaker
survival issue. Physical therapists and consumers need to know that a
residency or fellowship graduate can perform a minimally acceptable
standard of care for a particular diagnosis. A system of standardized
residency or fellowship curricula would indicate that all graduates of a
residency or fellowship program should be able to perform the standard
care for patients as described in the DACP or DSP or through a clear and
sound practice analysis. It is essential that the practice analysis be
valid and early discussion with the Committee is essential.
Our clinical staff wants to start a clinical residency or
fellowship and be credentialed by the APTA. What are the requirements of
the clinical faculty?
Collectively, the clinical faculty must possess the following
qualifications in order to effectively conduct all of the necessary
activities of a residency or fellowship program: (1) advanced clinical
skills, with at least one faculty member who is ABPTS-certified in the
content area; (2) expertise in teaching; and (3) involvement in
scholarly and professional activities.
We have the clinical faculty necessary to start a program. But
what other types of training do we need to provide in order to fulfill
APTA's credentialing requirements?
Clinical supervision of the residents or fellows by the clinical
faculty, while they are performing patient care, is critical. Other
aspects of the curriculum should include classroom and lab training
relevant to specialty or subspecialty area of physical therapy, and
clinical practice hours. Other options can include academic courses,
study groups, case presentations, clinical research, supervision of
staff, and community service. Many credentialed programs partner with
nearby physical therapist professional education programs that provide
academic expertise and assist with classroom and laboratory
teaching.
Are the "other options" you mentioned required for
credentialing?
The residency or fellowship program should be consistent with the
program's overall mission and philosophy and should include activities
that promote residents' or fellows' continued integration of practice,
research, and scholarly inquiry into their personal career
objectives.
Could you summarize what is required for APTA
credentialing?
The prospective program must provide evidence that the residency or
fellowship program and its institution meet specified requirements with
regard to organization, resources, curriculum, and performance measures,
all of which are necessary to conduct a residency or fellowship. Such
evidence is evaluated through: (1) a review of the application
materials, and (2) an on-site visit. The application packet and a
helpful Application Resource Manual are available on line. The
application packet contains the policies and procedures related to the
credentialing process, the application fee information, the application
and forms, and description of evidence requirements.
Once credentialed, how long before the next review or
re-application?
The initial credentialing is valid for five (5) years.
Re-credentialing is also for five (5) years. The Committee on Clinical
Residency and Fellowship Credentialing requires an annual review of each
credentialed program to ensure that the credentialing standards are
maintained.
What financial considerations are associated with the
credentialing process?
There is a graduated fee schedule that is dependent on numbers of
residents or fellows in the program. For programs enrolling up to five
(5) residents/fellows, the application fee is $1500. Programs of six (6)
to ten (10) residents/fellows must pay $2000, and programs of eleven
(11) or more residents/fellows are charged a fee of $2500. Additionally,
the program is responsible for the travel costs and expenses incurred by
those individuals performing the site visit (approximately $800 to
$2000). The annual fee is also graduated and is one-half the amount of
the application fee.
How do I obtain a copy of the Description of Specialty
Practice?
Call APTA's Service Center at 800-999-2782, x3395, or accesses the online store.
How does a prospective program obtain more information regarding
the requirements for credentialing?
Information – including a downloadable version of the most
current application -- can be obtained from the APTA's Professional
Development Department at 800-999-APTA, x8514.
Revised: June
2005
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